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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36 Specifications

410

Respiration

Heart Rate Averaging Method Three different methods are used:

Normally, heart rate is computed by averaging the 12 most

recent RR intervals.

For runs of PVCs, up to 8 RR intervals are averaged to compute

the HR.

If each of 3 consecutive RR intervals is greater than 1200 ms

(that is, rate less than 50 bpm), then the 4 most recent RR

intervals are aver\-aged to compute the HR.

Response Time of Heart Rate Meter to Change in Heart Rate HR change from 80 to 120 bpm:

Range: [6.4 to 7.2 seconds] Average: 6.8 seconds

HR change from 80 to 40 bpm:

Range: [5.6 to 6.4 sec] Average: 6.0 seconds

Heart Rate Meter Accuracy and Response to Irregular Rhythm Ventricular bigeminy: 80 bpm

Slow alternating ventricular bigeminy: 60 bpm

Rapid alternating ventricular bigeminy: 120 bpm

Bidirectional systoles: 90 bpm

Accuracy of Input Signal Reproduction Methods A and D were used to establish overall system error

and frequency response.

Pacemaker Pulse Rejection Performance Rejection of pacemaker pulses with amplitudes from ±2 mV to

±700 mV and widths from 0.1 ms to 2.0 ms (Method A)

ECG/Arrhythmia/ST Supplemental Information as required by AAMI EC11/13, IEC 60601-2-27

Respiration Performance Specifications

Respiration Rate Range Adult/pedi: 0 to 120 rpm

Neo: 0 to 170 rpm

Accuracy at 0 to 120 rpm ±1 rpm

at 120 to 170 rpm ±2 rpm

Resolution 1 rpm

Bandwidth 0.3 to 2.5 Hz (-6 dB)

Noise Less than 25 mΩ (rms) referred to the input

Respiration Alarm

Specifications

Range Adjustment Delay

High Adult/pedi: 10 to 100 rpm

Neo: 30 to 150 rpm

under 20 rpm: 1 rpm steps

over 20 rpm: 5 rpm steps

max. 14 seconds

Low Adult/pedi: 0 to 95 rpm

Neo: 0 to 145 rpm

under 20 rpm: 1 rpm steps

over 20 rpm: 5 rpm steps

for limits from 0 to 20 rpm:

max. 4 seconds

for limits above 20 rpm: max.

14 seconds

Apnea Alarm 10 to 40 seconds 5 second steps