Panorama TM Operating Instructions innovation is the best medicine
Datascope® is a U.S. registered trademark of Datascope Corp. Masimo SET® is a U.S. registered trademark of Masimo Corp. Nellcor® is U.S. registered trademark of Tyco International Ltd. Panorama™ is a U.S. trademark of Datascope Corp. Passport 2® is a U.S. registered trademark of Datascope Corp. Spectrum™ is a U.S. trademark of Datascope Corp. Symbol® is a registered trademark of Symbol Technologies, Inc. Copyright © Datascope Corp., 2003. Printed in U.S.A. All rights reserved.
Table of Contents Foreword ....................................................................................................................................................... xiii Warnings, Precautions and Notes..................................................................................................................... xiii Indications for Use ..........................................................................................................................................
Table of Contents Electrode Patch Location .................................................................................................................................. 4 - 2 Lead Placement............................................................................................................................................... 4 - 4 American Heart Association (AHA) Lead Placement .....................................................................................
Table of Contents Entering a Password ................................................................................................................................ 6 - 2 Sidebar Buttons ....................................................................................................................................... 6 - 3 Troubleshooting.......................................................................................................................................
Table of Contents Normal Screen Sidebar Button .......................................................................................................... 7 - 13 Troubleshooting .............................................................................................................................. 7 - 13 Events Tab ..................................................................................................................................................... 7 - 16 Accessing the Events Tab........
Table of Contents Configuring ST ................................................................................................................................ 7 - 35 Done Sidebar Button ................................................................................................................................ 7 - 35 Print Sidebar Button .................................................................................................................................
Table of Contents Print Status Tab Multi-Column List Box......................................................................................................... 8 - 33 Print Status Tab Buttons............................................................................................................................. 8 - 34 Troubleshooting....................................................................................................................................... 8 - 35 Additional Reports ........
Table of Contents Accessing the Installation Setup Tab........................................................................................................... 9 - 6 Entering a Password ................................................................................................................................ 9 - 6 Sidebar Button - Normal Screen ................................................................................................................ 9 - 7 Troubleshooting.......................
Table of Contents Accessing the Recalibrate Touch Screen Tab ............................................................................................... 9 - 35 Recalibrating the Touch Screen ................................................................................................................. 9 - 36 Sidebar Button - Normal Screen ................................................................................................................ 9 - 36 Troubleshooting.............................
Table of Contents Approved Accessories ................................................................................................................................... 10 - 11 Troubleshooting ............................................................................................................................................ 10 - 12 User Maintenance ........................................................................................................... 11 - 1 Touch Screen User Maintenance ....
Table of Contents Monitor Issues ....................................................................................................................................... 12 - 29 Recalibrate Touch Screen ....................................................................................................................... 12 - 31 Parameter Specifications................................................................................................. 13 - 1 Parameter Specifications...........................
Table of Contents Surface Temperature .............................................................................................................................. 15 - 8 Tip Over............................................................................................................................................... 15 - 8 Rigidity and Strength of Enclosure............................................................................................................
Table of Contents Fluid Spill Resistance ...................................................................................................................... 15 - 22 Surface Temperature ...................................................................................................................... 15 - 22 Tip Over ...................................................................................................................................... 15 - 22 Rigidity and Strength of Enclosure .........
Foreword The Panorama Operating Instructions are intended to provide the information required to operate the Panorama Patient Monitoring Network. For additional information and technical assistance, please contact an area or regional Datascope Patient Monitoring Representative. A general understanding of the features and functions of the Panorama Patient Monitoring Network and its components (shown in FIGURE 1-1) is a prerequisite for the proper use of this equipment.
Warnings xiv WARNING: Loading any unauthorized software on the Panorama Patient Monitoring Network render the application unsuitable for medical patient monitoring. WARNING: Do not attempt to load any devices or device drivers onto the Panorama Central Station or Panorama Telemetry Server. If the user connects or attempts to connect any unauthorized equipment, the Panorama Patient Monitoring Network may not operate as intended.
WARNING: Do not put MPSO (Multiple Portable Socket Outlets, i.e., multiple outlet extension cords) used with the Panorama Central Station System on the floor. Connect only Panorama Central Station accessories and components to the same MPSO as the Panorama Central Station. Do not overload MPSOs. Use only MPSOs that comply with the requirements of IEC 60601-1-1.
Cautions CAUTION: For proper operation do not obstruct the fan air holes. CAUTION: For proper operation use only hospital grade power cords. CAUTION: For proper operation do not use Panorama Patient Monitoring Network with a frayed or damaged power cord. CAUTION: For proper operation use only Datascope accessories with this product. CAUTION: For proper operation never place fluids on top of this equipment.
CAUTION: Operation of this equipment requires the prior coordination with a frequency coordinator designated by the FCC for the Wireless Medical Telemetry Service. CAUTION: Changes or modifications not expressly approved by Datascope Corp. could void the user's warranty. CAUTION: The Telepack should not be used when the Electro Surgical Unit (ESU) is active. CAUTION: To avoid potential system issues, deactivate the touch screen before cleaning.
xviii CAUTION: Thoracic respiration measurement may interfere with some pacemakers. Refer to the pacemaker’s manual. CAUTION: Prior to sterilization, Lead sets must be removed from the Telepack. The Telepack must not be sterilized. CAUTION: Do not block the speakers. Set the volume levels so that alarms can be heard at all times, as described in this Operation Manual. CAUTION: Visually inspect the battery compartment for any foreign object prior to use.
Indications for Use Panorama Patient Monitoring Network The indications for use for the Panorama Patient Monitoring Network include: • Viewing real time patient clinical and demographic data • Graphical and numeric trending of clinical data • Storing and printing of clinical and demographic data • Setting independent alarm limits for data sent by the bedside monitor.
Unpacking Information The Panorama Patient Monitoring Network must be installed by a certified Datascope Service Technician or authorized distributor. Please contact your authorized Datascope Service Representative for additional information.
Symbols and Descriptions SYMBOL DESCRIPTION SYMBOL DESCRIPTION Attention, Consult Accompanying Touchscreen Documents / Refer to Manual Alternating Current (AC) Alarm On Defibrillator proof - type CF Direct Current (DC) equipment Keyboard Alarm Off Mouse Alarm Mute Input/Output Earth Ground Speaker Monitor Patient Panorama Patient Network Network Ethernet Central Panorama Central Network Network Ethernet Dispose of the batteries in Canadian Standard Association accordance with a
SYMBOL 0044 DESCRIPTION A symbol designating compliance of the Panorama Central Station Monitoring system with the Medical Device Directive (MDD) 93/ 42/EEC, as a Class IIb device. A symbol designating compliance of the Panorama Central Station tower and the Panorama Telemetry Server with the Electromagnetic Compatibility Directive and compliance of the Panorama Patient Monitoring Network accessories to the Medical Device Directive (MDD) as Class I devices.
1.0 System Overview This section provides a high level view of the authorized components of the Panorama Patient Monitoring Network.
Components of the Panorama System 1.1 System Overview Components of the Panorama System The Panorama Patient Monitoring Network is a Medical Electrical System comprised of both medical and non-medical devices (data processing equipment components). The system and its components are marked in accordance with MDD, Annex IX classification criteria.
System Overview 1.1.1 Components of the Panorama System Licensing Key The Panorama Central Station uses a licensing key to regulate the operation of the system. The licensing key controls the following settings on the Panorama Central Station: • Number of displays • Number of channels • Number of ST licenses • Number of Arrhythmia licenses • Full Disclosure data For additional information regarding licensing keys, please have a System Administrator contact a Datascope representative.
Supported Devices 1.2 System Overview Supported Devices The Panorama Patient Monitoring Network is a networked configuration of devices, which collect patient data, and monitor user-defined parameters. The network consists of two local area networks (LAN); a Panorama Central Network, and a Panorama Patient Network. The Panorama Central Network manages stored patient data and controls data for other systems.
System Overview Supported Devices The Panorama Central Station supports the following devices for use with the system: • Panorama Central Station • Panorama Telemetry Server • Panorama Telepack-2.
Supported Devices 1.2.1 System Overview Panorama Central Station The Panorama Central Station is a device that monitors patients, collects data and performs alarm notification. Its settings may be customized to account for the special needs of patients. The Panorama Central Station can be networked with other Panorama Central Stations using Ethernet via the Panorama Central Network. 1.2.
System Overview 1.2.3 Supported Devices Panorama Telepack-2.4 and Panorama Telepack-608 The Panorama Telepack is a device that allows for the basic remote ECG monitoring of a patient. A Panorama Telepack monitors Heart Rate, ST, PVC and Arrhythmia. The Telepack sends data to the Panorama Central Station for analysis and storage via the Panorama Telemetry Server. The type of data that can be collected by a Telepack is dependent on the type of lead wire set and options configured for the connected patient.
Supported Devices 1.2.4 System Overview Panorama Wireless Transceiver (Panorama Telepack-608 only) The Panorama Wireless Transceiver and its components serve as a bridge between the wired and the wireless infrastructures. This system co-exists so that a patient can be monitored using either path. A patient using instrument telemetry can transition from wired to wireless, and back, while being monitored from the same screen location at the central station.
System Overview 1.2.5 Supported Devices Passport 2® Bedside Monitor Passport 2 bedside monitors may be used to monitor patient data. The Passport 2 may use either a hardwired or a wireless (2.4 GHz) configuration. The Passport 2 sends data to the Panorama Central Station for analysis and storage via an Ethernet connection or remotely via the Panorama Server. The type of data that can be collected by a Passport 2 is dependent on the type of lead wire set and sensors used.
Supported Devices System Overview Parameters/Waveforms (Continued) PARAMETERS SETTINGS PANORAMA ALARMS INSP/ET ENF Gas Module is installed, gas sensor is attached and the Agent ID is ENF. Agent ENF Inspired Agent ENF End Tidal INSP/ET DES Gas Module is installed, gas sensor is attached and the Agent ID is DES. Agent DES Inspired Agent DES End Tidal INSP/ET SEV Gas Module is installed, gas sensor is attached and the Agent ID is SEV.
2.0 Getting Started This section provides an overview of the Panorama Central Station.
The Panorama Central Station 2.1 Getting Started The Panorama Central Station The Panorama system collects patient data from both wireless and hard-wired devices and monitors it based on its configured settings. Data is collected from bedside monitors (Passport 2/Spectrum) and Panorama telepacks (2.4 GHz). The type of data that is collected and viewed is determined by the device. The Panorama system uses either a single or dual display setup to monitor the collected patient data.
Getting Started The Panorama Central Station The Panorama system uses a split-screen display (FIGURE 2-2) to allow users to simultaneously enter patient information, and monitor patient data. The top half of the screen displays patient data, while the bottom half of the screen is converted to a work space for entering and modifying patient information.
The Main Screen 2.2 Getting Started The Main Screen The Panorama Central Station’s main screen is used to monitor patient data and to navigate the system. The main screen includes the following elements: 2.2.1 • Patient Tiles (FIGURE 2-1/FIGURE 2-2) • Menu Bar (FIGURE 2-1/FIGURE 2-2) • Tabs (FIGURE 2-2) Patient Tiles Patient Tiles (FIGURE 2-3) are the core elements of the Panorama system. Patient tiles display patient information and data that is obtained from an external monitoring device.
Getting Started The Main Screen VIEW/MUTE Button The VIEW/MUTE (FIGURE 2-3) buttons share the same location within the patient tile. The button that is displayed is dependant on the operating state of the patient tile. During normal operating conditions the VIEW button is displayed in the patient tile. During an alarm condition the MUTE button is displayed in the patient tile. The VIEW button is available in a patient tile when no alarm conditions exist.
The Main Screen Getting Started • Alarms on/Alarms off icon • ST analysis icon • Arrhythmia analysis icon • Heart Rate parameter lead For information regarding supported devices and the parameters measured by each, refer to ‘‘Supported Devices’’ on page 1- 4. For information regarding the parameters displayed in the digital data tile, refer to ‘‘Parameter Specifications’’ on page 13- 2. The following table lists icons that may be shown in a digital data tile.
Getting Started The Main Screen The following guidelines regulate the display of messages in the Patient Status line: • The Patient Status line displays a patients demographic information, if available. Demographic information is shown in white text. • The Patient Status line displays all Alarm Priority 1 physiological messages in red text. • The Patient Status line displays Alarm Priority 2/3 physiological messages in yellow text.
The Main Screen Getting Started System Status Line The System Status line (FIGURE 2-4) displays messages regarding the status of the Panorama Central Station. The System Status line is located above the menu buttons, in the menu bar. System status messages refer to the operation of the system. For a listing of System Status messages, refer to ‘‘System Events’’ on page 14- 18. Menu Buttons Menu buttons (FIGURE 2-4) provide access to additional interactive screens.
Getting Started The Main Screen TABLE 2-1 Menu Bar Buttons BUTTON PURPOSE System Setup Provides access to the following tabs: • The Care Group tab is used to create the system level care group assignment. • The Parameter Color tab is used to create the system default color and parameter assignment. • The Installation Setup tab is an optional password-protected tab used to restrict access to additional default settings.
The Main Screen Getting Started Sidebar Buttons FIGURE 2-5 Tab Architecture 2.2.4 Sidebar Buttons Sidebar buttons (FIGURE 2-5) are used to perform an action (such as print, enable Arrhythmia or Normal Screen), add functionality to the tab (such as Skip to, Graphic and Alarm Responses), or change the contents of the tab (such as Alarm Responses or Alarm Limits).
Getting Started 2.3 Common Controls and Elements Common Controls and Elements This section provides information regarding several types of controls and elements that are used throughout the system. Common controls and elements include: • Buttons • Message Dialog Boxes • Keyboard Dialog Box • Keypad Dialog Box Buttons Buttons provide options to expand the functionality of a tab. For example: • To perform an action.
Common Controls and Elements Getting Started A Question message dialog box contains Yes and No buttons. • The Yes button confirms the action, closes the message box and enables all applicable sidebar buttons. • The No button cancels the action, closes the dialog box and enables applicable controls and sidebar buttons. FIGURE 2-8 Message Dialog Box (Question) An Informational message dialog box contains an OK button.
Getting Started Common Controls and Elements Field Name Edit Box Caps Lock Indicator FIGURE 2-10 Keyboard Dialog Box The keyboard dialog box includes: • The name of the selected field • An Edit box to show the entered value • A Close button to discard changes • An Enter button to accept changes • A Backspace (<==) button to clear a single character in the edit box • A Caps Lock button to enable or disable caps lock A Caps Lock indicator is shown when Caps Lock is enabled.
Common Controls and Elements 2 - 14 Getting Started • The name of the selected field • An Edit box to show the entered value • The acceptable range of values • A Clear button to delete all of the numbers in the edit box • A CE button to delete a single number from the edit box • A Cancel button to discard changes • An OK button to accept changes 0070-00-0575-50 Panorama™ Operating Instructions
Getting Started 2.4 Quick Reference Guide Quick Reference Guide The quick reference guide provides abbreviated procedural information for the operation of the Panorama Central Station. Quick reference procedures include: • Auto-Admitting a Patient • Standby • Discharge • Display • Patient Alarms (Limits and Responses) • Viewing List Trends • Viewing Events • Viewing Disclosure NOTE: 2.4.1 Demographic information is bi-directionally shared between the bedside monitor and the Panorama Central Station.
Quick Reference Guide Getting Started 4. Select a patient’s Standby location. a. Select a location from the patient location list b. Choose the Select button To activate Standby mode at the bedside monitor: • Select the STANDBY button on the front of the bedside monitor. This method places both the bedside monitor and the Panorama Central Station in Standby mode. To remove patient from Standby mode at the Panorama Central Station: 1. Select the Patient Setup menu button. 2.
Getting Started Quick Reference Guide 5. A message dialog box is displayed. a. If at least two of the three required demographic fields (First Name, Last Name, Patient ID) are entered, the following message is displayed: Are you sure you want to discharge this patient? Selecting Yes will move the patient to the discharge list. The YES button discharges the patient. The NO button continues monitoring the patient. b.
Quick Reference Guide Getting Started 6. Choose the Select button to confirm the choice. For additional information regarding parameter display, refer to‘‘Display Tab’’ on page 529. 2.4.5 Patient Alarms Patient alarms provide for customized alarm limits and responses based on patient need. For additional information on Patient Alarms, refer to ‘‘Patient Alarm Setup Tab (Optional)’’ on page 6- 2. Alarm Limits Alarm limits are the threshold settings at which a parameter alarm occurs.
Getting Started Quick Reference Guide Muting Alarms To mute a non-latched alarm (for example, IBP): • Select the Mute button in the alarming patient's tile to silence the alarm violation for the configured time period. For additional information on muting an alarm, refer to "VIEW/MUTE Button’’ on page 2-5. To mute a latched alarm (for example, lethal arrhythmias): • Select the digital data area or waveform area of the alarming patient tile to acknowledge the alarm AFTER the alarm condition is resolved.
Quick Reference Guide Getting Started 4. To view the waveform data associated with an event, highlight the desired event and select the View Waveform sidebar button. The event waveform can be printed by selecting the Print sidebar button. 2.4.8 Viewing Disclosure Disclosure data is all of a patient’s historical waveform, and associated numeric information, for a selected time period. To view Disclosure data: 1. Select the VIEW button in the desired patient tile. 2. Select the Disclosure tab. 3.
Getting Started 2.5 Troubleshooting Troubleshooting This section lists some of the potential issues that may occur when admitting a patient to the Panorama Central Station. MESSAGE/ISSUE * REASON SOLUTION Cannot admit patient/patient data not displayed at central station. Previous patient not discharged from system and/or monitoring device. Discharge patient from system. Monitoring device not assigned to Equipment List. Assign device to Equipment List.
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3.0 Alarm Behavior This section outlines the alarm types available in the system and the conditions that would trigger an alarm condition.
General Alarm Behavior 3.1 Alarm Behavior General Alarm Behavior The Panorama Central Station uses alarms to send notification when a patient’s physiological status changes, a patient has a specific technical issue, or when there is a system violation. When a patient is first admitted, the system alarm settings are in effect. Individual patient alarm settings can be modified by using the Patient Alarms button.
Alarm Behavior Physiological Alarms Bedside Alarm Tracking Bedside Alarm Tracking enables an automatic, bi-directional flow of limit change and alarm delay information, between a patient bedside monitor and a Panorama Central Station. This option can be enabled/disabled in the System Alarms (Alarm Options) tab. By default, Bedside Alarm Tracking is enabled.
Physiological Alarms 3.2.3 Alarm Behavior Physiological Alarm Responses The alarm responses associated with a physiological alarm are as follows. 3.2.3.1 Alarm Priorities The Panorama Central Station supports three alarm priorities. When alarm priority is turned on, the choices available are Alarm Priority of 1, 2 or 3. Alarm priority may be turned off by using the Priority Off setting. Alarm priorities associated with lethal alarm parameters cannot be changed from their default value of Priority 1.
Alarm Behavior Technical Alarms Priority Off Alarm priority can be turned off for certain alarms. Parameters configured to use Priority Off do not have any visual or audio alarm indicators, however, the Print on Alarm and Save to Event alarm response options still function. 3.2.3.2 Save to Event Save to Event enables the Panorama Central Station to save a 20 second snapshot of a specific alarm event so that it can later be retrieved and studied in more detail. 3.2.3.
System Alarms 3.4.1 Alarm Behavior Alarm Behaviors The visual and audio indicators associated with a system alarm are as follows: Visual Indicators System alarm audio indicators display as white text messages in the System Status line. Audio Indicators System audio alarm indicators are based on the settings in the Volume tab.
4.0 Lead Placement This section outlines the suggested lead placement procedures.
Introduction 4.1 Lead Placement Introduction Various monitoring issues are directly linked to poor site preparation and improper ECG electrode placement. If artifact is present on the ECG waveform, then the arrhythmia processing, alarm processing, and quality of the monitoring function may be affected. The presence of artifact can prevent the monitor from establishing an accurate reference ECG waveform thereby increasing the degree of difficulty the monitor has assessing the ECG rhythm.
Lead Placement Electrode Patch Location 2. Attach the electrode patch to the skin at the prepared site. Smooth the electrode patch down in a circular motion to ensure proper skin contact. If using soft gel electrodes, never push down directly over the contact gel medium as this may displace the gel and cause monitoring artifact. If using hard gel electrodes, it is recommended that during application, the center of the electrode should be slightly pressed onto the skin to ensure direct contact.
Lead Placement 4.4 Lead Placement Lead Placement The computerized arrhythmia algorithm works best when the patient’s R wave is significantly larger than the P wave or the T wave. If the R wave is not significantly larger than other lower voltage waves on the ECG tracing, the computer may have some difficulty in identifying the appropriate waves. On some patients, electrode patch placement and/or ECG lead viewed may need to be adjusted in order to obtain a significant R wave.
Lead Placement Lead Placement AHA Standard 5-wire Lead Set White Black RA LA Brown V Lead (any V position) V Green Red RL LL FIGURE 4-2 5-wire Lead Placement (AHA) • Place RA (white) electrode under the patient’s right clavicle, mid-clavicular line within the rib cage frame. • Place LA (black) electrode under the patient’s left clavicle, mid-clavicular line within the rib cage frame. • Place LL (red) electrode on the patient’s lower left abdomen within the rib cage frame.
Lead Placement Lead Placement AHA Standard 12-wire Lead Set RA LA V6 V5 V4 V1 LL RL V2 V3 FIGURE 4-3 12-wire Lead Placement (AHA) • Place RA (white) electrode under the patient’s right clavicle, mid-clavicular line within the rib cage frame. • Place LA (black) electrode under the patient’s left clavicle, mid-clavicular line within the rib cage frame. • Place LL (red) electrode on the patient’s lower left abdomen within the rib cage frame.
Lead Placement 4.4.2 Lead Placement International Electro-Technical Commission (IEC) Lead Placement The IEC lead placement is available for 3, 5 and 12-wire lead set configurations. IEC Standard 3-wire Lead Set Red Yellow R L Green F FIGURE 4-4 3-wire Lead Placement (IEC) • Place R (red) electrode under patient right clavicle, mid-clavicular line within the rib cage frame. • Place L (yellow) electrode under patient left clavicle, mid-clavicular line within the rib cage frame.
Lead Placement Lead Placement IEC Standard 5-wire Lead Set Red Yellow R L White C Lead (any C position) C Black Green N F FIGURE 4-5 5-wire Lead Placement (IEC) • Place R (red) electrode under the patient’s right clavicle, mid-clavicular line within the rib cage frame. • Place L (yellow) electrode under the patient’s left clavicle, mid-clavicular line within the rib cage frame. • Place F (green) electrode on the patient’s lower left abdomen within the rib cage frame.
Lead Placement Lead Placement IEC Standard 12-wire Lead Set L C6 C5 C4 C1 F N C2 C3 FIGURE 4-6 12-wire Lead Placement (IEC) • Place R (red) electrode under the patient’s right clavicle, mid-clavicular line within the rib cage frame. • Place L (yellow) electrode under the patient’s left clavicle, mid-clavicular line within the rib cage frame. • Place F (green) electrode on the patient’s lower left abdomen within the rib cage frame.
Lead Placement 4.4.3 Lead Placement Special Considerations Lead II Monitoring White Red Black Yellow R L Red Green F FIGURE 4-7 Lead II Monitoring (AHA) FIGURE 4-8 Lead II Monitoring (IEC) • Place RA (white) electrode under patient • Place R (red) electrode under patient right right clavicle, mid-clavicular line within the clavicle, mid-clavicular line within the rib rib cage frame. cage frame.
Lead Placement Lead Placement AHA Modified Chest Lead (MCL) Monitoring with a 3-wire Lead Set W hite RA Red Black LA LL FIGURE 4-9 MCL Monitoring with a 3-wire Lead Set (AHA) Some patients may require monitoring in a MCL configuration. • Place RA (white) electrode under patient left clavicle, mid-clavicular line within the rib cage frame. • Place LA (black) electrode right sternal border, fourth intercostal space within the rib cage frame.
Lead Placement Lead Placement IEC Modified Chest Lead (MCL) Monitoring with a 3-wire Lead Set Red R Yellow Green L F FIGURE 4-10 MCL Monitoring with a 3-wire Lead Set (IEC) Some patients may require monitoring in a MCL configuration. • Place R (red) electrode under patient left clavicle, mid-clavicular line within the rib cage frame. • Place L (yellow) electrode right sternal border, fourth intercostal space within the rib cage frame.
Lead Placement Lead Placement Neonatal Electrode Placement Using a 3-wire lead set, ECG lead placement on a neonate is usually directed towards obtaining the best possible respiration data through the ECG thoracic impedance technique. Thoracic impedance is usually measured between the Right Arm and Left Arm electrode patches. These patches should be placed on the chest directly across from each other to optimize the measuring of the neonate’s chest movement.
Lead Placement Lead Placement Monitoring a Pacemaker Patient White Black White Pacer V Brown Black Red Green FIGURE 4-13 3-wire Lead Placement for a Pacemaker Patient (AHA) Red FIGURE 4-14 5-wire Lead Placement for a Pacemaker Patient (AHA) A Pacemaker patient usually requires a different electrode patch placement configuration than a non-pacemaker patient. Do not place an ECG electrode directly over the pacemaker generator.
Lead Placement 4.5 Troubleshooting Troubleshooting This section lists some of the potential messages and issues that may occur. MESSAGE/ISSUE * REASON SOLUTION Noisy ECG traces Loose or dry electrodes. Apply fresh, moist electrodes. Defective electrode wires. Replace wires as necessary. Patient cable or leads are routed too close to other electrical devices. Eliminate 60 Hz interference. Use ECG cable with internal filter block.
Troubleshooting Lead Placement MESSAGE/ISSUE * REASON SOLUTION Base Line Wander Patient moving excessively. Secure lead wires and cable to patient. Patient respiration variance. Reposition electrodes Electrodes dry or loose Repeat skin preparation and apply fresh, moist electrodes. The 12-lead ECG is detecting muscle artifact, or electrical interference from auxiliary devices. Check leads, follow skin preparation procedure.
5.0 Patient Setup Functions This section describes patient setup at the Panorama Central Station.
Demographics Tab 5.1 Patient Setup Functions Demographics Tab The Demographics tab (FIGURE 5-1/FIGURE 5-2) allows for the entry and modification of patient demographic information (such as name, age and weight) and patient settings (such as care group, pacer, arrhythmia and ST.) The Demographics tab is only accessible when the selected patient tile is assigned to a monitoring device.
Patient Setup Functions 5.1.2 Demographics Tab Entering Data in the Demographics Tab This section outlines entering and modifying data in the Demographics tab. Select the Patient to be Set Up/Modified Choose a patient tile by selecting its digital data or waveform area. The patient’s last name and bed number are displayed in the Demographics field. Device Label Field The Device Label field displays the identification label for the device assigned to the selected patient tile.
Demographics Tab Patient Setup Functions First Name Field The First Name field is used to enter the first name of a patient. A patient’s first name can be entered at the bedside monitor, or the Panorama Central Station because the system enables an automatic bi-directional flow of information. 1. From the Demographics tab, select the First Name field. The keyboard dialog box is displayed. 2. Enter the patient’s first name (maximum of 15 characters).
Patient Setup Functions Demographics Tab Field Name Edit Box Dial Selector Arrow Buttons FIGURE 5-3 Height Dialog Box 2. Use the dial selector or the arrow buttons to select a value in the Height dialog. UNITS OF MEASURE INCHES (in) CENTIMETERS (cm) Range 8.0 to 120.0 in 20.0 to 305.0 cm Single arrow Step Setting 0.5 (8.0 to 20.0 in) 1.0 (20.0 to 120.0 in) 1.0 cm Double arrow Step Setting 1.0 (8.0 to 20.0 in) 10.0 (20.0 to 120.0 in) 10.0 cm 3.
Demographics Tab Patient Setup Functions 1. From the Demographics tab, select the Weight field. The Weight dialog box (FIGURE 5-4) displays. Field Name Edit Text Box Dial Control Arrow Buttons FIGURE 5-4 Weight Dialog Box 2. Use the dial control to select a value for the Weight dialog box. UNITS OF MEASURE POUNDS (lbs) KILOGRAMS (kg) Range 0.1 to 1100.0 lbs 0.1 to 500.0 kilograms Single arrow Increment 0.1 (0.1 to 10.0 lbs) 0.5 (10.0 to 100.0 lbs) 1.0 (100.0 to 1100.0 lbs) 0.1 (0.1 to 5.
Patient Setup Functions Demographics Tab Date Of Birth Field The Date Of Birth field is used to enter and modify the date of birth for a patient. A patient’s date of birth can be entered at either the bedside monitor or the Panorama Central Station. Data entered at the bedside monitor is automatically sent to the Panorama Central Station and data entered at the Panorama Central Station is automatically sent to the bedside monitor. To enter a date of birth: 1.
Demographics Tab Patient Setup Functions • The Enter button accepts the changes. Comment Field The Comment field is used to enter notes for the selected patient tile. 1. From the Demographics tab, select the Comment field. The keyboard dialog box is displayed. 2. Enter a note (maximum of 31 characters). • The Backspace (<==) button clears a single character in the edit box. • The Caps Lock button enables/disables the caps lock function. A Caps Lock indicator displays when Caps Lock is enabled. 3.
Patient Setup Functions Demographics Tab 2. Select the Pacer Enhancement button to enable or disable this setting. • A checkmark indicates that Pacer Enhancement is enabled. • An empty box indicates that Pacer Enhancement is disabled. 3. Select the Pacer Filter button to set the desired setting displays. The selections for Pacer Filter range from 0 to 80 ms (in increments of 5). 4. Accept or reject the selections made in the Pacer Setting dialog box. • The Done button accepts the selections.
Demographics Tab Patient Setup Functions 2. Select a Care Group button. 3. Accept or reject the Care Group selection. • The Done button accepts the Care Group selection. • The Cancel button discards the selection, closes the dialog box and returns to the Demographics tab. For additional information regarding Care Groups, refer to the ‘‘Care Group Tab’’ on page 9-2. Settings (Telepack) Select the Settings sidebar button to establish the type of ECG monitoring performed by the Telepack.
Patient Setup Functions Demographics Tab 3. Select the ST lead to be monitored. A. If a 3-lead cable is used the ST lead is not selected. B. If a 3-lead cable is used the ST lead is not selected. • The ST Lead 1 button selects the first ST monitoring lead.The selections available for ST Lead 1 include I, II, III, aVR, aVL, aVF and V. • The ST Lead 2 button selects the second ST monitoring lead.The selections available for ST Lead 2 include I, II, III, aVR, aVL, aVF and V.
Demographics Tab Patient Setup Functions • Allows for active monitoring of the retrieved patient • Restores Trend, Event and Disclosure records • Restores Wave Gain and Trend Storage settings • Restores Parameter Display, Print Setup, Alarm Responses and Alarm Limit settings, if Alarm Tracking is Off • Changes patient’s Alarm Limit settings to reflect the destination device, if Alarm Tracking is On To retrieve a discharged patient do the following: 1. Select the Retrieve Discharged Pt.
Patient Setup Functions 5.1.4 Demographics Tab Troubleshooting This section lists some of the potential messages and issues that may occur while using the Demographics tab. MESSAGE/ISSUE * REASON SOLUTION Can not admit Patient to this tile. No Device attached to this tile There is no device assigned to the selected tile. Select the OK button to close the dialog box. Select a patient tile that has a device attached to it or attach a device to the selected patient tile.
Transfer Tab 5.2 Patient Setup Functions Transfer Tab The Transfer tab (FIGURE 5-10) enables the transfer of a patient’s data from one device to another. Two types of transfers can be performed through the Transfer tab: • Room To Room Transfer Without Device • Central To Central Transfer Without Device This section describes the following: • Accessing the Transfer Tab • Room To Room Transfer Without Device • Central To Central Transfer Without Device • Sidebar Buttons • Troubleshooting 5.2.
Patient Setup Functions Transfer Tab • When a patient tile actively monitoring a patient, but experiencing a Communication Lost event, is selected as the source To perform a Room To Room Transfer Without Device: 1. Select the patient tile to be transferred. Choose a patient tile by selecting its digital data or waveform area. 2. Select the Room To Room Without Device button. The following prompt displays: Please touch tile to which you wish to transfer the patient. 3.
Transfer Tab Patient Setup Functions Demographics • For all transfers to a bedside monitor, the bed ID and patient size change to those of the destination device. The remaining demographic data only changes when the destination device has experienced a Communication Lost event. When communication is reestablished, the remaining demographic data is taken from the destination device.
Patient Setup Functions Transfer Tab 5. Select the Central To Central Without Device button. The Select Destination Panorama list box (FIGURE 5-11) is displayed. FIGURE 5-11 Select Destination Panorama List Box 6. Select the Destination Panorama device from the Select Destination Panorama list box. • Select the Done button.
Transfer Tab Patient Setup Functions 3. Select the Transfer tab (FIGURE 5-10). The Transfer tab displays. 4. Select the Accept/Reject button on the Transfer tab. The Transferred In Patient view (FIGURE 5-12) displays. FIGURE 5-12 Transferred In Patient View • Select the Accept button. The message All of the patient's data will be deleted in the destination tile.
Patient Setup Functions Transfer Tab • The Reject button terminates the transfer and returns to the Transfer tab. The message Transfer Out rejected by [the Destination Panorama name] Central. is displayed in the system status line of the Source Panorama. • The Cancel button returns to the Transfer tab without terminating the transfer. NOTE: A Central To Central Transfer Without Device can fail if the network connection is lost or if either Panorama loses power during the process.
Transfer Tab 5.2.4 Patient Setup Functions Sidebar Buttons The following sidebar buttons are used to expand the functionality of this tab. Recover Patient When a Central To Central Transfer Without Device has failed, the Recover Patient sidebar button is used to retrieve patient information that was collected in the Failed Transfer List. The list box in the Recover Failed Transfer Patients view (FIGURE 5-13) has three columns labeled First Name, Last Name and ID.
Patient Setup Functions Transfer Tab Delete Failed Patient When the Failed Transfer List has reached its maximum of five failed transfers, the Delete Failed Patient sidebar button is used to delete patient information from the list. The list box in the Delete Failed Transfer Patients view (FIGURE 5-14) has three columns labeled First Name, Last Name and ID. The list will contain at least two of these three demographic indicators. 1. Select the Delete Failed Patient sidebar button.
Transfer Tab Patient Setup Functions Transfer From Failed List The Transfer From Failed List sidebar button is used to resume a transfer of patient information that was collected in the Failed Transfer List when a Central To Central Transfer Without Device failed. The patient data and settings collected in the Failed Transfer List at one Panorama Central Station are transferred to a room in an area monitored by a different Panorama Central Station.
Patient Setup Functions 5.2.5 Transfer Tab Troubleshooting This section lists some of the potential messages and issues that may occur while using the Transfer tab. Room To Room Transfer MESSAGE/ISSUE * REASON SOLUTION The Room To Room Without Device button is disabled. The Transfer Failed list is full. The list stores a maximum of 5 failed transfers. Delete a patient from this list before transferring. A patient tile is not selected on the main screen.
Transfer Tab Patient Setup Functions Central To Central Transfer MESSAGE/ISSUE * REASON SOLUTION The Central To Central Without Device button is disabled. The Transfer Failed list is full. The list stores a maximum of 5 failed transfers. Delete a patient from this list before attempting to transfer. A patient tile is not selected on the main screen. Select the patient tile that is intended to be transferred. The selected patient tile has a device assigned but is not monitoring a patient.
Patient Setup Functions Transfer Tab Central To Central Transfer (Continued) MESSAGE/ISSUE * REASON SOLUTION The destination tile must have a device assigned to perform the transfer. The destination tile does not have a device assigned. Select the OK button on the message box and then select a destination tile that has a device assigned. Please touch tile to which you wish to transfer the patient. A destination tile has not been selected at the Destination Panorama.
Transfer Tab Patient Setup Functions Recovering Failed Transfer Patient Data MESSAGE/ISSUE * REASON SOLUTION The Recover Failed Transfer sidebar button is disabled. The Failed Transfer List is empty. N/A Selecting the Recover button has no effect. A patient has not been selected from the Failed Transfer List. Select the patient whose information is to be recovered from the list and then select the Recover button.
Patient Setup Functions 5.3 Discharge Tab Discharge Tab The Discharge tab is used to discharge a patient from a patient tile. If the required demographic information was previously entered for the patient to be discharged, the patient will be moved to the list of retrievable patients. For additional information on retrieving a patient see ‘‘Retrieve Discharged Pt.’’ on page 5-11.
Discharge Tab Patient Setup Functions Normal Screen Select the Normal Screen sidebar button to return the display to the full screen mode, close all tabs, message boxes and dialog boxes. 5.3.4 Troubleshooting This section lists some of the potential messages and issues that may occur while using the Discharge tab. MESSAGE/ISSUE * REASON SOLUTION No patient Selected! This message appears in the demographic field when either no patient tile or an empty patient tile has been selected.
Patient Setup Functions 5.4 Display Tab Display Tab The Display tab is used to select the digital and waveform parameters that will appear in the selected patient tile. The default settings for patient tiles are defined by the ‘‘Unit Choices Tab’’ on page 9-39. The layout and functionality of the Display tab changes based on the type of monitoring device assigned to the selected patient tile. The fields discussed in this section may not apply to all users.
Display Tab Patient Setup Functions • If the OFF option is selected from the Parameter list, the Are you sure you want to turn off the parameter message box appears. Select the YES button to turn OFF the parameter or the NO button to leave the parameter tile On. 4. Choose the SELECT button to highlight the selected parameter. The parameter is shown in the selected patient tile. NOTE: 5.4.3 A data parameter can only be shown in one parameter tile at any given time.
Patient Setup Functions Display Tab Table 5-1 shows the number of sub-tiles that each parameter occupies. For a list of the parameters listed by monitoring device, refer to ‘‘Supported Devices’’ on page 1-4. For additional information regarding the setup of a patient tile, refer to the ‘‘Display Tab’’ on page 5-29. .
Display Tab Patient Setup Functions • Always occupies the first digital data tile • Displays an ECG lead label for the lead acquiring the data • Displays an icon if Arrhythmia Analysis is enabled • Displays an icon if ST Analysis is enabled • Displays the standby location for a patient in Standby mode Waveform Parameter Data The patient tile is capable of showing up to two waveforms for a patient. FIGURE 5-21 shows an example of the Display tab (waveform data).
Patient Setup Functions Display Tab Restore Previous Settings Select the Restore Previous Settings sidebar button to return patient display settings to those in use when the tab was opened. Trend Storage The Trend Storage sidebar button is used to set the interval at which a patient’s trend data is stored in the Panorama Central Station. The default setting for the Trend Storage interval period is determined by the ‘‘Unit Choices Tab’’ on page 9-39. Selecting a Trend Storage Interval 1.
Standby Tab 5.5 Patient Setup Functions Standby Tab The Standby tab is used to place a patient in Standby mode at the Panorama Central Station and/or the bedside monitor. Standby mode temporarily suspends all patient monitoring, alarm processing, and trending activity. NOTE: Patients placed in Standby mode should be closely monitored.
Patient Setup Functions Standby Tab 2. In the Standby tab, select the type of Standby mode to be used for the patient. a. Standby at the Panorama Central Station only In the Standby tab, select the Panorama Standby Only button. Patient monitoring will continue at the bedside monitor. b. Standby at the bedside monitor and the Panorama Central Station • In the Standby tab, select the Bedside and Panorama Standby button. • At the bedside monitor, select the Standby button.
Standby Tab 5.5.5 Patient Setup Functions Troubleshooting This section lists some of the potential messages and issues that may occur while using the Standby tab. MESSAGE/ISSUE * REASON SOLUTION No patient Selected! This message appears in the demographic field when either a patient tile has not been selected or an empty tile was selected. Select an active patient tile.
Patient Setup Functions 5.6 Wave Gain Tab (Patient) Wave Gain Tab (Patient) The Wave Gain tab (FIGURE 5-24) is used to adjust the wave gain settings for the selected patient’s available waveforms. The initial wave gain settings for a patient are the system default settings at the time the patient is admitted. NOTE: The layout and functionality of the Wave Gain tab changes based on the type of monitoring device assigned to the selected patient tile.
Wave Gain Tab (Patient) Patient Setup Functions 4. Select the Resp Gain button until the desired wave gain is displayed. The settings available for the resp gain wave gain include 1, 2, 3, 4 and 5. 5. Select the CO2 (%, kPa, mmHG) button until the desired wave gain is displayed. • The settings available for the CO2 % wave gain include 5.0, 7.5 and 10.0 %. • The settings available for the CO2 kPa wave gain include 5.0, 7.5 and 10.0 kPa.
Patient Setup Functions 5.7 Print Setup Tab (Patient) Print Setup Tab (Patient) The Print Setup tab (FIGURE 5-25) is used to select the waveforms printed on a patient’s All Strip, Event Zoom-In and Full Disclosure Zoom-In reports. The default settings for this tab are determined by the System Settings. The layout and functionality of the Print Setup tab changes based on the type of monitoring device assigned to the selected patient tile. The fields discussed in this section may not apply to all users.
Print Setup Tab (Patient) 5.7.3 Patient Setup Functions Sidebar Buttons The following sidebar buttons are used to expand the functionality of this tab. Restore Previous Settings Sidebar Button Select the Restore Previous Settings sidebar button to return patient display settings to those in use when the tab was opened. Normal Screen Sidebar Button Select the Normal Screen sidebar button to return the display to the full screen mode, close all tabs, message boxes and dialog boxes. 5.7.
6.0 Patient Alarm Functions This section describes the configuration of patient alarms at the Panorama Central Station.
Patient Alarm Setup Tab (Optional) 6.1 Patient Alarm Functions Patient Alarm Setup Tab (Optional) The Patient Alarm Setup tab (FIGURE 6-1) provides password protected access to the patient alarm configuration. When the correct password is entered, the Alarm Limits and the Alarm Responses tabs are opened. The Patient Alarm Setup tab is only shown if the Password Protection option is set to ON in the System Alarms tab.
Patient Alarm Functions Patient Alarm Setup Tab (Optional) 3. The Alarm Limits (FIGURE 6-2) and the Alarm Responses (FIGURE 6-3) tabs are shown after the correct password is entered. For additional information about alarm limits and alarm responses, refer to “Alarm Limits Tab (Patient)” on page 6-4 and “Alarm Responses Tab (Patient)” on page 6-9. 6.1.3 Sidebar Buttons The following sidebar button is used to expand the functionality of this tab.
Alarm Limits Tab (Patient) 6.2 Patient Alarm Functions Alarm Limits Tab (Patient) The Patient Alarm Limits tab (FIGURE 6-2) adjusts patient alarm limit settings. NOTE: The layout of the Alarm Limits tab changes based on the type of monitoring device assigned to the selected patient tile. The fields discussed in this section may not apply to all users. For additional information regarding alarm limit settings, refer to ‘‘Alarms and Events’’ on page 14-1.
Patient Alarm Functions Alarm Limits Tab (Patient) 2. Use the scroll bar to select the alarm to be modified. • Double arrow buttons display the next/previous page of parameter slider controls (until the first/last page is reached). • Single arrow buttons display the next/previous slider control (until the last control is shown). 3. Set the high alarm limit button for the selected parameter. This button is either labeled OFF or has an alarm limit value.
Alarm Limits Tab (Patient) Patient Alarm Functions TABLE 6-1 Auto Set Percent Change 6.2.
Patient Alarm Functions Alarm Limits Tab (Patient) • When the Suspend All Alarms sidebar button is disabled, the button is blue with white text. Alarms are now re-enabled for the selected patient. Suspend Non-lethal Select the Suspend Non-lethal sidebar button to suspend all numeric, technical and nonlethal arrhythmia alarms for the selected patient tile. Lethal arrhythmia alarms continue to be monitored at the Panorama Central Station when non-lethal arrhythmia alarms are suspended.
Alarm Limits Tab (Patient) 6.2.4 Patient Alarm Functions Troubleshooting This section lists some of the potential messages and issues that may occur while using the Patient Alarm Limits tab. MESSAGE/ISSUE * REASON SOLUTION No patient Selected! This message appears in the demographic field when either no patient tile or an empty patient tile has been selected. Select an active patient tile.
Patient Alarm Functions 6.3 Alarm Responses Tab (Patient) Alarm Responses Tab (Patient) The Alarm Responses tab (FIGURE 6-3) adjusts the responses of alarms at the Panorama Central Station during an alarm condition. This section includes the following: • Accessing the Alarm Responses Tab • Configuring Alarm Responses • Sidebar Buttons • Troubleshooting 6.3.1 Accessing the Alarm Responses Tab 1. From the menu bar, select the Patient Alarms menu button.
Alarm Responses Tab (Patient) Patient Alarm Functions 3. Set the alarm priority for the alarm parameter. To set an alarm priority, select the Priority button until the alarm priority setting is shown. Alarm priority is associated with the severity of an alarm condition. It determines the audio and visual indicators that occur during an alarm condition. Alarm priority settings may include Off, 1, 2 and 3. Each alarm has predetermined alarm priority settings.
Patient Alarm Functions Alarm Responses Tab (Patient) To resume the monitoring of the alarms at the Panorama Central Station select the Suspend All Alarms sidebar button. • When the Suspend All Alarms sidebar button is disabled, it is blue with white text. Alarms are now re-enabled for the patient. Suspend Non-lethal Select the Suspend Non-lethal sidebar button to suspend all numeric, technical and nonlethal arrhythmia alarms for the selected patient tile.
Alarm Responses Tab (Patient) Patient Alarm Functions 3. Select the Alarm Delay time period for the selected patient’s alarm. Alarm Delay is the period of time that the Panorama Central Station delays the notification of an alarm. Alarm Delay options include None, 1 second, 2 seconds, 3 seconds, 4 seconds, 5 seconds, 6 seconds, 7 seconds and 8 seconds. NOTE: The Alarm Delay setting does not affect the alarm notification for ST, Apnea or Arrhythmia. 4. Select the Done or the Cancel button.
Patient Alarm Functions 6.4 Arrhythmias Arrhythmias Lethal and Non-lethal arrhythmia alarms and events may occur at the Panorama Central Station. 6.4.1 Lethal Arrhythmia Alarms A lethal arrhythmia is an arrhythmia that can be life threatening to a patient if left untreated. Ventricular Tachycardia (V-Tach), Ventricular Fibrillation (V-Fib) and Asystole alarms are lethal arrhythmias.
Arrhythmias Patient Alarm Functions Asystole Alarm An Asystole alarm is activated when there is an absence of detectable QRS complexes for a user-defined period of time in the absence of V-Fib. NOTE: An Asystole alarm is a latched alarm that must be acknowledged after the condition resolves. NOTE: The Asystole alarm is not available for the Neonate patient size.
Patient Alarm Functions Arrhythmias Couplet Alarm The Couplet alarm is activated when the Panorama Central Station identifies two consecutive PVCs between normal beats. NOTE: A Couplet alarm is not a latched alarm and can be acknowledged at anytime. NOTE: The Couplet alarm is not available for the Neonate patient size.
Arrhythmias Patient Alarm Functions NOTE: The Missed Beat alarm is not available for the Neonate patient size. The Missed Beat alarm priority settings include 2, 3 and OFF and behaves as follows: • If the Missed Beat alarm priority is OFF, the Panorama Central Station does not produce any audio alarm indicators for the Missed Beat alarm condition. • If the Missed Beat alarm priority is set to 2, the Panorama Central Station produces an Alarm Priority 2 sound once the condition is identified.
Patient Alarm Functions Arrhythmias The Trigeminy alarm priority settings include 2, 3 and OFF and behaves as follows: • If the Trigeminy alarm priority is OFF, the Panorama Central Station does not produce any audio alarm indicators for the Trigeminy alarm condition. • If the Trigeminy alarm priority is set to 2, the Panorama Central Station produces an Alarm Priority 2 sound once the condition is identified.
Arrhythmias Patient Alarm Functions The V-Rhythm alarm priority settings include 2, 3 and OFF and behaves as follows: • If the V-Rhythm alarm priority is OFF, the Panorama Central Station does not produce any audio alarm indicators for the V-Rhythm alarm condition. • If the V-Rhythm alarm priority is set to 2, the Panorama Central Station produces an Alarm Priority 2 sound once the condition is identified.
7.
Bedside Tab 7.1 Views Bedside Tab The Bedside tab (FIGURE 7-1) provides an expanded view of the selected patient data. A maximum of four waveforms and eight digital parameters can be scrolled into the viewable area of the display. The parameters and settings, selected for the monitoring device, determine the data that displays on the Bedside tab. The order in which the parameters are presented is specified in the Unit Priorities tab.
Views 7.1.1 Bedside Tab Accessing the Bedside Tab To display the Bedside tab, select the VIEW button located on the desired patient tile. To view a different patient, select another patient tile by choosing its digital data or waveform area. Patient Demographic Field Waveform Area Calipers Dialog Box Digital Data Area FIGURE 7-1 Bedside tab 7.1.
Bedside Tab Views One lead of ECG will always occupy the top waveform position, and will not scroll. This ECG waveform is the same waveform shown on the main screen. If a view of a different ECG lead is desired, it must be selected from the Display tab. See ‘‘Display Tab’’ on page 5-29 for additional information. All other waveforms can be scrolled into viewable position. The scrolling feature provides access to a wrapping list that returns to the beginning, once the last item has been reached.
Views 7.1.3.4 Bedside Tab Calipers Calipers are reference and measurement lines that measure the time and amplitude of any ECG waveform. The Calipers sidebar button replaces the Mark Event sidebar button when the Freeze sidebar button is selected. Select the Calipers sidebar button to display the Calipers dialog box (FIGURE 7-2). FIGURE 7-2 Calipers Dialog Box 7.1.3.5 Calipers Sidebar Button The Calipers sidebar button activates the Calipers dialog box (FIGURE 7-2).
Bedside Tab Views 3. Once the dashed, vertical reference line appears in the desired location, select the Vert button again. A solid vertical measurement line now appears on the view screen. 4. Adjust the location of the solid vertical measurement line as necessary in the same manner described in step 2. 5. Once the solid vertical measurement line has been adjusted to the desired location, select the SET button. The solid vertical measurement line is locked at its current location.
Views Bedside Tab Horizontal Calipers (Amplitude) 1. Select the Horiz button. A dashed horizontal reference line is placed at the bottom of the waveform. The dashed reference line represents the 0 value starting point. 2. Adjust the location of the dashed horizontal reference line as follows: • For coarse adjustments, select a point in the general area of the desired location. The reference line will move to that point.
Trends Tab 7.2 Views Trends Tab The trended digital data for a patient can be viewed in two formats, either as a list, (FIGURE 7-3) or graphically (FIGURE 7-5). Trend data is recorded at user specified intervals, and when an NIBP measurement is performed. If the Trends tab is selected before the first interval is reached, or before the first NIBP measurement occurs, the list will be empty. All previously collected parameter data will be displayed, even if the parameter is not currently being monitored.
Views Trends Tab If a priority 1 physiological or bedside alarm condition existed for a parameter during the time of trend record storage, that parameter’s data will be highlighted in red. If a priority 2 or 3 physiological or bedside alarm condition existed for a parameter during the time of trend record storage, that parameter’s data will be highlighted in yellow. 7.2.3.
Trends Tab Views FIGURE 7-4 Print Selection Dialog Box 2. Select the button for the desired time interval to be printed. 3. Select the Print button to send the print request to the default printer. The printout will span the selected number of hours of trend data starting from the time of the first viewable row at the top of the list. Selecting the Cancel button at any time will close the Print Selection dialog box and return to the List view of the Trends tab. 7.2.3.
Views 7.2.4 Trends Tab Graphic View of the Trends Tab The Graphic view of the Trends tab (FIGURE 7-5) provides a graphical representation of all of the trended digital data for a selected patient. All previously collected data is displayed, even if the parameter is not currently being monitored. The Graphic view for each parameter includes a range bar, plot area and parameter area for the selected time. A maximum of three parameters can be scrolled into the viewable area of the display. 7.2.4.
Trends Tab 7.2.4.4 Views Display Time Interval The display time interval is the current setting for the viewable snapshot and is one page of the Graphic view. When the Graphic view opens, the default display time interval is two hours. 7.2.4.5 Time Line The time line displays nine equally spaced time values based on the display time interval. 7.2.4.6 Range Bars The range bar for each parameter is displayed with the maximum and minimum values for that parameter.
Views Trends Tab Zoom In Button The Zoom In button decreases the display time interval to a minimum of 2 hours, in two hour increments. Zoom Out Button The Zoom Out button increases the display time interval to a maximum of 8 hours, in two hour increments. 7.2.4.10 List Sidebar Button The List sidebar button opens the List view of the Trends tab.
Trends Tab Views MESSAGE/ISSUE * REASON SOLUTION No more data found (Page Down Button) There is no data in the Trend database because the Trends tab was selected before the first interval was reached or before the first NIBP measurement occurred. Wait until the first interval is reached or until the first NIBP measurement occurs. The last row in the list is already highlighted. Select the OK button to close the message box and return to the List view of the Trends tab.
Views Trends Tab This section lists some of the potential messages and issues that may occur while using the Graphic View of the Trends tab. MESSAGE/ISSUE * REASON SOLUTION There is no trend data in the display. A patient has not been admitted to the selected tile. Admit a patient to the selected tile or choose a tile that already has an admitted patient. The Trends tab was selected before the first interval was reached or before the first NIBP measurement occurred.
Events Tab 7.3 Views Events Tab The Events tab lists all the events for a selected patient tile. In addition to the Events list, limited demographic information is also displayed in this tab. The patient’s last name, patient bed number and number of events is displayed in the demographic text box, located above the Events list. If no patient tile is selected when the Events tab is selected, a message No patient in tile is displayed in the demographic field.
Views Events Tab All previously collected parameter data is displayed, even if the parameter is not currently being monitored. 7.3.3 Refreshing the Events List The Events list is not dynamic, and therefore, will not regenerate until it is refreshed. To refresh the Events list, select anywhere outside of the Events tab, then reselect the Events tab. It may take several moments for new events to be displayed on the list. 7.3.
Events Tab Views 2. Select the Delete Single Event button. A confirmation dialog box is displayed. 3. Select Yes or No. • The Yes button deletes the event record. The event record is removed from the Events list. • The No button does not delete the event. NOTE: Not all event records can be deleted. Refer to the Alarms and Events chapter for more information about which events cannot be deleted. Delete Events Button Select the Delete Events button to remove multiple events from the Events list.
Views Events Tab Events List Filter Sidebar Button Selecting the Events List Filter sidebar button to open the Patient View - Event Filter dialog box. Print More Sidebar Button Select the Print More sidebar button to print the Event List report at a specified time interval. FIGURE 7-8 Print Selection dialog box To indicate the time interval for printing the Event List report, follow these steps: 1. Select the Print More sidebar button. The Print Selection dialog box (FIGURE 7-8) is displayed. 2.
Events Tab Views MESSAGE/ISSUE * REASON SOLUTION No patient in the tile There is no patient admitted to the selected tile. Admit a patient to the tile. Patient tile not selected. Select a patient tile. Patient tile not selected. Select a patient tile. None of the existing event data meets the criteria of the current event filter. Change the event filter. There is no patient admitted to the selected tile. Admit a patient to the tile. Events list column headers not displayed.
Views 7.3.7 Events Tab Waveform View of the Events Tab The Waveforms view of the Events tab displays 20 seconds of waveform data for the selected patient. In order for the event to display in the Waveforms view, there must be waveform data associated with the event. Physiological alarm events are stored as waveform data. All previously collected data is displayed, even if the parameter is not being monitored. For additional information refer to ‘‘Alarms and Events’’ on page 14-1. 7.3.
Events Tab 7.3.8.4 Views Event Description Field The event description field displays the event that was selected in the Event List view. For example, a Low Heart Rate Alarm. 7.3.8.5 Date Field The date field indicates the date the event occurred. 7.3.9 Navigating in the Waveforms View of the Events Tab Navigating in the Waveforms view is accomplished by using buttons and scroll bars. 7.3.9.
Views Events Tab Normal Screen Select the Normal Screen sidebar button to return the display to the full screen mode, close all tabs, message boxes and dialog boxes. 7.3.10.4 Troubleshooting This section lists some of the potential messages and issues that may occur while using the List View of the Events tab. MESSAGE/ISSUE * REASON SOLUTION Sidebar buttons disabled when Events tab selected. Patient tile not selected. Select a patient tile. There is no patient admitted to the selected tile.
Disclosure Tab 7.4 Views Disclosure Tab The Panorama Central Station creates a full disclosure database for each patient. This is a collection of continuous, running, available waveforms. The Disclosure tab provides two views of a patient’s full disclosure database: Zoomed Out (compressed) and Zoomed In (magnified). On initial entry to the Disclosure tab, the Zoomed Out view is displayed. The Zoom In button can be used to access the Zoomed In view.
Views 7.4.3 Disclosure Tab Waveform Area The Zoomed Out waveform area of the Disclosure tab provides a compressed view of the selected patient’s historical waveform data. A maximum of 10 minutes of waveform data can be scrolled into the viewable area of the display. Each row of historical disclosure data in the waveform area is displayed in one minute intervals. Each waveform is displayed in the color of the parameter.
Disclosure Tab Views • Red event markers indicate that a Level 1alarm occurred • Yellow event markers indicate that either a Level 2 or a Level 3 alarm occurred • Blue event markers indicate that a user marked event occurred at either the Panorama Central Station or the bedside monitor • Orange event markers indicate that a Communication Lost event or a clock adjustment occurred 7.4.6 7.4.6.
Views 7.4.6.6 Disclosure Tab Zoom In Button The Zoom In button magnifies a section of the compressed view of the patient’s disclosure waveform (FIGURE 7-11.) The section that is magnified is defined in one of the following two ways: • Selecting the Zoom In button without highlighting the waveform displays the magnified view beginning with the time at the upper left corner of the waveform area. • A section of the waveform can be highlighted by selecting a starting point and dragging to an end point.
Disclosure Tab Views Navigating in the Zoomed In View Scrolling through the Waveforms A horizontal scroll bar for scrolling the waveform time line is located along the bottom of the Zoomed In view. The left and right arrows of the scroll bar can be used for scrolling data into the current view in 1-second increments, or the bar can be dragged to move quickly through the time line.
Views 7.4.8 Disclosure Tab Display Choices Sidebar Button The Display Choices sidebar button is used to select the waveform that will be displayed in the Zoomed Out view of the Disclosure tab. The Display Choices dialog box (FIGURE 7-12) displays the choices that are available based on the monitoring device, ECG lead set and utilized sensors. Any previously used monitoring device, ECG lead set or sensors are displayed, even if they are not currently in use. 1. Select the Display Choices sidebar button.
Disclosure Tab Views 2. Use the dial controls to select the time and date to be displayed. Ensure that the selected time and date are within the timeframe of the database. • Select the Cancel button to return to the Disclosure tab. • Select the Done button to return to the Disclosure tab with the selected date displayed in the date area, and the selected time displayed in the upper left corner of the waveform area. 7.4.
Views 7.4.12.1 Disclosure Tab Troubleshooting This section lists some of the potential messages and issues that may occur while using the Disclosure tab. MESSAGE/ISSUE * REASON SOLUTION No patient in the tile The selected tile is not actively monitoring a patient. Choose a tile that is actively monitoring a patient. All displays are blank and all buttons (except Normal Screen) are disabled. The selected patient tile does not have any stored historical data.
Disclosure Tab Views MESSAGE/ISSUE * REASON SOLUTION Time out of range (Page Up button) There are less than 10 rows of data that are newer than the top row. Select the OK button to close the message box and return to the Disclosure tab. Wait for new data to accumulate. Time out of range (Page Down button) There are less than 10 rows of data that are older than the top row. Select the OK button to close the message box and return to the Disclosure tab. Data is not available.
Views 7.5 ST Tab ST Tab The ST tab is used to view the ST templates and data for the selected patient tile. The number of ST templates that display in the ST tab depend on the type of ECG lead set attached to the patient. 7.5.1 Accessing the ST Tab 1. Select the VIEW button in the selected patient’s tile. The tabs associated with the VIEW button are displayed. 2. Select the ST tab. The ST tab (FIGURE 7-15) is displayed. FIGURE 7-15 ST Tab (5-wire Lead Set) 7.5.
ST Tab Views • When utilizing a 3-wire lead set, the ST tab may contain an ST template for the lead that is currently being monitored. • When utilizing a 5-wire lead set and a bedside monitor, the ST tab may contain up to three ST templates. The ST templates that are displayed will be based on the three ST ECG waveforms that are being sent from the bedside monitor. • When utilizing a 12 lead cable, the ST tab may contain up to twelve ST templates. 7.5.3.
Views 7.5.4.1 ST Tab Configuring ST 1. Select the Config ST sidebar button in the ST tab. The ISO, J/ST and ST Point controls are displayed in the ST tab. 2. Select the directional arrows to configure the ISO reference line. The ISO reference line displays in white. • Select the left arrow to move the ISO reference line to the left one step setting. • Select the right arrow to move the ISO reference line to the right one step setting. 3. Select the directional arrows to configure the J/ST reference line.
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8.0 Report Functions This section outlines the types of reports generated by the Panorama Central Station.
Patient Reports Tab 8.1 Report Functions Patient Reports Tab The Patient Reports tab (FIGURE 8-1) is used to print patient-specific reports. The following reports can be printed from the Patient Reports tab: • All Strips Report • Full Disclosure Report • ST Report • Trend List Report • Event List Report • Patient Alarm Report 8.1.1 Accessing the Patient Reports Tab 1. From the menu bar, select the Report button. 2. Select the Patient Reports tab. 3.
Report Functions Patient Reports Tab FIGURE 8-2 shows an example of the All Strips Report (Page 1). FIGURE 8-2 All Strips Report (Page 1) FIGURE 8-3 shows an example of the Print All Strips Report (Page 2).
Patient Reports Tab 8.1.2.1 Report Functions Header The All Strips Report’s first page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
Report Functions 8.1.2.4 Patient Reports Tab ECG Waveforms The ECG waveforms shown in the All Strips Report are based on the ECG lead wire set currently in use and on the waveforms selected in the Print Setup tab.
Patient Reports Tab Report Functions • Select the Print All Strips button in the Patient Reports tab. Selecting the Print All Strips button will post an Alarm Report print request for the selected patient. • Select the REC button in a patient tile. • Select the Print button in the Bedside tab. • Enable the Print on Alarm option in the Alarm Responses tab when there is an alarm condition. • Select the Strip button on a Passport 2®. • Select the Strip button on a Spectrum™.
Report Functions 8.1.3 Patient Reports Tab Full Disclosure Report The Full Disclosure Report provides a compressed view of a patient’s historical ECG and nonECG waveform data. This report includes a header, waveform data and a footer.
Patient Reports Tab Report Functions FIGURE 8-5 shows an example of the Full Disclosure Report (non-ECG waveform layout). FIGURE 8-5 Full Disclosure Report (non-ECG waveform layout) 8.1.3.1 Header The Full Disclosure Report’s first page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
Report Functions Patient Reports Tab Page headers on subsequent pages of the report provide the report title, the date and time the data was collected, and limited demographic information about the patient (first and last name, identification number and bed number), if it is available. If the demographic data was not previously entered in the system, only the demographic label is shown. 8.1.3.
Patient Reports Tab Report Functions • The first column contains the time (hour and minute) of the disclosure record. The time format follows the system format specified in the Date/Time tab. • The second column contains a heart rate (HR) value. The heart rate value shown is from the last second of data that was collected during the disclosure record. If disclosure data is not available for the time period specified, dashes are shown in the place of a heart rate value.
Report Functions Patient Reports Tab The Print Selection Dialog Box Use the Print Selection dialog box (FIGURE 8-6) to determine a print interval. The report can be generated for 1, 2, 4, 8, 12 and 24 hour intervals. NOTE: If a new patient is selected while a dialog box is open, the dialog box closes. FIGURE 8-6 Print Selection Dialog Box Printing a Full Disclosure Report from the Print Selection Dialog Box 1. Select a time interval button.
Patient Reports Tab Report Functions FIGURE 8-7 shows an example of the ST Report (Page 1).
Report Functions Patient Reports Tab FIGURE 8-8 shows an example of the ST Report (Page 2). FIGURE 8-8 ST Report (Page 2) 8.1.4.1 Header The ST Report’s first page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
Patient Reports Tab Report Functions • One current and one reference template for the lead being monitored in a 3-lead cable connection. • Three current and three reference templates for the leads being monitored in a 5-lead cable connection. • Twelve current and twelve reference templates for all of the leads in a 12-lead cable connection.
Report Functions 8.1.5 Patient Reports Tab Trend List Report The Trend List Report shows a patient’s historical trended digital data for a 1, 2, 4, 8, 12 or 24 hour time period. This report includes a header, trend records and a footer. FIGURE 8-9 shows an example of the Trend List Report (Page 1).
Patient Reports Tab Report Functions FIGURE 8-10 shows an example of the Trend List Report (Page 2).
Report Functions 8.1.5.1 Patient Reports Tab Header The Trend List Report’s first page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
Patient Reports Tab 8.1.5.3 Report Functions Footer The Trend List Report contains a footer at the bottom of every page. The footer includes the following: • The date and time of the print request. The format displayed is taken from the System Date/Time tab. • A centered page number. • The name of the Panorama Central Station where the report was generated. 8.1.5.
Report Functions Patient Reports Tab Printing a Trend List Report from the Print Selection Dialog Box 1. Select a time interval button. NOTE: If the number of hours selected exceeds the amount of data in system, the report shows only the available data. 2. Select the Print or Cancel button. • Select the Print button to generate the report and close the report dialog box. • Select the Cancel button to close the dialog box without generating the print request.
Patient Reports Tab 8.1.6 Report Functions Event List Report The Event List Report shows a patient’s historical physiological, system and technical alarm events for a 1, 2, 4, 8, 12 and 24 hour time period. This report includes a header, event records and a footer. FIGURE 8-12 shows an example of the Event List Report (Page 1).
Report Functions Patient Reports Tab FIGURE 8-13 shows an example of the Event List Report (Page 2). FIGURE 8-13 Event List Report (Page 2) 8.1.6.1 Header The Event List Report’s page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
Patient Reports Tab Report Functions If the demographic data was not previously entered in the system, only the demographic label is shown. 8.1.6.2 Event Record The Event List Report’s event record section includes the digital data that occurred during the specified time period. The data in this report is determined by the events that occurred during the specified time period. Event data records are separated by a solid horizontal line.
Report Functions Patient Reports Tab Print multiple hours of event data by using any of the following methods: • Select the Event List Report button from the Patient Reports tab, select a time interval button (2 Hours, 4 Hours, 8 Hours, 12 Hours, 24 Hours), then select the Print button in the Print Selection dialog box.
Patient Reports Tab 8.1.7 Report Functions Patient Alarm Report The Patient Alarm Report is a single page report containing a patient’s alarm settings information (unit of measure, alarm limits, priority and alarm responses). This report includes a header, patient alarm data and a footer. FIGURE 8-15 shows an example of the Patient Alarm Report. FIGURE 8-15 Patient Alarm Report 8.1.7.
Report Functions Patient Reports Tab • The third column of this report displays the High alarm limit for the parameter specified. • The fourth column of this report displays the Low alarm limit for the parameter specified. • The fifth column of this report displays the alarm priority assigned to the parameter specified. • The sixth column of this report displays the Print on Alarm response assigned to the parameter specified.
Patient Reports Tab Report Functions MESSAGE/ISSUE * REASON SOLUTION Please select a Print Interval This message appears in the Patient Reports tab when the Print button is pressed before a time interval is selected in the Full Disclosure, Event or Trend reports. Select the OK button to close the dialog box. Select a print interval in the available dialog box. The report will not print There are several reasons that would cause a report not to print.
Report Functions 8.2 System Reports Tab System Reports Tab The System Reports tab is used to generate reports on a system level. A patient tile does not have to be selected to generate a system report. The following reports can be printed from the System Reports tab: • All Strips (All Patients) Report • Equipment Report 8.2.1 All Strips (All Patients) Report The All Strips (All Patients) Report contains real-time monitoring data for all the active patients monitored by the Panorama Central Station.
System Reports Tab Report Functions FIGURE 8-16 shows an example of the All Strips (All Patients) Report (Page 1). FIGURE 8-16 All Strips (All Patients) Report (Page 1) FIGURE 8-17 shows an example of the All Strips (All Patients) Report (Page 2).
Report Functions 8.2.1.1 System Reports Tab Header The All Strips (All Patients) Report’s first page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
System Reports Tab Report Functions • An ECG lead label • A wave gain scale bar and a calibration pulse for wave gains less than 30 mm/mV • A calibrated grid • Current ECG monitoring label • A continuous straight line for active ECG leads that are not connected Non-ECG Waveforms The non-ECG waveforms shown in the All Strips (All Patients) Report are based on the nonECG waveforms that are in use and the non-ECG waveforms that are selected to be printed.
Report Functions 8.2.2 System Reports Tab Equipment Report The Equipment Report contains a list of devices currently assigned to the Panorama Central Station. This report displays a maximum of 32 devices per page and includes a header, six columns and a footer. FIGURE 8-18 shows an example of the Equipment Report. FIGURE 8-18 Equipment Report 8.2.2.1 Header The header of the Equipment Report displays a centered report title. 8.2.2.2 Report Columns This Equipment Report contains six columns.
System Reports Tab Report Functions Patient Name column The Patient Name column contains the first name and last name of the patient attached to the device. If a patient is not attached to the device, the report displays six dashes in this column. Dashes also display if the device attached to the patient does not have the patient’s first and last name entered. Patient ID column The Patient ID column contains the identification number of the patient attached to the device.
Report Functions 8.3 Print Status Tab Print Status Tab The Print Status tab contains a list of current print requests. Once the status of a print request changes or the report prints, the list updates automatically without having to refresh the list. FIGURE 8-19 shows an example of the Print Status tab. . FIGURE 8-19 Print Status tab 8.3.1 Print Status Tab Multi-Column List Box Once a new print request is submitted, specific information displays in the Print Status tab.
Print Status Tab Report Functions Status column The Status column displays the current status of the print request.
Report Functions 8.3.3 Print Status Tab Troubleshooting This section lists some of the potential messages and issues that may occur while using the Print Status tab. MESSAGE/ISSUE * REASON SOLUTION Report is not printing Printer not selected in the Panorama Central Station. Refer to the Panorama Printer Configuration document (P/N 0070-00-0561). Printer is not turned on. Turn the printer on. Printer is offline. Verify that the printer is online. Printer is out of paper.
Additional Reports 8.4 Report Functions Additional Reports The Panorama Central Station is capable of generating additional reports from areas other than the Reports menu button. Reports generated by the Panorama Central Station, but cannot be generated from the Reports menu button include the following: • Event Zoom In Report • Full Disclosure Zoom In Report • Trend Graphic Report • 12-lead Report • Telepack Error Log Report • System Alarm Report 8.4.
Report Functions Additional Reports FIGURE 8-21 shows an example of the Event Zoom In Report (Page 2). FIGURE 8-21 Event Zoom In Report (Page 2) 8.4.1.1 Header The Event Zoom In Report’s first page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
Additional Reports Report Functions • A parameter label • A numeric measurement • A unit of measure label • A heart rate (HR) value • Dashes (--) to indicate missing or invalid digital data. • Square brackets [XX] to indicate alarming parameter values 8.4.1.3 NOTE: Digital Data is only shown on the first page of the report. NOTE: ST digital data includes Current (C) and Reference (R) values.
Report Functions Additional Reports • If the IBP waveform was labeled at the bedside monitor, the report contains that IBP label. • If the Anesthetic Agent was identified at the bedside monitor, the report contains that Agent label. 8.4.1.6 Footer The Event Zoom In Report contains a footer at the bottom of every page. The footer includes the following: • The date and time of the print request. The format displayed is taken from the System Date/Time tab. • A centered page number.
Additional Reports Report Functions FIGURE 8-22 Full Disclosure Zoom In Report (Page 1) FIGURE 8-23 shows an example of the Full Disclosure Zoom In Report (Page 2).
Report Functions 8.4.2.1 Additional Reports Header The Full Disclosure Zoom In Report’s first page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
Additional Reports Report Functions ECG Waveforms The ECG waveforms shown in the Full Disclosure Zoom In Report are limited to the ECG lead wire set currently in use and on the waveforms selected in the Print Setup tab.
Report Functions 8.4.4 Additional Reports Trend Graphic Report The Trend Graphic Report displays the trends for the selected patient tile in a graphical format. Graphic Trends are viewed by selecting the Graphic button in the Trends tab. This report includes a header, Digital data, Graphic data and a footer section. FIGURE 8-24 shows an example of the Trend Graphic Report (Page 1).
Additional Reports Report Functions FIGURE 8-25 shows an example of the Trend Graphic Report (Page 2). FIGURE 8-25 Trend Graphic Report (Page 2) 8.4.4.1 Header The Trend Graphic Report’s first page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor.
Report Functions 8.4.4.2 Additional Reports Digital Data The Trend Graphic Report’s digital data section displays measurements for the digital data parameters currently available for the selected patient tile. The displayed parameter order is determined by the system Unit Priorities tab. The digital data section contains the following: • A parameter label • A numeric measurement • A unit of measure label • A heart rate (HR) value • Dashes (--) to indicate missing or invalid digital data.
Additional Reports Report Functions • This report shows a cursor line in the graph for the Cursor Time posted on the report. • The data plotted in the Trend Graphic Report reflects the trend data records that were collected based on the Trend Storage Interval settings in the Panorama Central Station. • The report shows one plotted point for each parameter sensor. • Dual sensor parameters (such as INSP/ET CO2) are plotted individually then connected with a line (for example, inspired and end tidal values).
Report Functions Additional Reports FIGURE 8-26 shows an example of the 12-lead Report. FIGURE 8-26 12-lead Report 8.4.5.1 Header The 12-lead Report’s page header provides the title of the report and basic demographic information, if it is available. The demographic information includes the patient’s first and last name, identification number, bed number, weight, height and doctor. If the demographic data was not previously entered in the system, only the demographic label is shown.
Additional Reports Report Functions • Unconfirmed Report: The 12-lead Report is marked as an Unconfirmed Report when interpretation strings are printed on the report. 8.4.5.2 Waveform Data The 12-lead Report section displays 2.5 seconds of waveform data for each of the 12 leads monitored at the bedside monitor, a 10-second ECG rhythm strip for Lead II, a calibration pulse and a wave gain setting of 1 millivolt. 8.4.5.
Report Functions Additional Reports FIGURE 8-27 shows an example of the Telepack Error Log Report. FIGURE 8-27 Telepack Error Log Report 8.4.6.1 Header The Telepack Error Log Report header provides the title of the report and the connected Device ID for the connected wireless device. 8.4.6.2 Error Log Data The Telepack Error Log Report’s error log data section displays all of the logged error messages for any connected Telepack device. There are five columns in this report.
Additional Reports 8.4.6.3 Report Functions Footer The Telepack Error Log Report contains a footer at the bottom the page. The footer includes the following: • The date and time of the print request. The format displayed is taken from the System Date/Time tab. For more information regarding date/time formats, refer to the “Date/ Time Tab” on page 9-27. • A centered page number. • The name of the Panorama Central Station from which the report was generated. 8.4.6.
Report Functions 8.4.7 Additional Reports System Alarm Report The System Alarm Report shows all of the system default settings for the parameter alarms available in the Panorama Central Station. The report includes header, System Alarm data and a footer section. FIGURE 8-28 shows an example of the System Alarm Report. FIGURE 8-28 System Alarm Report 8.4.7.1 Header The System Alarm Report’s header provides the title of the report and the connected Device ID for the connected wireless device. 8.4.7.
Additional Reports Report Functions The following alarm information is shown in the report: • Parameter: This is the name of the parameter for which the alarm is set. • Units: This is the default unit of measure in which the parameter is shown. If the unit of measure is not applicable to the parameter, dashes (---) display instead of a unit of measure. • High Limit: This is the high limit for the alarm setting. Measurements that exceed this setting will trigger an alarm condition.
Report Functions 8.4.8 Additional Reports Troubleshooting This section lists some of the potential messages and issues that may occur while trying to print an additional report. MESSAGE/ISSUE * REASON SOLUTION The Print sidebar button is disabled. A patient is not currently selected. Select a patient before trying to print a report. The Please select a Print Interval error message is displayed.
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9.0 System Setup Functions This section outlines the system default configuration of the Panorama Central Station.
Care Group Tab 9.1 System Setup Functions Care Group Tab The Panorama Central Station has twelve Care Groups that can be used to categorize the patient tiles in the system. Each care group is associated with a unique color indicator and a unique reference label. Care Groups may be used to indicate a special meaning with regard to a patient tile. For example, Care Groups may be used to represent a care-giver, hospital department or a special monitoring condition for the patient.
System Setup Functions Care Group Tab 2. Select the Edit Labels button. The keyboard dialog box is displayed. 3. Enter the name for the selected care group. (maximum 6 characters). The name is displayed in the white text box. 4. Accept or reject the text entered in the keyboard dialog box. For additional information about using the keyboard dialog box, refer to ‘‘Keyboard Dialog Box’’ on page 2-12. 9.1.
Parameter Color Tab 9.2 System Setup Functions Parameter Color Tab The Parameter Color tab (FIGURE 9-2) selects the system default colors for parameters displayed at the Panorama Central Station. This section includes the following: • Accessing the Parameter Color Tab • Selecting a Color for Parameter Data • Sidebar Button - Normal Screen • Troubleshooting 9.2.1 Accessing the Parameter Color Tab 1. From the menu bar, select the System Setup button.
System Setup Functions 9.2.4 Parameter Color Tab Troubleshooting This section lists some of the potential messages and issues that may occur Parameter Color tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled. The System Setup function is already open on a Panorama display and cannot be opened on multiple displays. Close the System Setup function on the Panorama display on which it is opened. * Messages are shown in all bold text.
Installation Setup Tab 9.3 System Setup Functions Installation Setup Tab The system Installation Setup tab (FIGURE 9-3) controls access to restricted Panorama Central Station functions. The Installation Setup tab is a password protected tab. This section includes the following: • Accessing the Installation Setup Tab • Entering a Password • Sidebar Button - Normal Screen • Troubleshooting 9.3.1 Accessing the Installation Setup Tab 1. From the menu bar, select the System Setup button.
System Setup Functions 9.3.3 Installation Setup Tab Sidebar Button - Normal Screen Select the Normal Screen sidebar button to return the display to the full screen mode, close all tabs, message boxes and dialog boxes. 9.3.4 Troubleshooting This section lists some of the potential messages and issues that may occur while using the Installation Setup tab. MESSAGE/ISSUE * REASON SOLUTION Incorrect password. Please try again The wrong password was entered in the Password text box.
Volume Tab 9.4 System Setup Functions Volume Tab The system Volume tab (FIGURE 9-4) adjusts the volume levels at the Panorama Central Station. Volume levels can be adjusted for Touch Click, System alarms and Physiological alarms. This section includes the following: • Accessing the Volume Tab • Setting Volume Levels • Sidebar Button - Normal Screen • Troubleshooting 9.4.1 Accessing the Volume Tab 1. From the menu bar, select the System Setup button. The first set of System Setup tabs are displayed. 2.
System Setup Functions 9.4.2 Volume Tab Setting Volume Levels Setting a Touch Click Volume Level The Touch Click volume setting determines the volume of the sound associated with each touch of the Panorama display. Characteristics of the Touch Click volume setting include the following: • A volume level range of “0 - 10 Maximum” • A factory default setting of 5 • Can be turned OFF NOTE: Adjustments to the Touch click volume setting will take effect immediately.
Volume Tab System Setup Functions • The time period format for Physiological Alarms will follow the system’s time format • A volume level range of “Minimum - 10 Maximum” • A factory default setting of 10 • Cannot be turned OFF CAUTION: Do not block the speakers. Set the volume levels so that alarms can be heard at all times, as described in this Operation Manual. 1. Select the colored tile that corresponds to the time period for which the volume level is being adjusted.
System Setup Functions 9.5 System Alarms Tab System Alarms Tab The System Alarms tab (FIGURE 9-5) sets the system defaults for the alarm options, alarm limits and alarm response functions. This section includes the following: • System Alarms (Options) Tab • Setting the System Alarms Options • Sidebar Buttons • Troubleshooting 9.5.1 System Alarms (Options) Tab The System Alarms (Options) tab controls the system default settings for system alarms. 9.5.1.1 Accessing the System Alarm (Options) tab 1.
System Alarms Tab System Setup Functions NOTE: Changes to the Latch Alarms option will only affect new alarm violations. 2. Select the Show HR Limits in Tile toggle button to either enable or disable the display of heart rate alarm limits in the Bedside tab. Show HR Limits in Tile options include ON and OFF. The factory default setting is ON. The Heart Rate alarm limits define the range in which heart rate values are measured.
System Setup Functions System Alarms Tab 7. Select the Bedside Alarm Tracking toggle button to either enable or disable the ability to track alarms at the bedside monitor. Bedside Alarm Tracking options include ON and OFF. The factory default setting is ON. Bedside Alarm tracking will automatically track alarm limit settings from the bedside monitor to the Panorama Central Station and from the Panorama Central Station to the bedside monitor when it is enabled.
System Alarms Tab System Setup Functions Normal Screen Select the Normal Screen sidebar button to return the display to the full screen mode, close all tabs, message boxes and dialog boxes. 9.5.1.4 Troubleshooting This section lists some of the potential messages and issues that may occur while using the System Alarm Options tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled.
System Setup Functions System Alarms Tab NOTE: Changes to the system Alarm Limit settings will only apply to newly admitted patients when the Bedside Alarm Tracking option is set to OFF. 2. Use the scroll bars in the System Alarms (Alarm Limits) tab to select the slider control for the alarm limit to be set or modified. Each page can show a maximum of six and a minimum of one slider controls on each screen.
System Alarms Tab System Setup Functions Normal Screen Select the Normal Screen sidebar button to return the display to the full screen mode, close all tabs, message boxes and dialog boxes. 9.5.2.4 Troubleshooting This section lists some of the potential messages and issues that may occur while using the System Alarm Limits tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled.
System Setup Functions System Alarms Tab 2. Select the alarm Priority button to select the alarm priority for the selected alarm. The Alarm Priority setting determines the audio sound that the Panorama Central Station will make when the alarm condition occurs. Alarm Priority is based on the severity of the alarm condition. Every alarm condition will have predetermined alarm priority choices. The Alarm Priorities available include Off, 1, 2 and 3.
System Alarms Tab 9.5.3.3 System Setup Functions Troubleshooting This section lists some of the potential messages and issues that may occur while using the System Alarm Responses tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled. The System Setup function is already open on a Panorama display and cannot be opened on multiple displays. Close the System Setup function on the Panorama display on which it is opened. * Messages are shown in all bold text.
System Setup Functions 9.6 Passwords Tab Passwords Tab The system Passwords tab (FIGURE 9-8) establishes and modifies the passwords used to access the System Setup and Patient Alarm Setup areas of the Panorama Central Station. This section includes the following: • Accessing the Installation Setup Tab • Modifying an Alarm Password • Sidebar Button - Normal Screen • Troubleshooting 9.6.1 Accessing the Installation Setup Tab 1. From the menu bar, select the System Setup button.
Passwords Tab System Setup Functions NOTE: Passwords are case sensitive. 5. Select the New Password text box. The keyboard dialog box displays. 6. Using the keyboard dialog box, enter the new alarm password. The Alarm password is case sensitive and has a maximum 15 characters. 7. Accept the text entered in the keyboard dialog box. For additional information about using the keyboard dialog box, refer to ‘‘Keyboard Dialog Box’’ on page 2-12. 8. Select the Confirm text box.
System Setup Functions 9.7 Equipment Setup Tab Equipment Setup Tab The Equipment Setup tab (FIGURE 9-9) adds, deletes and modifies the equipment used with the Panorama Central Station. The Equipment Setup tab includes an equipment list that shows the types of equipment that may communicate with the Panorama Central Station.
Equipment Setup Tab System Setup Functions • The first column of the equipment list box displays the device Label for the equipment listed. • The second column of the equipment list box displays the Type of device listed. • The third column of the equipment list box displays the Tile number associated with the equipment. • The fourth column of the equipment list box displays the Device ID number for the equipment listed.
System Setup Functions Equipment Setup Tab Select the Done button to accept the selection or the Cancel button to discard the selection. The device type is displayed in the Type field. 4. Select the Label text box to enter a label for the new equipment. 5. Use the keyboard dialog box to enter the device label for the new equipment. A device label must be entered in the equipment list and can only use alphanumeric characters and underscores ( _ ). There is a maximum of 14 characters. 6.
Equipment Setup Tab System Setup Functions 2. Select the Delete button under the equipment list box. NOTE: Only equipment not actively monitoring a patient can be deleted. 3. The Are you sure you want to delete this device message dialog box is displayed. • Select the Yes button to delete the selected device and close the dialog box. • Select the No button to keep the selected device and close the dialog box. 9.7.
System Setup Functions Equipment Setup Tab MESSAGE/ISSUE * REASON SOLUTION Illegal Device Label. Device Label must be defined. Please try again. This message appears when the Done button is pressed in the Equipment Setup tab before a device label is selected. Select the OK button to close the dialog box. Select a device label in the Device Label dialog box. Device Label already exists! Please enter a new one This message appears when a duplicate device label is entered in the Device Label field.
Equipment Setup Tab System Setup Functions MESSAGE/ISSUE * REASON SOLUTION Cannot delete a device connected to a patient The device that you are trying to delete is currently connected to a patient. Select the OK button to close the dialog box. Disconnect the patient from the selected device before it can be deleted. The Tile button, Type button and Device ID field are disabled. The equipment that was selected to be edited is currently monitoring a patient.
System Setup Functions 9.8 Date/Time Tab Date/Time Tab The Date/Time tab (FIGURE 9-10) configures the default date and time formats used throughout the Panorama Central Station, and is used to set the system time and date. This section includes the following: • Accessing the Date/Time Tab • Set Date/Time • Sidebar Button - Normal Screen • Troubleshooting 9.8.1 Accessing the Date/Time Tab 1. From the menu bar, select the System Setup button. The first set of System Setup tabs is displayed. 2.
Date/Time Tab System Setup Functions 3. Select the Month field in the Date/Time tab.The keyboard dialog box is displayed. The range available is 1 to 12. 4. Using the keyboard dialog box, enter the number that represents the current month. • Select the Enter button on the keyboard dialog box to accept the day that was entered. The number is entered in the Month field. • Select the backspace button (<==) to clear a character that was entered in the dialog box.
System Setup Functions Date/Time Tab • Select the Close button to discard the entry in the dialog box and return to the Date/ Time tab. The Min. field will remain unchanged until the Done button is pressed. 5. Select the AM/PM toggle button to select either AM or PM. NOTE: The AM/PM button is only available if the current time format is in 12 hour mode. 6. Select the Time button to select the desired time format.
More Tab 9.9 System Setup Functions More Tab The More tab displays additional System Setup tabs. This section includes the following: • Accessing Additional (More) Tabs • Tabs Accessed Via the More Tab 9.9.1 Accessing Additional (More) Tabs 1. From the menu bar, select the System Setup button. The first set of System Setup tabs is displayed. 2. Select the Installation Setup tab.The Installation Setup tab is displayed. 3. Enter the correct System password.The next set of System Setup tabs is displayed.
System Setup Functions 9.10 Previous Tab Previous Tab The Previous tab displays additional System Setup tabs. This section includes the following: • Accessing Previous Tabs • Tabs Accessed Via the Previous Tab 9.10.1 Accessing Previous Tabs 1. From the menu bar, select the System Setup button. The first set of System Setup tabs is displayed. 2. Select the Installation Setup tab. The Installation Setup tab is displayed. 3. Enter the correct System password.The next set of System Setup tabs is displayed.
Print Setup Tab (System) 9.11 System Setup Functions Print Setup Tab (System) The Print Setup tab (FIGURE 9-13) defines the printers to be used by the Panorama Central Station. The system is capable of communicating with two network printers simultaneously. The Print Setup tab selects the default waveforms printed in the All Strip, Event Zoom-In and Full Disclosure Zoom-In reports. NOTE: The network printer(s) must be properly configured to communicate with the Panorama Central Station.
System Setup Functions Print Setup Tab (System) • A check mark in a printer’s check box button indicates that if the printer has been properly configured with the Panorama Central Station it will be capable of printing Panorama reports. • An empty check box button indicates the printer is not selected and will not print reports. 2. Select the printer’s check box button to enable/disable the printing of strips. The print setup settings are changed instantly.
Print Setup Tab (System) 9.11.4 System Setup Functions Sidebar Button - Normal Screen Select the Normal Screen sidebar button to return the display to the full screen mode, close all tabs, message boxes and dialog boxes. 9.11.5 Troubleshooting This section lists some of the potential messages and issues that may occur while using the System Print Setup tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled.
System Setup Functions 9.12 Recalibrate Touch Screen Tab Recalibrate Touch Screen Tab The Recalibrate Touch Screen tab recalibrates the Panorama Central Station touch screen. This section includes the following: • Accessing the Recalibrate Touch Screen Tab • Recalibrating the Touch Screen • Sidebar Button - Normal Screen • Troubleshooting 9.12.1 Accessing the Recalibrate Touch Screen Tab 1. From the menu bar, select the System Setup button. The first set of System Setup tabs is displayed. 2.
Recalibrate Touch Screen Tab 9.12.2 System Setup Functions Recalibrating the Touch Screen 1. Select the Recalibrate Touch Screen tab. The process for recalibration of the touch screen is initiated. 2. Touch the red targets on the screen as instructed.Three calibration targets are displayed. 3. The Touch different areas on the screen. Does the cursor jump to your fingertip. Select the ESC key to cancel now message displays.
System Setup Functions 9.13 Unit Priorities Tab Unit Priorities Tab The Unit Priorities tab (FIGURE 9-16) selects the default order for parameters in the Panorama Central Station. The settings in the Unit Priorities tab will determine the initial order in which parameters in the Main Screen, Bedside tab, Trends tab and Event (List) tab areas are shown.
Unit Priorities Tab System Setup Functions 3. Select the Select button. The selected parameter is assigned its new unit priority position and will be shown in the box on the right of the selected unit priority. 4. Select the Done button. All priority changes in the Unit Priorities tab have now been confirmed. The changes that were made will only be applied to newly admitted patients and will not affect patients currently being monitored. 9.13.
System Setup Functions 9.14 Unit Choices Tab Unit Choices Tab The Unit Choices tab (FIGURE 9-17) configures pacemaker settings, the order of demographic data and to select units of measure for the Panorama Central Station. This section includes the following: • Accessing the Unit Choices Tab • Setting the Unit Choices • Sidebar Buttons • Troubleshooting 9.14.1 Accessing the Unit Choices Tab 1. From the menu bar, select the System Setup button. The first set of System Setup tabs is displayed. 2.
Unit Choices Tab System Setup Functions NOTE: Changing the Pacer Enhancement option will affect all newly admitted patients and will have no affect on patients currently being monitored. 2. Select the Pacer Reject button to select the system default pacer reject period. Pacer Reject adjusts the time period at which pacemaker-induced ECG complexes are filtered for ECG sampling processes. Pacer Reject options include 0 to 80 milliseconds (ms) in five-second increments.
System Setup Functions Unit Choices Tab 7. Select the Demographic Line Position 4 button to select the system default demographic data to be shown in the fourth demographic line position of the Patient Status line in the main screen of the Panorama Central Station. Demographic Line Position 4 options include ID, Demo Off, Last Name, First Name and Bed. The factory default setting is ID.
Unit Choices Tab System Setup Functions NOTE: Changing the Arrhythmia option will affect all newly admitted patients and will have no affect on patients currently being monitored. Settings (Telepack) Select the Settings sidebar button to establish the default ECG monitoring filter to be performed for the Telepack and to select the ECG leads for ST monitoring is specific to a Telepack device. • The Monitor mode for ECG filtering establishes the frequency response range for non-ST ECG monitoring.
System Setup Functions Unit Choices Tab • A checkmark in the ST Filter box indicates that the ST filter is enabled. • An empty ST Filter box indicates that the ST filter is disabled. 5. Accept or reject the selections made in the dialog box. • Select the Done button to accept the selections. • Select the Cancel button to discard the selections, close the dialog box and return to the Unit Choices tab.
Wave Gain Tab (System) 9.15 System Setup Functions Wave Gain Tab (System) The Wave Gain tab (FIGURE 9-19) sets the system default wave gain settings for the Panorama Central Station. For information on the setting of patient wave gains, refer to the ‘‘Wave Gain Tab (Patient)’’ on page 5-37. NOTE: The changes made in the Wave Gain tab (System) will apply to newly admitted patients.
System Setup Functions Wave Gain Tab (System) 2. Select the IBPX mmHg buttons until the desired IBPx wave gains is displayed. There are four IBP buttons. The settings available for the IBP wave gains include 0 - 20, 0 - 40, 0 - 80, 60 - 140, 0 160, 0 - 320 and (-10) - 10 mmHg. The factory default setting is 0 - 320 mmHg. NOTE: If the IBP has been labeled at the bedside monitor it will have the same label on its wave gain button. 3.
Wireless Tab 9.16 System Setup Functions Wireless Tab The Wireless tab manages the devices on the Panorama wireless network. It can be used to retrieve information from a wireless device as well as to program it. The Wireless tab should only be used when a wireless monitoring device is assigned to the selected patient tile. NOTE: The layout and functionality of the Wireless tab changes, based on the type of monitoring equipment assigned to the selected patient tile.
System Setup Functions Wireless Tab Device ID The Device ID field displays the identification number that was assigned to the connected wireless device. A Device ID has a maximum of 8 alphanumeric characters. Data is shown in the Device ID field when the Wireless tab’s Read sidebar button is selected. If the read was not successful the Device ID field will remain blank. To view the connection status of the wireless device check the message in the Connect field.
Wireless Tab System Setup Functions • Data is shown in the Telepack IP Address field when the Wireless tab’s Read sidebar button is pressed and has a factory default setting of blank. If the read was not successful the Telepack IP Address field will remain blank. To view the connection status for the wireless device check the message in the Connect field. • A Telepack IP Address can be programmed in a connected device by selecting the Program sidebar button.
System Setup Functions Wireless Tab Protocol Selection The Protocol Selection button displays the protocol selection for the assigned device. It sets the protocol of the attached device. Protocol selection options include Visa™ and OpenNet. • Data is shown in the Protocol Selection field when the Wireless tab’s Read sidebar button is pressed and has a factory default setting of blank. If the read was not successful the Protocol Selection field will remain blank.
Wireless Tab System Setup Functions Selecting the Program sidebar button will display the Are you sure you want to program the wireless device? message. • Select the Yes button to program the wireless device. The Wireless device programmed successfully. message displays. • Select the No button to cancel the programming of the connected device. NOTE: 9.16.4 The Program sidebar button will be disabled until a valid device has been detected by the Panorama Central Station.
System Setup Functions 9.16.6 Wireless Tab Connect Field The Connect field displays the status of the connection between the Panorama Central Station and the wireless device. A connection status is shown in the Connect field when the Wireless tab’s Read sidebar button is selected. The status in the Connect field cannot be edited and has a factory default setting of blank. The messages shown in the Connect field include: MESSAGE REASON “Connected to 2.4 Telemetry” The connection with the Telepack 2.
Wireless Tab System Setup Functions • A successful read from a known device will display the fields and sidebar buttons appropriate to the attached device. • An unsuccessful read will only display a connect status in the Connect field. Telepack Sidebar Button The Error Log contains a Telepack sidebar button. Select the Telepack button to return the tab to the Wireless tab display. Clear Sidebar Button The Error Log contains a Clear sidebar button.
System Setup Functions 9.16.6.2 Wireless Tab Free Connected Channel Sidebar Button Select the Free Connected Channel sidebar button to free a channel from a connected device that supports channels. 9.16.6.3 NOTE: The Free Connected Channel sidebar button will be disabled until a valid device has been detected by the Panorama Central Station. NOTE: The Free Connected Channel sidebar button is reserved for future use with WMTS wireless devices.
Wireless Tab System Setup Functions MESSAGE/ISSUE * REASON SOLUTION Program Failure: Unable to obtain a channel. The system tried to obtain a channel from the Panorama Central Station but was unsuccessful. Select the OK button to close the error message dialog box. Free up any unused channels. Try again to obtain a channel from the system. The system administrator can also purchase additional channels. Network Error: Unable to obtain device list.
10.
Introduction 10.1 Telepack (Optional) Introduction The Panorama Telepack (2.4 and 608) is a battery powered ambulatory device that acquires ECG information from an adult patient and transmits it to the Panorama Telemetry Server for analysis. The Panorama Telemetry Server is capable of performing data analysis functions such as Heart Rate determination, R-wave detection, and ECG filtering. CAUTION: The Telepack is a wireless product and may be subject to intermittent signal dropout.
Telepack (Optional) 10.2 Button Indicators Button Indicators The following buttons are found on the Telepack device: TELEPACK-2.4 • One Nurse Call button • Two Attendant Present • One Test buttons button • One Record button TELEPACK-608 • One Nurse Call button • Two Attendant Present • One LEAD SELECT • One CHECK CHECK button (functionality not available at this time) LEAD SELECT button • One RECORD 10.2.
Button Indicators 10.2.3 Telepack (Optional) LEAD SELECT Button (Telepack-608 only) Currently, the functionality for the ECG LEAD SELECT is unavailable. When functioning, pressing the ECG LEAD SELECT button will cause the following to occur: • The active Lead for a 3-Lead ECG Lead select will change • The ECG LED that is active will turn on for 2 seconds 10.2.
Telepack (Optional) 10.3 Indicator Lights Indicator Lights The Telepack uses LED indicator lights to verify the functionality of the device. The indicator lights on the device include the following: • 3-wire (for Telepack-608 only) and 5-wire ECG lead indicator lights • 1 Link Status indicator light • 1 Battery Status indicator light 10.3.1 ECG Lead Diagram LED Indicator Lights The Telepack ECG Lead diagram’s LED indicator lights show the status of the lead connections with the patient.
Indicator Lights Telepack (Optional) RA LA L V C LL F RL N FIGURE 10-3 Front View of Telepack-608 (AHA) FIGURE 10-4 Front View of Telepack-608 (IEC) • White RA (right arm) • Red R (right arm) • Black LA (left arm) • Yellow L (left arm) • Brown V (chest) • White C (chest) • Green RL (right leg) • Black N (right leg) • Red LL (left leg) • Green F (left leg) The ECG Lead LED indicator lights remain off except during the initial power up phase and during a lead test sequence.
Telepack (Optional) Indicator Lights This test determines if the patches are connected based on thoracic impedance. If a patch adhesive is not sticking, a patch is dry, or the skin gel is dry, the test fails. The Telepack’s ECG Lead LED indicator lights remains on for approximately 10 seconds during the test sequence, indicating that the Telepack has good lead connectivity. An unlit ECG Lead LED light indicates that the Telepack has no lead connectivity. NOTE: 10.3.
Indicator Lights Telepack (Optional) NOTE: 10 - 8 The batteries used may be subject to local regulations regarding disposal. At the end of the battery life, never dispose of the batteries in a fire but dispose of the batteries in accordance with any local regulations.
Telepack (Optional) 10.4 Operating Instructions Operating Instructions This section of the manual provides instructions for programming the Telepack device for use with the Panorama Central Station. 10.4.1 Initial Setup of Telepack The Panorama Central Station should be installed and running before you begin to set up the Telepack device. For additional information, refer to the Panorama Service Manual (P/N 0070-00-0457).
Operating Instructions Telepack (Optional) CAUTION: Visually inspect the battery compartment for any foreign object prior to use. CAUTION: The Telepack may not function if the batteries installed in the device are corroded. The Telepack will not transmit data to the Panorama Central Station once the batteries have become depleted. To test the batteries, press the Lead/Link/Battery Test/CHECK button and confirm that both the Link LED and the Battery LED is lit.
Telepack (Optional) Approved Accessories The Device ID is found on the back of the Telepack device. After assigning the device to the Panorama Central Station, the Telepack is ready for patient use. 10.4.1.4 Telepack Power Up Sequence The Telepack goes through a power up sequence each time the batteries are inserted in the device. The power up sequence includes an ECG Lead connection status test, a link status test and a battery status test.
Troubleshooting 10.6 Telepack (Optional) Troubleshooting This section lists some of the potential messages and issues that may occur while using a Telepack device. MESSAGE/ISSUE * REASON SOLUTION Telepack/LED’s not turning on Batteries are not installed correctly, batteries are depleted, or batteries corroded. Visually inspect the battery compartment for any foreign object. Replace the batteries. Telepack not transmitting data to the Panorama Central Station.
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Troubleshooting 10 - 14 Telepack (Optional) 0070-00-0575-50 Panorama™ Operating Instructions
11.0 User Maintenance This section of the manual outlines proper maintenance of the Panorama Central Station touch screen and Telepack device.
Touch Screen User Maintenance 11.1 User Maintenance Touch Screen User Maintenance The Panorama display uses a touch screen overlay for more simple navigation of the system. (A mouse can also be used for point-and-click navigation of the system.) There is one button for turning the Touch Screen on or off. • When the Touch Screen On button displays, the Touch Screen is active. • When the Touch Screen Off button displays, the Touch Screen is deactivated. 11.1.
User Maintenance 11.2 Telepack User Maintenance Telepack User Maintenance The following sections provide information about storing and cleaning the Telepack device. 11.2.1 Storing the Telepack When not in use, carefully store the Telepack by wrapping the lead set loosely around the casing of the Telepack device, or with the lead set attached and hanging freely. Do not wrap the lead set tightly around the casing of the Telepack as it may damage the wires.
Telepack User Maintenance User Maintenance The cleaning solutions that can be used are: • Soap and water • Glutaraldehyde 2% (for example, Cidex) • Dilute chlorine bleach (sodium hypochlorite), 10% solution, freshly prepared in past 24 hours • Isopropyl alcohol 70% • Ethyl alcohol Guidelines for Cleaning the Telepack • Remove the batteries, and reattach the end cap of the battery compartment firmly.
User Maintenance Telepack User Maintenance • Use the cleaning solution to wipe and rinse the lead set. • The cleaning solution should be wiped away with a cloth moistened with distilled water. • A lint free cloth should be used to dry the lead set thoroughly. CAUTION: Use of accessories and cables other than those approved by Datascope may result in increased Emissions or decreased Immunity of the Telepack.
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12.0 Troubleshooting This section outlines the messages and issues that may occur while using the Panorama Central Station, provides reasons why the issue may have occurred and then offers solutions to resolve the issue. Each section of this manual contains a troubleshooting section but for ease-of-use, all of the same troubleshooting issues have been compiled and listed alphabetically, by tab or task, in this section of the manual.
Messages and Issues 12.1 Troubleshooting Messages and Issues Error messages generally occur when the user has done something incorrectly/improperly while using the Panorama Central Station (for example, a patient tile is not selected). Issues generally occur when there is a system hardware issue that needs to be addressed. 12.1.1 Additional Reports This section lists some of the potential messages and issues that may occur while trying to print an additional report.
Troubleshooting Messages and Issues MESSAGE/ISSUE * * 12.1.3 REASON SOLUTION Network setting on monitoring device is incorrect. Access the Installation Menu, System Information submenu. For more information, refer to Passport 2/Spectrum Operations Instructions. Telepack batteries may need to be replaced. Test batteries, and if necessary, replace batteries. Telepack batteries improperly installed. Reinstall batteries. Messages are shown in all bold text.
Messages and Issues 12.1.4 Troubleshooting Alarm Responses Tab (Patient) This section lists some of the potential messages and issues that may occur while using the Patient Alarm Responses tab. MESSAGE/ISSUE * REASON SOLUTION No patient Selected! This message appears in the demographic field when either no patient tile or an empty patient tile has been selected. Select the OK button to close the dialog box. Select an active patient tile.
Troubleshooting 12.1.6 Messages and Issues Care Group Tab (System) This section lists some of the potential messages and issues that may occur while using the System Care Group tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled. The System Setup function is already open on a Panorama display and cannot be opened on multiple displays. Close the System Setup function on the Panorama display on which it is opened. * 12.1.7 Messages are shown in all bold text.
Messages and Issues Troubleshooting MESSAGE/ISSUE * REASON SOLUTION You have reached the maximum number of ST licenses available There are no more ST licenses available Select the OK button to close the dialog box. ST Analysis cannot be selected until it is discontinued on another patient. The System Administrator can purchase additional ST licenses. Retrieve Discharged Patient Failed: The destination tile is currently occupied A patient cannot be retrieved into an occupied tile.
Troubleshooting Messages and Issues MESSAGE/ISSUE * REASON SOLUTION A section of the waveform is blank. The system time was altered during the storage of the row of data. Wait for new data to accumulate. The device was placed into Standby mode during the storage of the row of data. Restore the system to normal operating mode to resume data collection. The device experienced a Communication Lost event during the storage of the row of data.
Messages and Issues Troubleshooting MESSAGE/ISSUE * REASON SOLUTION Time out of range (Done button in the Skip To dialog box) A time and date that is older than the oldest data or newer than the most recent data was entered in the Skip To dialog box. Select the OK button to close the message box. Select the Skip To sidebar button and enter a time and date that is within the time frame of the database. The Print More sidebar button is disabled. More than 1 hour of data is not available.
Troubleshooting Messages and Issues MESSAGE/ISSUE * REASON SOLUTION Invalid Device Type This message appears when the Done button is pressed in the Equipment Setup tab before a device type is selected. Select the OK button to close the dialog box. Select a device type in the Device Type dialog box. Illegal Device Label. Device Label must be defined. Please try again. This message appears when the Done button is pressed in the Equipment Setup tab before a device label is selected.
Messages and Issues Troubleshooting MESSAGE/ISSUE * REASON SOLUTION System Setup menu button is disabled. The System Setup function is already open on a Panorama display and cannot be opened on multiple displays. Close the System Setup function on the Panorama display on which it is opened. Cannot delete a device connected to a patient The device that you are trying to delete is currently connected to a patient. Select the OK button to close the dialog box.
Troubleshooting Messages and Issues This section lists some of the potential messages and issues that may occur while using the Waveform view of the Events tab. MESSAGE/ISSUE * REASON SOLUTION Sidebar buttons disabled when Events tab selected. Patient tile not selected. Select a patient tile. There is no patient admitted to the selected tile. Admit a patient to the tile. No patient in the tile There is no patient admitted to the selected tile. Admit a patient to the tile.
Messages and Issues Troubleshooting MESSAGE/ISSUE * REASON SOLUTION Low Amplitude ECG Signal Gain set too low. Readjust the ECG wave gain as required. Refer to the ‘‘Wave Gain Tab (System)’’ on page 9-44 for instructions on adjusting the wave gain setting. No ECG Waveform Base Line Wander Artifact Electrodes dry/old Apply fresh, moist electrodes. Skin improperly prepared Abrade skin. Possibly not patient's normal complex. Check with 12-lead electrocardiogram.
Troubleshooting 12.1.16 Messages and Issues Passwords Tab This section lists some of the potential messages and issues that may occur while using the Passwords tab. MESSAGE/ISSUE * REASON SOLUTION Incorrect password. Please try again The wrong password was entered in the text box. Select the OK button to close the dialog box. Enter the correct password in the dialog box. The System Setup menu button is disabled.
Messages and Issues Troubleshooting MESSAGE/ISSUE * REASON SOLUTION Please select a Print Interval This message appears in the Patient Reports tab when the Print button is pressed before a time interval is selected in the Full Disclosure, Event or Trend reports. Select the OK button to close the dialog box. Select a print interval in the available dialog box. The report will not print There are several reasons that would cause a report not to print.
Troubleshooting 12.1.21 Messages and Issues Print Status Tab This section lists some of the potential messages and issues that may occur while using the Print Status tab. MESSAGE/ISSUE * REASON SOLUTION Report is not printing Printer not selected in the Panorama Central Station. Refer to the Panorama Printer Configuration document (P/N 0070-00-0561). Printer is not turned on. Turn the printer on. Printer is offline. Verify that the printer is online. Printer is out of paper.
Messages and Issues 12.1.23 Troubleshooting Standby Tab This section lists some of the potential messages and issues that may occur while using the Standby tab. MESSAGE/ISSUE * REASON SOLUTION No patient Selected! This message appears in the demographic field when either a patient tile has not been selected or an empty tile was selected. Select an active patient tile.
Troubleshooting 12.1.26 Messages and Issues System Alarm (Alarm Responses) Tab This section lists some of the potential messages and issues that may occur while using the System Alarm Responses tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled. The System Setup function is already open on a Panorama display and cannot be opened on multiple displays. Close the System Setup function on the Panorama display on which it is opened. * Messages are shown in all bold text. 12.
Messages and Issues 12.1.28 Troubleshooting System Setup Tab This section lists some of the potential messages and issues that may occur while using the System Setup tab. MESSAGE/ISSUE * REASON SOLUTION Incorrect password. Please try again The wrong password was entered in the Password text box. Select the OK button to close the dialog box. Enter the correct password in the text box. Incorrect password. This is your last chance. Please try again.
Troubleshooting Messages and Issues MESSAGE/ISSUE * REASON SOLUTION Flashing Link Status LED indicator light Telepack is not communicating with the Panorama Central Station Verify that Device ID is registered on the Panorama Central Station. Verify that Panorama Central Station is functioning. * 12.1.30 Messages are shown in all bold text. Transfer Tab This section lists some of the potential messages and issues that may occur while using the Transfer tab.
Messages and Issues Troubleshooting Room To Room Transfer (Continued) MESSAGE/ISSUE * REASON SOLUTION At the destination tile, the digital data is displayed but the waveform is not displayed The destination tile was in Standby mode when the transfer completed. Return to normal monitoring mode. The destination tile is blank and all buttons on the Transfer tab are unavailable. The destination tile was in a Communication Lost state when the transfer completed. Re-establish communication.
Troubleshooting Messages and Issues Central To Central Transfer (Continued) MESSAGE/ISSUE * REASON SOLUTION Transfer In Request from [the Source Panorama name] cancelled due to user timeout. At the Destination Panorama, either the Accept or Reject button on the Transferred In Patient view of the Transfer tab was not selected within 10 minutes of initiating the Central To Central Transfer Without Device.
Messages and Issues Troubleshooting Recovering Failed Transfer Patient Data MESSAGE/ISSUE * REASON SOLUTION The Recover Failed Transfer sidebar button is disabled. The Failed Transfer List is empty. N/A Selecting the Recover button has no effect. A patient has not been selected from the Failed Transfer List. Select the patient whose information is to be recovered from the list and then select the Recover button.
Troubleshooting 12.1.31 Messages and Issues Trends Tab This section lists some of the potential messages and issues that may occur while using the List View of the Trends tab. MESSAGE/ISSUE * REASON SOLUTION There is no data in the List view of the Trends tab. A patient has not been admitted to the selected tile. Admit a patient to the selected tile or choose a tile that already has an admitted patient.
Messages and Issues Troubleshooting MESSAGE/ISSUE * REASON SOLUTION No more events found (Next Event Button) There is no event data in the Trend database. Wait until an event is recorded to the Trend database. None of the rows that are above the currently highlighted row contain a parameter with an event condition. Select the OK button to close the message box and return to the List view of the Trends tab. The first row in the list is already highlighted.
Troubleshooting Messages and Issues MESSAGE/ISSUE * REASON SOLUTION No more data found (Page Right Button) There is no data in the Trend database because the Trends tab was selected before the first interval was reached or before the first NIBP measurement occurred. Wait until the first interval is reached or until the first NIBP measurement occurs. The most recent recorded data has been reached. No further data exists after this time.
Messages and Issues 12.1.34 Troubleshooting Volume Tab This section lists some of the potential messages and issues that may occur while using the Volume tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled. The System Setup function is already open on a Panorama display and cannot be opened on multiple displays. Close the System Setup function on the Panorama display on which it is opened. * 12.1.35 Messages are shown in all bold text.
Troubleshooting 12.1.37 Messages and Issues Wireless Tab This section lists some of the potential messages and issues that may occur while using the Wireless tab. MESSAGE/ISSUE * REASON SOLUTION The System Setup menu button is disabled. The System Setup function is already open on a Panorama display and cannot be opened on multiple displays. Close the System Setup function on the Panorama display on which it is opened.
Messages and Issues Troubleshooting MESSAGE/ISSUE * REASON SOLUTION Free Error: Device not found The device channel was not successfully freed. Select the OK button to close the error message dialog box. Try to free a different channel from the system. The system administrator can also purchase additional channels. Program Failure: The channel was successfully freed but an error was encountered when programming the device.
Troubleshooting General Troubleshooting Issues 12.2 General Troubleshooting Issues 12.2.1 Monitor Issues This section lists some of the potential issues that may occur with the monitor. MESSAGE/ISSUES * REASON SOLUTION No trace for a desired parameter Improper attachment of transducer to monitor. Check transducer connection. Faulty transducer. Try a different transducer. Wandering ECG Respiration artifact. Try a different base line lead configuration.
General Troubleshooting Issues Troubleshooting MESSAGE/ISSUES * REASON SOLUTION Display Appears to be Off Mains power switch may not be on. Check main power switch on side panel. Unit may not be plugged into an AC outlet. Check power cord (Is it plugged in?). If used as a portable, battery pack may be drained. If battery pack is drained, plug into an AC outlet to recharge the battery. A period of 16 hours is required for a full charge. MUTE button pressed.
Troubleshooting General Troubleshooting Issues MESSAGE/ISSUES * REASON SOLUTION “CHK Lead” Message Due to increased impedance. Chest hair under electrodes. Prep chest. Dried electrode gel. Change electrodes. Replace electrode. Lead off. Replace lead. Cracked lead wires. Replace lead wires. Poor skin prep. Clean and abrade skin before applying electrodes. “CVA” Message Can be caused by shallow breathing or an apnea event. Check the patient Adjust scales or leads if necessary. No Resp.
General Troubleshooting Issues 12 - 32 Troubleshooting 0070-00-0575-50 Panorama™ Operating Instructions
13.0 Parameter Specifications This section is for reference only. The Parameter Specifications section lists the allowable range specifications for all of the parameters measured by the Panorama Central Station and the invalidation of parameter data.
Parameter Specifications 13.1 Parameter Specifications Parameter Specifications The parameters displayed on the Panorama Central Station are dependent on the type of equipment connected to the Panorama system. 13.1.1 Heart Rate: HR The Heart Rate parameter obtains data from ECG, SPO2, IBP or NIBP sources.
Parameter Specifications Parameter Specifications Heart Rate Source: SPO2 (Masimo SET®) PATIENT SIZE MINIMUM VALUE (bpm) MAXIMUM VALUE (bpm) Neonate 30 235 Pediatric 30 235 Adult 30 235 Heart Rate Source: SPO2 (Nellcor®) PATIENT SIZE MINIMUM VALUE (bpm) MAXIMUM VALUE (bpm) Neonate 20 249 Pediatric 20 249 Adult 20 249 MINIMUM VALUE (bpm) MAXIMUM VALUE (bpm) Heart Rate Source: IBP PATIENT SIZE Neonate 30 350 Pediatric 30 300 Adult 30 300 Heart Rate Source: NIBP PATIENT SIZ
Parameter Specifications Parameter Specifications Respiration Source: ECG Thoracic Impedance PATIENT SIZE MINIMUM VALUE (rpm) MAXIMUM VALUE (rpm) Neonate 4 199 Pediatric 4 199 Adult 4 199 Respiration Source: CO2 PATIENT SIZE MINIMUM VALUE (rpm) MAXIMUM VALUE (rpm) Neonate 0 150 Pediatric 0 150 Adult 0 150 Respiration Source: Gas Module PATIENT SIZE MINIMUM VALUE (rpm) MAXIMUM VALUE (rpm) Neonate 4 60 Pediatric 4 60 Adult 4 60 The Panorama Central Station supports respir
Parameter Specifications Parameter Specifications NIBP (Sys) PATIENT SIZE MINIMUM VALUE (mmHg) MAXIMUM VALUE (mmHg) Neonate 45 120 Pediatric 55 160 Adult 55 235 PATIENT SIZE MINIMUM VALUE (mmHg) MAXIMUM VALUE (mmHg) Neonate 20 100 Pediatric 30 150 Adult 30 200 NIBP (Dia) NIBP Mean PATIENT SIZE MINIMUM VALUE MAXIMUM VALUE Neonate mmHg greater than the NIBP (Dia) value mmHg less than the NIBP (Sys) value Pediatric mmHg greater than the NIBP (Dia) value mmHg less than the NIB
Parameter Specifications Parameter Specifications NOTE: IBP parameter labels include IBP, Art, UA, LV, PA, CVP, ICP, LA and RA. The label used is based on the label selected at the bedside monitor.
Parameter Specifications Parameter Specifications INSP/ET CO2 PATIENT SIZE MINIMUM VALUE (mmHg) MAXIMUM VALUE (mmHg) Neonate 0 113 Pediatric 0 113 Adult 0 113 PATIENT SIZE MINIMUM VALUE (%) MAXIMUM VALUE (%) Neonate 0 15 Pediatric 0 15 Adult 0 15 PATIENT SIZE MINIMUM VALUE (KPA) MAXIMUM VALUE (KPA) Neonate 0 15 Pediatric 0 15 Adult 0 15 The Panorama Central Station supports a CO2 waveform. 13.1.7 O2 The Panorama Central Station supports INSP/ET O2. 13.1.
Parameter Specifications Parameter Specifications INSP/ET N2O 13.1.10 PATIENT SIZE MINIMUM VALUE (%) MAXIMUM VALUE (%) Neonate 0 100 Pediatric 0 100 Adult 0 100 Anesthetic Agents: ISO, ENF, DES, SEV, HAL, Agent The Panorama Central Station supports the INSP and ET measurements of the Isofluorane (ISO), Enflurane (ENF), Desflurane (DES), Sevoflurane (SEV) and Halothane (HAL) anesthetic agents.
Parameter Specifications 13.1.11 Parameter Specifications Premature Ventricular Contraction (PVC) The Panorama Central Station supports PVC data. Unit of Measure: PVC/min Resolution: 1 PVC/min PATIENT SIZE LEADS MINIMUM VALUE MAXIMUM VALUE Neonate 3 lead or 5 lead Not Available Not Available 12 lead Not Available Not Available Pediatric 3 lead or 5 lead 0 PVC/min 200 PVCs/min 12 lead 0 PVC/min Less than the Current HR value (PVCs/min) Adult NOTE: 13.1.
Parameter Specifications 13 - 10 Parameter Specifications PATIENT SIZE MINIMUM VALUE (MM) MAXIMUM VALUE (MM) Neonate Not Applicable Not Applicable Pediatric -10.0 10.0 Adult -10.0 10.0 NOTE: A (C) next to an ST measurement indicates that the value represents a Current measurement. NOTE: An (R) next to an ST measurement indicates that the value represents a Reference measurement.
Parameter Specifications 13.2 Invalid Data Display Invalid Data Display The Panorama Central Station uses dashes (---), Xs (XX) or a straight line (waveform) to show invalid data.
Invalid Data Display Parameter Specifications Straight Line (Waveforms) Waveform data is replaced with a continuous straight line for the following reasons: • ECG leads are disconnected • ECG cable is not connected to the system • SPO2 cable is not connected to the system • Respiration parameter is disabled at the bedside monitor and the source is ECG • Respiration parameter is using a 12-lead card at the bedside monitor and the source is ECG • SPO2 cable is connected and not in use • IBP cable is connect
14.0 Alarms and Events The alarms available at the Panorama Central Station are dependent on the monitoring devices used and the options that are available at the Panorama Central Station. This section outlines the alarms and events that occur at the Panorama Central Station.
Physiological Alarms and Events 14.1 Alarms and Events Physiological Alarms and Events The Panorama Central Station alarms to indicate that a monitored patient’s physiological alarm thresholds have been violated. 14.1.1 Alarm Limit Settings This section identifies high and low alarm limit settings, and available alarm priorities for the Physiological Alarms, by patient size.
ALARM PRIORITY ALARM LIMIT NEONATE PEDIATRIC ADULT DEVICES Heart Rate Units: bpm 1 or 2 Factory Default: 2 High Limit Off, 100-350 Factory Default: 200 Off, 100-300 Factory Default:180 Off, 60-250 Factory Default:150 Passport2 Spectrum VPCS Low Limit Off, 30-200 Factory Default: 100 Off, 30-150 Factory Default: 80 Off, 30-120 Factory Default: 50 High Limit Off, 30-200 Factory Default: Off Off, 15-150 Factory Default: Off Off, 10-100 Factory Default: Off Low Limit Off, 5-50 Factory Defa
ALARM PRIORITY ALARM LIMIT NEONATE PEDIATRIC ADULT NIBP Dia.
ALARM PRIORITY ALARM LIMIT T1/T2 Units: C° 2 or 3 Factory Default: 3 High Limit ST Single Units: mm ST Dual Units: mm 1, 2 or 3 Factory Default: 2 1, 2 or 3 Factory Default: 2 0070-00-0575-50 PVC Units: PVCs/min 2 or 3 Factory Default: 3 Arrhythmia Run 2 or 3 Factory Default: 3 Apnea Delay Units: Seconds 2 or 3 Factory Default: 3 NEONATE Off, 35-43o PEDIATRIC ADULT Off, 35-43° Factory Default: Off Off, 35-43° Factory Default: Off Off, 26-38° Factory Default: Off Off, 26-38° Factory Def
Physiological Alarms and Events 14.1.2 Alarms and Events Bedside Alarms Alarms that are set at the bedside may be displayed and tracked at the Panorama Central Station. Bedside alarm limit adjustments must be entered at the bedside monitor. The Panorama Central Station only displays Bedside alarms if the Bedside Alarm Tracking option has been disabled at the Panorama Central Station. For additional information regarding Bedside Alarm Tracking, refer to ‘‘System Alarms (Alarm Limits) Tab’’ on page 9-14.
Alarms and Events Physiological Alarms and Events PARAMETER PANORAMA CENTRAL STATION MESSAGES REASON Note: x = 1, 2, 3 or 4 when used with IBP IBPx (Dia) Labels include: IBP1, IBP2, IBP3, IBP4, ART, UA, LV, PA, CVP, ICP, LA, RA High IBPx Diastolic Alarm Low IBPx Diastolic Alarm Bedside IBPx Diastolic Alarm The Panorama Central Station activates an IBPx Diastolic alarm when the current value is either equal to or higher/lower than the set alarm limits.
Physiological Alarms and Events PARAMETER 14 - 8 Alarms and Events PANORAMA CENTRAL STATION MESSAGES REASON NIBP (Mean) High NIBP Mean Alarm Low NIBP Mean Alarm Bedside NIBP Mean Alarm The Panorama Central Station activates an NIBP Mean alarm when the current value is either equal to or higher/lower than the set alarm limits.
Alarms and Events 14.2 Physiological Alarms and Events: Arrhythmias Physiological Alarms and Events: Arrhythmias This section lists alarms and events and alarm messages that may appear for Arrhythmias at the Panorama Central Station Arrhythmia Alarms PARAMETER ALARM PRIORITY PANORAMA CENTRAL STATION MESSAGES V-Tach 1 V-Tach The Panorama Central Station activates a V-Tach alarm when there are eight or more consecutive PVCs at a rate equal or greater than the V-Tach threshold.
Physiological Alarms and Events: Arrhythmias PARAMETER 14 - 10 Alarms and Events ALARM PRIORITY PANORAMA CENTRAL STATION MESSAGES REASON V-Rhythm 2,3 or Off Factory Default: 3 V-Rhythm The Panorama Central Station activates a V-Rhythm alarm when a number of consecutive PVCs (at a rate less than the V-Tach threshold) is detected.
Alarms and Events 14.3 Technical Alarms and Events Technical Alarms and Events The Panorama Central Station uses Technical alarms to indicate that an issue relating to a monitored patient’s monitoring functions has occurred. This section provides the event messages that may be shown in the Patient Status line at the Panorama Central Station.
Technical Alarms and Events Alarms and Events Technical Events (Continued) MESSAGE REASON Arrhythmia Off The Arrhythmia Off event will be posted in the Events database if the Arrhythmia option is disabled on a patient’s monitoring equipment. The Arrhythmia Off event cannot be deleted from the Event database. ST On The ST On event will be posted in the Events database if the ST option is enabled on a patient’s monitoring equipment. The ST On event cannot be deleted from the Event database.
Alarms and Events Technical Alarms and Events Technical Events (Continued) MESSAGE REASON V1-V6 Lead Off The V1-6 Lead Off event will be posted in the Events database if a V1-6 lead is not connected to the patient and a 12 lead card is in use. The V1-V6 Lead Off message will be shown in the Patient Status line in white text.
Technical Alarms and Events Alarms and Events Technical Events (Continued) MESSAGE REASON SPO2 Unrecognized Sensor The SPO2 Unrecognized Sensor event will be posted in the Events database if an unrecognized SPO2 Masimo sensor is detected by the system. The SPO2 Unrecognized Sensor message will be shown in the Patient Status line in white text. SPO2 Sensor Off The SPO2 Sensor Off event will be posted in the Events database if the SPO2 Masimo sensor is off.
Alarms and Events Technical Alarms and Events Technical Events (Continued) MESSAGE REASON CO2 Calibrating The CO2 Calibrating event will be posted in the Events database if the CO2 device is calibrating. The CO2 Calibrating message will be shown in the Patient Status line in white text. CO2 Zeroing The CO2 Zeroing event will be posted in the Events database if the CO2 device is zeroing. The CO2 Zeroing message will be shown in the Patient Status line in white text.
Technical Alarms and Events Alarms and Events Technical Events (Continued) MESSAGE REASON N2O Calibrating The N2O Calibrating event will be posted in the Events database if the N2O device is calibrating. The N2O Calibrating message will be shown in the Patient Status line in white text. N2O Zeroing The N2O Zeroing event will be posted in the Events database if the N2O device is zeroing. The N2O Zeroing message will be shown in the Patient Status line in white text.
Alarms and Events Technical Alarms and Events Technical Events (Continued) MESSAGE REASON NIBP Retry The NIBP Retry event will be posted in the Events database during an NIBP measurement retry. The NIBP Retry message will be shown in the Patient Status line in white text. NIBP Pump Higher The NIBP Pump Higher event will be posted in the Events database if the patient’s NIBP cuff needs additional pressure in order to take a measurement.
System Events 14.4 Alarms and Events System Events The Panorama Central Station uses System events to indicate system-wide issues at the Panorama Central Station. System events are listed based on the system violation. System events are resolved when the system-wide condition no longer exists. This section provides the system event messages that may be shown in the system status line of the Panorama Central Station menu bar.
15.0 Specifications This section outlines performance specifications for the Panorama Monitoring Network and the Panorama Telepack.
ECG Performance Requirements 15.1 Specifications ECG Performance Requirements Three Lead Displayable Leads: I, II, III (one vector at a time) Five Lead Displayable Leads: I, II, III, aVR, aVL, aVF, V1 Twelve Lead Displayable Leads: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5 and V6 Standardizing Voltage: The ECG size is indicated by a scale bar displayed on the left of the waveform window with a scale indicating the height of the bar in mV.
Specifications ECG Performance Requirements Waveform Displays Each waveform in the All Strips, Event List Zoom-In, Full Disclosure Zoom-In and ST reports will be displayed on a calibrated grid (5mm x 5mm) that conforms to ANSI/ AAMI EC13: 2002.4.2.9.7d. Each second of the waveforms in the All Strips, Event List Zoom-In, Full Disclosure Zoom-In and ST reports will be marked with a time annotation marker that conforms to ANSI/AAMI EC13: 2002.4.2.9.7e.
ECG Derived Heart Rate Meter Performance Requirements 15.2 Specifications ECG Derived Heart Rate Meter Performance Requirements Range: 30 to 300 bpm Adult/Pediatric ANSI/AAMI EC13–2002, 4.2.7 30 to 350 bpm Neonatal ANSI/AAMI EC13–2002, 4.2.7 Resolution: 15.2.1 1 bpm Alarm Response High HR alarm Range 60-250 bpm Adult 100-300 bpm Pediatric 100-350 bpm Neonatal (ANSI/AAMI EC13-2002, 4.2.8.1) Low HR alarm Range 30-120 bpm Adult 30-150 bpm Pediatric 30-200 bpm Neonatal (ANSI/AAMI EC13-2002, 4.2.8.
Specifications ECG Derived Heart Rate Meter Performance Requirements User Selectable ST Measurement Points: 40, 60 and 80 ms after J point (heart rate independent) Or 60/80 Heart Rate Dependent 15.2.3 Arrhythmia Analysis Arrhythmia analysis is disabled in neonatal mode. Arrhythmia analysis will identify ventricular arrhythmia. The following arrhythmia calls will be displayed: 15.2.
ECG Derived Heart Rate Meter Performance Requirements 15.2.6 Specifications IBP Heart Rate Meter Range: 30 to 300 bpm Adult/Pediatric 30 to 333 bpm Neonatal Resolution: 15.2.7 1 bpm Temperature Performance Requirements Scale: Selectable Celsius or Fahrenheit Range: 15 °C to 45 °C 59 °F to 113 °F Resolution: 0.1 °C 0.1 °F 15.2.8 15.2.9 15.2.10 15.2.11 15 - 6 ECG Respiration Performance Requirements Range: 4 to 199 breaths per minute Resp.
Specifications 15.3 Panorama Central Station Panorama Central Station Panorama Central Station hardware consists of a computer, hard drives, Ethernet, display controllers, case and a power supply. There is one basic hardware platform for the Panorama Central Station computer system. It contains the following: • 512 MB of RAM • 1280 x 1024 dpi 65535 color display controller • 20.
Panorama Central Station 15.3.7 Specifications Storage Temperature • -20 to +60 º C 15.3.8 Storage Humidity • 5% to 80% Relative Humidity Maximum, non-condensing, maximum wet bulb 35 º C 15.3.9 Storage Altitude • 1060 to 700 hPa (-1250 to 9889 feet ASL) (-380 - 3014 m) (795 to 525 mm Hg) 15.3.10 Surface Temperature Temperature does not exceed the values shown in table 16, parts 1 and 2 of EN 60950: 1992. 15.3.11 Tip Over EN 60950:1992, section 4.1.
Specifications Panorama Central Station Radiated Emissions • EN55022:1998 Class A Radiated (RF) Conducted Emissions • EN55022:1998 Class A Conducted Radiated Susceptibility • EN 61000-4-3:1998: 3 V/M: 26 MHz – 1 GHz 80% AM Conducted Susceptibility • EN 61000-4-6:1996 0.
Panorama Central Station Specifications • EN 61000-3-2: 1995, Amendment A1: 1998 and A2: 1998 Voltage Fluctuations and Flicker • EN 61000-3-3:1995 Steady State Voltage • FDA Reviewer Guidance 1993. App A (m) 7 (c) (1) AC Dropout • Draft IEC 601-1-2: 1996 • FDA Reviewer Guidance 1993 App A (m) 7 (c) (2) AC Slow Sags and Surges • FDA Reviewer Guidance 1993 App A (m) 7 (c) (3) Quasi-Static • FDA Reviewer Guidance 1993 App A (m) 7 (f) 15.3.16 Safety Enclosure Risk Current • 3.5 mA max.
Specifications 15.3.17 Panorama Central Station Physical Characteristics Maximum Size • Depth: 18.87" (479 mm) • Height: 17.18" (436 mm) • Width: 7.44" (189 mm) Maximum Weight • 36.5 lbs (16.
Panorama Telemetry Server 15.4 Specifications Panorama Telemetry Server Panorama Telemetry Server hardware consists of a computer, hard drives, Ethernet, display controllers, case and a power supply. There is one basic hardware platform for the Panorama Telemetry Server computer system. It contains the following: • 512 MB of RAM • 1280 x 1024 dpi 65535 color display controller • 20.
Specifications 15.4.7 Panorama Telemetry Server Storage Temperature • -20 to +60 º C 15.4.8 Storage Humidity • 5% to 80% Relative Humidity Maximum, non-condensing, maximum wet bulb 35 º C 15.4.9 Storage Altitude • 1060 to 700 hPa (-1250 to 9889 feet ASL) (-380 - 3014 m) (795 to 525 mm Hg) 15.4.10 Surface Temperature Temperature does not exceed the values shown in table 16, parts 1 and 2 of EN 60950: 1992. 15.4.11 Tip Over EN 60950:1992, section 4.1.
Panorama Telemetry Server Specifications Radiated Emissions • EN55022:1998 Class A Radiated (RF) Conducted Emissions • EN55022:1998 Class A Conducted Radiated Susceptibility • EN 61000-4-3:1998: 3 V/M: 26 MHz – 1 GHz 80% AM Conducted Susceptibility • EN 61000-4-6:1996 0.
Specifications Panorama Telemetry Server Harmonics • EN 61000-3-2: 1995, Amendment A1: 1998 and A2: 1998 Voltage Fluctuations and Flicker • EN 61000-3-3:1995 Steady State Voltage • FDA Reviewer Guidance 1993. App A (m) 7 (c) (1) AC Dropout • Draft IEC 601-1-2: 1996 • FDA Reviewer Guidance 1993 App A (m) 7 (c) (2) AC Slow Sags and Surges • FDA Reviewer Guidance 1993 App A (m) 7 (c) (3) Quasi-Static • FDA Reviewer Guidance 1993 App A (m) 7 (f) 15.4.16 Safety Enclosure Risk Current • 3.5 mA max.
Panorama Telemetry Server 15.4.17 Specifications Physical Characteristics Maximum Size • Depth: 18.87" (479 mm) • Height: 17.18" (436 mm) • Width: 7.44" (189 mm) Maximum Weight • 36.5 lbs (16.
Specifications 15.5 Keyboard Keyboard • Keyboard is supported for system diagnostics only. • This keyboard is offered in English language only and is not required for normal operation, but will be required for non-application system maintenance. • The System will not require a keyboard to boot up and enter Panorama Central Station application software. 15.6 Mouse • The mouse is supported for system diagnostics and user interface. • Supported as an interface control device.
Displays Specifications 15.7 Displays 15.7.1 21" CRT Display This is an integrated monitor that includes an internal touch screen controller and has the following features: • SXGA • 1280 x 1024 dpi capability • 0.27mm dot pitch • 19" viewable image measured diagonally 15.7.2 20" CRT Display This is an integrated monitor that includes an internal touch screen controller and has the following features: • SXGA • 1280 x 1024 dpi capability • 0.27mm dot pitch • 18.
Specifications 15.8 Network Printer Network Printer • The network printer is the standard hard copy output device for the output of Panorama Central Station waveform strip-charts and reports. • There is no provision to support a printer mounted within Panorama Central Station CPU enclosure. • The printer connects to the system via the Panorama Central Network. • Two network laser printers are supported per Panorama Central Station.
Panorama Wireless Transceiver/Splitters/Antennas 15.10.1.2 Specifications Physical Characteristics Maximum Size • Depth: 16.2" (411.48 mm) • Height: 5.2" (132.08 mm) • Width: 17" (431.8 mm) Maximum Weight • 12.35 lbs (5.6 kg) 15.10.1.3 Frequency Range Receiver Range • 608-614 MHz Transmit Range • 1395-1400 MHz and 1427-1429.5 MHz (not available at this time) 15.10.2 Panorama Antenna Physical Characteristics Maximum Size • Depth: 7.6" diameter (193.04 mm) • Height: 5.5" (139.
Specifications 15.10.3 Panorama Wireless Transceiver/Splitters/Antennas Splitter Physical Characteristics Maximum Size • Depth: 2" (50.8 mm) • Height: 2" (50.8 mm) • Width: 1.25” (31.75 mm) Maximum Weight • 0.22 lbs. (0.1 kg) 15.10.4 Environmental Characteristics for the Panorama Wireless Transceiver/Splitters/Antennas 15.10.4.1 Operating Temperature • +5 to +40 º C 15.10.4.2 Operating Humidity • 20 % to 80 % Relative Humidity Maximum, non-condensing, maximum wet bulb 29 º C 15.10.4.
Panorama Wireless Transceiver/Splitters/Antennas Specifications • CAN/CSA Standard C22.2 No. 950-95, Third Edition, and UL 1950, which does not require the shock and vibration testing. 15.10.4.9 Fluid Spill Resistance • UL 1950, which does not require fluid spill resistance testing. 15.10.4.10 Surface Temperature • Temperature does not exceed the values shown in table 16, parts 1 and 2 of UL 1950: 1995. 15.10.4.11 Tip Over • UL 1950: 1995, section 4.1.
Specifications Panorama Wireless Transceiver/Splitters/Antennas Electrical Fast Transient (EFT/B) • EN 61000-4-4:1995 2kV supply and control 1kV data and signal Surge Immunity • EN 61000-4-5:1995 2kV common mode; 1kV differential to AC line Magnetic Emissions • MIL-STD-461D • RES101 30 Hz to 100KHz @ 7cm Magnetic Immunity • EN 61000-4-8: 1994 50 HZ, 3 A/m Voltage Dips, Short Interruptions and Voltage Variations • EN 61000-4-11:1994 Steady State Voltage • FDA Reviewer Guidance 1993.
Panorama Wireless Transceiver/Splitters/Antennas 15.10.4.15 Specifications Safety Enclosure Risk Current • 3.5 mA max. per EN 60950 Dielectric Withstand • The Panorama Wireless Transceiver and its components shall withstand and operate as specified after application of 1500 V RMS at 50 or 60 Hz for 1 minute from AC mains hot or neutral to chassis.
Specifications 15.11 Telepack Specifications Telepack Specifications The following are the specifications for the Telepack: TABLE 15-1 SPECIFICATION DESCRIPTION Pacer Detection Provides pacer detection capability Acquired Leads ECG 3-Lead: I, II, III (one vector at a time) ECG 5-Lead: Three vectors (I, II, III, aVR, aVF, V(n)) Battery Type and Runtime (Telepack-2.
Telepack Specifications Specifications TABLE 15-3 (Continued) SPECIFICATION DESCRIPTION Pacer Rejection Pacer signals from ±2mV to ±700mV (RTI) amplitude and 0.1ms to 2ms in duration and a maximum of 100µs rise time are rejected. ECG Frequency response is 0.05Hz to 40.00Hz ECG Derived Heart Rate Meter • Range 30 to 300 bpm for Adult • Resolution 1 bpm • Accuracy ± 3 bpm or ± 3% at 30 to 250 bpm, whichever is greater.
Specifications Telepack Specifications TABLE 15-3 (Continued) SPECIFICATION DESCRIPTION Input Impedance 2.5M W single ended at 10Hz per ANSI/AAMI EC13-2002, 4.2.9.2 Noise Less than 30 µV p-p, referred to input, through shielded 51K W resistors in parallel with 47nF capacitors (ANSI/AAMI EC13-2002, 4.2.9.3). Overall System Error 5% or 40µV, whichever is greater (ANSI/AAMI EC13-2002, 4.2.9.8, complying with the more stringent requirements of EC11-1992.) Gain Stability Per ANSI/AAMI EC13-2002, 4.2.
Telepack Specifications 15.11.3 Specifications Environmental Characteristics The environmental characteristics of the Telepack device are as follows: TABLE 15-4 15.11.4 SPECIFICATION DESCRIPTION Maximum Size (Telepack-2.4) Height: 6.5" (162.56 mm) Width: 3.7" (93.98 mm) Depth: 1.5" (38.1 mm) Maximum Size (Telepack-608) Height: 5.10” (129.54 mm) Width: 2.95” (74.93 mm) Depth: 1.23” (31.24 mm) Maximum Weight (Telepack-2.4) 11.0 oz. (311.84 g) without batteries Maximum Weight (Telepack-608) 6.
Specifications Telepack Specifications TABLE 15-5 GUIDANCE AND DATASCOPE CORP. DECLARATION - ELECTROMAGNETIC EMISSIONS It is important that the Telepack is used in the electromagnetic environment specified in the following table. EMISSIONS TEST COMPLIANCE ELECTROMAGNETIC ENVIRONMENT - GUIDANCE RF emissions CISPR 11 Group 1 The Telepack uses RF energy only for its internal function and external data transmission.
Telepack Specifications Specifications TABLE 15-6 (Continued) GUIDANCE AND DATASCOPE CORP. DECLARATION - ELECTROMAGNETIC IMMUNITY It is important that the Telepack is used in the electromagnetic environment specified in the following table.
Specifications Telepack Specifications TABLE 15-7 GUIDANCE AND DATASCOPE CORP. DECLARATION - ELECTROMAGNETIC IMMUNITY It is important that the Telepack is used in the electromagnetic environment specified in the following table.
Telepack Specifications Specifications TABLE 15-8 RECOMMENDED SEPARATION DISTANCES BETWEEN PORTABLE AND MOBILE RF COMMUNICATIONS EQUIPMENT AND THE TELEPACK The Telepack is intended for use in an electromagnetic environment where radiated RF disturbances are controlled.
Specifications 15.11.7 Panorama Instrument Radio-608 Compliance The Telepack complies with the following standards: AGENCY AND INDUSTRY STANDARDS EN 60601-1:1990/IEC 60601-1:1988 and A1:1991 and A2:1995 EN 60601-2-27:1994/IEC 60601-2-27:1994 IEC 60601-1-2:2001 UL2601-1:1997 CSA Standard C22.2 No. 601.1 M90 ANSI/AAMI EC 13:2002 IEEE 802.11 Std 802.
Panorama Instrument Radio-608 Specifications Datascope maintains a policy of continual product improvement and reserves the right to change materials and specifications without notice.
16.0 Glossary This section provides a glossary of terminology used throughout the Panorama Operating Instructions.
Terms, Acronyms and Abbreviations 16.
Glossary Terms, Acronyms and Abbreviations ACRONYMS/ DEFINITIONS ABBREVIATIONS AHA American Heart Association American Hospital Association ART Arterial Line bpm Beats per minute C Current ST Chest Lead (IEC) cm Centimeters CO2 Carbon Dioxide CVA Cardiovascular Artifact CVP Central Venous Pressure DES Desoflurane ECG Electrocardiogram EMC Electromagnetic Compatibility ENF Enflurane ET End-Tidal when referencing CO2/O2/N2O/Agent parameters Elapsed Time when referencing NIBP F L
Terms, Acronyms and Abbreviations ACRONYMS/ Glossary DEFINITIONS ABBREVIATIONS MAP Mean Arterial Pressure MDD Medical Device Directive mmHg Millimeters of Mercury N Right Leg when referring to ECG Leads (IEC) N2O Nitrous Oxide NIBP Non-Invasive Blood Pressure NSR Normal Sinus Rhythm O2 Oxygen PA Pulmonary Artery Pleth Plethysmograph PVC Premature Ventricular Contraction R Right Arm when referring to ECG Leads (IEC) Referenced ST RA Right Atrium when referring to IBP Right Arm wh
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Datascope Corp., US, Canada & Latin America • Patient Monitoring • Worldwide Headquarters • 800 MacArthur Blvd • Mahwah, NJ 07430 • USA • Dom. Customer Service: 1.800.288.2121 • Dom. Fax: 1.800.926.4275 • Intl. Customer Service: 201.995.8000 • Intl. Fax: 201.995.8659 • E-Mail Address: pm_sales@datascope.com Datascope Europe Africa Office • Drs. W van Royenstraat 8 • P.O. Box 26 • 3870 CA • Hoevelaken • The Netherlands • Tel: +31.33.2544911 • Fax: +31.33.
