User's Manual

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Table Of Contents

IntelliVue Patient Monitor
- 1 Introduction 13
- 2 Alarms 49
- 3 Patient Alarms and INOPs 65
- 4 Managing Patients 95
- 5 ECG, Arrhythmia, ST and QT Monitoring 111
- 6 Monitoring Pulse Rate 155
- 7 Monitoring Respiration Rate (Resp) 159
- 8 Monitoring SpO2 165
- 9 Monitoring NBP 173
- 10 Monitoring Temperature 181
- 11 Monitoring Invasive Pressure 183
- 12 Monitoring Cardiac Output 195
- 13 Monitoring Carbon Dioxide 213
- 14 Monitoring Airway Flow, Volume and Pressure 225
- 15 Monitoring tcGas 233
- 16 Monitoring Intravascular Oxygen Saturation 241
- 17 Monitoring EEG 249
- 18 Monitoring BIS 257
- 19 Assigning a Telemetry Device and a Monitor to One Patient 265
- 20 Trends 271
- 21 Calculations 283
- 22 High Resolution Trend Waves 289
- 23 Event Surveillance 291
- 24 ProtocolWatch 309
- 25 Recording 317
- 26 Printing Patient Reports 325
- 27 Using the Drug Calculator 337
- 28 IntelliBridge EC10 Module 343
- 29 VueLink Modules 347
- 30 Using Timers 351
- 31 Respiratory Loops 355
- 32 Laboratory Data 359
- 33 Care and Cleaning 361
- 34 Maintenance and Troubleshooting 365
- 35 Accessories 369
- 36 Specifications 387
- 37 Default Settings Appendix 429
- Index 449
Introduction
- Introducing the Monitor
  - Major Parts and Keys
- Devices for Acquiring Measurements
  - Flexible Module Rack (M8048A)
  - 4-Slot Flexible Module Rack (FMS-4)
  - Measurement Modules
    - Example Module (SpO2)
  - X1 Multi-Measurement Module (M3001A)
    - X1 Connectors and Symbols
  - X2 Multi-Measurement Module (M3002A)
  - MMS Extensions
    - M3014A, M3015A, M3015B and M3016A Capnography MMS Extensions
    - M3012A Hemodynamic MMS Extension
- Operating and Navigating
  - Selecting Screen Elements
  - Using the Touchscreen
  - Disabling Touchscreen Operation
  - Using a Mouse or Trackball
  - Moving Windows
  - Using Keys
  - Using the Remote Control
    - Using the SmartKeys Key
  - Using the On-Screen Keyboard
  - Using the On-Screen Calculator
- Operating Modes
  - Standby Mode
- Understanding Screens
  - Switching to a Different Screen
  - Changing a Screen's Content
- Connecting Additional Displays to the Monitor
- Using the XDS Remote Display
- Using the Visitor Screen
- Understanding Profiles
  - Swapping a Complete Profile
  - Swapping a Settings Block
  - Default Profile
  - Locked Profiles
- Understanding Settings
  - Changing Measurement Settings
  - Switching a Measurement On and Off
  - Switching Numerics On and Off
  - Adjusting a Measurement Wave
- Changing Wave Speeds
  - Changing the Wave Group Speed
  - Changing Wave Speed for a Channel
- Freezing Waves
  - Freezing An Individual Wave
  - Freezing All Waves
  - Measuring Frozen Waves
  - Changing The Wave Speed
  - Updating The Frozen Wave
  - Releasing Frozen Waves
- Using Labels
  - Changing Measurement Labels (e.g. Pressure)
  - About Label Sets
  - Resolving Label Conflicts
  - Label Compatibility
- Entering Measurements Manually
  - Switching Manually Entered Measurements On and Off
- Changing Monitor Settings
  - Adjusting the Screen Brightness
  - Setting the Date and Time
- Checking Your Monitor Revision
- Getting Started
  - Inspecting the Monitor
  - Switching On
  - Power On/Power Off Behavior
  - Setting up the Modules
  - Starting Monitoring
- Disconnecting from Power
  - Monitoring After a Power Failure
- Networked Monitoring
- Using the Integrated PC
  - Starting the iPC
  - Viewing the iPC Desktop on the Monitor Display
  - Adjusting the iPC Audio Volume
  - Using Input Devices with the iPC and Monitor
  - Shutting the iPC Down
    - Special Situations at Shutdown
- Using the X2 or MP5 with a Host Monitor
Alarms
- Visual Alarm Indicators
- Audible Alarm Indicators
- Acknowledging Alarms
  - Acknowledging Disconnect INOPs
  - Alarm Reminder
- Pausing or Switching Off Alarms
- Alarm Limits
- Reviewing Alarms
  - Alarm Messages Window
  - Review Alarms Window
- Latching Alarms
  - Viewing the Alarm Latching Settings
  - Alarm Latching Behavior
- Testing Alarms
- Alarm Behavior at Power On
- Alarm Recordings
Patient Alarms and INOPs
- Patient Alarm Messages
- Technical Alarm Messages (INOPs)
Managing Patients
- Admitting a Patient
  - Patient Category and Paced Status
  - Admitting a Centrally-Monitored Patient
- Quick Admitting a Patient
- Editing Patient Information
- Discharging a Patient
  - To Discharge a Patient
  - New Patient Check
- Transferring Patients
- Data Upload from an MMS
- Care Groups
ECG, Arrhythmia, ST and QT Monitoring
- Skin Preparation for Electrode Placement
- Connecting ECG Cables
- Selecting the Primary and Secondary ECG Leads
- Checking Paced Status
- Understanding the ECG Display
- Monitoring Paced Patients
  - Setting the Paced Status (Pace Pulse Rejection)
  - Avoiding Pace Pulse Repolarization Tails
- Changing the Size of the ECG Wave
  - To Change the Size of an Individual ECG Wave
  - To Change the Size of all the ECG Waves
- Changing the Volume of the QRS Tone
- Changing the ECG Filter Settings
- Selecting Positions of Va and Vb Chest Leads (for 6-lead placement)
- Choosing EASI or Standard Lead Placement
- About ECG Leads
  - ECG Leads Monitored
  - Changing Lead Sets
- ECG Lead Fallback
- ECG Lead Placements
  - Standard 3-Lead Placement
  - Standard 5-Lead Placement
  - 6-Lead Placement
  - Chest Electrode Placement
  - 10-Lead Placement
  - Conventional 12-Lead ECG
    - Modified 12-Lead ECG
  - Choosing Standard or Modified Electrode Placement
- Capture 12-Lead
  - Viewing the Realtime 12-Lead ECG
  - Capturing the 12-Lead ECG
  - Setting Up the 12-Lead ECG
  - Storing and Sending the 12-Lead ECG
  - Printing the 12-Lead ECG
  - Capture 12-Lead Pop-up Keys
- EASI ECG Lead Placement
  - EASI Electrode Placement
- ECG and Arrhythmia Alarm Overview
- Using ECG Alarms
  - Extreme Alarm Limits for Heart Rate
  - ECG Alarms Off Disabled
  - HR Alarms When Arrhythmia Analysis is Switched Off
  - Enhanced Asystole Detection
- ECG Safety Information
- About Arrhythmia Monitoring
  - Arrhythmia Options
  - Where Can I Find More Information?
- Switching Arrhythmia Analysis On and Off
- Choosing an ECG Lead for Arrhythmia Monitoring
  - Aberrantly-Conducted Beats
  - Atrial Fibrillation Alarm
  - Intermittent Bundle Branch Block
- Understanding the Arrhythmia Display
  - Viewing Arrhythmia Waves
  - Arrhythmia Beat Labels
  - Arrhythmia Status Messages
    - Rhythm Status Messages
    - Ectopic Status Messages
- Arrhythmia Relearning
  - Initiating Arrhythmia Relearning Manually
  - Automatic Arrhythmia Relearn
    - Arrhythmia Relearn and Lead Fallback
- Arrhythmia Alarms
  - Yellow Arrhythmia Alarms
  - Arrhythmia Alarms and Latching
  - Switching Individual Arrhythmia Alarms On and Off
  - Switching All Yellow Arrhythmia Alarms On or Off
  - Adjusting the Arrhythmia Alarm Limits
  - Arrhythmia Alarm Timeout Periods
    - What is a Timeout Period?
    - Resetting the Timeout Period
  - How are Yellow Arrhythmia Alarms Indicated?
    - Arrhythmia Alarm Chaining
  - Understanding PVC-Related Alarms
- About ST Monitoring
- Switching ST On and Off
  - Selecting Leads for ST Analysis
- Understanding the ST Display
- Updating ST Baseline Snippets
- Recording ST Segments
- About the ST Measurement Points
  - Adjusting ST Measurement Points
- ST Alarms
  - Single- or Multi-lead ST Alarming
  - Changing ST Alarm Limits
- Viewing ST Maps
  - Current View
  - Trend View
  - Viewing an ST Map
  - Working in the ST Map Task Window
- About QT/QTc Interval Monitoring
  - QT Measurement Algorithm
    - Where Can I Find More Information?
  - Indications For Use Of QT Interval Monitoring
  - Limitations For Use Of QT Interval Monitoring
  - Selecting The QT Leads
  - QT View
- QT Alarms
  - Switching Individual QTc Alarms On and Off
  - Changing QTc Alarm Limits
- Switching QT Monitoring On and Off
Monitoring Pulse Rate
- Entering the Setup Pulse Menu
- System Pulse Source
- Switching Pulse On and Off
- Using Pulse Alarms
Monitoring Respiration Rate (Resp)
- Lead Placement for Monitoring Resp
- Understanding the Resp Display
- Changing Resp Detection Modes
- Changing the Size of the Respiration Wave
- Changing the Speed of the Respiration Wave
- Using Resp Alarms
- Changing the Apnea Alarm Delay
- Resp Safety Information
Monitoring SpO2
- SpO2 Sensors
- Applying the Sensor
- Connecting SpO2 Cables
- Measuring SpO2
- SpO2 Signal Quality Indicator (Fast SpO2 only)
- Assessing a Suspicious SpO2 Reading
- Changing the Averaging Time
- Understanding SpO2 Alarms
- Pleth Wave
- Perfusion Numeric
- Perfusion Change Indicator
- Setting SpO2/Pleth as Pulse Source
- Setting Up Tone Modulation
- Setting the QRS Volume
- Calculating SpO2 Difference
Monitoring NBP
- Introducing the Oscillometric NBP Measurement
- Preparing to Measure NBP
  - Correcting the Measurement if Limb is not at Heart Level
  - Understanding the NBP Numerics
- Starting and Stopping Measurements
- Enabling Automatic Mode and Setting Repetition Time
- Enabling Sequence Mode and Setting Up The Sequence
- Choosing the NBP Alarm Source
- Switching Pulse from NBP On/Off
- Assisting Venous Puncture
- Calibrating NBP
Monitoring Temperature
- Making a Temp Measurement
  - Selecting a Temperature for Monitoring
  - Extended Temperature Label Set
- Calculating Temp Difference
Monitoring Invasive Pressure
- Setting up the Pressure Measurement
  - Selecting a Pressure for Monitoring
  - Extended Pressure Label Set
- Zeroing the Pressure Transducer
- Adjusting the Calibration Factor
- Displaying a Mean Pressure Value Only
- Changing the Pressure Wave Scale
- Optimizing the Waveform
- Using the Wave Cursor
- Non-Physiological Artifact Suppression
- Choosing the Pressure Alarm Source
  - Extreme Alarm Limits for Pressure
- Calibrating Reusable Transducer CPJ840J6
  - Making the Pressure Calibration
  - Troubleshooting the Pressure Calibration
- Calculating Cerebral Perfusion Pressure
- Calculating Pulse Pressure Variation
- Measuring Pulmonary Artery Wedge Pressure
- Editing the Wedge
- Identifying the Pressure Analog Output Connector
Monitoring Cardiac Output
- Hemodynamic Parameters
- Using the C.O. Procedure Window
- Accessing the Setup C.O. and Setup CCO Menus
- Entering the HemoCalc Window
- Measuring C. O. Using the PiCCO Method
- Measuring C.O. Using the Right Heart Thermodilution Method
- Documenting C.O. Measurements
- C.O. Injectate Guidelines
- C.O./CCO Curve Alert Messages
- C.O./CCO Prompt Messages
- C.O./CCO Warning Messages
- C.O./CCO Safety Information
Monitoring Carbon Dioxide
- Measurement Principles
- Measuring CO2 using M3014A or X2
  - Preparing to Measure Mainstream CO2
  - Preparing to Measure Sidestream CO2
    - Using the Sidestream Sensor Holder
    - Removing Exhaust Gases from the System
- Measuring Mainstream CO2 using M3016A
- Measuring Microstream CO2 using M3015A/B
- Setting up all CO2 Measurements
Monitoring Airway Flow, Volume and Pressure
- Attaching the Flow Sensor
- Zero Calibration
- Automatic Purging
  - Adult Mode
  - Neonatal and Pediatric Modes
- Manual Purging
- Gas Compensation
- Setting up Spirometry
Monitoring tcGas
- Identifying tcGas Module Components
- Setting the tcGas Sensor Temperature
- Using the tcGas Site Timer
- Setting the tcGas Barometric Pressure
- Remembraning the tcGas Transducer
  - New/Dried Out Transducers
  - Storing tcGas Transducers
- Calibrating the tcGas Transducer
  - Calibration Failure
  - Troubleshooting tcGas Calibration
- Applying the tcGas Transducer
  - Selecting the tcGas HeatPowerDisplay Mode
  - Zeroing the tcGas Relative Heat Power
- Finishing tcGas Monitoring
- TcGas Corrections
  - Temperature Correction for tcpCO2
  - Metabolism Correction for tcpCO2
Monitoring Intravascular Oxygen Saturation
- Selecting a Measurement Label
- Preparing to Monitor with the M1021A Wide Module
- Preparing to Monitor with the M1011A Narrow Module
- Further Information for Both Modules
  - Checking Suspicious Values
  - Calculating Oxygen Extraction
Monitoring EEG
- EEG Monitoring Setup
- Using the EEG Impedance/Montage Window
- About Compressed Spectral Arrays (CSA)
  - Changing CSA Settings
- Changing EEG Settings
- EEG Reports
- EEG Safety Information
- EEG and Electrical Interference
Monitoring BIS
- BIS Monitoring Setup
- BIS Continuous Impedance Check
- BIS Cyclic Impedance Check
  - Starting a Cyclic Impedance Check
  - Stopping a Cyclic Impedance Check
- BIS Window
  - BIS Impedance Indicators
- Changing the BIS Smoothing Rate
- Switching BIS and Individual Numerics On and Off
- Changing the Scale of the EEG Wave
- Switching BIS Filters On or Off
- BIS Safety Information
Assigning a Telemetry Device and a Monitor to One Patient
- How Can You Combine Devices?
  - Indirect Connection - Manual Pairing
    - Telemetry Data Window
  - Direct Connection - Automatic Pairing
    - Pairing an X2 or MP5 With a Telemetry Interface to a Host Monitor
- Functions Available When the Telemetry Data Window is Displayed
- General Telemetry-related Functions
  - ECG Source Tracking at the Information Center
  - Synchronized Settings
- Use Models With Telemetry
Trends
- Viewing Trends
- Setting Up Trends
- Documenting Trends
- Trends Databases
  - Aperiodic Trends Database
  - Trending Multiple-Value Measurements
- Screen Trends
Calculations
- Viewing Calculations
  - Calculations Windows
  - Calculations Pop-Up Keys
- Reviewing Calculations
- Performing Calculations
- Entering Values for Calculations
- Documenting Calculations
High Resolution Trend Waves
- Changing the Hi-Res Trend Waves Displayed
- Hi-Res Trend Wave Scales
- Hi-Res Trend Waves and OxyCRG
- Printing Hi-Res Trend Wave Reports
- Hi-Res Trend Wave Recordings
Event Surveillance
- Levels of Event Surveillance
- Event Groups
- Event Episodes
- Events Pop-Up Keys
- Event Triggers
- The Events Database
- Viewing Events
- Annotating Events
- Documenting Events
ProtocolWatch
- SSC Sepsis Protocol
Recording
- Central Recording
- Starting and Stopping Recordings
- Overview of Recording Types
- All ECG Waves Recordings
- Creating and Changing Recordings Templates
- Changing ECG Wave Gain
- Recording Priorities
- Recording Strip
- Reloading Paper
- Recorder Status Messages
Printing Patient Reports
- Starting Report Printouts
  - Printout Location
  - Starting the Different Types of Report
- Stopping Reports Printouts
- Setting Up Reports
- Setting Up Individual Print Jobs
- Checking Printer Settings
- Printing a Test Report
- Switching Printers On Or Off for Reports
- Dashed Lines on Reports
- Unavailable Printer: Re-routing Reports
- Checking Report Status and Printing Manually
  - Printing Manually
- Printer Status Messages
- Sample Report Printouts
Using the Drug Calculator
- Accessing the Drug Calculator
- Performing Drug Calculations
- Charting Infusion Progress
- Using the Titration Table
- Documenting Drug Calculations
IntelliBridge EC10 Module
- Connecting an External Device
- Changing Waves and Numerics Displayed
- Viewing the IntelliBridge Device Data Window
- Using Screens with External Device Data
- Alarms/INOPs from External Devices
  - INOPs from the IntelliBridge Module
- Language Conflict with External Device Drivers
VueLink Modules
- Connecting an External Device
- Changing VueLink Waves and Numerics Displayed
- Viewing the VueLink Device Data Window
- Using VueLink Screens
- Switching VueLink On and Off
- Alarms/INOPs From External Devices
- Language Conflict with External Device Drivers
Using Timers
- Viewing Timers
  - Timer Types
- Timer Setup Pop-up Keys
- Setting Up Timers
- Displaying a Timer On The Main Screen
  - Main Screen Timer Pop-up Keys
- Displaying A Clock On The Main Screen
Respiratory Loops
- Viewing Loops
- Capturing and Deleting Loops
- Showing/Hiding Loops
- Changing Loops Display Size
- Using the Loops Cursor
- Changing Loops Type
- Setting Up Source Device
- Documenting Loops
Laboratory Data
- Viewing Received Data
Care and Cleaning
- General Points
- Cleaning the Monitor
- Disinfecting the Monitor
- Sterilizing the Monitor
- Cleaning, Sterilizing and Disinfecting Monitoring Accessories
- Cleaning the SO2 Optical Module
- Cleaning the Recorder Printhead (M1116B only)
Maintenance and Troubleshooting
- Inspecting the Equipment and Accessories
- Inspecting the Cables and Cords
- Maintenance Task and Test Schedule
- Troubleshooting
- Disposing of the Monitor
- Disposing of Empty Calibration Gas Cylinders
Accessories
- ECG/Resp Accessories
  - Recommended Cables
  - Supported Cables
- NBP Accessories
- Invasive Pressure Accessories
- SpO2 Accessories
- Temperature Accessories
- Cardiac Output (C.O.) Accessories
- Mainstream CO2 Accessories
- Sidestream CO2 Accessories
- Mainstream CO2 Accessories (for M3016A)
- Microstream CO2 Accessories
- Spirometry Accessories
  - Measurement of CO2 and Spirometry with Neonates
- tcGas Accessories
- EEG Accessories
- BIS Accessories
- SO2 Accessories for M1021A
- SO2 Accessories for M1011A
- Recorder Accessories
- Battery Accessories
Specifications
- Intended Use
- Manufacturer's Information
  - BIS Manufacturer's Information
  - Trademark Acknowledgement
- Symbols
- Installation Safety Information
  - Connectors
- Monitor Mounting Precautions
- Altitude Setting
- Monitor Safety Specifications
- EMC And Radio Regulatory Compliance
- Physical Specifications
- Environmental Specifications
- Performance Specifications
- Interface Specifications
- Measurement Specifications
- Safety and Performance Tests
Default Settings Appendix
- Country-Specific Default Settings
- Alarm and Measurement Default Settings
- Alarm Default Settings
- ECG, Arrhythmia, ST and QT Default Settings
- Pulse Default Settings
- Respiration Default Settings
- SpO2 Default Settings
- NBP Default Settings
- Temperature Default Settings
- Invasive Pressure Default Settings
- Cardiac Output Default Settings
- CO2 Default Settings
- Spirometry Default Settings
- tcGas Default Settings
- Intravascular Oxygen Saturation
- SvO2 Default Settings
- ScvO2 Default Settings
- EEG Default Settings
- BIS Default Settings
- VueLink Default Settings
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225

14Monitoring Airway Flow,

Volume and Pressure

The M1014A Spirometry Module is designed to be used in combination with Philips-branded airway

flow sensors and combined CO

/airway flow sensors. It produces a real time wave for flow, volume

and pressure of respiratory gases together with numerics for analysis of ventilatory mechanics.

The measurement provides:

• Airway flow, airway volume and airway pressure waveform.

•Numerics for:

– respiratory rate

– tidal volume

– minute volume

– PEEP (positive end-expiratory pressure)

– PIP (peak inspiration pressure)

– dynamic compliance

– airway resistance

• Numerics for: (only visible in

SpirometryValues Window, no alarming, no trending)

– peak inspiratory flow

– peak expiratory flow

– negative inspiratory pressure

– mean airway pressure

– plateau pressure numeric

–I:E ratio

The measurement also provides pressure-volume loops, flow-volume loops and pressure-flow loops.

Please see “Respiratory Loops” on page 355 for details on loops.

When using combined CO

/Flow sensors you can also perform mainstream capnography with

intubated adult, pediatric and neonatal patients. See the Monitoring Carbon Dioxide chapter for details

on the CO

measurement and the Accessories chapter for a list of compatible accessories.