Vital Signs Monitor Directions for Use Models 242, 244, 246 Software Version 3.1X Please check for Updates in the back pocket of this manual.
Copyright © 2000 by Protocol Systems, Inc. Protocol®, Propaq®, Propaq® CS, Acuity®, Protocol Cordless®, and Flexible Monitoring® are registered trademarks and Smartcuf™ is a trademark of Protocol Systems, Inc. Protocol Systems, Inc. is protected under various patents and patents pending. NELLCOR®, DURASENSOR®,C-LOCK® and OXISENSOR® are registered trademarks of Mallinckrodt, Incorporated. LIFEPAK 5® and LIFEPAK 6s® are registered trademarks of Physio-Control Corporation.
Table of Contents Contents 1 – General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Intended Use, Symbols, and Safety Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Controls and Connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Menus . . . . . . . .
6 – Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Connect the Monitor to the Acuity System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Disconnect the Monitor from the Acuity System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 7 – Defibrillator Synchronization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Synchronous Cardioversion with LIFEPAK 5 Defibrillator . . . . . . . . . . .
1 – General Information Intended Use, Symbols, and Safety Information . . . . . . . . . . . . . . . . . . . . . Intended Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . General Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 7 7 9 Display .
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Intended Use, Symbols, and Safety Information Intended Use The Propaq CS monitor is intended to be used by skilled clinicians for multiparameter vital signs monitoring of neonatal, pediatric, and adult patients in health care facility bedside applications. It is also intended for intra-facility and ambulance transport. The ECG channel is intended for five-lead or three-lead ECG monitoring.
The following symbols may appear on the Propaq CS monitor or accessories. They are defined by the International Electrotechnical Commission, IEC 878 and IEC 417A. Off (Standby) Two way communication port On Input port For continued fire protection, use only the specified fuse Output port Direct current Alternating current1 Direct current or alternating current Separate batteries from other disposables for recycling.
General Warnings and Cautions Familiarize yourself with all warnings and cautions before using the Propaq CS monitor. In addition to the following, other warnings and cautions appear throughout this manual. Warning Safe interconnection between the Propaq CS monitor and other devices must comply with applicable medical systems safety standards such as IEC 601-1-1. Within certain governmental jurisdictions, all interconnected accessory equipment must be labeled by an approved testing laboratory.
Caution Do not autoclave the Propaq CS monitor. Autoclave accessories only if the manufacturer's instructions clearly approve it. Many accessories can be severely damaged by autoclaving. Federal USA law restricts this device to sale, distribution, or use by or on the order of a licensed medical practitioner. It is possible for the monitor to detect a problem that prevents the monitor from operating properly. If this occurs, the monitor displays an error message and error number.
Touch-Screen Controls The front panel touch-screen provides five softkeys along the bottom and three icon-labeled keys along the right side. An Acuity NET OFF key is displayed in the upper left corner if the monitor is connected to an Acuity system. These keys allow control of all monitoring and setup functions. Note Avoid pressing more than one touch-screen key at a time. Touching more than one key area at a time can cause the touch-screen to misinterpret the command and respond to the wrong key.
Patient Connectors (Left Side Panel) Model 242 Model 246 Model 244 ECG NIBP Temperature (two channels)* ECG Invasive Pressure (two channels) NIBP Temperature (two channels)* ECG Invasiv Pressure (one channel) NIBP Temperature (two channels)* ECG / EKG RESP INV. BP ECG / EKG RESP P1 INV. BP P1 ECG / EKG RESP ! NIBP PSNI NIBP PSNI T1 NIBP PSNI T1 ! T2 ! T2 T2 INV. BP Propaq CS Model 242 Propaq CS Model 244 ECG / EKG RESP INV. BP T1 P2 Propaq CS Model 246 INV.
Display You can select up to four waveforms to be shown on the Propaq CS monitor. When only one waveform is selected, a trend window automatically appears beneath the waveform. Patient mode NET OFF to disconnect from the Acuity network. Time of day 17:05:10 NET ADULT OFF ON NETWORK ALLEN KIM Status messages can appear here. HR PRINT FAULT BPM II mV 1cm Patient name entered at Acuity Central Station.
Menus Menus for some patient vital signs are displayed only if the option is included in your Propaq CS monitor.
Setup Menus ECG/ RESP INVASIVE PRESSURE SpO2/ CO2 SETUP ALARMS WAVE WAVE SEL SELECT TRENDS MORE NIBP SETUP MENU 1 STATSCALE SETUP MENU 2 NEXT ACUITY CHANGE WAVE SELECT PRINTER MORE TREND MENU PRINT NEXT TREND PRINT OXYCRG NET OFF SNAPSHOT PREVIOUS MENU ALL ALARMS LIMITS PREVIOUS MENU UP DOWN ON/ OFF ACUITY MENU1 ALARMS MENU SUSPEND General Information STAT SET RESUME ALARM LIMITS MENU2 NEXT PARAMETER NEXT SETTING 1 Acuity Menu is displayed if the monitor is connected to A
Learn Propaq CS Operation with In-Service Mode You can practice using the Propaq CS monitor with the in-service mode of operation. The in-service mode cannot be activated while you are monitoring a patient. During in-service mode, the monitor display and all printouts include the message SIMULATING or SIMULATED DATA. To practice with your Propaq CS monitor: 1. Disconnect all patient cables connected to the monitor. You can leave the NIBP cuff connected to the monitor so you can take NIBP measurements. 2.
2 – Setup Prepare the Propaq CS Monitor for a New Patient . . . . . . . . . . . . . . . . . . 19 Set Patient Alarms and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Change the Current Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Change Powerup Patient Mode or Store Customized Settings . . . . . . . . 23 Change the Powerup Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Prepare the Propaq CS Monitor for a New Patient Warning Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target. 1. Press the gray recessed MONITOR button on the right side of the monitor to turn the monitor off (if it is on). Press it again to turn the monitor on.
5. To select which vital sign waveforms will display, from the Main Menu press SETUP, MORE, WAVE SELECT. Use NEXT and ON/OFF to turn on the desired waveforms in the Wave Select window. . WAVE SELECT SETUP ECG1 : ON CO2 : ON ECG2 : ON RESP : ON PA : ON SpO2 : ON P2 : ON NIBP : ON NEXT PREVIOUS MENU INSERVICE ON/ OFF You can turn on all waveforms, but only the first four waveforms selected as ON in the Wave Select window are displayed. You cannot turn off the ECG1 waveform. 6.
Set Patient Alarms and Alarm Limits 1. From the Main Menu, press SETUP, ALARMS to access the Alarms Status Menu: P2 ALARM STATUS ( NIBP RR/BR : APNEA : HR/PR : SpO2 : P1 : NIBP : P2 : TEMP : CO2 : (M) S D ( 85) mmHg TEMP °F MCO2 mmHg T1 T2 ∆T 100.4 98.6 1.8 BR 38 12 Br/m SpO2 SUSPEND ALL ALARMS Bells also appear in numerics windows. 97 % STAT SET 25 9 122 58 S D 15) mmHg (M) LIMITS PREVIOUS MENU All alarm limits are on. At least one alarm limit is off. (No bell) 2.
Change the Current Patient Mode 1. To change the current patient mode, from the Main Menu press SETUP, MORE, CHANGE to access the Patient Mode window: PATIENT MODE BATTERY: 8.2 VOLTS SELECT PATIENT MODE BASED ON AGE: NEO : < 44 WEEKS GEST. AGE PED : > 44 WEEKS GEST. AGE, < 9 YEARS ADULT: > 9 YEARS NEONATAL 2. PEDIATRIC ADULT SETUP PREVIOUS MENU Based on the patient’s age, press NEONATAL, PEDIATRIC, or ADULT. When the confirmation window appears, press YES to confirm your selection.
Change Powerup Patient Mode or Store Customized Settings The Propaq CS monitor has standard, preset, default powerup settings and alarm limits for each patient mode: Adult, Pediatric, and Neonatal. These are “Factory Patient Mode” settings (listed on page 97). You can also choose to customize and store programmable powerup settings and alarm limits for each patient mode. These are “Custom Patient Mode” settings.
Customize Patient Mode Settings 1. 2. 3. From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window. The patient mode you want to reprogram (ADULT, PED, or NEO) must be currently selected. To make sure it is currently selected, press NEXT as needed to highlight the desired mode, then press USE NOW and YES. Press Home to exit the Mode Setup window, then use other menus and keys to set the monitor settings and alarm limits as desired.
3 – Monitoring Perform ECG/RESP Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Prepare for ECG/RESP Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Use the ECG Filter to Display a Better Waveform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Use the Propaq CS Monitor With Pacemaker Patients . . . . . . . . . . . . . . . 32 Perform Invasive Blood Pressure (IBP) Monitoring . . . . . . . . . . . . . . . . .
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Perform ECG/RESP Monitoring ECG/R ESP Warning Impedance pneumography detects respiratory effort via changes in chest volume; therefore, impedance pneumography can be used to detect central apnea. However, apnea episodes with continued respiratory effort, such as obstructive apnea and mixed apnea, may go undetected. Also, artifact due to patient motion, apnea mattress shaking, or electrocautery use may cause apnea episodes to go undetected.
Caution To protect the Propaq CS monitor from damage during defibrillation, for accurate ECG information, and for protection against noise and other interference, use only ECG electrodes and cables specified or supplied by Protocol Systems (these cables have the required current-limiting resistors). Follow recommended application procedures. • Impedance pneumography (RESP) is not recommended for use with high frequency ventilation.
6. Attach lead wires to the electrodes before applying them to the patient. Apply the electrodes to the patient as shown. G LA RA + Standard 3-lead Configuration If using MCL1, select LEAD II on the monitor, and use all three electrodes. LL Marriott Configuration MCL 1 (G)=LA (-)=RA (+)=LL RA LA LA RA V1 V6 One of six V lead electrode placement sites for the C lead. RL 5-lead Configuration LL LL Neonate 3-lead Configuration 7. 8.
11. To set up the ECG/RESP display, from the Main Menu press ECG/RESP to display the first ECG/RESP menu: ECG1 lead selected ECG1 size selected ECG2 lead The ECG2 lead is always V, except when the ECG1 lead is V (in that case the ECG2 lead is II). RESP waveform is displayed (with RESP option) 17:05:10 NET ADULT OFF ON NETWORK ALLEN KIM PRINT FAULT BPM II mV 1cm P1 12.
14. Press NEXT and CHANGE as desired to adjust the display. HR/PR TONE Sets heart tone loudness to LOW, MEDIUM, HIGH, or OFF. If SpO2 is monitored, tone pitch varies with the SpO2 value. PACER DISPLAY Turns on and off the pacer indicator in the ECG waveform. If the patient has a pacemaker, you may want to turn on the pacer indicator (see page 32). ECG BANDWIDTH Selects the bandwidth for displayed and printed data. MONITOR is 0.5-40 Hz (Adult mode) or 0.5-120 Hz (Pediatric and Neonatal mode).
Use the Propaq CS Monitor With Pacemaker Patients Warning Pacemaker signals can differ from one pacemaker to the next. The Association for Advancement of Medical Instrumentation (AAMI) cautions that “in some devices, rate meters may continue to count the pacemaker rate during occurrences of cardiac arrest or some arrhythmias. Do not rely entirely upon rate meter alarms. All pacemaker patients should be kept under close or constant observation.
Perform Invasive Blood Pressure (IBP) Monitoring INV PRS Warning If electrocautery is used, always avoid using any transducer with a conductive (metal) case that is electrically connected to its cable shield. Using a conductive transducer case with such a shield connection risks high-frequency burns at the ECG electrodes if the transducer case becomes earth grounded.
5. If the ZERO menu is not displayed, from the Main Menu press INVASIVE PRESSURE, then ZERO (or ZERO P2). The word ZEROING appears in the numerics window during zeroing. P1 If you want to cancel the zeroing process, press CANCEL. 6. Wait for a brief tone to sound and the word ZEROED to appear in the blood pressure numerics window. 7. 8. Close the transducer's stopcock. The monitor displays the pressure scale and numerics.
10. To display all invasive pressure waveforms on one scale (when two IBP channels are active), press RANGE to select the Range Mode. I N V 180 90 Press RANGE again to select another scale. Five scales are available: 300/150/0 180/90/0 120/60/0 60/30/0 30/15/0 P R S 0 RANGE To display each invasive waveform on its own scale, press RESCALE to select the Rescale Mode.
Take a Non-Invasive Blood Pressure (NIBP) Reading NIBP Warning Periodically observe the patient’s limb to make sure that the circulation is not impaired for a prolonged period of time. Also make sure the cuff is properly placed according to the following instructions. Prolonged impairment of circulation or improper cuff placement can cause bruising. The Propaq CS monitor should never be used to monitor NIBP on one patient while simultaneously monitoring ECG on another patient.
If artifact is so severe while Smartcuf is enabled that it affects the accuracy of an NIBP measurement, that measurement is marked with a special symbol on the display and on printouts: MON NIBP TREND RR/BR TIME HR/PR SpO2 S D (M) Br/M HH:MM BPM % mmHg 80 97 122 58 ( 85) 12 10:01 80 97 126 62 ( 86) 12 9:46 80 97 127 62 ( 86) 12 9:31 80 97 134 66 ( 89) 12 9:20 80 97 124 57 ( 86) 12 9:08 80 97 127 58 ( 88) 12 8:52 80 97 124 56 ( 85) 12 8:47 80 97 126 57 ( 84) 12 8:41 80 97 127 58 ( 85) 12 8:35 80 97 132 61 (
3. Place the cuff on the limb. If possible, place it at the same level as the heart. If above the heart, add 1.9 mmHg to the NIBP measurement for every inch above the heart. If below the heart, subtract 1.9 mmHg for every inch. Cuff applied evenly and snugly with bottom edge of cuff one inch above antecubital fossa The cuff should be snug, but not uncomfortable. The hose must not be kinked or pinched. Possible cuff placements for neonates Make sure the cuff tubing is centered over the brachial artery.
INTERVAL Selects the measurement interval for Automatic Mode NIBP measurements: 1, 2, 3, 5, 10, 15, 30, or 60 minutes. For intervals 5, 10, 15, 30, or 60, measurements occur at corresponding intervals past the hour. For example, if 5 is selected at 10:47:20, the measurements occur at 10:50, 10:55, 11:00, etc. For intervals 1, 2, or 3 minutes, measurements begin 1, 2, or 3 minutes after the interval is set. For example, if 1 is selected at 10:47:20, the next measurement starts at 10:48:20.
Perform Temperature Monitoring 1. TEMP Place the temperature probe on the patient. Warning Application and use of metal-jacketed temperature probes that come in contact with conductive objects or clinical personnel during electrocautery may cause burns at the patient-probe/electrode contact points. Do not touch conductive temperature sensors during defibrillation or cautery. Use only temperature probes listed in the Protocol Systems Products and Accessories booklet.
Perform SpO2 Monitoring SpO2 Warning Oxygen saturation measurements using pulse oximetry are highly dependent on proper placement of the sensor and patient conditions. Patient conditions such as shivering and smoke inhalation may result in erroneous oxygen saturation readings. If pulse oximetry measurements are suspect, verify the reading using another clinically accepted measurement method, such as arterial blood gas measurements.
4. From the Main Menu, press SpO2 (or SpO2/CO2, then SpO2) to display the first SpO2 menu: 1 MCO2 70 S p O mmHg 2 X BR 38 12 Br/m Oxygen saturation percentage SpO2 2 97 % SIZE PREVIOUS MENU MORE Pulse amplitude indicator 5. 6. Press SIZE to adjust the waveform size for best viewing (1x, 2x, 4x, or 8x). 7. Press MORE to display the second SpO2 menu: Adjust the placement of the sensor until a good SpO2 waveform is displayed.
11. If patient movement interferes with measurements, consider the following possible solutions: • be sure the sensor is secure and properly applied • use a new sensor with fresh adhesive backing • select a different type of sensor • move the sensor to a less active site • set the RESPONSE mode to SLOW • consider using C-LOCK; see step 9.
Perform Mainstream CO2 Monitoring CO2 The capnography (CO2) option measures End-tidal CO2 (ETCO2), Inspired CO2 (INCO2), Breath Rate, and Apnea. Patients using Mainstream CO2 must either be intubated or breathing through a tight-fitting face mask connected to a breathing system such as an anesthesia circle system. The Mainstream CO2 option requires the SpO2 option. Warning Avoid exposing older Mainstream CO2 sensors to non-patient sources of CO2 such as vehicle engine exhaust or smoke.
Warning Before using an airway adapter, always look through the window lumen and inspect the adapter for inadvertently lodged obstructions and for window integrity. If the sensor does not easily slide onto the adapter, do not attempt to force these components together. They fit together in only one way. Take care not to damage the glass window. After attaching the sensor to the adapter, check for proper placement.
Perform Sidestream CO2 Monitoring The capnography (CO2) option measures End-tidal CO2 (ETCO2), Inspired CO2 (INCO2), Breath Rate, and Apnea. Patients using Sidestream CO2 can either be intubated or non-intubated using a CO2 Sampling cannula or a combination CO2 Sampling/Oxygen Delivery nasal cannula. The Sidestream CO2 option requires the SpO2 option. Warning Do not use Sidestream CO2 if flammable anesthetic gases are in use.
3. For a non-intubated patient, position the cannula on the patient according to the manufacturer’s instructions. 3. For an intubated patient, connect the gas sampling elbow and elbow connector into the patient’s breathing circuit according to the manufacturer’s instructions. Warning Watertrap The cannula is disposable and should only be used for a single patient. Do not reuse the cannula for another patient.
Set Up the CO2 Display and Alarm Limits Note After you connect a Mainstream CO2 sensor or Sidestream CO2 watertrap, the Propaq CS monitor displays the waveform briefly without a scale. It displays WARM UP (for Mainstream) or START UP (for Sidestream) in the CO2 numerics window. After about 30 seconds, the monitor displays the CO2 measurement and waveform range.
4. Press MORE to access the second CO2 menu and status window: CO2 ( NIBP GAS COMPENSATION: OFF RESPONSE : NORMAL CO2 SOURCE : SIDESTREAM SWEEP SPEED : 6.25 mm/s BAROMETER FLOW RATE (M) 5. S D ( 85) mmHg TEMP °F SCO2 : 756.8 mmHg mmHg T1 T2 ∆T 100.4 98.6 1.8 BR 38 12 Br/m SpO2 : 175 ml/min % GAS COMP 25 9 122 58 S D 15) mmHg (M) RESPONSE SOURCE FLOW RATE FLOW RATE is only displayed for Sidestream CO2 (not Mainstream CO2).
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Respond to Patient Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53 Customize Alarm Limits Based on Patient’s Current Vital Signs . . . . . . .54 Alarm Holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55 Connect Nurse Call Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Respond to An Equipment Alert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Alarms & Alerts Respond to Patient Alarms When an apnea alarm or patient alarm occurs, the monitor produces an audible tone and visual indicators and displays the following: Alarm lights (see table on page 109) Press to suspend the tone for 90 seconds. Flashing numerics indicate that limits have been violated. Press LIMITS to adjust alarm limits (if LIMITS is available). 1. Press the Suspend/Resume Alarms key in the upper right corner of the screen or SUSPEND in the Patient Alarm Menu.
Customize Alarm Limits Based on Patient’s Current Vital Signs 1. To quickly set all alarm limits, from the Main Menu press SETUP, ALARMS, STAT SET. The monitor turns on all alarms and calculates new alarm limits based on the patient’s current vital sign values. Make sure that the new limits are appropriate for the patient.
To help minimize false alarms, the monitor briefly delays or “holds off” triggering alarms for limit violations for HR/PR, SpO2, and RR/BR. After the alarm holdoff period begins, if the monitor detects that the patient’s vital sign has returned to acceptable limits, the monitor cancels the alarm holdoff. The next time a vital sign limit is violated, the monitor starts a new holdoff period.
Respond to An Equipment Alert When the monitor detects an equipment problem, it produces an audible alert tone every five seconds.
Alarms & Alerts Troubleshooting Equipment Alert Messages ECG Messages If a lead fault occurs, the ECG equipment alert typically shows which lead failed. If multiple leads fail, the monitor displays MULTIPLE. ECG LEAD CHANGED. The Propaq CS monitor has automatically changed an ECG lead due to a lead wire or electrode problem. LEAD FAIL: REPLACE ELECTRODES. The cable may not be properly connected to the electrodes or the electrodes may have failed. Check for proper connection; replace electrodes if needed.
OVERPRESSURE CONDITION (ERR# 4). The pressure in the cuff exceeded the acceptable limits for patient mode. Check the hose and try taking another measurement. WEAK PULSES, CAN'T FIND SYS/DIA (ERR# 5). There are not enough pulses to determine the systolic or diastolic pressures, but a mean pressure is available. Try reapplying the cuff after squeezing as much air from it as you can. ARTIFACT, CAN’T FIND SYS/DIA (ERR# 6).
Alarms & Alerts The following messages can appear in the NIBP status window. CALIBRATING. The NIBP channel is running an internal calibration. DISABLED, LOW BATT. See LOW BATTERY, NIBP DISABLED above. NIBP DISABLED, SERVICE REQUIRED. See SERVICE REQUIRED, NIBP DISABLED above. RETRY. Since the Propaq CS monitor did not receive a valid NIBP reading, it will automatically attempt to take another reading.
Mainstream CO2 Messages Messages for the Mainstream CO2 option can appear in the equipment alert window and in numeric zones. If a sensor is damaged, contact Protocol Systems’ Technical Services Department for information on sensor service options. ALTIMETER FAILURE - RANGE. The Propaq CS monitor is operating at an altitude outside the Mainstream CO2 option’s operating altitude range of -2,000 to 15,000 feet.
ALTIMETER FAILURE - RANGE. The Propaq CS monitor is operating at an altitude outside the Sidestream CO2 option’s operating altitude range of -2,000 to 15,000 feet. Returning the monitor to within this range automatically cancels this message and restores operation. ALTIMETER FAILURE - RATE. The altimeter has detected that the ambient pressure is changing at a rate greater than 100 mmHg/minute.
Network Alert Message with Acuity NETWORK FAULT, CHECK ACUITY/DATA COMM CONNECTION. The Propaq CS monitor detects a problem in communication with Acuity. Check the Acuity network cable to be sure it is plugged in to the side panel and to the bedside jack. If the cable is damaged, replace the cable. If the cable appears undamaged and the Acuity system is operating normally, ask your service personnel to check the network and the Propaq CS monitor Acuity connector.
Alarms & Alerts Printer Alert Messages CHECK DOOR. The door on the bottom of the printer is open. Close the door to remove this message. LOW BATTERY, PRINTER DISABLED. The monitor’s battery voltage is too low to support printing. Connect the ac power adapter to recharge the battery (see page 87). OVERHEATING. The printer is overheating. Service may be required. PAPER OUT. To add printer paper, see page 90. Defibrillator Alert Message DEFIB FAULT, CHECK INTERFACE CABLE.
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5 – Printing & Trends Print Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Print the Displayed Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Set Printer Options and Automatic Printing. . . . . . . . . . . . . . . . . . . . . . . . 70 Print OxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Printing & Trends Display or Print Trends . . . .
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Print Patient Data Print the Displayed Waveforms 1. Press SNAPSHOT or START/STOP. The Propaq CS monitor prints up to three of the displayed waveforms. When four waveforms are displayed, the monitor prints the top three displayed waveforms (except for the ECG2 waveform which is never printed). If you pressed START/STOP, the monitor continues to print until you press START/STOP again.
Display or Print Trends Display or Print a Single Trend 1. To display a patient data trend, press SETUP, TRENDS from the Main Menu. The monitor displays the Trend Menu: The monitor stores trends every 2 minutes (except for NIBP) for up to 5 hours. After 5 hours, newly recorded trends replace the oldest trends. NIBP trends are stored when measured. Up to 128 NIBP trends can be stored (up to 8 hours). The TIME, HR/PR, and SpO2 are stored for all trends. OFF indicates the vital sign was not being monitored.
Print Multiple Trends Manually or Automatically 1. Press SETUP, MORE, PRINTER from the Main Menu to display the Printer Setup Page: P2 PRINTER SETUP PAGE CONTINUOUS AUTO PRINT ALARM PRINT NIBP TICKET APNEA TICKET OXYCRG ON ALARM AUTO TREND NIBP : RESP : P1 : Select ON to include in trend printing. 25.0 mm/s OFF OFF OFF ON OFF : 01 05 09 13 17 21 ON : OFF P2 TEMP : OFF OFF ON NIBP (M) Press to scroll to the next selection. CHANGE Press to change the displayed value.
Set Printer Options and Automatic Printing 1. Press SETUP, MORE, PRINTER from the Main Menu to display the Printer Setup Page: PRINTER SETUP PAGE CONTINUOUS AUTO PRINT ALARM PRINT NIBP TICKET APNEA TICKET OXYCRG ON ALARM AUTO TREND NIBP : RESP : P1 : : : : : : : : OFF ON OFF ON 25.0 mm/s OFF OFF OFF ON OFF (M) NIBP (M) TEMP °F mmHg Press to scroll to the next selection. 2. CHANGE Press to change the displayed value. T1 T2 ∆T 100.4 98.6 1.
Print OxyCRG The OxyCRG is a printout of two minutes of continuous HR/PR and SpO2 numerics, and a compressed respiratory waveform. 1. To print OxyCRG, from the Main Menu press SETUP, TRENDS, PRINT OXYCRG. If any of the parameters have been completely inactive for the two minutes prior to the printout, the associated band is empty.
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6 – Acuity Connect the Monitor to the Acuity System . . . . . . . . . . . . . . . . . . . . . . . . 75 Print at Acuity from the Propaq CS Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Disconnect the Monitor from the Acuity System. . . . . . . . . . . . . . . . . . . . .
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Connect the Monitor to the Acuity System Warning Connect the Propaq CS monitor to an Acuity system only. Connecting to other networks could damage the monitor or injure the patient. If in doubt about the network jacks or devices, consult your facility’s Biomedical Engineering Department. Make sure the Acuity network cable is not damaged. The Acuity network cable is the sole link between the Propaq CS monitor and the Acuity Central Station.
3. 4. 5. 6. Plug in the Acuity network cable to the Acuity network jack on the monitor side panel as shown. Plug in the other end of the cable to the bedside Acuity network jack. Connect the ac power adapter to the monitor and the wall outlet to charge the battery (see page 87 for instructions). Check to see that the green battery charging light on the monitor’s right side panel is on.
7 – Defibrillator Synchronization Synchronous Cardioversion with LIFEPAK 5 Defibrillator . . . . . . . . . . . . 79 Install the Interface Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Perform Synchronous Cardioversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Remove the Interface Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Synchronous Cardioversion with LIFEPAK 5 Defibrillator Warning Use only the correct Protocol Systems cable with the LIFEPAK 5 Defibrillator as listed in the Protocol Systems Products and Accessories guide when performing synchronous cardioversion. (This cable contains circuitry in addition to wiring.) The use of any other cable will result in incorrect operation. The Defibrillator Synchronization option is designed to operate only with the LIFEPAK 5 or LIFEPAK 6s defibrillator.
Perform Synchronous Cardioversion 1. Set up the LIFEPAK 5 Defibrillator and any other instrumentation according to institutional procedures and manufacturer’s operating instructions. 2. Confirm the monitor displays an ECG waveform with tall, distinct R-waves and minimal artifact. Warning The R-wave amplitude must be at least 0.
Warning If the R-wave synchronization markers do not appear to be nearly simultaneous with the R-waves on the Propaq CS monitor display or are not present, do not proceed with synchronized cardioversion. You must press the LIFEPAK 5 Defibrillator SYNC button and check for appropriate synchronization markers on the Propaq CS monitor before each attempt at cardioversion. Protocol Systems cannot guarantee the delay from the sync marker to the defibrillator discharge.
Synchronous Cardioversion with LIFEPAK 6s Defibrillator Warning Use only the correct Protocol Systems cable with the LIFEPAK 6s Defibrillator as listed in the Protocol Systems Products and Accessories guide when performing synchronous cardioversion. (This cable contains circuitry in addition to wiring.) The use of any other cable will result in incorrect operation.
4. Connect the other end of the cable to the SYNC connector at the top rear of the LIFEPAK 6s Defibrillator. 5. With the LIFEPAK 6s turned on, press the SYNC button on the front control panel The SYNC button lights when activated. 6. INTRNL PADDLE DISCHG SYNC SYNC 1 2 3 ENERGY SELECT DELIVERED ENERGY –– JOULES Check the Propaq display for synchronization markers as shown on page 80. The markers should be nearly simultaneous with the R-waves.
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8 – Maintenance Connect the AC Power Adapter to Recharge the Battery . . . . . . . . . . . . . 87 Replace Power Adapter Fuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Replace Monitor Input Power Fuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Install Printer Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Inspect and Clean the Monitor and Accessories . . . . . . . . . . . . . . . . . . . .
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Connect the AC Power Adapter to Recharge the Battery Warning Use only the Protocol Systems ac power adapter and power cord appropriate for your location and ac power source as listed in the Protocol Systems Products and Accessories booklet. Use of other power adapters or power cords could cause a current leakage hazard or damage the Propaq CS monitor. Place the power adapter where it cannot fall and harm someone.
Replace Power Adapter Fuses If the green battery charging light is off and the ac power adapter does not provide power to the monitor even when all connections are intact, the adapter fuses may need to be replaced. This procedure must be performed by a qualified service person. To change fuses: 1. 2. 3. Unplug the removable power cord from the ac power source and adapter. Using a small, flat-blade screwdriver, carefully pry the fuse module away from the adapter.
Replace Monitor Input Power Fuse If the green battery charging light is off and the ac power adapter does not provide power to the monitor even when all connections are intact, the monitor’s input power fuse may need to be replaced. This procedure must be performed by a qualified service person. To change fuses: 1. Disconnect the monitor from the patient and turn off the monitor. 2. Disconnect the ac power adapter from the monitor. 3.
Install Printer Paper Caution Use only low-debris printer paper listed in the Protocol Systems Products and Accessories booklet. Use of other paper can cause unclear printing of patient data, printhead damage, and eventual printer failure. Store all paper (including a monitor loaded with paper) in compliance with paper storage specifications (see page 113). 1. 2. 3. 4. Lay the monitor on its back to gain access to the bottom of the printer. 5. 6. 7.
Inspect and Clean the Monitor and Accessories Before cleaning, thoroughly inspect the monitor and all accessories for any signs of damage, cracks, or improper mechanical function of keypads, switches, connectors, and printer paper door. While gently bending and flexing cables and tubing, inspect for damage, cracks, cuts, abrasions, extreme wear, exposed wires or bent connectors. Confirm connectors securely engage. Report damage or improper function to your service department.
Service Interval Recommendations At the intervals recommended below, qualified biomedical service personnel should service the Propaq CS monitor. Service information is described in the Propaq CS Service Manual (P/N 810-1101-XX).
Set the Time and Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Time/Day Settings and Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Change the Date Format, ECG Filter, and Units . . . . . . . . . . . . . . . . . . . . 96 Factory Default Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Reference Set the Time and Date 1. From the Main Menu press SETUP, MORE, MORE to display the Time/Day window: (M) TIME D ( 85) mmHg DAY TEMP H:MIN:S MO/DA/YR 15:55:10 10/21/99 °F MCO2 mmHg T1 T2 ∆T 58 100.4 98.6 1.8 BR 38 12 Br/m SpO2 % NEXT 2. UP DOWN ENTER 97 SERVICE Press NEXT, UP, and DOWN as needed to set the time and date. Then press ENTER to store the new time and date.
Change the Date Format, ECG Filter, and Units 1. 2. Make sure you are in the Adult patient mode (from the Main Menu press SETUP, MORE, CHANGE, ADULT, YES). From the Main Menu press SETUP, MORE, MORE, SERVICE, YES (to access the Service Menu), The monitor displays the Settings window: MORE, MORE, SETTINGS. P2 BATTERY: 9.3 VOLTS SETTINGS DATE FILTER : MO/DA/YR : 60 Hz (M) NIBP (M) TEMP °F DECIMAL : . MCO2 CO2 UNITS: mmHg mmHg 3. CHANGE T1 T2 ∆T 100.4 98.6 1.
The monitor is shipped from the factory with these preset default settings. For information about how to customize your monitor settings, see page 23.
Factory Default Settings (Continued) Setting Factory Default Trend Group NIBP Alarm Limits HR/PR Alarm Limits1 HR Limits All are ON except P2 CAN TURN OFF Adult: 50, 120 beats per minute Ped: 50, 150 beats per minute Neonate: 100, 200 beats per minute Adult: 75, 220 mmHg Ped: 75, 145 mmHg Neonate: 50, 100 mmHg Adult: 35, 110 mmHg Ped: 35, 100 mmHg Neonate: 30, 70 mmHg Adult: 50, 120 mmHg Ped: 50, 110 mmHg Neonate: 35, 80 mmHg Adult: 75, 220 mmHg Ped: 75, 145 mmHg Neonate: 50, 100 mmHg Adult: 35, 110 mm
Reference Specifications ECG Specifications The ECG channel meets all the requirements for Cardiac Monitors Heart Rate Meters and Alarms specified ANSI/AAMI EC13-1992, except for Standardizing Voltage (section 3.2.9.9). The channel also meets the American National Standard, Safe Current Limits for Electromedical Apparatus (ANSI/AAMI ES1-1993).
ECG Specifications (Continued) Characteristic HR Accuracy Heart Rate Averaging Method Drift Tolerance (AAMI Specification EC13-1992, 3.2.6.3) Pacer Display Pacer Pulse Rejection Specification ±3 beats per minute or 3%, whichever is greater NOTE: AAMI Test 4.1.4 part f: Accuracy is affected (i.e., rate drops) when QRS and pacer spikes are nearly simultaneous as occasionally is the case during this AAMI test. Heart rate = 60 / latest average interval in seconds.
Special cables are required to interface the defib sync connector to a Physio-Control LIFEPAK 5 or LIFEPAK 6s defibrillator. The sync and real-time ECG outputs do not operate during in-service mode. Signal Specification Sync Output 0 to 5 V pulse, 100 ±5 ms wide, starts within 35 ms after peak of R-wave. 15 mA short circuit current. Range = ±6 V minimum, centered about 0 V, Gain = 1000X, noninverting for lead II, inverting for all other leads, delay <3 ms, 0.05-100 Hz, going to -5.
Impedance Pneumography (RESP) Specifications Characteristic Sweep speed Amplitude range Excitation signal characteristics Sensing electrodes Base impedance (in addition to 1kΩ resistors in ECG cables) Impedance dynamic range Signal bandwidth after detection Breath detection threshold Respiration rate range Respiration rate accuracy Respiration rate source (RR) Apnea alarm delay accuracy Resolution Apnea alarm delay settings Cardiovascular artifact rejection (CVA) Motion artifact rejection Obstructive apne
Reference Invasive Pressure Specifications Characteristic Transducer Type Transducer Excitation Impedance Range Transducer sensitivity Excitation Voltage Connector Bandwidth Zero Drift Zero Adjustment Numeric Accuracy Pressure range Pulse range Leakage Current Electrosurgery interference suppression Specification Strain-gauge resistive bridge, or HP quartz (with HP Option). 1 200 to 2000 Ω 5 µV/V/mmHg 4.85 V Pulsed dc @ 181 Hz 2 ITT-Cannon plug MS3106F-14S-6P Std.
NIBP Specifications Characteristic Method Control Auto Intervals Turbocuf Displayed Pressures Systolic Range Diastolic Range Mean Range Static Manometer Accuracy Minimum Inflation Pressure Maximum Allowable Pressure Default Inflation Pressure Normal Overpressure Limit (results in up to 2 retries) Single Fault Overpressure Limit Leak Rate Pulse Rate Range Maximum Determination Time (with retries) Maximum Determination Time (no retries) Typical Determination Time without Artifact Minimum Time between
Reference Temperature Specifications Characteristic Range Displays Probes Units Channel Accuracy Resolution Electrosurgery interference suppression Specification 0° to +50°C; 32° to +122°F T1, T2, and ∆T Compatible with YSI Series 400 and 700 probes. HP side panel only compatible with YSI 400 and has HP connector. °C and °F selectable Temperature Range Tolerance 0° to +10°C ±0.2°C >10° to +50°C ±0.1°C +32° to +50°F ±0.4°F >50° to +122°F ±0.2°F 0.1°C or °F Included in all models.
Capnography (CO2) Specifications General CO2 Specifications (Mainstream CO2 and Sidestream CO2) Characteristic Specification CO2 Display Screen Display Numeric Display Ranges Waveform Scale (Maximum) Units Sweep Speed Response Modes Gas Compensation Alarm Limit Ranges Resolution Accuracy CO2 waveform and ETCO2 and INCO2 (when in alarm) numerics ETCO2: 0-99 mmHg, 0-13.2 kPa, 0-23.1% INCO2: 81-25 mmHg, 1.11-5 kPa, 1.11-5% 0-100 mmHg, 0-14 kPa, 0-14% mmHg, kPa,%; user-selectable 3.13, 6.25, 12.
Reference Mainstream CO2 Specifications Characteristic Specification Mainstream CO2 Sensor Sensor Type Principle of Operation Warm-up time (CO2 sensor and monitor) Response Time Waveform Rise Time Calibration Sensor Housing Temperature Mainstream Non-dispersive, infrared, single-beam, single path/wavelength, ratiometric 45 s typical, 3 min maximum 30 ms typical, 60 ms maximum <120 ms to 90% after step change Verify semi-annually, calibrate only as required 42°C nominal Mainstream CO2 Sensor and Cable D
Sidestream CO2 Specifications Characteristic Sensor Type Principle of Operation Operating Ambient Temperature Startup Time Rise Time Delay Time Total System Response Time Calibration Sampling Chamber Pneumatic and Exhaust System Barometric Pressure Compensation BTPS, ATPS, STPD2 Sampling Line Watertrap Flow Rate Specification Sidestream, internal Non-dispersive, infrared, single-beam, single path/wavelength, ratiometric 5° to 40°C 30 seconds typical, 3 minutes maximum 240 ms (10% to 90%) at 175 ml/min 1.
Reference Alarms Specifications Characteristic Indicators (see table below) Tone Frequency Selectable Tone Volume Limits Control Alarm Priority Alarm on Tachycardias Apnea delay setting Alarm Holdoff Time Period1 Audio Alarm Holdoff with Acuity Specification Red indicator light: flashing light indicates patient alarm; continuously on indicates patient alarms are suspended.
Propaq CS Monitor Audible Alarm Indications Alarm Condition Tone Patient alarm Apnea alarm Equipment alert Continuous ON ON for 1 second, OFF for 1 second ON for 1 second, OFF for 4 seconds Nurse Call Specifications Characteristic Specification Maximum switch current Maximum switch voltage Isolation Alarm relay Customized cable2 (Protocol Systems Part Number 008-0634-XX); see below.
Reference Trends Specifications Specification 1 Characteristic Model 242 Parameters Model 244 Parameters Model 246 Parameters Duration Resolution NIBP, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate/Resp Rate NIBP, P1, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate/Resp Rate NIBP, P1, P2, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate/Resp Rate 5 hours for non-NIBP trends (up to 150 rea
Monitor (Physical) Specifications Characteristic Specification Protection Classifications, all Configurations 1 Type of Protection against Electric Shock—Power Adapter Type of Protection against Electric Shock—Monitor (connected to power adapter or internal battery) Degree of Protection Against Electric Shock, for Parts Applied to Patients Method of Disinfection Flammable Anesthetics Power adapter class 1 Height Width Depth Weight 8.2 in (20.8 cm) with handle 9.6 in (24.4 cm) 5.6 in (14.1 cm) 7.
Reference Characteristic Specification Printer Mechanism Printing Method Dot structure Printing width Horizontal Dot Pitch Vertical Dot Pitch Paper Feed Method Paper Feed Precision Paper Width Thermally sensitive dot method 320 dots per line 53 mm 0.165 mm, 6 dots/mm 0.
Characteristic Specification Low Battery Voltage and Operation < 7.8 V: Caution message LOW BATTERY. < 7.6 V: Caution messages LOW BATTERY, PRINTER DISABLED and LOW BATTERY, NIBP DISABLED. < 7.4 V: Equipment alert VERY LOW BATTERY < 7.3 V: Equipment alert LOW BATTERY, HEATER DISABLED (MCO2) < 7.0 V: Monitor automatically turns off.
Index B Bandwidth selection, ECG 31 Battery Long-term storage precautions 92 Low battery message 63, 87 Recharging 87 Recycling 92 Beeper loudness 20 Brightness display control 20 Propaq CS Directions for Use C Cannula for Sidestream CO2 47 Capnography(see Mainstream CO2 and Sidestream CO2) Caution statements, general 9 Centigrade temperature units 40 Change alarm limits 21 Charge battery 87 Cleaning instructions 91 Clock setting 95 C-LOCK, SpO2 measurement 42 CO2 Alarm limits 49 Equipment alert messages
Defib sync markers 80 ECG/RESP 30 Equipment alert messages 57 Equipment alerts 56 General description 13 IBP waveforms 34 NIBP 38 Pacemaker indicators 32 Specifications 111 SpO2 42 Sweep speed selection 20 Sweep speed selection, CO2 and RESP 48 Temperature 40 Trends 68 Waveform selection 20 E ECG Bandwidth selection 31 Display 30 Electrode selection and placement 28 Electrosurgery and interference 29 Equipment alert messages 57 Filter to reduce interference 31 Lead selection 30 Pacemaker display indicators
Loudness adjustment, HR/PR tone 31 Loudness selection 20 Low battery message 63, 87 N NET OFF, disconnect from Acuity 76 Network fault equipment alert message 62 New patient setup 19 NIBP Artifact 7, 38, 39, 67, 68 Propaq CS Directions for Use Index M Main Menu, General description 14 Mainstream CO2 Airway adapter 44 Alarm limits 49 Display 48 Equipment alert messages 60 Gas compensation 49 Menus 48 Monitoring 44 Response time 49 Specifications 107 SpO2 option and CO2 44 Switch to Sidestream CO2 49 Turn
Periodic maintenance 92 Physical inspection 91 Physical specifications 112 Power Specifications 113 Power Adapter Specifications 114 Power adapter 87 Power fuse replacement 89 Powerup patient mode 23 Powerup procedure 19 Practice using Encore 16 Print Automatic alarm printing 70 Automatic apnea ticket printing 70 Automatic NIBP ticket printing 70 Automatic OxyCRG printing 70 Automatic printing 70 Automatic trend printing 69 Continuous printing 70 Displayed trend 68 Displayed waveforms 67 Multiple trends 69
T Temperature Display 40 Equipment alert messages 59 Monitoring 40 Select measurement units 96 Specifications 105 Warnings 40 Propaq CS Directions for Use Temperature units, change 40 Time and date setting 95 Tone volumes 20 Transducer for IBP 33 Trends Automatic printing 69 Delete all trends 69 Display 68 NIBP and symbol 68 Print all selected trends 69 Select trends for printing 69 Specifications 111 TURBOCUF (automatic NIBP) 39 Turn on waveform display 20 U Units of measure, CO2 96 Units of measure, tem
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