Philips Telemetry System with the M2601B Transmitter and Telemetry Functions at the IntelliVue Information Center Notice Operation of this equipment requires the prior coordination with a frequency coordinator designated by the FCC for the Wireless Medical Telemetry Service. Instructions for Use Part Number: M2600-92201 Printed in the U.S.A.
Notice Equipment specifications are subject to alteration without notice. All changes will be in compliance with regulations governing manufacture of medical equipment. Printed in the USA. Document number: M2600-92201 © Copyright 2004 Koninklijke Philips Electronics N.V. All Rights Reserved. OxiCliq and OxiMax are registered trademarks of Nellcor Incorporated. Printing History New editions of this document incorporate all material updated since the previous edition.
About this Book About this Book This book contains operating instructions for use of the M2601B Transmitter, a part of the Philips Telemetry System. It also includes operational information for the telemetry functions of the IntelliVue Information Center. The intended audience is the clinician who uses and/or teaches others to use the equipment in a healthcare environment.
About this Book Document Conventions Procedures Procedures are indicated in text by the heading Task Summary followed by the following table: Step Action 1 2 3 Bold Typeface Objects of actions in procedures appear in bold typeface. Note the following example: Click the Standby button. Warnings Warning Warnings are information you should know to avoid injuring patients and personnel. Cautions Caution Cautions are information you should know to avoid damaging your equipment and software.
Product Safety Information Product Safety Information The warnings below refer to the following devices: • • • Philips M2601B Transmitter Philips Telemetry System IntelliVue Information Center Warning For continued safe use of this equipment, it is necessary that the listed instructions are followed. Instructions in this manual in no way supersede established medical procedures. Warning Do not touch the patient, or table, or instruments during defibrillation.
Product Safety Information Warning Do not use patient cables with detachable lead wires that have exposed male pins. Electrocution could result if these pins are plugged into AC power. Warning Use of product accessories (e.g., ECG lead sets, SpO2 sensors) other than those prescribed by Philips could lead to patient injury. Warning Strangulation Hazard! Under no circumstances should any pouch be tied solely around a patient’s neck.
Product Safety Information Warning ECG SAFETY FOR PACED PATIENTS The output power of the M2601B Transmitter and other sources of radio frequency energy, when used in the proximity of a pacemaker, can be sufficient to interfere with pacemaker performance. Due to the shielding effects of the body, internal pacemakers are somewhat less vulnerable than external pacemakers. However, caution should be exercised when monitoring any paced patient.
Product Safety Information Warning ST/AR ARRHYTHMIA SAFETY FOR ALL PATIENTS During complete heart block or pacemaker failure (to pace or capture), tall P-waves (greater than 1/5 of the average R-wave height) can be erroneously counted by the arrhythmia algorithm, resulting in missed detection of cardiac arrest. Learning/Relearning --If you initiate learning during ventricular rhythm, the ectopics can be incorrectly learned as the normal QRS complex.
Product Safety Information Warning ST/AR ARRHYTHMIA SAFETY FOR PACED PATIENTS It is possible that pacemaker pulses will not be detected when the ECG analog output of a defibrillator or telemetry unit is plugged into a bedside monitor. This can result in the arrhythmia algorithm’s failure to detect pacemaker non-capture or asystole. Some pace pulses can be difficult to reject.
Product Safety Information x
Contents 1. Introduction to the Philips Telemetry System. . . . . . . . . . . . . . . . . . . . . . . . . 1-1 What’s New. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 New Transmitter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 Connection to TeleMon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1 Alarm Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2 Pause/Suspend Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2 Alarm Behavior with Own Bed Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Displayed ST Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4 EASI ST Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4 Adjusting Measurement Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5 Establishing ST Reference Beats (Baseline) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. Maintenance and Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1 Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2 Basic Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2 Testing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A. Optional Patient Monitor/Holter Interface (Analog Output) . . . . . . . . . . . A-1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2 Correct Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2 Analog Output Bedside Monitor Cables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents-6
This chapter introduces the Philips Telemetry System. It includes the following sections: • • • • • • • • • • • • What’s New. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5 System Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7 Transmitters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What’s New What’s New This section highlights the differences between the M2600B Philips Telemetry System, utilizing the M2601B Transmitter and the Philips M2600A Telemetry System, Release C, utilizing the M2601A Transmitter. New Transmitter Differences Between Transmitters Function 1-2 The main difference between the two systems is the introduction of the new M2601B transmitter. The following table summarizes the differences between the two transmitters.
What’s New M2601B Controls & Indicators M2601A Spot Check SpO2 initiated by inserting Manual measurement initiated by sensor cable button push on transmitter Auditory feedback for Spot Check and N/A self test Two electrode placement diagrams show both Standard and EASI placement One electrode placement diagram appropriate for the transmitter: either Standard or EASI placement Check button for verifying transmitter N/A status: lead set type, battery level, EASI indicator (if in use) Battery gauge to ind
What’s New Connection to TeleMon The M2601B Transmitter also has a different method of connecting to the TeleMon Companion Monitor: • • Own Bed Overview M2601B: Transmitter is connected to the outside of TeleMon via a 3meter tether cable. M2601A: Transmitter is docked in TeleMon. The system supports the concept of Own Bed Overview, the pairing of a telemetry bed and an IntelliVue Patient Monitor (Release B.1 or higher) for a single patient.
Indications for Use Indications for Use The paragraphs below are the elements of the indications for use statement for the Philips Telemetry System. Condition Prescription Versus Overthe-Counter Part of the Body or Type of Tissue with which the Device Interacts The licensed clinician decides that the Philips Telemetry System should be used to monitor the patient. The Philips Telemetry System is a prescription device.
Indications for Use Intended Use The Philips Telemetry System is a comprehensive ambulatory system solution for the intermediate care unit for adult and pediatric patients. The foundation of the system is a transmitter that can capture and transmit ECG signals and SpO2 values (if available) that are then processed and displayed on the IntelliVue Information Center. The Information Center generates alarms and recordings, thus notifying clinicians of changes in patients' conditions.
System Overview System Overview The Philips Telemetry System is used with the IntelliVue Information Center to provide multi-parameter measurements for transitional care and other ambulatory monitoring environments for adult and pediatric patients. The system: • • • • • • Enunciates patient monitoring alarms. Monitors adult and pediatric patients’ ECG. Provides ST/AR arrhythmia detection. Measures pulsatile arterial oxygen saturation (SpO2) and pulse rate, if available.
System Overview M2601B EASI, 3 5 Philips Telemetry System Dual-Band Operation The Philips Telemetry System (M2600B) can operate in both the 406-480 MHz and 590-614 MHz ranges. The exact operating frequency for each transmitter/ receiver pair is set so as to meet specific customer needs, while maintaining compliance with local and international radio regulations.
Transmitters Transmitters The following Philips transmitters can be used with the Philips Telemetry System: • • ECG-only transmitter ECG/SpO2 transmitter Standard and EASI M2601A transmitters can also be used. These transmitters can operate simultaneously with M2601B transmitters. For operating information, refer to the Instructions for Use for the Philips Telemetry System (part number M2600-9001C). Note—“What’s New” on page 1-2 summarizes the differences between the M2601B and M2601A transmitters.
Transmitters M2601B Transmitter Features • • • • • • • • • • • • Clinician-selectable Standard or EASI leads in same transmitter, at the bedside. Powered by two AA Alkaline batteries. Spot Check SpO2 without using any control buttons. FAST-SpO2 (Fourier Artifact Suppression Technology) for improved motion artifact rejection and low-perfusion performance. Simultaneous operation in system with M2601A Transmitter. Two sizes - smaller ECG-only version and larger ECG-SpO2 version.
Transmitters Transmitter Controls Front i ii a M2601B b EASI, 3 5 c d A B 1 C 2 iii 3 ECG/SpO2 Transmitter - Front View The labeled items in the diagram above include: • • • • Transmitter controls (A-C) Indicators (a-d) Labels (1-3) Ports (i-iii) These items are defined on subsequent tables.
Transmitters Controls Callout Control A Definition Telemetry Button: Depending on the configuration, this multi-function button directs the Information Center to generate a Nurse Call, central recording, both, or none. If desired, you can turn Nurse Call off for individual patients at the Information Center by using the Telemetry Setup Window. See “Turning Nurse Call On/Off” on page 1-23 for additional information.
Transmitters Indicators Callout Indicator Definition a Lead Indicator. • Lights momentarily to display leads attached when lead set is inserted or when the Check button is pressed. • When a Leads Off condition occurs, the light(s) indicate the lead(s) that need to be reapplied. The light(s) remain on until the Leads Off condition ends. Note—The 6th indicator (left-most LED) is not used for the M2601B Transmitter. b EASI Indicator. Illuminates momentarily upon insertion of lead set in EASI position.
Transmitters Front Labels Callout Label Definition 1 M2601B EASI, 3 5 Lead Set Insertion Guide. See “Connecting the ECG Cable” on page 314. 2 Device Identification Label 3 Unit Identification Label. (one of seven colors). Color-coded sticker. Ports Callout 1-14 Definition i ECG Lead Set Port. Connection for 3-wire or 5-wire lead set. ii SpO2 Sensor Port. Connection for SpO2 sensor. iii TeleMon/Service Port. Connection for cable to TeleMon Companion Monitor or to Service Tool.
Transmitters Transmitter Controls Back EASI EASI EASI A S A I E 1 FCCID: XXXXXXXX CANADA IC: XXXX 2 ! 0123 5 8-11 not shown (inside battery compartment) 5 3 6 i 4 7 ECG/SpO2 Transmitter - Back View TO TRANSLATORS: use appropriate graphic showing electrode colors (IEC graphics are in "13 August graphics IEC"). The labeled items in the diagram above include: • • Labels (A) Safety symbols and other markings (1-11) These items are defined on subsequent tables.
Transmitters Back Labels Callout A Safety Symbols and Other Markings Callout 1 Definition Electrode Placement Diagrams (See “Positioning ECG Electrodes” on page 3-8.) Label ! 2 3 The transmitter patient connections are protected against defibrillation (DEFIBRILLATION-PROOF) and are a TYPE CF APPLIED PART. 4 Prescription device. Rx 5 Follow operating instructions.
Transmitters Callout 6 Label Definition Non-Ionizing Radiation. Interference to electronic equipment may occur in the vicinity of devices marked with this symbol. 7 Complies with all applicable Canadian and American standards. 8 Serial Number. Needed to identify the equipment during a call to the Response Center. SN 9 Philips Catalog Number. REF 10 MAC Address of device. MAC 11 Date of manufacture.
Transmitters Sounds The transmitter produces auditory information signals to inform you of measurement and battery conditions. The main tone, which can be set to one of 5 different volume settings or turned off, is configurable. In addition, a lower pitched tone is used to identify a pulse beat occurring during an SpO2 Spot Check measurement.
Briefing the Patient Briefing the Patient Warning Patients should be instructed not to open the battery cover while the transmitter is in use. If the Telemetry button has been configured to generate a Nurse Call, recording at the Information Center, or both, instruct the patient to use the button when needed. Note—If desired, the clinician can turn off patient use of the button at the Information Center. See “Turning Nurse Call On/Off” on page 1-23.
Briefing the Patient Securing the Pouch Task Summary Step 1 Action Secure the pouch on the patient with upper ties around the patient’s head and arm, and lower ties around the patient’s lower torso. Warning To avoid strangulation, do not tie a pouch solely around the patient’s neck. 2 Insert the transmitter into the pouch with lead wires and SpO2 sensor cable, if used, exiting from the same side. Important—Do not coil the cables inside the pouch.
Briefing the Patient Step Action 3 Fold the flap down and snap closed. 4 Check that the patient is comfortable wearing the pouch with transmitter. Showering Warning Signal quality and leads off detection may be compromised when showering due to significant patient movement. Appropriate clinical precautions must be taken. The transmitter can be used to monitor a patient in the shower, but only when placed inside a Philips carrying pouch with the flap closed and the snaps secured.
Making Monitoring Adjustments Drying the Transmitter after Showering After showering, perform the following steps to continue monitoring: 1. 2. 3. 4. 5. Pat dry the lead set connections at the electrodes. Wipe the lead wires with care. If wet, dry the outside of the transmitter with a non-lint-producing cloth. If wet, wipe the inside of the battery compartment dry. Dry the batteries. If wet, disconnect the ECG lead block and shake out any water. Dry the connector pin area with a cotton swab.
Making Monitoring Adjustments Turning Telemetry Monitoring On/Off Telemetry monitoring can be turned on or off in one of two ways: • Manually, by activating Monitoring Standby at the IntelliVue Information Center (see “Standby Mode” on page 1-24). Automatically, if Auto Shutoff is enabled at the transmitter and if all leads are off for 10 minutes (see “Transmitter Auto Shutoff” on page 1-23). • Note—Turning telemetry monitoring off does not turn the transmitter off.
Making Monitoring Adjustments Step Standby Mode Action 2 On the All Controls Window click Telemetry Setup. 3 On the Telemetry Setup Window turn the Telemetry button on or off by clicking in the Telemetry Button Allow Calls checkbox. A check mark in the checkbox indicates that the Telemetry button is on. When a patient is temporarily off the unit or out of antenna range you can suspend monitoring by placing telemetry in Standby mode.
Use with TeleMon B, Options A02/A03 Step 3 Action Click the Suspend Monitoring button. This suspends all monitoring and displays the following message in the Patient Sector TELEMETRY STANDBY and the location (for example, X-Ray). Note—Be sure to take the bed out of Standby before discharging.
Use with TeleMon B, Options A02/A03 • • • • SpO2 Operation • • Defibrillation 1-26 After a change in lead set or SpO2 sensor, TeleMon returns to the default ECG settings. Be sure to check the monitoring leads after you switch leads or sensor. Arrhythmia relearn will occur at TeleMon automatically if the lead set is changed. When the Check button is pressed, the transmitter battery gauge indicates full regardless of battery state.
Testing the Transmitter Functionality Testing the Transmitter Functionality There are two tests of the transmitter functionality: • • Self Test - performed automatically each time the transmitter is turned on. Status Check - initiated manually by the clinician. Self Test Warning Do not use the transmitter for patient monitoring if it fails the Power On Self Test.
Testing the Transmitter Functionality Status Check You can check the status of the transmitter indicators at any time. Task Summary To initiate a Status Check, use the following instructions. Step 1-28 Action 1 Press the Check button. 2 The following indicators should illuminate for as long as the Check button is depressed.
Battery Information Battery Information Battery Safety Information Warning Use Duracell MN 1500 AA 1.5V Alkaline batteries to ensure specified performance. Outdated, mismatched, or poor-quality batteries can give unacceptable performance (e.g., insufficient Battery-Weak warning time). The use of fresh high-quality alkaline batteries is strongly recommended. Batteries should be removed from the transmitter at the end of the battery’s useful life to prevent leakage.
Battery Information Disposal of Batteries Caution The battery must be removed if a transmitter will be stored for an extended period of time. Important—When disposing of batteries, follow local laws for proper disposal. Dispose of batteries in approved containers. If local regulations require you to recycle batteries, recycle batteries in accordance with regulations. Battery Life Battery life is dependent upon: • • Condition of the batteries.
Battery Information Inserting/ Removing Batteries The battery compartment is located at the bottom of the transmitter and accommodates a pair of AA 1.5V Alkaline batteries. Only this type of disposable battery shall be used. Important—Do not use rechargeable batteries. Use of this type of battery will adversely affect: • • • Task Summary Battery gauge performance. Battery low warnings. Battery life performance. Insert batteries into the transmitter using the following procedure.
Battery Information Batteries should be changed in sets, that is, if you change one battery, change them both. If you remove good batteries to turn off the transmitter, keep them together as a set for later re-use so that both batteries will have the same level of power remaining. Batteries should be removed when the transmitter is not in use or is being stored. DO NOT STORE BATTERIES BY LEAVING THEM IN THE INCORRECT POLARITY POSITION INSIDE THE TRANSMITTER. Be careful not to short circuit the batteries.
Battery Information Battery Gauge 2 green indicators 1 green indicator Task Summary Approximate Battery Life Remaining (ECG Only) >25% Approximate Operating Time Remaining >10.
Receiver Module Receiver Module The Philips receiver modules are housed in the receiver mainframe. Each receiver module is dedicated to a specific transmitter by an internal identity code. This prevents another patient's waveform from being erroneously transmitted and displayed. The receiver acquires the ECG and SpO2 signals from the transmitter and sends them to the receiver mainframe.
Receiver Mainframe Receiver Mainframe The Philips receiver mainframe houses up to eight receiver modules. For each receiver, the receiver mainframe calculates the heart rate, and sends the waveform, patient alarms, technical alarms, and status messages over the Philips patient care system to the IntelliVue Information Center for display and recording. If SpO2 is available, the transmitter processes the data and sends it to the IntelliVue Information Center via the network as well.
Antenna System Antenna System The telemetry antenna system is custom-designed for your unit to ensure adequate coverage, therefore the telemetry signal can only be received where there are receiving antennas. After it is received by the antenna system, it is sent to the receiver which recovers the patient's ECG and optional SpO2. This information is then sent to a monitoring display.
This chapter describes alarm behavior and lists Physiologic Alarms (Patient Alarms) and Technical Alarms (Inoperative Conditions). Both types of alarms are listed alphabetically. • • • • • Alarm Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2 Pause/Suspend Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2 Alarm Behavior with Own Bed Overview . . . . . . . . . . . . . . . . . . . . . . 2-3 Physiologic (Patient) Alarms . .
Alarm Indicators Alarm Indicators A description of visual and auditory information signals for patient and technical alarms on the Information Center is located in the IntelliVue Information Center Instructions for Use and the Online Help. The Information Center documentation also includes the default alarm settings and physiological alarm limit ranges. Pause/Suspend Alarms All alarms for a patient can be paused/suspended from the Information Center, or from the TeleMon Companion Monitor, if connected.
Alarm Behavior with Own Bed Overview Alarm Behavior with Own Bed Overview Both the IntelliVue Patient Monitor and the telemetry system source alarms. The following tables summarize alarm behavior when Own Bed Overview is used. For detailed information, see the IntelliVue Patient Monitor Instructions for Use and the IntelliVue Information Center Instructions for Use.
Alarm Behavior with Own Bed Overview Alarm Silence When an active alarm is silenced, the types of alarms that are silenced depend on the alarm source and where the silence was initiated. Effect at Paired Bedside Effect at Information Center Bedside Alarm is silenced Bedside alarm is silenced.
Alarm Behavior with Own Bed Overview Alarm/INOPs at the Information Center The alarms and INOPs that are displayed, recorded and stored at the Information Center depend on the type of alarm. Type of Alarm/INOP Effect at Information Center All ECG telemetry alarms and INOPs Note—ECG is generated from telemetry when paired. Displayed, recorded (if configured), and stored Bedside ECG INOPs and RESP INOPs Ignored.
Physiologic (Patient) Alarms Physiologic (Patient) Alarms There are no physiologic (patient) alarm signals generated by the transmitter. All physiologic alarms are generated at the IntelliVue Information Center, and all alarm signals must be acknowledged at the Information Center.
Physiologic (Patient) Alarms Physiologic (Patient) Alarms Alarm Text Priority Condition Source ***ASYSTOLE Red Asystole. No QRS for 4 consecutive seconds ST/AR Basic and Enhanced Arrhythmia Mainframe cardiotach *** BRADY yyy
Physiologic (Patient) Alarms Physiologic (Patient) Alarms 2-8 Alarm Text Priority Condition Source ** LOW HR Yellow Low Heart Rate. HR < low HR Limit Mainframe cardiotach ** NURSE CALL Yellow Telemetry button press on the transmitter (when configured for Nurse Call operation) Clinician/patientinitiated at the transmitter ** SpO2 yyy > xxx Yellow High SpO2. SpO2 value greater than high SpO2 Limit SpO2 ** SpO2 yyy < xxx Yellow Low SpO2.
Physiologic (Patient) Alarms Physiologic (Patient) Alarms Alarm Text Priority Condition Source * NON-SUSTAIN VT Yellow Non-Sustained VT. NonSustained Ventricular Tachycardia ST/AR Enhanced Arrhythmia * PACER NOT CAPT Yellow Pacer Not Capture. Missed beat with pace pulse (paced patient). ST/AR Basic and Enhanced Arrhythmia * PACER NOT PACE Yellow Pacer Not Pacing. Missed beat without pace pulse (paced patient). ST/AR Basic and Enhanced Arrhythmia * PAIR PVCs Yellow Pair of PVCs.
Physiologic (Patient) Alarms Physiologic (Patient) Alarms 2-10 Alarm Text Priority Condition Source * VENT BIGEMINY Yellow Ventricular Bigeminy. Predominant Bigeminy rhythm present. ST/AR Enhanced Arrhythmia * VENT RHYTHM Yellow Ventricular Rhythm. Ventricular rhythm present. ST/AR Enhanced Arrhythmia * VENT TRIGEMINY Yellow Ventricular Trigeminy. Predominant Trigeminy rhythm present.
Technical Alarms (INOPs) Technical Alarms (INOPs) Technical Alarms, or INOPs, are sourced at the transmitter or TeleMon Companion Monitor, and identify inoperative conditions. There are three types of Technical Alarms. Severe technical alarms must be acknowledged by a clinician. A Hard technical alarm indicates that monitoring and alarms are disabled and generates an audible tone at the Information Center. With a Soft technical alarm, monitoring and alarms remain active, and no audible tone is generated.
Technical Alarms (INOPs) Technical Alarms (INOPs) Alarm Text Priority Condition What to do CANNOT ANALYZE ST Soft ST algorithm cannot reliably generate any valid ST values on any monitored lead. Assess the lead selections. Note—See “Optimizing System Performance” on page 3-22. ECG EQUIP MALF Hard Failure of the ECG equipment or failure to calibrate ECG Replace transmitter or calibrate ECG with Service Tool.
Technical Alarms (INOPs) Technical Alarms (INOPs) Alarm Text Priority Condition What to do NO RECEIVER Hard Receiver absent or malfunctioning This message appears after the mainframe is turned on and indicates the absence of a receiver or a receiver is faulty. Contact Service Provider. NO SIGNAL Hard Patient is out of range, radio board has failed, no batteries in transmitter, or batteries inserted incorrectly. Make sure that the transmitter is in range. Check batteries for correct insertion.
Technical Alarms (INOPs) Technical Alarms (INOPs) Alarm Text Priority Condition What to do SpO2 INTERFERENCE Hard Level of ambient light or level of electrical interference are so high that the SpO2 sensor cannot measure SpO2 and pulse rate. Reduce ambient light to sensor or electrical noise sources. Conceal/cover sensor with opaque non-white cover. SpO2 NO TRANSDUCER Hard No sensor attached to SpO2 device Attach SpO2 sensor.
Technical Alarms (INOPs) Technical Alarms (INOPs) Alarm Text Priority Condition What to do TEL CANNOT ANALYZE Hard INOP Shorts bursts of data corruption inhibiting an accurate HR count. (Often accompanied by WEAK SIGNAL, NO SIGNAL, or INTERFERENCE INOPs.) Check that there are no transmitters stored with batteries. Check to see if the patient is in the coverage area, and return patient if needed.
Technical Alarms (INOPs) Technical Alarms (INOPs) Alarm Text Priority Condition What to do TRANSMITTER OFF Soft RF shut off after 10 minutes of leads off Reattach ECG leads to patient. WEAK SIGNAL Soft Weak RF signal received at Telemetry Mainframe from transmitter Move transmitter into RF coverage area and re-check transmitter. If condition exists in close proximity to the antenna, replace transmitter. Check to see if the patient is in the coverage area, and return patient if needed.
3 ECG & ST/AR Measurement This chapter covers the specifics of ECG measurement, as well as arrhythmia monitoring using the ST/AR algorithm. It includes the following sections: • • • • • • • • • Measuring ECG. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2 Setting Up for ECG Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7 Connecting the ECG Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Measuring ECG Measuring ECG The electrocardiogram (ECG) measures the electrical activity of the heart and displays it on the Information Center as a waveform and a numeric. There is no cardiotach within the transmitter: cardiotach analysis resides in the telemetry mainframe. The type of ECG analysis depends on whether or not arrhythmia analysis is on or off at the Information Center.
Measuring ECG Electrode Locations and Colors LA AAMI Electrode Color Black Yellow RA White Red LL Red Green LA Black Yellow RA White Red LL Red Green RL Green Black V Brown White S Black Yellow I White Red A Red Green N Green Black E Brown White Lead Set Type Electrode Location 3-wire 5-wire (in Standard Mode) (in EASI Mode) IEC Electrode Color ECG & ST/AR Measurement 3-3
Measuring ECG ECG Leads Monitored Depending on the lead set connected to the transmitter, a different set of viewable leads are available at the Information Center. The transmitter can source up to four raw ECG waves. The transmitter automatically recognizes the lead set connected. If you are using ... these leads are available 3-wire If Lead Select is configured off: • Default is II. • To monitor a different lead, change the electrode placement to the lead you want.
Measuring ECG If you are using ... these leads are available 5-wire (Standard Mode) I, II, III, aVR, aVL, aVF, MCL, and V Defaults are II, V, III In Standard mode, the raw ECG waves are received as: • • • Channel 1 = Lead II Channel 2 = Lead III Channel 3 = Lead MCL Lead selection is available at the Information Center. Important—Do not set the primary and secondary channels to the same lead.
Measuring ECG Reconstructed Leads Reconstruction of 3 and 5 leads from the sourced wave is defined by the calculations in the following table. EASI reconstructed leads are a linear combination of all three raw EASI leads. Default labels/leads are shown in bold.
Setting Up for ECG Monitoring Setting Up for ECG Monitoring Task Summary Step Action 1 Prepare the patient’s skin. Good electrode-to-skin contact is important for a good ECG signal, as the skin is a poor conductor of electricity. • Select sites with intact skin, without impairment of any kind. • Clip or shave hair from site, as necessary • Wash site with soap and water, leaving no soap residue.
Setting Up for ECG Monitoring Positioning ECG Electrodes Warning Do not mix and match electrodes of different types. In particular, do not use electrodes of dissimilar metals. This helps ensure optimal signal quality. Warning When you are connecting the electrodes or the patient cable, make sure that the connectors never come into contact with other conductive parts, or with earth.
Setting Up for ECG Monitoring Locating the Fourth Intercostal Space Angle of Lewis For accurate chest electrode placement and measurement, it is important to first locate the fourth intercostal space. This can be done using the Angle of Lewis. 1. Locate the second intercostal space by first palpating the Angle of Lewis (the bony protuberance where the body of the sternum joins the manubrium).
Setting Up for ECG Monitoring 5-wire Placement (Standard Mode) V1 3-10 V2 V3 V4 V5 V6 Lead Placement RA directly below the clavicle and near the right shoulder LA directly below the clavicle and near the left shoulder RL on the right lower abdomen LL on the left lower abdomen V on the chest, the position depends on your required lead selection. The default position is V2.
Setting Up for ECG Monitoring Lead Placement V2 on the fourth intercostal space at the left sternal border V3 midway between the V2 and V4 electrode positions V4 on the fifth intercostal space at the left midclavicular line V5 on the left anterior axillary line, horizontal with the V4 electrode position V6 on the left anterior axillary line, horizontal with the V4 electrode position ECG & ST/AR Measurement 3-11
Setting Up for ECG Monitoring 5-wire Placement (EASI Mode) Warning EASI derived 12-lead ECGs and their measurements are approximations to conventional 12-lead ECGs. As the 12-lead ECG derived with EASI is not exactly identical to the 12-lead conventional ECG obtained from an electrocardiograph, it should not be used for diagnostic interpretations.
Setting Up for ECG Monitoring 3-wire Placement Lead Placement RA directly below the clavicle and near the right shoulder LA directly below the clavicle and near the left shoulder LL on the left lower abdomen ECG & ST/AR Measurement 3-13
Connecting the ECG Cable Connecting the ECG Cable Task Summary Note—Your transmitters may have alignment guides that assist lead set insertion. Step 1 Action Match the arrow on the ECG cable with the arrow on the Lead Set Insertion Guide according to the lead type you have chosen, and insert the ECG cable into transmitter. Important—Make sure that the cable is pushed completely into the transmitter. When correctly inserted, the orange line at the base of the cable is not visible.
Connecting the ECG Cable Step Action 5-wire Note—If you are using the 5-wire lead set in both Standard and EASI modes, insert the protective plug into the open lead port with the wide lip facing the leads. Then, press down firmly so that the plug is securely under the lead set and the orange line is not visible. Standard Mode: Match the arrow on the cable with the right arrow (labeled 5) on the Lead Set Insertion Guide.
Connecting the ECG Cable Step 2 Action Check that the correct lead indicators are lit for the lead set you are using, and that the EASI indicator light is illuminated appropriately. See “Verifying Electrode Connections” on page 3-17. Important—When using 5-wire Standard, note that the EASI indicator does not illuminate. When using EASI, the EASI indicator should illuminate for 5 seconds after the lead set is inserted (as well as when the Check button is pressed).
Verifying Electrode Connections Verifying Electrode Connections The electrode indicator LEDs (Light Emitting Diodes) enable you to verify that the leads are available for the desired monitoring. Each electrode is color-coded. Pressing and holding the Check button enables you to view the lead set status. During routine use of the transmitter for monitoring, all LEDs are off.
Making ECG Adjustments During routine monitoring, the electrode indicators also notify you if one or more leads are not functioning. When a LEADS OFF condition occurs, the transmitter automatically illuminates the indicator corresponding to the missing lead. Making ECG Adjustments You can make the following adjustments from the IntelliVue Information Center: • • Change the lead or the lead label. Change the wave size. With 5-wire lead sets, you can monitor two leads.
Monitoring During Leads Off Note—If the TeleMon Companion Monitor is available, you can change the lead on a 3-wire lead set (if configured for Lead Select). See “ECG Leads Monitored” on page 3-4. • Adjusting Wave Size For a 5-wire lead set, you can change the lead without moving the electrodes. To change the amplitude of the ECG wave on the display or for recordings, place your cursor over the wave in the Patient Window and select the size you want from the pop-up box.
Monitoring During Leads Off Multilead Analysis If the system is using multilead analysis, the active secondary lead becomes the primary lead, and the arrhythmia algorithm switches the leads on the display. When the Leads Off condition is corrected, the leads are switched back to their original state. Arrhythmia Relearn does not occur. Singlelead Analysis For singlelead analysis, if there are two leads available, the other lead is made the primary lead until the Leads Off condition is corrected.
Monitoring During Leads Off Using EASI Leads to Troubleshoot If there is artifact in the ECG waves or a CANNOT ANALYZE ECG technical alarm condition, you can use the three EASI leads to troubleshoot: 1. Click 12-Lead ECG on the Patient Window, then on 3 EASI Leads. 2. The three directly acquired EASI leads will be displayed so that you can determine which electrodes are causing the problem and need to be replaced.
Optimizing System Performance Optimizing System Performance While telemetry monitoring offers many advantages, it can be a challenge. The reliability and quality of the signal transmission through the air and hospital walls is governed by a number of variables which can be difficult to control. A telemetry system cannot be as dependable as a hardwired bedside monitor that transmits its signal through a wire.
Optimizing System Performance Troubleshooting Signal Disturbance Dropouts Because the telemetry system is a wireless system, under certain conditions RF “dropouts” can occur. Dropouts result from a weak signal or RF interference. There will be signal drops to the bottom of channel for a minimum of 200 ms to indicate to the clinical user that it is a non-physiological event.
Optimizing System Performance Warning If you put telemetry in Standby mode, you must remember to turn monitoring back on when the patient returns to the unit. • Radio Frequency Interference Muscle and Movement Artifact 3-24 If the patient is in the coverage area and is stationary, try moving the location of the transmitter or patient about 6 inches (15 cm.). Radio frequency (RF) interference is caused by anything that intrudes into the transmitted electrical signal, such as paging transmitters.
Optimizing System Performance Use the following table to help you troubleshoot the most common sources of ECG noise. Problem Cause Remedy 60-Cycle (AC) Interference Poor electrode placement. Re-apply electrodes Muscle Artifact Possible non-grounded instrument near patient. Disconnect electrical appliances near patient (one at a time) by pulling wall plugs, to determine faulty grounding. Have engineering check grounding. Tense, uncomfortable patient. Make sure patient is comfortable.
Optimizing System Performance Problem Cause Remedy Baseline Wander Movement of patient. Make sure patient is comfortable. Improperly applied electrodes. Re-apply electrodes, using good skin preparation (see “Setting Up for ECG Monitoring” on page 3-7). Check that patient cable is not pulling electrodes. Respiratory interference. Move electrodes away from areas with greatest movement during respiration. Poor Electrode Contact Loose electrodes. Defective cables. Lead set not firmly connected.
ECG Safety Information ECG Safety Information Warning FOR ALL PATIENTS Always confirm Information Center observations with clinical observation of the patient before administering interventions. Every lead should be secured to an electrode on the patient. Conductive parts of electrodes should not contact earth or other conductive parts. Philips recommends that you change the lead label only to reflect the physical placement of electrodes.
ST/AR Arrhythmia Analysis Warning FOR PACED PATIENTS The output power of the transmitter and other sources of radio frequency energy, when used in the proximity of a pacemaker, can be sufficient to interfere with pacemaker performance. Due to the shielding effects of the body, internal pacemakers are somewhat less vulnerable than external pacemakers. However, caution should be exercised when monitoring any paced patient.
ST/AR Arrhythmia Analysis algorithm is effective when monitoring both paced and non-paced patients in a clinical environment. ST/AR provides Heart Rate and PVC Rate numerics and alarm detection for the conditions listed in the table below. There are two levels: Basic and Enhanced. Enhanced includes the Basic alarms. See “Physiologic (Patient) Alarms” on page 2-6 for arrhythmia alarm text and descriptions.
ST/AR Arrhythmia Analysis Beat classification determined by the ST/AR algorithm is shown on the primary delayed wave in Arrhythmia Analysis at the Information Center. To access the waves with beat annotations, select Arrhythmia Analysis from the Patient Window. The annotation requires clinical validation of the analyzed heart rhythm. If the analysis is inaccurate, perform a Relearn of the rhythm.
ST/AR Arrhythmia Analysis ST/AR Arrhythmia Safety Information Warning FOR ALL PATIENTS During complete heart block or pacemaker failure (to pace or capture), tall P-waves (greater than 1/5 of the average R-wave height) can be erroneously counted by the arrhythmia algorithm, resulting in missed detection of cardiac arrest. Learning/Relearning --If you initiate learning during ventricular rhythm, the ectopics can be incorrectly learned as the normal QRS complex.
ST/AR Arrhythmia Analysis Warning FOR PACED PATIENTS It is possible that pacemaker pulses will not be detected when the ECG analog output of a defibrillator or telemetry unit is plugged into a bedside monitor. This can result in the arrhythmia algorithm’s failure to detect pacemaker non-capture or asystole. Some pace pulses can be difficult to reject. When this happens, the pulses are counted as a QRS complex, and could result in an incorrect HR and failure to detect cardiac arrest or some arrhythmias.
This chapter describes the ST/AR ST algorithm for telemetry of the IntelliVue Information Center. It includes the following sections: • • • • • ST/AR ST Algorithm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2 Adjusting Measurement Points. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5 Establishing ST Reference Beats (Baseline) . . . . . . . . . . . . . . . . . . . . 4-7 Turning ST On/Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ST/AR ST Algorithm ST/AR ST Algorithm Intended Use The intended use of the ST/AR ST algorithm for the IntelliVue Information Center is to monitor ST segment elevation or depression for each available telemetry ECG lead and produce events/alarms simultaneously. ST values update with every measurement period and enunciate, depending upon the severity of the change, events and alarms as they are detected. Patient Population You can perform ST analysis on both non-paced and atrially paced patients.
ST/AR ST Algorithm The Measurement The ST measurement for each beat complex is the vertical difference between two measurement points. The isoelectric point provides the baseline for the measurement and the ST point provides the other measurement point. It is positioned with reference to the J point.
ST/AR ST Algorithm How the Algorithm Works When ST analysis is being performed on two leads, the averaged derived and reconstructed ST waves and associated ST segment values are given for up to six leads, depending on the type of patient cable: • 3-wire: one lead • 5-wire: up to two leads if monitoring a chest and a limb lead • 5-wire: up to six leads if monitoring two limb leads with the Philips transmitter (without EASI monitoring) • 5- wire: up to 12 leads if monitoring using EASI Note—No ST an
Adjusting Measurement Points Adjusting Measurement Points The ST Setup Window allows you to adjust the ST measurement points to ensure accurate data. There are three measurement cursors: • The ISO measurement cursor positions the isoelectric point in relation to the R-wave peak. • The J-point cursor positions the J point in relation to the R-wave peak. The purpose of the J point is to correctly position the ST measurement point.
Adjusting Measurement Points Step 3 Action Adjust the J point, if necessary, by placing the cursor over the Jpoint button to access the adjustment arrows. Then use the arrows to position the bar at the end of the QRS complex and the beginning of the ST segment. R T P Q 4 S J point Adjust the ST point, if necessary, by using the J point as an “anchor” and place the bar at the midpoint of the ST segment. Choices are J + 0, J + 20, J + 40, J + 60, or J + 80).
Establishing ST Reference Beats (Baseline) Establishing ST Reference Beats (Baseline) After adjusting the measurement points, you can establish baseline reference beats for all available leads in the ST Review window at the IntelliVue Information Center. Reference beats enable you to compare waveform changes, for example from admission, or prior to or after treatment. The reference continues to be saved beyond the 24 hour review window, but you can update it to any beat within the last 24 hours.
ST Alarms ST Alarms All IntelliVue Information Center alarm settings (limits and on/off status) have unit default settings. The Information Center however, lets you set the high and low ST alarm limits for individual patients based on: • Your assessment of the patient's clinical condition. • Unit protocols. • Physician orders or medication specified limits.
ST Alarms ST Alarm Adjustments Task Summary Make adjustments to ST alarms on the ST Alarms window. Step Action 1 Access the ST Alarms window by clicking on the All Controls button in the Patient Window then clicking the ST Alarms button under Alarm Management and Setup. 2 Make the adjustments on the ST Alarms window. Choices for setting the ST alarm limits are: Unit Settings—Click on this button if want to have the specific limits that are pre-set for your unit.
ST Alarms 4-10 ST/AR ST Segment Monitoring
This chapter provides an introduction to the SpO2 measurement and its application. It includes the following sections: • • • • • • • • • • About the Pulse Oximetry Measurement . . . . . . . . . . . . . . . . . . . . . . . 5-2 Preparing for Telemetry SpO2 Monitoring. . . . . . . . . . . . . . . . . . . . . . 5-7 SpO2 Sensors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8 Selecting an SpO2 Sensor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
About the Pulse Oximetry Measurement About the Pulse Oximetry Measurement The M2601B transmitter supports an SpO2 sensor connection using Fourier Artifact Suppression Technology (FAST). The FAST algorithm provides superior motion artifact rejection and low-perfusion performance. SpO2 can be measured continuously, where a value is sent to the Information Center every second, or as a single, individual measurement (Spot Check).
About the Pulse Oximetry Measurement Pulse Indication During Spot Check measurement, the pulse signal is detected and communicated to you via an auditory signal. The indicator is a single low-pitched tone for each pulse detected. The tone (volume, mute) is configured. The pulse indication stops when a measurement is complete.
About the Pulse Oximetry Measurement SpO2 Information for the User1 The pulse oximeter is calibrated to indicate fractional oxyhemoglobin, and displayed results can range from 0 to 100%. A 10 second averaging filter is used in the calculation of the result. Displayed results are typically updated every second, but the update period can be automatically delayed by up to 30 seconds in the presence of noise. Physiological SpO2 alarm signals will be generated at the Information Center.
About the Pulse Oximetry Measurement SpO2 Safety Information Warning Prolonged, continuous monitoring can increase the risk of changes in skin characteristics, such as irritation, reddening, blistering or pressure necrosis, particularly on patients with impaired perfusion and varying or immature skin morphology. Specific attention must be given to sensor site inspection for changes in skin quality, proper optical path alignment and attachment.
About the Pulse Oximetry Measurement Warning Removal of the SpO2 sensor during Continuous SpO2 monitoring results in a SpO2 NO TRANSDUCER technical alarm. There is no technical alarm for a "No sensor" condition in Spot Check mode.
Preparing for Telemetry SpO2 Monitoring Preparing for Telemetry SpO2 Monitoring The Philips Telemetry System provides remote monitoring of SpO2 measurement for adult and pediatric patients. You need to prepare your telemetry patient and perform setup tasks for the measurement to display at the IntelliVue Information Center or the TeleMon Companion Monitor.
SpO2 Sensors SpO2 Sensors Disposable Sensors Only use disposable sensors once and then discard. However, you can relocate them to a different patient-site if the first location does not give the desired results. Do not reuse disposable sensors on different patients. Disposable sensors are not available as Philips Medical Systems parts in the USA or Canada. Contact Nellcor® Incorporated at 1-800-635-5267 or 1-888-744-1414.
Selecting an SpO2 Sensor Selecting an SpO2 Sensor Philips reusable sensors in adult, pediatric and infant models can be used, as well as Philips and Nellcor disposable sensors. Use only specified sensors (probes) and cables. “Selecting an SpO2 Sensor” on page 5-10 is a guide in selecting the correct sensor type. To use the figure, find the patient’s weight on the vertical axis. On the horizontal axis at this weight, the shaded areas indicate that the sensor is a "best choice" for the patient.
Selecting an SpO2 Sensor Patient Weight ( lb ) Patient Weight ( kg ) Adult Adult Adult Adult Adult 110 50 40 Pedi Pedi Pedi Pedi Pedi 30 66 44 15 33 Infant 22 3 Neo 7 Philips Part # M1192A M1191A M1194A M1901B M1903B M1904B Oxisensor OxiCliq/OxiMax N-25 N Reuseable sensor D-20 P Disposable sensor Preferred sensor types Alternative sensor types Selecting an SpO2 Sensor 5-10 SpO2 Monitoring 88 20 10 Infant Pedi D-25 A
Selecting an SpO2 Sensor Caution Do not use OxiCliq disposable sensors in a high humidity environment, or in the presence of fluids. These can contaminate sensor and electrical connections, and thereby cause unreliable or intermittent measurements. Do not use disposable sensors on patients who have allergic reactions to the adhesive.
Applying the Sensor Applying the Sensor Sensor Application Safety Information Warning Failure to apply a sensor properly can reduce the accuracy of the SpO2 measurement. Loose/Tight sensor: If a sensor is too loose, it can compromise the optical alignment or fall off. If it is too tight, for example because the application site is too large or becomes too large due to edema, excessive pressure can be applied.
Applying the Sensor Select an appropriate sensor and apply the sensor properly to avoid incorrect measurements. Applying a small amount of pressure at the application site can improve the measurement. Use one of the preferred application sites for your sensor.
Applying the Sensor Adult Finger Sensor (M1191A) Place the sensor over the fingertip in such a way that the fingertip touches but does not protrude from the end of the sensor. The fingertip must be uppermost and the cable must lie on the back of the hand. This ensures that the light sources cover the base of the fingertip giving the best measurement results. The cable can be held in place by the accompanying wristband. Warning Failure to apply the sensor properly may cause incorrect measurement of SpO2.
Applying the Sensor Small Adult/ Pediatric Finger Sensor (M1192A) Place the sensor over the fingertip in such a way that the fingertip touches but does not protrude from the end of the sensor.
Applying the Sensor Ear Clip Sensor (M1194A) Clip the probe onto the fleshy part of the ear lobe as shown in the diagram below. The plastic fixing mechanism helps to minimize artifact generated by patient motion. Do not position the probe on cartilage or where it presses against the head. The clip sensor can be used as an alternative if the adult finger sensor does not provide satisfactory results.
Connecting the SpO2 Cable Connecting the SpO2 Cable Task Summary Step Action 1 Connect the sensor cable to the transmitter. If you are using a disposable sensor, plug the sensor into the adapter cable and plug this cable into the transmitter. Plug reusable sensors directly into the transmitter 2 Ensure that the sensor and connector are positioned away from power cables, to avoid electrical interference. Caution Extension cables: Do not use extension cables with the transmitter.
Making SpO2 Measurements Making SpO2 Measurements SpO2 measurements can be made continuously, or manually on an as-needed basis (Spot Check). The SpO2 parameter is turned on/off by inserting/removing the sensor cable into the transmitter. SpO2 monitoring consumes considerable electrical energy. If the battery power is not at least 25% full, no measurements of SpO2 can be made. Setting the mode at Continuous or Spot Check is done at TeleMon or is configured using the Service Tool.
Making SpO2 Measurements Making a Spot Check Measurement When the transmitter is configured for Spot Check measurement, use the following instructions to take an individual, manual SpO2 reading from the transmitter. Task Summary Step Action 1 Attach the sensor to the patient. 2 Connect the SpO2 cable to the transmitter, and check that: • The SpO2 sensor light turns on. • A low-pitched tone detecting each pulse is audible (unless sounds are muted).
Making SpO2 Measurements Monitoring SpO2 Continuously When the transmitter is configured for Continuous SpO2 measurement, use the following directions to initiate Continuous SpO2 monitoring. Task Summary Step Action 1 Insert the SpO2 cable to the transmitter, and check that the sensor light turns on. 2 Attach the sensor to the patient. 3 After approximately 15 seconds, the value, with the measurement time, is displayed at the Information Center.
Making SpO2 Measurements Turning the SpO2 Parameter On/Off You can turn the SpO2 parameter on/off at the Information Center by using the Telemetry Setup Window. Note—If SpO2 is turned on, the Patient Sector and Patient Window of the Information Center display the numeric with "T" (for example, SpO2 T 90%) to indicate that the measurement was made via telemetry.
Making SpO2 Measurements SpO2 Parameter Auto ON The SpO2 parameter is automatically turned on at the IntelliVue Information Center if a manual SpO2 measurement is initiated at the transmitter while in Spot Check mode or the SpO2 sensor is inserted into the transmitter while the transmitter is in Continuous SpO2 mode. When a patient is discharged and the transmitter is in Continuous mode, the SpO2 parameter is turned off.
Making SpO2 Measurements Turning the Pulse Parameter On/Off If monitoring SpO2 continuously, the Pulse parameter is available at the IntelliVue Information Center. You can turn the SpO2 pulse parameter on or off by using the Telemetry Setup Window. Task Summary Turn the pulse parameter on or off by performing the following steps: Step Action 1 On the Patient Window click the All Controls button. 2 On the All Controls Window click the Telemetry Setup button.
Measurement Limitations Measurement Limitations Refer to this section on problem situations if you have difficulty getting a signal or obtaining accurate measurements. Distortion Ambient light, motion, perfusion or incorrect sensor placement may affect the accuracy of the derived measurements.
Optimizing Sensor Performance Optimizing Sensor Performance To get the best results from your SpO2 reusable sensor: • Always handle the sensor and cable with care. The soft finger sleeve houses a sensitive electronic device that can be damaged by harsh treatment. Always protect the cable from sharp-edged objects. • Use the wristband that is supplied with your M1191A sensor. By keeping the cable between the finger sensor and the wristband fairly loose, you will maintain good monitoring conditions.
SpO2 Alarms and Technical Alarms 5-26 SpO2 Monitoring
This chapter describes how to maintain the telemetry equipment and configure the system. It includes the following sections: • • • • • • Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2 Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3 Transmitter Cleaning, Disinfection, & Cross-Infection Prevention . . . . 6-4 Receiver Mainframe Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . .
Troubleshooting Troubleshooting Basic Troubleshooting For problems with... • ECG measurement refer to “Optimizing System Performance” on page 3-22 “Technical Alarms (INOPs)” on page 11 • SpO2 measurement “Measurement Limitations” on page 5-24 “Technical Alarms (INOPs)” on page 11 • Batteries “Battery Information” on page 1-29 “Status Check” on page 1-28 • Testing Alarms 6-2 Nurse Call Alarm Nurse Call may have been turned off for the patient. See “Turning Nurse Call On/Off” on page 1-23.
Maintenance Maintenance Before beginning monitoring on a patient: • • • • • Check for any mechanical damage. Check all the external leads, plug-ins and accessories. Check all the functions of the instrument which are needed to monitor the patient. Ensure that the instrument is in good, working order. Ensure that any needed gunk guards are in place.
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Transmitter Cleaning, Disinfection, & Cross-Infection Prevention The procedures in this section keep the transmitter clean and provide protection against infectious agents and bloodborne pathogens. Both the outside of the transmitter and the inside of the battery compartment must be kept free of dirt, dust, and debris.
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Step Action 3 Rinse the transmitter in water. 4 Flush device orifices with a forceful water stream to remove any residue in the openings. 5 Allow to air-dry, or dry with a non-lint producing cloth. 6 Continue with either Disinfection or Cross-Infection Prevention procedure, according to your hospital’s protocol.
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Wiping the Transmitter Step Action 1 Remove the batteries and any cables or accessories. 2 Wipe the transmitter clean by using a cloth dampened modestly with one of the following approved cleaning agents: • • Isopropyl Alcohol (> 70%) Sodium Hypochlorite (chlorine bleach), 10% solution prepared within 24 hours. 3 Wipe all disinfected surfaces with distilled water to remove any residue.
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Step Action 3 Dip all cleaned surfaces in bowl of distilled water to remove any residue. 4 Dry the equipment with a non-lint producing cloth. Cross-Infection Prevention for the Transmitter The transmitter can be subjected to one ETOH cross-infection prevention process four times per year for 2 years. Completion of this procedure achieves a cross-infection prevention assurance level of 10E-6.
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Use the following equipment and material to process the transmitter: 1. Ethylene Oxide (Allied Signal Oxyfume-2002™), heretofore referred to as EO. 2. Gas sterilizer, made by American Sterilizer Company or other manufacturers. 3. Mechanical aerator. The intake air for the aeration chamber must be routed through bacterial filters, and the exhaust air must be vented outside the building.
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Step Action 6 Apply -26 inHg +/- 1 (-12.77 psig +/- .49) vacuum to the sterilizer chamber. 7 Humidify the chamber at 50% +/- 10% relative humidity for 20 to 30 minutes. 8 Taking a minimum of five minutes, slowly introduce EO sterilant until the sterilizer unit pressure gauge reaches 11 +/- 1 psig. Note—At this pressure, the concentration of sterilant in the chamber will be 600 +/- 50 mg/liter, regardless of the chamber size.
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Step 11 Action Air-wash the chamber and material as follows: a. Apply -26 inHg +/- 1 (-12.77 psig +/- .49) vacuum to the chamber and processed material again, to remove residual EO. The vacuum pump must be vented to the outdoors. b. Return the sterilized chamber to ambient pressure by introducing air that has been bacterially filtered. 12 Continue with the "Aeration Procedure" (following).
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Task Summary Aerate the processed equipment by performing the following steps: Step 1 Action To dissipate residual EO, aerate the processed equipment with air that has been bacterially filtered, using a mechanical aerator or combination sterilizer/aerator as follows:1 Time: 8-9 hours Temperature: 54.4 +/- 2.8oC (130 +/- 5oF) Ventilation Frequency: At least 30 air exchanges per hour. 2 Continue with the Test Procedure (following).
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Note—This test assumes that the telemetry system and Information Center are fully installed, and that you have performed the procedure to learn the transmitter identity code. Task Summary Test the transmitter by performing the following steps. If the test indications do not appear, refer to your Service Provider.
Transmitter Cleaning, Disinfection, & Cross-Infection Prevention Step 3 Action Test the transmitter: a. Put fresh batteries in the transmitter and close the battery door. Result: All indicator lights on the front of the transmitter light momentarily, and you will hear a single beep. b. Attach a lead set to the ECG port, and attach an SpO2 sensor to the SpO2 port. If an ECG simulator is available, attach the ECG leads to the simulator and the SpO2sensor to yourself.
Receiver Mainframe Cleaning Receiver Mainframe Cleaning The receiver mainframe should be kept free of dust and dirt. You can only clean the outside of the receiver mainframe.
Configuration Configuration How your telemetry system performs depends in large part on the configuration choices made during system installation. This chapter provides a summary of the factory-set defaults and the alternative configuration choices that relate to clinical practice. Configuration for the telemetry system is performed at the receiver mainframe, except for Philips transmitters, which are configured at the TeleMon Companion Monitor or using the Service Configuration Tool.
Configuration Settings Configuration Settings M2604A Mainframe The following table lists the mainframe configuration settings used by the IntelliVue Information Center.
Configuration Settings Item Factory Default User Choices M2601X SERIES TRANSMITTERS ECG PARAMETERS Lead Selection - 5 Electrode Primary = II Secondary = V Primary = I, II, III, aVR, aVL, aVF, MCL, V Secondary = I, II, III, aVR, aVL, aVF, MCL, V, OFF Note—The ECG primary and secondary must be different lead types, and the primary cannot be OFF.
Configuration Settings Philips M2601B Transmitter The following table lists the configuration settings for the Philips M2601B Transmitter.
This chapter provides information on regulatory requirements compliance for patient safety, safety-oriented installation and maintenance procedures, and specifications for the Philips Telemetry System. It includes the following sections: • • • • • • • Product Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2 Philips Telemetry System Warnings. . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4 Electromagnetic Compatibility . . . . . . . . . . . . . . . .
Product Safety Product Safety 0123 ! The M2600B Philips Telemetry System, complies with the requirements of the Council Directive 93/42/EEC of 14 June 1993 concerning medical devices and carries CE-marking accordingly. ( ) 0123 The following symbol ! means that this device is considered Class 2 radio equipment per Directive 1999/5/EC for which Member States may apply restrictions on putting the device into service or placing it on the market.
Product Safety Authorized EU Representative: Philips Medizinsysteme Boeblingen GmbH Hewlett-Packard Str. 2 D-71034 Boeblingen Germany System Classification Class I Equipment M2604A Receiver Mainframe Class II Equipment 453563647161 Universal Power Converter (UPC) Characteristic Definition Internally Powered Equipment The M2601B Transmitter is an internally powered device. Continuous Operation All equipment is Ordinary Equipment, IPX0, and provides continuous operation.
Philips Telemetry System Warnings Essential Performance The Philips Telemetry System provides Essential Performance (EP) under normal operating conditions (includes EMC exposure) only as a complete Medical Electrical System, consisting of the M2601B Patient-Connected Device, M2636B TeleMon (opt. A02, A03) Companion Monitor (Optional), M2603A/M2604A Receiver/Mainframe, and M3150A IntelliVue Information Center.
Electromagnetic Compatibility Warning Do not install or use power modules for analog output and antennas within a 2.44 m (8 ft.) radius of the patient. This helps ensure patient electrical safety. Caution Installation and setup must be performed by a Philips Medical Systems service representative or designee according to the instructions in Philips Telemetry Installation & Configuration Guide, which can be found in the M2600B Documentation Kit (order number M2600-90323).
Electromagnetic Compatibility assistance with the minimum recommended separation distance between RF communications equipment and the product. The cables, sensors/transducers, and other accessories for which compliance is claimed are listed in “Appendix B. Accessory List” in this Instructions for Use and in the Philips Telemetry System Service Guide.
Electromagnetic Compatibility Once the source is located, attempt to attenuate the interference by distancing the product from the source as much as possible. If assistance is needed, contact your local Service Provider. Restrictions for Use FCC Compliance (USA only) Artifact on ECG and other physiological waveforms caused by electromagnetic interference should be evaluated by a physician or physician authorized personnel to determine if it will negatively impact patient diagnosis or treatment.
Electromagnetic Compatibility For operation outside 608-614 MHz Contact your local Industry Canada offices as licensure is required. To provide maximum RF shielding and minimum RF interference to the licensed service, this device should be operated indoors and away from windows.
System Symbols System Symbols The following is an explanation of the symbols found on the hardware components of the Philips Telemetry System: Symbol Explanation AC Line Current. Active Antenna Combiner. Antenna Input. Attention. See Instructions for Use.
System Symbols Symbol Explanation Class 2 Equipment Data In Data In, Data Out Data Out Date of Manufacture DC Voltage 2 Do Not Reuse. Use Only Once. Dispose of properly after use in accordance with local regulations.
System Symbols Symbol Explanation Electrical Output. Equipotential Grounding System. Follow Operating Instructions. i Frequency Converter Fuse Input. Grounding system.
System Symbols Symbol Explanation Non-ionizing Radiation Power On/Off Product Option Protective Earth (Ground) Power Tee Receiver Mainframe Malfunction Receiver Mainframe. For future use.
System Symbols Symbol Explanation IPX0 The M2600B is rated IPXO in degrees of protection by enclosures; not protected against ingress of water. Complies with applicable Canadian and American medical safety standards. 0123 ! Rx Compliance to Council Directive 93/42/EEC (Medical Device Directive) Class 2 Radio equipment identifier (1999/5/EC): Member states may apply restrictions on putting this device into service or placing on the market.
Installation and Maintenance Safety Type CF Defibrillation Proof The following symbol identifies a device that is Type CF Defibrillation Proof. TYPE CF DEFIBRILLATION PROOF Type CF Defibrillation Proof equipment is protected against defibrillation (DEFIBRILLATION-PROOF) and is a TYPE CF APPLIED PART. Installation and Maintenance Safety Caution Installation and setup must be performed by a Philips Medical Systems service representative or designee, except for transmitters purchased individually.
Installation and Maintenance Safety instrument and cause damage to the components and circuits. Allow at least 5 cm (2 inches) clearance around the instrument for proper air circulation. Grounding To protect hospital personnel, the cabinet of the Philips Telemetry System must be grounded. Accordingly, the system is equipped with a detachable 3-wire cable which grounds the instrument to the power line ground (protective earth) when plugged into an appropriate 3-wire receptacle.
Installation and Maintenance Safety Receiver Mainframe Rear Panel The rear panel of the receiver mainframe is shown below. SDN Connectors CPC Configuration Connector Cover Power Supply Not Analog CPC Used Output Board Connector (optional) Green ON Antenna Input Signal Connector AC Power Protective Equipotential Connector Earth Grounding Lug (Ground) The back of the mainframe should be removed only by qualified service personnel.
Installation and Maintenance Safety Connector Description Equipotential Grounding Lug Grounding stud connector, used to equalize the grounding potential between products (see “Secondary Ground Wire”, below) SDN Upstream and downstream connectors that connect to the Philips monitoring network Secondary Ground Wire A secondary ground wire is provided with this instrument to comply with IEC60601-1-1.
Installation and Maintenance Safety For all voltages, use Universal Power Converter (UPC), part number 453563647161. Preventive Maintenance Preventive maintenance should be performed by a qualified service person. The Safety and Performance Tests, and what to do if the equipment does not meet these specifications, are described in the Philips Telemetry System Service Guide in the M2600B Documentation Kit. Contact your biomedical department if your equipment needs testing for safety or performance.
Additional Safety Information Additional Safety Information Warning The equipment is not suitable for use in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide. Warning This device is not to be used in the vicinity of electrosurgery units because use may interrupt or interfere with the transmission of signals from the transmitter. Warning Do not touch the patient, or table, or instruments during defibrillation. The battery door must be closed during defibrillation.
System Specifications System Specifications This section lists the specifications for battery life, environmental and electrical power specifications for the hardware components of the system, and measurement specifications. For complete specifications, see the M2600B Documentation Kit. Battery Life Specifications Equipment Specification Battery Type 2 fresh disposable AA alkaline batteries Note—The battery life times listed below are based on Duracell MN 1500 batteries.
System Specifications Environmental Specifications For all hardware components of the Philips Telemetry System except Philips transmitters and reusable pulse oximetry sensors Operating Temperature Range: 0 to 55ºC (32 to 131ºF) Altitude Range: Up to 4570 m (15,000 ft.) Humidity Range: 15 to 95% relative humidity Storage Temperature Range: -40 to +70ºC (-40 to +158ºF) Altitude Range: Up to 4570 m (15, 000 ft.
System Specifications After showering, perform the following steps to continue monitoring: 4. 5. 6. 7. 8. Pat dry the lead set connections at the electrodes. Wipe the lead wires with care. If wet, dry the outside of the transmitter with a non-lint producing cloth. If wet, wipe the inside of the battery compartment dry. Dry the batteries. If wet, disconnect the ECG lead block and shake out any water. Dry the connector pin area with a cotton swab.
System Specifications 47 - 118 MHz: < -54 dBm 118 - 174 MHz: < -46 dBm 174 - 230 MHz: < -54 dBm 230 - 470 MHz: < -38 dBm (excluding channel output) 470 - 862 MHz: < -54 dBm (excluding channel output) 862 - 1000 MHz: < -38 dBm > 1000 MHz: < -30 dBm Frequency Accuracy Frequency @25oC +/- 2.5 ppm @ (0 - 45oC) Occupied Bandwidth < 10 KHz Data Rate 9600 bits per second Modulation Type GMSK RF Specifications in 608-614 WMTS Band Frequency Ranges Option Band #037: 608 - 614 MHz (WMTS) RF Output Power @ 25oC 6.
System Specifications Defibrillator Protection Transmitter ECG input protected against 400 joules discharge into 50 Ohm load Batteries Two disposable 1.
System Specifications M2603A Receiver Module Frequency Tuning Programmable, synthesizer, PLL controlled. Channel Spacing 25 kHz. Carrier Frequency Range Frequency range depends on transmitter option Patient Monitor Holter Recorder Interface (Analog Output) Option J01 Power Module 453563647161 Input Voltage 100-240 VAC +/- 10% Frequency Range 47 - 63 Hz.
System Specifications Bedside Attenuator: Output (3-conductor phone jack) Holter Attenuator: Output (set of 5-button connectors) ECG Bandwidth M2601B: 0.5 - 40 Hz To ensure proper operation, installation and setup must be performed by a Philips Medical Systems service representative or designee according to the instructions in Patient Monitor/ Holter Recorder Interface (Analog Output) Installation Note (part number M2600-90194).
System Specifications M2607A Multiple Unit Power Supply Note—M2607A specifications cover both power module and power tee. Input Voltage CE Mark Power Module 453563647161: 100-240 VAC +/- 10% Frequency Range 47-63 Hz RF Frequency Range 406-650 MHz Power Consumption 33 VA maximum Output Voltage 23 VDC nominal Output Current 1 Amp maximum (Limited by the circuit breaker in the power tee) Indicators Green LED is on when power is present.
System Specifications Red LED indicates DC power/signal cable connected incorrectly.
System Specifications Power Consumption 14.0 VA maximum RF Input Frequency Range 590-632 MHz RF Output Frequency Ranges #130 460-502 MHz #136 454-496 MHz #142 448-490 MHz #148 442-484 MHz #154 436-478 MHz #160 430-472 MHz #166 424-466 MHz Indicators Green LED is ON when power is present.
System Specifications Measurement Specifications ECG ECG channel transmitted leads 3 electrodes Channel #1: I, II, or III 5 electrodes Channel #1: II Channel #2: III Channel #3: MCL 5 electrodes, EASI Channel #1: Vai Channel #2: Vas Channel #3: Ves Resolution 5 µV ECG Input Differential, defibrillator protected against 400 joules discharge into a 50 ohm load Input Impedance > 5 megohms (@ 10 Hz Input Dynamic Range +/- 9 mmV (EASI mode, +/-4.
System Specifications Lead Wires 3 or 5-wire set. 5-lead compatible with IntelliVue Patient Monitor, AAMI or IEC color code Time to baseline from Defibrillator AAMI: 5 s max (until ECG wave is on display but not yet centered, monitoring bandwidth) Pacer Rejection Performance (pace pulses with no tails) Positive pacers Amplitude +2 to +700 mV +2 to +500 mV +2 to +400 mV Width 0.1, 0.2, 0.5, and 1.0 ms 1.5 ms 2 ms Negative pacers Amplitude -2 to -700 mV -2 to -500 mV -2 to -400 mV Width 0.1, 0.2, 0.
System Specifications SpO2 Measurement Range (Calibration and Display) 0-100% Display of SpO2Numerics SpO2 values are displayed as xxx % SpO2 to meet ISO/EN standard EN 865 Accuracy See tables, following Resolution 1% SpO2 Numerics Averaging 10 seconds SpO2 & Pulse Numerics - Update Rate Transmitted once per second Pleth Wave - Sampling Rate 125 sps Technical Alarms Triggered if the sensor is disconnected, if a pulse is not detected, if the signal is noisy, if light interference is detected, if the sensor
System Specifications Sensor Accuracy . Type Description Model Number Philips Reusable Sensors Adult Finger Adult Finger Adult Finger Pediatric Finger Pediatric Finger Adult/Pediatric Ear Adult/Pediatric Ear M1191A M1191AL M1191NL M1192A M1192N M1194A M1194N Type Description Model Number Philips Disposable Sensors Adult Finger Pediatric Finger Adult Finger M1901B M1903B M1904B Accuracy% Arms (70-100% Range) 2.0 2.0 2.0 2.0 2.0 3.0 3.0 Accuracy% Arms (70-100% Range) 3.0 3.0 3.
System Specifications Type 7-34 Description Model Number OxiCliq A, Adult Nellcor Disposable Sensors (not OxiCliq N, Adult >40 kg (88 lb) available from Philips) OxiCliq P, Pediatric N/A Accuracy% Arms (70-100% Range) 3.0 N/A 3.0 N/A 3.0 OxiMax MAX-A, Adult >30 kg (66 lb) N/A 3.0 OxiMax MAX-AL, Adult >30 kg (>66 lb) N/A 3.0 OxiMax MAX-N, Adult >40 kg (>88 lb) N/A 3.0 OxiMax MAX-P, Pediatric N/A 3.0 Oxisensor II D-20, Pediatric 10-50 kg (22-110 lb) N/A 3.
This chapter describes the optional Patient Monitor/Holter Interface (Analog Output). It includes the following sections: • • • • • • • Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-2 Analog Output Bedside Monitor Cables. . . . . . . . . . . . . . . . . . . . . . . .A-3 Lead Placement and Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-5 Controls for Telemetry Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Overview Overview The optional Patient Monitor/Holter Interface (Analog Output) gives the Philips Telemetry System the capability of providing ECG outputs to bedside monitors, holter monitors, and other recording devices. This option is not available for telemetry systems with EASI monitoring. Warning The Patient Monitor/Holter Interface (Analog Output) Option is intended for display and recording purposes only.
Analog Output Bedside Monitor Cables Analog Output Bedside Monitor Cables To connect the telemetry transmitter to the bedside monitor via the optional Patient Monitor/Holter Interface (Analog Output), you will need an analog output bedside monitor cable. The end of the cable that connects to the bedside monitor will have either a small 12-pin connector or a larger 8-pin connector (See the illustration below). The other end of the cable has a phone plug connector, and it plugs into the wallplate.
Analog Output Bedside Monitor Cables The following table shows all available analog output bedside monitoring cables. Lead Set Bedside Monitor Cable Connector Analog Output Bedside Monitor Cable 3-wire lead set 8-pin (large) HP78599AI-#K71 12-pin (small) HP78599AI-#K72 8-pin (large) HP78599AI-#K73 12-pin (small) HP78599AI-#K74 5-wire lead set Caution To ensure correct lead labeling at the bedside monitor, it is important that you use the correct bedside monitor cable.
Lead Placement and Selection Lead Placement and Selection To ensure valid waves with the correct lead label, you must remember to use the following: • Standard lead placement (shown on the telemetry transmitter case and in further detail in IntelliVue Information Center or TeleMon On-line Help). • Valid lead selection (performed at the bedside monitor) The following table summarizes recommended lead placement and selection.
Controls for Telemetry Setup Controls for Telemetry Setup The interaction with ECG depends on how the system is installed. If it is installed so that you can make changes from the IntelliVue Information Center, the interface for lead and size selection is the same as described in “Changing Lead/Label” on page 3-18. If not, make adjustments at the bedside monitor.
Technical Alarms (Inoperative Conditions) Technical Alarms (Inoperative Conditions) With the Patient Monitor/Holter Interface (Analog Output) Option, the following telemetry technical alarms (inoperative conditions) will appear as a LEADS OFF message at the bedside monitor. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
Holter Interface Holter Interface If you are using a holter monitor, it should be connected to a holter wallplate. Warning Using a holter wallplate to interface to a bedside monitor could result in mislabeled leads.
This appendix lists all ECG and SpO2 accessories that can be used with the transmitter. For additional information on connecting and using these accessories, see the individual parameter chapters. Note—Accessories are subject to change. To get the latest accessories, visit the Philips Medical Supplies website located at the following address: http://shop.medical.philips.com.
ECG Accessories ECG Accessories Electrodes Order Number Description M2202A 60 packages of 5 radio translucent foam electrodes (300 per box) 40489E 10 packages of 30 paper tape electrodes (300 per box) 40493D 60 packages of 5 foam electrodes (300 per box) 40493E 10 packages of 30 foam electrodes (300 per box) Lead Sets B-2 Order Number Description 989803133831 3-wire, patient cable set, 79 cm (30”), AAMI, Snap 989803133841 3-wire, patient cable set, 79 cm (30”), AAMI, Grabber 989803133851
ECG Accessories Order Number Description 989803137261 Colored 5-wire, patient cable set, 79 cm (30”), IEC, Snap 989803137271 Colored 5-wire, patient cable set, 79 cm (30”), IEC, Grabber Order Number Description 989803134771 Skin preparation sheets, 10 preps/sheet, 10 sheets/ package Order Number Description 989803140401 Single, package of 10 989803140411 Single tethered, package of 10 989803140421 Double, package of 10 Order Number Description 989803140431 ECG, package of 10 989803140
SpO2 Accessories Pouches Order Number Description 989803137831 Telemetry pouch, box of 50 989803140371 Telemetry pouch, case of 200 Order Number Description 989803137841 5-wire ECG trunk cable Trunk Cable SpO2 Accessories Reusable Sensors B-4 Order Number Description M1191A Philips Adult finger, 2 m (6.6 feet) M1191AL Philips Adult finger, 3 m (9.8 feet) M1191NL Philips Adult finger, 3 m (9.8 feet) M1192A Philips Pediatric finger 1.5 m (4.9 feet) M1192N Philips Pediatric finger, 1.
SpO2 Accessories Disposable Sensors Single Use Note—OxiCliq, OxiMax and Oxisensor II sensors are not available from Philips in the USA or Canada. Adapter cables are not available from Philips in Canada or Japan. In those countries, contact Nellcor Incorporated directly.
SpO2 Accessories Wristband Order Number M1627A B-6 Description 10 bands per pack
For more information, please call your local Philips Medical Systems sales office listed in your telephone directory or a Philips Medical Systems regional office listed below for the location of your nearest sales office. Corporate Headquarters: Philips Medical Systems Netherlands B.V. Postbus 10.
Latin America Headquarters Philips Medical Systems 5200 Blue Lagoon Drive 9th Floor Miami, FL 33126 (305) 267-4220 Asia Pacific Headquarters Philips Medical Systems 24F Cityplaza One 1111 King’s Road Taikoo Shing, Hong Kong (+852) 3197 7777 C-2
A C accessories ECG, B-2 ordering information, B-1 SpO2, B-4 alarms behavior with Own Bed Overview, 2-3 list of physiologic, 2-6 list of technical (INOPs), 2-11 pause/suspend, 2-2 SpO2, turn on/off, 5-22 testing, 6-2 ambient light effect on SpO2, 5-24 analog output, 7-17 bedside monitor cables, A-3 INOPs, A-7 lead labeling, A-2 lead placement and selection, A-5 making adjustments, A-6 use with paced waves, A-6 antenna amplifiers, 7-17 arrhythmia ST/AR algorithm, 3-28 artifact, muscle and movement, 3-24 au
ECG noise troubleshooting, 3-24 ECG waves changing size, 3-19 electromagnetic compatibility, 7-5 essential performance, 7-4 EU representative, address, 7-3 Extended Monitoring, 3-20 F fallback EASI, 3-20 multilead/singlelead analysis, 3-20 FAST SpO2 algorithm, 5-2 G grounding, telemetry, 7-15 H Holter Interface option see analog output I indications for use, 1-5 instructions to patient, 1-19 IntelliVue TRx transceiver, 1-9 L labels changing ECG, 3-18 lead sets, 3-2 capabilities, 3-18 leads changing, 3-
retaining settings, 1-35 turning on/off, 1-35 RF interference, 3-23, 3-24 reducing, 7-6 restrictions for use, 7-7 S safety accessories, B-1 installation, 7-14 maintenance, 7-14 pacing, 3-32 pouch, 1-20 ST/AR arrhythmia, 3-31 safety information, 7-19 sensors adult finger, 5-14 application safety information, 5-12 applying, 5-12 ear clip, 5-16 positioning, 5-13 selecting, 5-25 small adult/pediatric, 5-15 showering drying transmitter, 1-22 use of transmitter, 1-21 signal too low (ECG) action to take, 3-23 Sma
ST/AR arrhythmia analysis, 3-28 standby mode, 1-24 symbols explanation of, 7-9 system classification, 7-3 compliance, Canadian radio equipment, 7-7 components, 1-7 diagram of, 1-8 electromagnetic compatibility, 7-5 environmental specifications, 7-21 essential performance, 7-4 FCC compliance, 7-7 indications for use, 1-5 intended use, 1-6 regulatory information, 1-6 RF interference, 7-6 safety compliance, 7-2 symbols, 7-9 transmitters used with, 1-9 warnings, 7-4 T technical alarms analog output, A-7 teleme
