Advance-150 V1.7 Manual Usuario
Advance-150 V1.7 Manual Usuario
Advance-150 V1.7 Manual Usuario
Advance-150
User Manual
(Version 1.7)
This Manual is written and compiled in accordance with the IEC 60601-1(Medical electrical equipment Part1: General
requirements for safety)and MDD 93/42/EEC. It complies with both international and enterprise standards and is also
approved by State Technological Supervision Bureau. The Manual is written for the current Advance-150 Patient
Monitor.
The Manual describes, in accordance with the Advance-150 Patient Monitor’s features and requirements, main structure,
functions, specifications, correct methods for transportation, installation, usage, operation, repair, maintenance and
storage, etc. as well as the safety procedures to protect both the user and equipment. Refer to the respective chapters for
details.
The Manual is published in English and we have the ultimate right to explain the Manual. No part of this manual may
be photocopied, reproduced or translated into another language without the prior written consent. We reserve the right
to improve and amend it at any time without prior notice. Amendments will however be published in a new edition of
this manual.
All rights reserved.
0 Warning: must be followed to avoid endangering the operator and the patient.
☞ Note: contains some important information and tips about operations and application.
Attention: must be followed to avoid causing damage to the monitor.
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User Manual for Patient Monitor
3502-3450004
Instructions to User
Dear Users,
Thank you very much for purchasing our product. Please read the following information very
carefully before using this device.
Read these instructions carefully before using this monitor. These instructions describe the
operating procedures to be followed strictly. Failure to follow these instructions can cause
monitoring abnormity, equipment damage and personal injury. The manufacturer is NOT
responsible for the safety, reliability and performance issues and any monitoring abnormality,
personal injury and equipment damage due to user’s negligence of the operation instructions. The
manufacturer’s warranty service does not cover such faults.
0 WARNING-PACEMAKER PATIENTS. 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. Keep pacemaker patients under close
surveillance. See this manual for disclosure of the pacemaker pulse rejection
capability of this instrument.
0 The monitor is defibrillator proof. Verify that the accessories can function safely
and normally and the monitor is grounded properly before conducting
defibrillation.
0 Disconnect the monitor and sensors before MRI scanning. Use during MRI could
cause burns or adversely affect the MRI image or the monitor’s accuracy.
0 If you have any doubt to the grounding layout and its performance, you must use
the built-in battery to power the monitor.
0 All combinations of equipment must be in compliance with standard of IEC 60601-1-1 medical
and electric system requirements.
0 The SpO 2 measurement of this monitor may not work for all testees. If stable
readings can not be obtained at any time, discontinue using.
0 Each time the monitor is used, check the alarm limits to ensure that they are
appropriate for the patient being monitored.
0 The monitor is intended only as an adjunct in patient assessment. It must be used
in conjunction with clinical signs and symptoms.
0 When taking the measure of a pediatric or neonate’s (less than 10 years old) blood pressure, do
NOT operate in the adult mode. The high inflation pressure may cause lesion or even body
putrescence.
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User Manual for Patient Monitor
0 The monitor is prohibited from applying to those who have severe hemorrhagic tendency or
who are with sickle cell disease for they may develop partial bleeding when this monitor is used
to take the blood pressure measurement.
0 DO NOT take blood pressure measurement from a limb receiving ongoing transfusion or
intubations or skin lesion area, otherwise, damages may be caused to the limb.
0 Continuous use of SpO2 sensor may result in discomfort or pain, especially for those with
microcirculatory problem. It is recommended that the sensor should NOT be applied to the
same place for over two hours, change the measuring site periodically if necessary.
0 SpO2 measuring position must be examined more carefully for some special patient. Do NOT
install the SpO2 sensor on the finger with edema or vulnerable tissue.
0 To prevent the risk of the short circuit and to ensure the ECG signal quality, the equipment must
be properly grounded.
0 Although biocompatibility tests have been performed on all the applied parts, some exceptional
allergic patients may still have anaphylaxis. Do NOT apply to those who have anaphylaxis.
0 All the connecting cables and rubber tubes of the applying parts should be kept away from the
patient’ s cervix to prevent any possible suffocation of the patient.
0 All the parts of the monitor should NOT be replaced at will. If necessary, please use the
components provided by the manufacturer or those that are of the same model and standards as
the accessories along with the monitor which are provided by the same factory, otherwise,
negative effects concerning safety and biocompatibility etc. may be caused.
0 DO NOT stare at the infrared light of SpO2 sensor when switch it on, for the infrared may do
harm to the eye.
0 If the monitor falls off accidentally, please do NOT operate it before its safety and technical
indexes have been tested minutely and positive testing results obtained.
0 It is recommended to take the blood pressure measurement manually. The automatic or
continuous mode should be used at the presence of a doctor/nurse.
0 Reuse, disassembly, cleaning, disinfecting or sterilizing the single patient use CO2 cannula kits
and on-airway adapters may compromise functionality and system performance leading to a
user or patient hazard. Performance is not guaranteed if an item labeled as single patient use
is reused.
0 Electrical Shock Hazard: Always disconnect the CO2 Sensor before cleaning. Do NOT use if it
appears to have been damaged. Refer servicing to qualified service personnel.
0 Electrical Shock Hazard; No user serviceable parts inside the CO2 Sensor.
0 After the life cycle of the Sidestream CO2 Sensor and its accessories has been met, disposal
should be accomplished following national and/or local requirements.
0 Please peruse the relative content about the clinical restrictions and contraindication.
0 When disposing of the monitor and its accessories, the local law should be followed.
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User Manual for Patient Monitor
Table of Contents
CHAPTER 1 OVERVIEW .......................................................................................................................1
1.1 FEATURES ............................................................................................................................................1
1.2 PRODUCT NAME AND MODEL ..............................................................................................................2
1.3 SCOPE OF APPLICATION .......................................................................................................................2
1.4 OPERATING ENVIRONMENT .................................................................................................................2
1.5 IMPACT ON THE ENVIRONMENT AND RESOURCES ................................................................................2
1.6 SAFETY ................................................................................................................................................3
CHAPTER 2 WORKING THEORIES....................................................................................................4
2.1 OVERALL STRUCTURE .........................................................................................................................4
2.2 COMPOSITION ......................................................................................................................................4
2.3 WORKING THEORIES............................................................................................................................4
CHAPTER 3 INSTALLATION AND CONNECTION ..........................................................................6
3.1 INSTALLATION .....................................................................................................................................6
3.1.1 Opening the Box and Check .......................................................................................................................... 6
3.1.2 Connecting the AC Power Cable ................................................................................................................... 6
3.1.3 Starting the Monitor ....................................................................................................................................... 6
3.2 APPEARANCE .......................................................................................................................................7
3.2.1 Front Panel ..................................................................................................................................................... 7
3.2.2 Left and Right Panel ...................................................................................................................................... 8
3.2.3 Rear Panel ...................................................................................................................................................... 9
3.3 CONNECTION .....................................................................................................................................10
3.3.1 ECG Connection .......................................................................................................................................... 10
3.3.2 Blood Pressure Cuff Connection .................................................................................................................. 11
3.3.3 To connect the SpO2 ..................................................................................................................................... 14
3.3.4 TEMP Transducer Connection ..................................................................................................................... 15
3.3.5 Battery Installation ....................................................................................................................................... 15
3.3.6 Loading Printing Paper ................................................................................................................................ 16
CHAPTER 4 MONITORING SCREEN ...............................................................................................18
4.1 MAIN SCREEN....................................................................................................................................18
4.1.1 Date and Time Setup .................................................................................................................................... 18
4.1.2 Screen Description ....................................................................................................................................... 19
4.2 DISPLAY2 SCREEN .............................................................................................................................23
4.2.1 Viewing Screen ............................................................................................................................................ 23
4.2.2 Seven ECG Waveforms on the Same Screen ............................................................................................... 24
4.2.3 Eight Channels Real-time Waveforms and Trends on the Same Screen ...................................................... 25
4.2.4 Operating Instructions .................................................................................................................................. 25
4.3 FREEZE AND S-T SEGMENT ANALYSIS SCREEN ..................................................................................26
4.3.1 Screen Description ....................................................................................................................................... 26
4.3.2 Operation Instruction ................................................................................................................................... 27
4.4 MODE SELECTION SCREEN ................................................................................................................27
4.5 SPO2 TREND LIST SCREEN .................................................................................................................27
4.5.1 Screen Description ....................................................................................................................................... 28
4.6 BLOOD PRESSURE TREND LIST SCREEN .............................................................................................28
4.6.1 Screen Description ....................................................................................................................................... 28
4.6.2 Operation Introduction ................................................................................................................................. 28
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User Manual for Patient Monitor
9.1.1 How to Obtain High Quality ECG and Accurate Heart Rate Value ............................................................. 67
9.1.2 Factors affecting ECG signal ....................................................................................................................... 67
9.2 NIBP MONITORING ...........................................................................................................................68
9.3 SPO2 MONITORING ............................................................................................................................70
9.4 RESPIRATION MONITORING ...............................................................................................................71
9.4.1 Measuring Principle ..................................................................................................................................... 71
9.4.2 Factors affecting respiration monitoring ...................................................................................................... 72
9.5 TEMPERATURE MONITORING .............................................................................................................72
9.6 CO2 MONITORING .............................................................................................................................72
9.6.1 Measuring Principle ..................................................................................................................................... 72
9.6.2 Mainstream vs. Sidestream Sampling .......................................................................................................... 72
CHAPTER 10 TROUBLESHOOTING.................................................................................................73
10.1 NO DISPLAY ON THE SCREEN ...........................................................................................................73
10.2 EXCESSIVE ECG SIGNAL INTERFERENCE OR TOO THICK BASELINE .................................................73
10.3 NO BLOOD PRESSURE AND PULSE OXYGEN MEASURES ..................................................................73
10.4 SYSTEM ALARM...............................................................................................................................73
CHAPTER 11 MAINTENANCE ...........................................................................................................74
11.1 SERVICE AND EXAMINATION ............................................................................................................74
11.2 BATTERY MAINTENANCE .................................................................................................................74
11.3 CLEANING, STERILIZATION AND DISINFECTION ................................................................................75
11.4 CLEANING, STERILIZATION AND DISINFECTION OF ACCESSORIES .....................................................76
11.5 STORAGE .........................................................................................................................................76
11.6 TRANSPORTATION ............................................................................................................................76
CHAPTER 12 APPENDIX .....................................................................................................................77
12.1 ALARM INFORMATION .....................................................................................................................77
12.2 DEFAULT ALARMING VALUES AND SETUP RANGE............................................................................78
12.3 ABBREVIATION OF ARRHYTHMIA .....................................................................................................80
12.4 STATUS/ERROR DURING NIBP MONITORING ...................................................................................81
12.6 TYPICAL PRESSURES AND CO2 READINGS AT ALTITUDES ................................................................83
12.7 ACCESSORIES LIST ...........................................................................................................................84
12.8 INSTRUCTIONS FOR SPO2 PROBE......................................................................................................85
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User Manual for Patient Monitor
Chapter 1 Overview
1.1 Features
Advance-150 Patient Monitor is the combination of the functions of patient monitor, which can be used to monitor
patient’s 6 physiological parameters: ECG, respiratory rate, body temperature, non-invasive blood pressure (NIBP),
pulse oxygen saturation (SpO2), and pulse rate.
15″high-resolution color LCD to display patient’s ECG waveform, respiration waveform, SpO2 cubage
waveform, NIBP waveform, and CO2 waveform;
User-friendly and intuitive display interface, multiple configuration of ECG waveform display:
Default screen view: displays the information of all the waveforms and parameters visually.
Observing screen view: heart rate value and SpO2 value display in big fonts.
Seven lead waveforms on one screen view: displays the information of 7 ECG lead waveforms and different
monitoring parameters on one screen.
Eight channel real-time waveforms and two hours’ trends screen view: intuitionistic knowing the
physiological status of patient.
Battery power indicator, which enables real-time battery power detection and displays the battery power.
The cuff can be also used as a tourniquet, which is convenient and practical in use as an additional function,
and different cuff pressure can be set according to patient’s condition.
Up to 20 types of arrhythmia can be analyzed automatically, waveform freezing is available and automatic S-T
segment measurement.
“8/24/120/480 hours” trend graph analysis function, under working status, up to 120 hours trend data can be
stored, including HR, Temp, SpO2, RR, IBP and NIBP etc. trends;
Up to 100 groups of arrhythmia events’ data can be stored, as well as the corresponding ECG, Temp, SpO2,
RESP and pulse value of each case;
Up to 1000 groups of NIBP measurement can be stored, as well as the corresponding HR, Temp, RR, SpO2
and PR while the blood pressure measurement is taken, it can be recalled by list table or graphic trend.
Up to 14 hours store and recall ECG waveform data eternally even if the device is out of power;
Unique file management, which enables recording, modifying, deleting and saving operation of patient’s
information.
Displays heart rate trend, SpO2 trend, respiration trend or waveform simultaneously on oxyCRG screen, to
know the instantaneous condition change of neonate.
Unique pulse oximetry technique achieves accurate SpO2 and pulse rate measurement;
Multiple interface monitoring, which enables simultaneous monitoring of several ECG waveforms;
Precise alarm system, different alarm events adopt different alarm degrees; 3 degrees visual and audible alarm
function;
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User Manual for Patient Monitor
Easy to color-code and change the color of the font, background and waveforms if needed;
Cardiac pacemaker restraining function enables to be used along with cardiac pacemaker;
Protection against defibrillator and resistance against the interference from electrosurgical unit.
Blood pressure may be measured in the mode of “adult/infant/neonate”, which may be selected via the menu,
to better suit the adult, infant and neonatal patient;
8. Do not use mobile phone nearby, so as to avoid strong radiant field interference.
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User Manual for Patient Monitor
1.6 Safety
a) This device conforms to IEC60601-1, electric safety classification: Class I, with Type BF and CF applied
parts.
b) This device can resist against the discharge of defibrillator and the interference of eletro-surgical unit.
c) This device can monitor the patients with pace-maker.
d) DO NOT use this device while the patient is under MRI scanning.
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User Manual for Patient Monitor
Figure. 2.1
2.2 Composition
1. The monitor consists of the main units and the corresponding functional components (ECG leads, non-invasive
blood pressure cuff, SpO2 probe, temperature transducer, appendix of invasive blood pressure and side-stream
CO2).
2. The patient monitor has 6 measurement channels: the ECG and respiration channel, the NIBP channel, the
SpO2, pulse channel, the temperature channel, IBP channel, and EtCO2, InsCO2 channel.
3. The patient monitor has two output channels: the networking communication port and the printer.
4. Basic parameters include: heart rate, respiration rate, EtCO2, InsCO2, temperature, SpO2, NIBP and pulse.
Advance-150 Patient Monitor, which performs physiological parameter measurement through different modules, is a
product of module design. It consists of six modules: ECG module, NIBP module, SpO2 module, IBP module, CO2
module and the main unit.
1. The ECG module collects the heart rate, respiration waveforms through the ECG leads and collects the
temperature data through the temperature probes as well.
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User Manual for Patient Monitor
2. The SpO2 module collects the data of pulse rate, pulse oxygen saturation (SpO2) and SpO2 volume waveform
via the SpO2 probe.
3. The NIBP module collects the blood pressure data, including the diastolic, systolic and mean arterial pressure
through the NIBP cuff. The cuffs are designed for adult, infant and neonate respectively, and the NIBP
measurement has three modes: adult, infant and neonate.
4. The IBP module collects the data and the waveforms of invasive blood pressure through the IBP cable.
5. The CO2 module collects the data of respiration rate, EtCO2, InsCO2 through the sampling tube.
6. The main unit consists of main board, multi-function board, and the keyboard. The multi-function board
performs the data communication among the main board, ECG module, SpO2 module, NIBP module, IBP
module, and CO2 module.
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User Manual for Patient Monitor
2. Open the users’ manual to sort the accessories according to the packing list.
Please contact the local dealer or our company in case of any problems. We are to offer you the best solution for
your satisfaction.
Use the power cable prepared by the manufacturer. Insert one end of it to the power port of the monitor
and the other end to the grounded three-phase power jack.
Connect the monitor to the grounding port with the provided ground cable.
The provided battery of the monitor must be recharged after transportation or storage. So if the
monitor is switched on without being connected to the AC power socket, it may not work properly
due to insufficient power supply.
Check all the applicable functions to make sure that the monitor works normally.
If the built-in battery is applied, please recharge it after the monitor is used to ensure sufficient power
storage.
0 Do not use the device to monitor the patient if the device appears obvious damage or indication of
fault. Please contact the local dealer or our company.
After the monitor is switched off, it’s recommended to delay 1 minute to restart it.
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User Manual for Patient Monitor
3.2 Appearance
1. :Power switch
Press it for 3 seconds to turn on or turn off the monitor.
2. ~:AC indicator
When AC indicator is on, it means this device is using mains power supply.
4. :ECG Lead
Click it to shift the ECG monitoring circulatory among I, II, and III, aVR, aVL, aVF and V.
5. :Alarm silence
Press this key to set or activate the system alarm silence function.
In the monitoring screen, press (Alarm) to set the alarm silent time. The time shows up on the lower left
corner of the screen. When the alarm timer is activated, the system begins to count down and alarm when the
set time has passed.
The alarm silent time has four options: 2 minutes, 5 minutes, 10 minutes and 20 minutes, or the system alarm is
in the alarm status.
6. :Freeze
Press this key to freeze ECG waveforms or the waveforms of ECG, SpO2 and RESP for S-T segment analysis
according to system setting.
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User Manual for Patient Monitor
7. :NIBP
Press it to start or stop NIBP measure.
8. :Print
Press it to print different waveforms of different status according to system setups.
In the main menu print Ⅱlead ECG waveform and the second waveform, this can be selected in the system
menu.
9. :Display
Click it to shift the display modes. Press it to shift the main screen, list screen, viewing screen and the seven
leads on the same screen and return to the main screen from other screens.
10. Navigation knob: It is the major operating key of the system.
Rotate it to the left or right to select functions or parameters. Press and release it to shift the screen and to
confirm the function or other operating tips.
The majority operations of this system are finished by navigation knob.
11. Alarm indicator
Indicator Color Alarm Level Alarm Event
Exceeding the limits, pulse stop, suffocation or low
Red flashing High priority alarm
battery power
Yellow flashing Middle priority alarm Leads and probe off, VE RONT and SVE RONT
Yellow light Low priority alarm Other arrhythmia phenomenon
Green light Normal
Figure 3.2 the Left Panel Figure 3.3 the Right Panel
Different ports are located in different positions of the monitor for operating convenience.
The built-in printer is at the left panel, shown as Figure 3.2
The cable and transducer ports are at the right panel, shown as Figure 3.3.
(1) TEMP1, TEMP2: TEMP probe connector
(2) NIBP: NIBP hose connector
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User Manual for Patient Monitor
(6) -Battery cover, remove the cover to install or change rechargeable battery. Factory default: two
rechargeable batteries (12V 2.3Ah); battery specification: FB 12V 2300mAh.
“TO AVOID BATTERY DAMAGE, ALWAYS REMOVE BATTERY(S) BEFORE SHIPPING OR STORAGE”
Type BF
(7) Nameplate
CE mark
Serial number
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User Manual for Patient Monitor
3.3 Connection
4. Skin clean
¾ Clean and dry-abrade skin to ensure low sensor impedance. Mild soap and Water is recommended as a skin
cleanser.
Note: Alcohol is not recommended as a skin cleanser; for it leaves a film layer that may cause high sensor
impedance. If alcohol is used, ensure 30-second dry time.
¾ Dry-abrading the skin gently with a dry wash cloth, gauze, for skin preparation is helpful to remove the
non-conductive skin layer.
The symbol indicates that the cable and accessories are designed to have special protection against electric
shocks, and is defibrillator-proof.
The locations of the electrode are in the following Figure:
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User Manual for Patient Monitor
Advance-150 Patient Monitor can only be equipped with ECG leads provided by our company; using ECG
leads supplied by other companies may cause improper performance or poor protection while using
defibrillator.
Electric parts of electrodes, leads and cables are forbidden to contact any other electric parts (including
ground).
Advance-150 Patient Monitor can resist against defibrillator and electrosurgical unit. Readings may be
inaccurate for a short time after or during using defibrillator or electrosurgical unit.
Transient caused by cable circuitry blocks while monitoring may be similar to the real heartbeat waveform, as
a result resistance heart rate alarm rings. If the electrodes and cable are placed proper positions according to
this manual’s instructions and the instructions for using electrode, the chance to occur this transient will be
decreased.
0 To the patient with pacemaker, because this device has been designed to resist against the interference of
pacemaker, generally the pacemaker pulse is not counted in heart rate measurement and calculation unless the
cycle time of pacemaker pulse is over 2ms. In order to reduce this possibility, observe the ECG waveforms
on the screen carefully and do NOT rely entirely on the heart rate display and alarm system of this monitor
when monitoring this kind of patients.
0 The improper connection with electrosurgical unit may not only cause burns, but also damage or arouse
deviations of measurement. You can take some steps to avoid this situation, such as do NOT use small ECG
electrodes, choosing the position which is far away from the estimated Hertzian waves route, using larger
electrosurgical return electrodes and connecting with the patient properly.
0 No predictable hazard will be caused by the summation of leakage currents when several items of monitor
are interconnected.
ECG leads may be damaged while using defibrillator. If the leads are used again, please do the functional
check first.
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User Manual for Patient Monitor
Note: The size of the cuff selected should suit the subjects while measuring.
Cuff Model Arm Circumference Cuff Width
Neonate Cuff 6.0cm~9.5cm 3cm
Small-sized Infant Cuff 6cm~11cm 4.5cm
Middle-sized Infant Cuff 10cm~19cm 8cm
Large-sized Infant Cuff 18cm~26cm 10.6cm
Adult Cuff 25cm~35cm 14cm
2) When putting on the cuff, unveil and wrap it around the upper arm evenly to appropriate tightness.
3) Remember to empty the residual air in the cuff before the measurement is commenced.
4) Locate the cuff in such a way that the “φ” mark is at a location where the clearest pulsation of brachial artery is
observed.
5) The cuff should be tightened to a degree where insertion of one finger is allowed.
6) The lower end of the cuff should be 2cm above the elbow joint.
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User Manual for Patient Monitor
Mode 1: The inflation can be activated by Monitor so the pressure will increase automatically untill it
exceeds the limit value specified in table A. This pressure limit value depends on the patient type selection
as shown in table A:
Adult 240mmHg
Child 200mmHg
Neonate 120mmHg
Table A
During the inflation, the Monitor will close the deflating valve, and the pressure value will be shown during
the process. If there is no manual deflation operation, the pressure will persist untill deflation by manual
operation, so it is necessary to use a manual valve for doing adequate deflation in several steps to verify the
pressure accuracy in the full scale of measurement range.
Mode 2: No automatic inflation by Monitor during the pressure accuracy verification.
Increase the pressure manually by the pumping balloon, and the verification can be done by applying
different pressure value manually. If the increased pressure exceeds the given limit as shown in table B, the
Monitor will deflate automatically because of over-pressure protection.
Adult 300mmHg
Child 240mmHg
Neonate 140mmHg
Table B
After the verification, do press the button again to return to normal working mode, then continue
other operation, or the NIBP key will be invalid.
Pressure accuracy verification must be operated by technician or equipment manager. Doctor or nurse
is not allowed to do the verification, it is very dangerous especially when the pressure cuff is still on
patients.
¾ Air Leakage Check
In order to avoid significant error of blood pressure measurement or even no measurement result caused by air
leakage in the pneumatic system including the cuff during measuring, it is recommended to check if there is leak in
the pneumatic system as well.
Please remove the cuff from patient while performing the leakage check.
Safety Instructions for NIBP Monitoring
0 When taking the measure of an infant or neonate’s (less than 10 years old) blood pressure, do NOT
operate in the adult mode. The high inflation pressure may cause lesion or even body putrescence.
0 It is recommended to take the blood pressure measurement manually. Automatic or continuous
measurement should be taken at the presence of a doctor/nurse.
0 NIBP monitoring is prohibited to those who have severe hemorrhagic tendency or with sickle cell
disease, or partial bleeding will appear.
0 Do NOT bind NIBP cuff on limbs with transfusion tube or intubations or skin lesion area, otherwise,
damages may be caused to the limbs.
0 Pay attention to the color and sensitivity of the limb when measuring NIBP; make sure the blood
circulation is not blocked. If blocked, the limb will discolor, please stop measuring or move the cuff
to other positions. Doctor should examine this timely.
0 The time of the automatic pattern noninvasive blood pressure measurement pulls too long, then the
body connected with the cuff possibly have the purpura, lack the blood and the neuralgia. When
guarding patient, it is a must to inspect the luster, the warmth and the sensitivity of the body far-end
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User Manual for Patient Monitor
frequently. Once any exception is observed, please stop the blood pressure measurement
immediately.
The subject should lie on the back so that the cuff and the heart are in a horizontal position and the most
accurate measure will be taken. Other postures may lead to inaccurate measurement.
Do not speak or move before or during the measurement. Take care to avoid that the cuff will not be hit or
touched by other objects.
The measurements should be taken at appropriate intervals. Continuous measurement at too short intervals
may lead to pressed arm, reduced blood flow and lower blood pressure, and resulting in inaccurate measure
of blood pressure. It is recommended the measure be taken at intervals of more than two minutes.
When an adult subject is monitored, the machine may fail in giving the blood pressure measure if the infant
mode is selected.
Prior to use of the cuff, empty the cuff until there is no residual air inside it to ensure accurate measurement.
Do NOT twist the cuff tube or put heavy things on it.
When unplugging the cuff, hold the head of the connector and pull it out.
The symbol indicates that the cable and accessories are designed to have special protection against electric
shocks, and is defibrillator proof.
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User Manual for Patient Monitor
High ambient light sources such as surgical lights (especially those with a xenon light source), bilirubin lamps,
fluorescent lights, infrared heating lamps, and direct sunlight can interfere with the performance of an SpO2 sensor. To
prevent interference from ambient light, ensure that the sensor is properly applied, and cover the sensor site with
opaque material.
Failure to take this action in high ambient light conditions may result in inaccurate measurements.
If patient movement presents a problem, verify that the sensor is properly and securely applied; move the sensor to a
less active site; use an adhesive sensor that tolerates some patient motion; or use a new sensor with fresh adhesive
backing.
For reusable sensors, follow the sensor directions for use for cleaning and reuse. For single-patient use sensors, use a
new sensor for each patient. Do not sterilize any sensor by irradiation, steam, or ethylene oxide.
0 Continuous use of fingertip SpO2 sensor may result in discomfort or pain, especially for those
patients with microcirculatory problem. It is recommended that the sensor should NOT be applied to
the same finger for over two hours.
0 SpO2 measuring position must be examined more carefully for some special patient. Do NOT install
the SpO2 sensor on the finger with edema or fragile tissue.
0 Do NOT put the SpO2 sensor and pressure cuff on the same limb, otherwise the NIBP measuring will
affect SpO2 measuring and cause the alarm error.
Do NOT use the damaged SpO2 sensor.
Please do not use nail polisher or other cosmetic product on the nail.
The SpO2 sensor cannot be immerged into water, liquor or cleanser completely, because the sensor has no
capability to resist the harmful ingress of water.
Connecting methods:
Note: When unplugging the probe, be sure to hold the head of the connector and pull it out.
2. Open the battery cover, insert the battery into any slot of battery compartment, and pay attention to the
instruction of polarity direction in the compartment. Do not reverse the battery.
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User Manual for Patient Monitor
4. Remove the battery cover. (According to your need, you can insert one more storage battery to prolong using
time.)
Please take out the battery from battery compartment, if it won’t be used for a long time.
1. Press both “OPEN” notches with force on printer shield with two thumbs to open it.
2. Move the tab of rubber roller lock at the left 90°upwards to unlock it.
3. Cut one end of the paper into triangle, and load the paper from the underside of the rubber roller.
4. Turn the roller clockwise to get the paper rolled, and put the paper roll into the compartment.
6. Move the tab of the rubber roller lock 90° downwards to lock it.
1~2 steps are the same with the 1~2 steps mentioned above for loading printing paper.
3. Roll the loading roller anti-clockwise and pull the paper out.
4~5 steps are the same with the 6~7 steps mentioned above for loading printing paper.
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User Manual for Patient Monitor
Power Indicator
Open button
Error Indicator
Paper cartridge
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User Manual for Patient Monitor
The system will stay on this screen for 10 seconds. If you do not rotate the navigation knob within this period, the
screen will enter into the Main Screen.
Follow the steps below to set date and time.
Step 2: Press the knob, and then gray cursor stays on the Year of the date. Press the knob again and the gray
cursor becomes highlighted. Rotate the knob left or right to increase or decrease the year value.
Step 3: When the Year is set, press the knob to move the gray cursor to the Month of the date.
Step 4: Repeat Step 2 and Step3 to adjust the Year, Month, Date, Hour and Minute.
Step 5: If you have finished adjusting the date and time, press the knob and rotate the knob to move the cursor
to “Save”, press it to save the settings. Then move the cursor to “Exit”, press it to exit the date and time
setting screen, meanwhile enter into the main screen shown in Figure 4.2.
The system is initialized and enters into Main Screen where monitoring and system operation are performed. (as shown
in Figure 4.2)
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“ADUL”: The patient type. There are three selectable patient types: “Adult”, “Infant” and “Neonate”.
“MON”: ECG Filter type. There are three types: “Diagnosis”, “Monitor”, and “Operation”. The option
can be set in the system menu.
“ ”: battery power indicator; When the indicator is yellow and displays only one “grid”, it means
there is a little battery power left. When the indicator turns red and blinks, as well as less than one “grid”
displays, the system alarm will be on to remind the battery shortage. Please connect the device to the mains
power supply in time to ensure the normal use of monitor, and the battery will be recharged. When the
battery power is full, battery power indicator displays full grid. During recharging, the grids in the battery
indicator are rolling circularly.
“2011-06-20 16:36:04”: Current calendar time and date. The system time and date can be set during the
system start-up when the screen displays the time and data setups. The current figure shows the time and
date: June 20th, 16:36:04, 2011.
“Push Display, changing interface”: System prompt or description for the current status.
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“ID”: The patient ID. It can be entered or changed in the archive management window.
Waveform area:
1st trace: The first trace is ECG waveform for lead II. The left side of the ECG shows the sign I, which
indicates the ECG scale. The scale sign changes its length according to the ECG gains. All ECG
waveforms have their own scale. When the third measured trace change to lead II, the first trace will
automatically change to lead I.
2nd Trace: The second trace is for the ECG waveform of lead III. When the third measured trace displays
the ECG for the lead III, this waveform automatically changes to the ECG for lead I.
3rd trace: The third trace is the measurable ECG channel. Its lead can be adjusted and will not repeat the
1st and 2nd traces.
“ ”: The heart beating symbol. Its flashing corresponds to the R wave of the ECG waveform. The speed
is the same with the heart rate.
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“PR”: pulse rate value measured by NIBP measurement; “63”: pulse rate value;
“MANU”: The NIBP measurement mode: manual. “17:43”: NIBP measuring time.
“SpO2”: SpO2 label. “98” on the right side is the current SpO2 value.
“PR”: Pulse rate label. “61” on the lower left shows the pulse rate value.
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“RR”: Respiration Rate: The bpm after that is the unit of the respiration, i.e., beat per min.
“EtCO2”: The label and the value will become gray when CO2 is turned off. “39.4” is EtCO2 value;
“Ins”: The label of the minimal inhalational CO2, the label and the value will become gray when CO2 is
turned off. “2.9” is InsCO2 value;
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In this screen, press the Display key to switch the ECG lead, or press the Print key to print the ECG waveform and the
second waveform. The second waveform can be selected in the System menu.
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4.2.3 Eight Channels Real-time Waveforms and Trends on the Same Screen
When the Disp2 option is “Trend” on system menu screen, press the Display key on the main screen, then the system
will enter the trend screen, as shown in Figure 4.11. Eight channel real-time waveforms and trend graph can be viewed
on this screen.
Figure 4.11 Eight Channel Real-time Waveforms and Two Hours Trends
On this screen, the first channel waveform is ECG waveform of Lead II; the second (CAS) one is the continued ECG
for the first channel waveform; the third one is ECG waveform of Lead I; the fourth one is the continued ECG for the
third channel waveform; the fifth one is IBP1 waveform; the sixth one is IBP2 waveform; the seventh one is SpO2
waveform; the last channel is respiration waveform. On the right of waveform area, from the top down, respectively is
heart rate, temperature, SpO2, IBP1, IBP2, EtCO2 trend graph, the abscissa of trend graph (-2h-0) means various trend
of every parameter value from now on to two hours before, waveform in trend graph shifts from right to left. On this
screen press Lead key can perform switching ECG Lead status, the changing regulation of leads is the same with the
leads operation on the main screen.
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In the main screen, press the Freeze key to freeze three channel ECG waveforms or all the waveforms on the screen, as
shown in Figure 4.12.
Freezing, S-T segment analysis screen is similar with the main screen, except the waveforms are frozen. For example,
the Figure 4.13 is a portion of the frozen waveform. The symbols on the screen were described briefly on the screen.
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First, rotate the Navigation Knob to move the base point (the red cross) horizontally to baseline point (the baseline is
between the Q wave and the P wave). At this point, the frozen screen shows “S-T+0.xxx mV, Set Base, DIRC HOR”.
Second, press the Navigation Knob. The screen shows “S-T+0.xxx mV, Set Base, DIRC VER”. Then rotate the knob to
move the base point vertically to the baseline point.
Third, press the Navigation Knob again. The screen shows “S-T+0.xxx mV, Set S-T, DIRC HOR”. Rotate the knob to
move the S-T point (the yellow cross) horizontally to the point to be measured on the S-T segment.
Last, press the Navigation Knob again. The screen shows “S-T+0.xxx mV, Set S-T, DIRC VER”. Rotate the knob to
move the S-T point vertically to the point to be measured on the S-T segment.
One the main screen allows pressing the Freeze key to enter the S-T segment analysis screen.
NOTE: The S point is the end point of S wave, and the T point is the start point of T wave.
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Up to 13 groups of the latest data can be printed each time when printing SpO2 list and the printing data is the SpO2 list
on current screen. Rotate the knob to display the next screen and then press the Print key to perform printing, the next
page of SpO2 list will be printed.
All the parameters in the SpO2 trend list are corresponding to the time when the SpO2 measurements were taken.
There is only one record every 4 seconds.
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If you want to enter one of the trend graphs, the procedures are: rotate the Navigation knob, move the cursor to one of
the parameter. For example, from the left to right, we can view “ECG”, “S-T”, “Temperature”, “NIBP”, “SpO2”,
“IBP1”, “IBP2”, “Respiration” and “EtCO2” trend graphs. The corresponding screens are described in the following
figures.
The “8” on the top shows the trend graph time. Move the cursor to the trend time, press the knob and rotate it, and the
trend graph time will change to 24 or 120, which changes the horizontal axis to be 24 hours or 120 hours. The
corresponding trend graph also changes to 24-hour trend or 120-hour trend.
After choosing “Scan”, the trend graph display a triangle and a vertical line, a moving ruler mark that can be moved by
rotating the knob. As shown in the figure, when you move the mark to a specific point, the data area below the graph
will display the time, and its corresponding heart rate, respiration rate, SpO2, temperatureⅠ, temperatureⅡ. When
rotating Navigation knob key to move the mark, the moving interval is a changing value. The rule is that the initial step
is 1, after moving it towards the same direction 5 times, the interval becomes 5, and with 5 more steps the interval
becomes 10, then 20 and 40. No matter what the interval is, as long as you move towards the other direction, the
interval becomes 1 of the other direction. Therefore, it is very easy to find the time you are looking for.
The last option on the right is “Exit”. Move the cursor to the “Exit”, and press the Navigation knob to return to the
previous screen. The screen returned to is the Mode Selection screen.
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Please note that the maximum value on the vertical axis of the ECG is 150, not the value of ECG upper limit 300. The
graph is scaled down for better view of the waveforms. When the ECG value exceeds 150, the vertical axis’s maximum
value will automatically change to 300. That is to say, the vertical axis value 0-75-150 will change to 0-150-300 if ECG
value exceeds 120 automatically. When system gets reset or the patient ID is changed, the vertical axis will return to its
original value of 0, 75, and 150. Other changes of vertical axis value in other trend graph are similar to that of ECG.
The Trend graph shows parameter value of the current time. For example, in the 8 hours trend graph, when the
monitoring time exceeds 8 hours, the data 8 hours ago will be move out of the graph. This ensures the screen always
display the current data for review. The data moved out of the graph is not deleted but is just hidden temporarily. When
the time frame changes from 8 hours to 24 hours (while the monitoring time is less than 24 hours), the complete set of
data will display. Other trend graphs follow the same rule.
The S-T segment, respiration rate, body temperature and other trend graph are similar to that of ECG’s and we will not
cover them in detail again. Please note that for those trend graphs, the horizontal axis is the number of times the blood
pressure measured instead of time.
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②The EtCO2 trend graph can be viewed only when the CO2 measurement function is activated through the setting:
“System menu→SETUP→CO2→Switch→ ON”.
Move the gray cursor to “RCALL” in the mode selection screen, and press Navigation Knob to enter into Recall trend
screen, displays in the same position shown as Figure 4.25. The recall waveform is the selected lead waveform and
displayed in third channel. Generally a piece of recall record is saved every one hour, if the time is less than one hour
when the patient is changed, this record will be separately saved as a piece of recall record.
Leads and gain etc parameters of saved ECG always keep in accordance with the settings of system parameter.
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HIST: Press the key to shift between the History key and Current key. Press HIST and the recall list on the left displays
the history data list. Press the Current, the recall list on the left side displays the current one. When entering the recall
screen, the system defaults the current one.
Delete: Press this key, and the selected record in the recall list becomes green. Rotate the Navigation knob to choose the
reviewed record that is to be detected, press it, release it 2 seconds later, and then the record is deleted. The current
record cannot be deleted, or system will exit Delete screen.
In this screen, the system can print the recalled data list or the recalled waveform.
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Move the gray cursor to “ARR” and press Navigation Knob to enter ARR screen, shown in Figure 4.28. The structure is
similar to recall screen. We will cover each function key below.
View: Press this key, and the selected record in the ARR list, which is to be reviewed, becomes green. Rotate the
Navigation Knob to choose the record and display the corresponding waveform in the 3rd ECG channel. Press the knob
again to exit.
Exit: press this key to exit the arrhythmia detection screen and return to the system menu.
During monitoring, if arrhythmia is detected, the system will alarm. The ARR alarm is system default and does not
need setup.
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During arrhythmia detection, incorrect detection might occur if the non-ECG waveforms (e.g.; square wave and triangle
wave) appear.
During arrhythmia detection, the arrhythmia module is very important. The system requires a group of stable ECG
waveforms. If the system detects the arrhythmia incorrectly, please re-learn arrhythmia by pressing “Learn” button and
capture correct template.
To set up the system parameter, rotate the Navigation knob to move the cursor to the corresponding button, and press it
to perform corresponding settings.
At the same time, the DEF button returns the settings to the default value, but the patient document and the recalled
data will not be changed. We will cover the functions of each button.
SYSTEM PARAMETER SETTINGS
Mode: Monitor mode selection. The “Real Time” shows the real time waveform, i.e. normal monitoring
state. The “Demo” shows the demo waveforms. In the demo state, all the signals and data are generated
from the patient monitor for demo and testing purpose. The default is “Real Time”
LANG: The current language used, which can be selected by the user. There is no default for this setting.
However, the setting can be saved.
Fill: When the fill setting is ON, the display fills the volume for the SpO2 and Respiration. When it is OFF,
the system displays the line graph. The default is OFF.
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Frze: Pressed the key to freeze the selected waveform. The options are “All” and “ECG”. When ECG is
selected, the system only freezes ECG waveforms. When “All” is selected, the system freezes all the
waveforms including ECG, SpO2, and Respiration. The factory default is “ECG”
Disp2: The display 2. Three options: Trend, Obser (Observation) and 7 ECG (7 ECG lead) can be
selected. The factory default is Observation.
VOL: The sound volume. The maximum volume is 7 and minimum is 0, i.e. no sound. The default is 5.
Key: If the setting is ON, the press of the button will generate a keystroke sound. The factory is ON.
Net Type: select net type: net or COM
Beep: The synchronous heart beat sound. The range of setting is “0~7”, The factory default is “5”
IBP:turn on or turn off the IBP function.
PRINTER SETTINGS
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Gain: The ECG gain, 6 options x1/4, x1/2, x1, x2, x4 and Auto. Auto is for automatic gain control. The
factory default is “x1”.
Mode: ECG filter mode. Three options: MON, DIA, and OPE
MON: Monitoring mode. Moderate filtering that can filter out interference and present good ECG
waves.
DIA: Diagnosis. No filtering, represent the true ECG without filtering.
OPE: Operation. Deep filtering, filtering out strong interference.
The factory default is “MON”.
BtSnd: Heart beat sound. The synchronous heart beat sound during monitoring. “0~7” level adjustable.
1mV: Generating the 1mV signal. This signal is used to test the function of the machine. It is not used
during normal operation. Factory default is “OFF”.
50Hz: frequency filter. It means turn on or turn off the 50Hz frequency filter.
Pace:Pace detecting switch. The default is “OFF”. When the option is on, the mark will be made in the
first ECG channel of any screen if pace is detected, as shown below.
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☞ Limits setup: Move the gray cursor to the High or Low limits of the alarm settings, and press the
Alarm silence key to turn ON or OFF the alarm for the setting. Yellow color shows ON status, and gray
color shows the OFF status.
Unit: Temperature unit. The default is °C (Celsius) and it can be set to °F (Fahrenheit).
TD: Temperature difference value. When the TD value is higher than the set value, the alarm will ring.
NIBP PARAMETER SETTINGS
MAP Hi/Lo: High and Low limits of mean arterial pressure alarm
Unit: The pressure unit, mmHg and kPa can be selected. The factory default is “mmHg”.
Mode: The cuff inflation mode, manual or automatic. The factory default is manual. The operator needs to
press the NIBP button to perform NIBP measurement. If the Auto mode is chosen, the operator needs to set
an interval cycle as well.
Cycle: The inflation interval when the NIBP measurement is set to Auto. The options are STAT, 1 min, 2
min…240 min. Press NIBP and the system begins to count down. It takes blood pressure measurement
automatically after finishing counting down If STAT is selected, press NIBP to take 5 minutes’ measurement.
Initial inflation pressure setup: Cuff pressure to be inflated initially, its options are different depending on
patient type.
for neonate: initial inflation pressure can be: 60, 70, 80mmHg, default setting: 70 mmHg;
for infant: initial inflation pressure can be: 80, 100, 120, 140 mmHg, default setting: 100 mmHg;
for adult: initial inflation pressure can be: 80, 100, 120, 140, 160, 180, 200mmHg, default setting: 150
mmHg.
NIBP Cali: The NIBP Cali has three options: NIBP Cali Mode 1, NIBP Cali Mode 2 and OFF. Make sure
the key is off with manual after the NIBP calibration, or the user could not do other operations. The factory
default is OFF.
Gas Leak: For professional person to test gas leak on blood pressure.
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WARNING: STAT can only be used for Adult. Using this mode to Infant/Neonatal patient
can cause serious injury.
☞ Limits setup: Move the gray cursor to the upper or lower limits of the alarm settings, and press the
Alarm silence key to turn ON or OFF the alarm for the setting. Yellow color shows ON status, and gray
color show the OFF status.
SPO2 PARAMETER SETTINGS
Gain: Respiration amplification/gain, 4 options, x1/2, x1, x2, and x4. The default is “x2”.
Apnea: The timeout for apnea alarm (in second). The timeout setting range is 5~120 or the alarm is disabled.
When the patient stop breathing for the time longer than the set period, the Respiration display channel
display warning “Apnea xxx second”. The default is “OFF”.
RR Hi: High limit of respiration rate alarm
Lo: Low limit of respiration rate alarm
Speed: Respiration display speed, 2 options 6.25mm/s and 12.5 mm/s. The default is “12.5 mm/s”
☞ Limits setup: Move the gray cursor to the High or Low limits of the alarm settings, and press the
Alarm silence key to turn ON or OFF the alarm for the setting. Yellow color shows ON status, and gray
color shows the OFF status.
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In the mode selection screen, move the gray cursor to “COLOR” and press the Navigation Knob to enter color setting
screen, shown in Figure 4.37.
In the mode selection screen, move the gray cursor to “FILE” and press the Navigation Knob to enter document
management screen, shown in Figure 4.38.
ID: or Patient ID. To enter patient ID, choose the patient ID field using the Navigation Knob. Press it to enter
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the text entry box. Rotate the knob to choose the letter and press the knob to enter the letter. To delete the
letter, move the cursor to the letter to be deleted and rotate the knob to enter spaces (after the H). Use the
spaces to replace the letters. After finishing entering the patient ID, choose Exit button and press the knob to
exit the text entry. The patient ID is the unique identifier for the patient. When the patient ID changes, the
system considers the patient has changed.
Age: Choose the age field and use the rotate knob to select an age.
Synchro: Selecting “Synchro” can upload the current patient file to patient archive screen of center unit for
management, and also can send patient archive of center unit to bedside unit for management.
Note: The function of Synchro ONLY can be performed in communication of bedside unit and center unit
with dual-screen center system.
Save: The operator can choose how much of the data that needs to be saved. The unit is hour. Once the time
is chosen, the system starts to save data from the current time. If OFF is selected, it means that the data will
not be saved. The system will determine the time range according to the disk space available. If no disk space
available, SAVE will be displayed as OFF. When the user intends to save the current ECG waveform
permanently, please delete the history files.
Net Type: The type of network connection to the central monitoring system. There are three selectable
options: “OFF”, “NET” and “COM”. The option “OFF” means no data transmission at all, that is to say,
disconnection to the outside world; The option “NET” means the network is “Ethernet” for data transmission
by TCP/IP data packet; The option “COM” means the network is “RS-232” for data transmission.
When the option of Net Type is not “NET”, the field of “HostIP” and “PORT” will represent gray which tells
the user these fields are inactivated and there no need to set them. If the option is “OFF”, press “Exit” to end
the data transmission, therefore, the data communication is terminated. Similarly, if the option is “NET” or
“COM”, pressing “Exit” to activate the data communication. But the change of current Net Type needs
hardware initialization, so if the users want to change Net Type, they should exit from the setting screen firstly,
then manually turn off the device and reboot it to make the new setting effective.
Note: The Net Type will remain the last setting when the monitor is restarted.
Host IP: The users should set the host IP (IP number of the work station in the central monitoring system)
when the option of Net Type is “NET”. If it is necessary to change the IP number, as mentioned above, the
user should turn off the monitor manually and reboot it to make the new setting effective.
Port: The port number to which the monitor will connect to the work station in the central monitoring system.
It can also be used to represent the patient bed number which can be set in the range from 6001 to 6064, e.g.
the port number 6002 means the monitor is assigned to the bed number 2 in the CSM. It is known that the
work station can connect to up to 64 bedside monitors. In order to make the new setting effective, as
mentioned above, the user should power off and reboot monitor after change the port number.
Note: 1.Make sure the work station and patient monitors are in the same local domain when using “NET” type
network connection, different monitor should be set to unique port number, in case causing repeated bed number
and failing to connect with the work station.
2. “Help” symbol on monitor will give corresponding information prompts during the process of detecting
and establishing network connection.
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3. If the following situations occur: the network cable is disconnected suddenly or the software running on
the work station is closed accidentially (but the bedside monitor is under normal monitoring state), the user
should re-connect the network or re-run the software on the work station to enable the network re-connection
automatically, at this time, please be patient to wait, as the network searching time can be up to 2 minutes.
In the mode selection screen, move the gray cursor to “OXY” and press the Navigation Knob to enter oxyCRG screen,
shown in Figure 4.39 (1) or (2). This screen displays the value or waveform of HR, SpO2, and Respiration waveform or
Respiration Rate in selected time. The time can be set as 1 minute, 2 minutes and 4 minutes by the lower left button.
Press the middle button to set the third channel waveform display: Respiration waveform (Fig.4.39) or Respiration Rate
(Fig. 4.39 (2)). Press “Exit” button or Display key to exit from this screen.
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4.14 MC Calculator
In the mode selection screen, move the gray cursor to “MC” and press the Navigation Knob to enter MC analysis
screen, shown in Figure 4.40. This series monitor supplies 10 kinds of medicine calculation and titration display
function
On medicine calculation screen, first the operator should move the gray cursor to “Medicine” to select the calculated
medicine name, and then move the cursor to “Weight” to select and confirm patient weight, at this time MC analysis
screen is shown as Figure 4.41
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Rotate the Navigation knob to move the cursor to the option which needs to be calculated, press the knob and rotate it to
obtain calculating value. When the calculating value is selected, the calculated value will be displayed in corresponding
position. Each calculating option has limit range, if the result exceeds range, it will display “…”.
On MC analysis screen, other menu options cannot enter value unless entering patient’s weight and
medicine name again, in default status it is no effective. The values in system is a group of stochastic
initial values, the operator should not consider it as calculating standard, please follow doctor’s device
enter a group values which are suitable for patient.
The unit of every medicine is settled unit or unit series. The operator must select the appropriate unit
according to doctor’s device. In a unit series, unit carry performs automatic adjustment along with the
current entering value. When exceeding the range of this unit expression, the system will display “…”.
When the operator finishes one option entering, the system will give visible indication in menu to
remind operator to check the correctness of entering value.
For every new entering value, please perform confirming. The operator should take it seriously,
only when the entering is correct, the calculating result is believable and reliable.
Select Medicine Type: Move the cursor to “Medicine”, rotate Navigation knob to perform selection. Ten options:
AMINOPHYLLINE, DOBUTAMINE, DOPAMINE, EPINEPHRINE, HEPARIN, ISUPREL, LIDOCAINE, NIPRIDE,
NITROGLYCERIN, and PITOCIN. The default medicine is AMINOPHYLLINE.
Weight: when entering into medicine calculating window, the operator should enter patient’s weight; the weight is used
for MC calculation only; weight: 0.5Kg to 300Kg selectable; step: 0.5Kg; default: 70 Kg for adult; 20Kg for infant; 3.0
Kg for neonate.
Medicine calculation function just supplies a medicine calculator function. The values in table can
have no relation with the monitored patient, so the weight in this menu and the weight in system are
two different values. When update a patient in system operation, the value in this menu will not be
affected.
4.14.2 Titration
When entering medicine name and weight again, MC analysis screen displays as Figure 4.38, and then move the gray
cursor to “Titration” button and press it with the Navigation knob, the titration screen will display on screen, as shown
in Figure 4.42
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In the mode selection screen, move the gray cursor to “CUFF” and press the Navigation Knob to enter Cuff screen,
shown in Figure 4.43
Alarm: the time of alarm, 1 to 60 minutes continuous adjusting range. If the set is “xx” minutes, the system
will alarm until ending deflation when the time reaches ending deflation is “xx” minutes, and the alarm type
is high priority alarm. The default value is “5” minutes. (For example: the duration is 40 minutes, the alarm
set is 5 minutes, the alarm will ring when the duration countdown left time is 5 minutes.)
Start: Press it with the Navigation knob, the blood cuff starts being inflated; after inflating this field displays
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Respiration Rate High: Setting the upper alarm limit of CO2 respiration rate.
Low: Setting the lower alarm limit of CO2 respiration rate.
EtCO2 High: Setting the upper alarm limit of EtCO2.
Low: Setting the lower alarm limit of EtCO2.
InsCO2 High: Setting the upper alarm limit of InsCO2.
Low: Setting the lower alarm limit of InsCO2.
Baro (Barometric pressure): set ambient atmospheric pressure. It can be determined by barometer or the
ambient altitude. Altitude can be used to determine the typical barometric pressure if a barometer is not
available, refer to Appendix Typical Pressures and CO2 Readings at Altitudes for details.
Zero: The method to calibrate CO2: Zero calibration. Calibration must be carried out in a drafty place, and
the CO2 module must have worked continuously for 5 minutes to ensure an accurate calibration, or the
calibration will not work.
Flow (CO2 flow): It is flow rate of the CO2 sampling. Its value is 50ml/min.
The information promoted for Zero calibration is as follows:
Please apply the reference air with 0% CO2, the air in the drafty room usually can be regarded as the air with 0% CO2.
Press “OK”, and the result will be displayed on the screen several seconds later.
Apnea: display time of the respiration rate value in data area when the previous respiration has been detected
while the next one is not, meanwhile, the device will prompt apnea information. The setting range is 10s~60s,
the default is 20s. For example, if 20 seconds is set here, it means the respiration rate value will disappear
after it has been shown for 20 seconds in the data area if on respiration is detected during this period.
Period: setting the calculation cycle of EtCO2 value, there are three selectable options: “1b”, “10s” and “20s”.
“1b”: means the EtCO2 value will be calculated once every respiration cycle; “10s”: means the EtCO2 value
will be calculated once every 10s, and the maximum EtCO2 value measured during this 10s will be displayed
on data area; “20s”: means the EtCO2 value will be calculated once every 20s, and the maximum EtCO2 value
measured during this 20s will be displayed on data area
TEMP: setting the temperature value of the current measured air flow. For instance, the temperature is
usually set as 37℃ while measuring the patient’s respiration by air flow. However, if the air flow to be
measured is the reference gas, the temperature is set as 25℃. The setting range: 0~50; Unit: ℃; Default value:
35.0.
O2 Compen: adjusting the concentration of compensating gas in patient’s respiration air flow. Generally, the
compensating gas is oxygen, so it can be called oxygen compensation concentration. The unit: %; Setting
range: 0%~100%; Default value: 16.
Balance: setting the balance gas in patient’s respiration air flow. There are three kinds of selectable balance
gas: “Air”, “N2O” and “He”, namely: air, nitrous oxide and helium. If on specific balance gas is given, the
balance gas can be set as “Air”.
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Agent: setting whether adding the anesthetic gas to patient’s respiration air flow and the concentration of
anesthetic gas. The setting range is 0.0%~20.0%, the default status is: not adding anesthetic gas, that’s to say,
the concentration is 0.0%.
2. To set the color of CO2 parameters on Color Settings screen.
Extending airway tube for connecting to sampling tube (Single patient use)
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Wye Connector
On-air Connector
Adapter
(2) Nasal Sidestream Cannula Kits
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Sensor cable
Adapter
CO2 sensor
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0 Inspect the sidestream on-airway adapters and sidestream sampling kits for damage prior to
use. DO NOT use the sidestream on-airway adapters and sidestream sampling kits if they
appear to be damaged or broken.
0 If the CO2 waveform (Capnogram) appears abnormal, inspect the CO2 airway adapters and
replace if needed.
0 Periodically check the CO 2 /Flow sensor and tubing for excessive moisture or
secretion buildup. Do not use them if there is excessive moisture or exterior condensation.
0 Electric Shock Hazard: The CO2 Sensor contains no user serviceable parts.
0 Refer service to qualified service personnel. Do not open the sensor cabinet at will, as electric
shock hazard may occur.
0 Place the exhaust vent of the CO2 Sensor in drafty ambient and do not let anything block the
exhaust vent.
0 Always disconnect the CO2 Sensor before cleaning. Do NOT use if it appears to have been
damaged. Refer servicing to qualified service personnel.
0 DO NOT sterilize or immerse the CO2 Sensor in liquids.
0 Replace the sidestream on-airway adapters and sidestream sampling kits if excessive secretions
are observed.
0 Do not operate the CO2 Sensor when it is wet or has exterior condensation.
0 Monitor the CO2 waveform (Capnogram). If you see changes or abnormal appearance, check
the patient and the sampling line. Replace line if needed.
0 DO NOT use device on patients that can not tolerate the withdrawal of 50 ml/min +/- 10 ml/min
from the airway or patients that can not tolerate the added dead space to the airway.
0 Do not apply excessive tension to any sensor cable or pneumatic tubing.
0 Explosion Hazard: DO NOT use in the presence of flammable anesthetics or other flammable
gasses. Use of the CO2 Sensor in such environment may present an explosion hazard.
☞ The power voltage over monitor working voltage may cause damage to CO2 sensor. Likewise,
too low power voltage may affect the CO2 measuring accuracy or even make the CO2 sensor not
work.
☞ When changing sampling tube, it is suggested to choose the default sampling tube with
dehumidifying function. The sampling tube without dehumidifying function may be easily
blocked by excessive moisture. (Use life: ordinary sampling tube: 6~12 hours; the sampling tube
with dehumidifying function: about 120 hours.)
☞ If the measurement appears abnormity caused by sampling tube block, please replace it.
☞ The total length of the sampling tube and extending airway tube shouldn’t be longer than 3
meters, too long may cause measurement abnormity. If using T connector sampling cannula kits,
please insert the sampling tube with the tubes upward to avoid the affects of excessive moisture;
☞ Altitudes are different in different area, so set the Barometric Pressure setting value as the
ambient barometric pressure.
☞ Use only our company approved accessories.
☞ While using the CO2 sensor, a system leak, that may be caused by an uncuffed endotracheal tube
or a damaged CO2 sensor may significantly affect flow-related readings. These include flow,
volume, pressure and other respiratory parameters.
☞ When stopping CO2 monitor, please disconnected the CO2 sensor from the patient monitor.
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☞ Disposal of the CO2 Sensor and its accessories should comply with national and/or
local requirements.
☞ In the presence of electromagnetic devices (i.e., electrocautery), patient monitoring may be
interrupted due to electromagnetic interference. Electromagnetic fields up to 20 V/m will
not adversely affect system performance.
☞ Nitrous oxide, elevated levels of oxygen, helium and halogenated hydrocarbons can
influence the CO2 measurement.
☞ Excessive moisture in the CO2 may affect the accuracy of the flow measurement.
Waveform area
5th trace: CO2 waveform. It can be respiration waveform or CO2 waveform.
Data area
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Note: only when the setting item “System Menu→SETUP→CO2→Switch”is set as “ON”, CO2 monitoring
function is available.
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Chapter 6 Alarm
Over HR limit
Over RR limit
Over TEMP1 limit
Over TEMP2 limit
Over SpO2 limit
Over PR limit
Over NIBP SYS limit
Over NIBP DIA limit
Over NIBP MAP limit
Over EtCO2 limit
Over InsCO2 limit
Over TD limit
Over S-T limit
Over NIBP PR limit
ECG ARREST
Unable to detect HR
Unable to detect SpO2
The battery capacity will exhaust
Medium Priority:
VE RONT
SVE RONT
Lead Off
Probe Off
Sensor Over Temp
Sensor Faulty
Zero Required
CO2 Out of Range
Check Airway Adapter
Check Sampling Line
The Sensor Off
Low Priority:
Other arrhythmia phenomenon(Except ECG ARREST, VE RONT and SVE RONT, refer to 12.3 Abbreviation of
arrhythmia for details.)
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Note: Visual alarm indicators can not be suspended or removed. Audible alarms may be decreased in volume or
silenced.
0 DO NOT silence the audible alarm or decrease its volume if patient safety could be
compromised.
To verify adjustable alarm function, select “Demo” for the item of Mode in system parameter settings menu and adjust
alarm limits or change alarm setting, then pay a close attention to the alarm. If the alarm is sent out according to your
setting, it means the alarm function is effective.
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7.10 Classification
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Patient Monitor is intended for use in the electromagnetic environment specified below. The customer or the
user of the equipment or system should assure that it is used in such an environment.
Voltage
fluctuations/flicker
Complies
emissions
IEC61000-3-3
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Table 2
Guidance and manufacturer’s declaration-electromagnetic immunity
for all EQUIPMENT AND SYSTEMS
Patient Monitor is intended for use in the electromagnetic environment specified below. The customer or the user
of the equipment or system should assure that it is used in such an environment.
Electromagnetic environment
Immunity test IEC60601 test level Compliance level
-guidance
Electrostatic ±6 kV contact ±6 kV contact Floors should be wood, concrete
discharge(ESD) ±8kV air ±8kV air or ceramic tile. if floors are
IEC61000-4-2 covered with synthetic material,
the relative humidity should be at
least 30%
Electrical fast ±2kV for power ±2kV for power Mains power quality should be
transient/burst Supply lines Supply lines that of a typical commercial or
±1 kV for ±1 kV for hospital environment.
IEC61000-4-4 input/output lines input/output lines
Surge ±1kV line (s) to line(s) ±1kV differential Mains power quality should be
IEC 61000-4-5 ±2kV line(s) to earth mode that of a typical commercial or
±2kV common hospital environment.
mode
Voltage dips, short Mains power quality should be
interruptions and voltage that of a typical commercial or
variations on power hospital environment. If the user
supply input lines of the equipment or system
IEC61000-4-11 requires continued operation
during power mains interruptions,
it is recommended that the
equipment or system be powered
from an uninterruptible power
supply or a battery.
NOTE: UT is the a.c. mains voltage prior to application of the test level.
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Table 3
Guidance and manufacturer’s declaration – electromagnetic immunity-for
EQUIPMENT and SYSTEM that are not LIFE-SUPPORTING
Patient Monitor is intended for use in the electromagnetic environment specified below. The customer or the
user of Patient Monitor should assure that it is used in such an electromagnetic environment.
Compliance
IMMUNITY test IEC 60601 test level Electromagnetic environment - guidance
level
Portable and mobile RF communications
equipment should be used no closer to any part of
Patient Monitor, including cables, than the
recommended separation distance calculated
from the equation applicable to the frequency of
the transmitter.
Conducted RF 3V
Recommended separation distance
IEC 61000-4-6 3 Vrms
150 kHz to 80 MHz
Radiated RF 3 V/m
IEC 61000-4-3 3 V/m
80 MHz to 2.5 GHz
Where P is the maximum output power rating of
the transmitter in watts (W) according to the
transmitter manufacturer and d is the
recommended separation distance in metres (m). b
Field strengths from fixed RF transmitters, as
determined by an electromagnetic site survey ,a
should be less than the compliance level in each
frequency range .b
Interference may occur in the vicinity of
equipment marked with the following symbol.
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
a: Field strengths from fixed transmitters, such as base stations for radio (cellular / cordless) telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted
theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, and
electromagnetic site survey should be considered. If the measured field strength in the location in which Patient
Monitor is used exceeds the applicable RF compliance level above, Patient Monitor should be observed to
verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as
re-orienting or relocating Patient Monitor.
b: Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3V/m.
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Table 4
Recommended separation distances between portable and mobile RF
communications equipment and The equipment or system-
for EQUIPMENT and SYSTEM that are not LIFE-SUPPORTING
Patient Monitor is intended for use in an electromagnetic environment in which radiated RF disturbances are
controlled. The customer or the user of the equipment or system can help prevent electromagnetic
interference by maintaining a minimum distance between portable and mobile RF communications equipment
(transmitters) and the equipment or system as recommended below, according to the maximum output power
of the communications equipment.
Separation distance according to frequency of transmitter
Rated maximum m
output power of 150kHz to 80MHz 80MHz to 800MHz 80MHz to 2,5GHz
transmitter
W
100 12 12 23
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in
metres (m) can be determined using the equation applicable to the frequency of the transmitter, where p is the
maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.
NOTE 1: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
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8.1 Packaging
The product is packed in high quality corrugated cartons with foam inside to protect the apparatus against damage in
the handling process.
Gross weight: Details see the indication on the outer package
Dimension: 500(L) ×320(W) ×460(H) mm
8.2 Accessories
(1) ECG lead cable One set
(2) NIBP cuff One set
(3) SpO2 probe One piece
(4) Body temperature probe One piece
(5) Power supply cable One piece
(6) Equipotential grounding wire One piece
(7) Disposable electrode Ten pieces
(8) User Manual One copy
(9) Warranty One copy
(10) Quality certificate One copy
(11) Assembly report Two copies
(12) Dustproof mantle One set
(13) Printing paper (optional) Ten rolls
(14) CO2 accessories (optional)
Note: The accessories are subject to change. Detailed items and quantity see the Packing List.
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First of all, the hospital should be equipped with a 100~250V power supply system with a typical grounding wire. If big
interference in ECG continues, connect one end of the grounding wire provided with this equipment to the grounding
wire on the back panel of this monitor, and the other end to the special grounding wire, water pipe or radiator.
A common ECG plate electrode used together with this monitor has short shelf life. Generally, the shelf life is only one
month after the package is opened. When outdated plate electrode is used, due to skin’s contact impedance and big
electrode potential, the chance of interference will be increased, and the ECG baseline will have an unstable inclination.
Therefore, always use valid plate electrodes.
9.1.2 Factors affecting ECG signal
Interference from Electrosurgical Unit;
Doesn’t filter the interference waveform;
Poor grounding;
Electrodes are not placed properly;
Use expired electrode or use disposable electrode repeatedly;
The skin placed electrode is uncleaned or poor contract caused by scurf and hair;
Electrode long-time used.
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Blood pressure may be measured in an invasive way (whereby the sensor will be inserted into blood vessel directly) or
a non-invasive way. The non-invasive way includes several methodologies, such as the Korotkoff Sound Method and
oscillating method. The Korotkoff Sound Method is used as a conventional way, whereby stethoscope is used to
measure the blood pressure. By the oscillating method, an inflation pump will fill the air, and release it slowly. A
computer will record change of the cuff pressure when the air is released. With this record, the blood pressure value
will be determined. First of all, make sure the signal quality judgment by computer meets the requirements of accurate
calculation (such as sudden limb movement or cuff being hit during the measurement). If the answer is negative, give
up the calculation. If the answer is positive, proceed with calculation of the blood pressure value.
As change of the blood pressure is recorded by electric sensor, which sensitivity is much higher than that of human
ears, the oscillating method uses different definitions for measurement of diastolic pressure, mean arterial pressure and
systolic pressure from the Korotkoff Sound Method. When the oscillating method is used, the circuit in the measuring
apparatus will separate the amplitude of the cuff pressure from its change with pulsation. With the oscillating method,
the blood pressure at the maximum amplitude of cuff pressure is defined as the mean arterial pressure. The blood
pressure at amplitude of cuff pressure forward reduced according to proper proportion is defined as systolic pressure,
while the blood pressure at amplitude of cuff pressure backward reduced according to proper proportion is defined as
diastolic pressure. The maximum change of pulse pressure occurs at these two points. They are equivalent to the point
with pulse sound and the point without pulse sound respectively in the Korotkoff Sound Method.
When the risk of invasive monitoring method outweighs its advantage of accuracy, non-invasive monitoring method
shall be used.
Blood pressure measurement by the oscillating method and Korotkoff Sound Method has good correlation with the
invasive measurement. Notwithstanding, any of the non-invasive blood pressure measurements has its one-sidedness
when it is compared to the invasive measurement. The oscillating method has its advantages over the Korotkoff Sound
Method in less error, higher reliability and stability. Their differences may be reflected in the following aspects.
1. The measures by the Korotkoff Sound Method are liable to effect of human factors. For example, different
people may have different sound judging ability, or different reactivity when listening to heart sound and
reading mercury meter. The air release speed and subjectivity may also affect the judgment. By the oscillating
method, the computation is accomplished by the computer, thus relieving the possibility of effect due to human
factor.
2. With the Korotkoff Sound Method, the measure is taken on the basis of appearance and disappearance of heart
sound. The air release speed and heart rate may have direct effect on the measurement accuracy. It also has the
disadvantages of rapid air release and poor accuracy. In the contrast, with the oscillating method, the
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determination is calculated on the basis of cuff pressure oscillatory waveform envelope, and the air release
speed and heart rate has little effect on the measurement accuracy.
3. Statistics show that, when measuring the hypertension, the measure taken by the oscillating method is likely to
be lower than that taken by the Korotkoff Sound Method. When measuring the hypotension, the measure taken
by the oscillating method is likely to be higher than that by the Korotkoff Sound Method. But, it doesn’t mean
the advantages or disadvantages between the oscillating method and the Korotkoff Sound Method. Comparison
with the results taken by more accurate method, let’s say comparison of the invasive pressure result with the
output value by the blood pressure measuring simulator, will show which method has more accurate results. In
addition, higher or lower value should be a statistical concept. It is recommended those used to adopt the
Korotkoff Sound Method use different physiological calibration for values determined by the oscillating
method.
4. The studies have shown that the Korotkoff Sound Method has the worst accuracy when it comes to
measurement of hypotension, while the oscillating method has worse accuracy when it comes to measurement
of controlled hypertension relief.
9.2.2 Factors affecting NIBP measuring
Like common non-invasive blood pressure measurement, improper operation may cause inaccurate or blank result or
misunderstanding of the measuring information when the oscillating method is used to take the measure of blood
pressure. This point needs particular attention of the operators.
1. Requirements of the cuff:
1) Appropriate cuff should be selected according to the age of the subject. For more information, see Chapter 3.
2) Remember to empty the residual air in the cuff before the measurement is commenced.
3) Locate the cuff in such a way that the “φ” mark is at a location where the clearest pulsation of brachial artery
is observed.
4) The cuff should be tightened to a degree where insertion of one finger is allowed.
5) The lower end of the cuff should be 2cm above the elbow joint.
2. The subject should lie on the back so that the cuff and the heart are in a horizontal position and the most
accurate measure is taken. Other postures may lead to inaccurate measurement.
3. Do not speak or move before or during the measurement. Care should be taken so that the cuff will not be hit
or touched by other objects.
4. The measures should be taken at appropriate intervals. Continuous measurement at too short intervals may lead
to pressed arm, reduced blood flow and lower blood pressure, and resulting inaccurate measure of blood
pressure. It is recommended the measure be taken at intervals of more than two minutes.
5. With the oscillating method, when blood pressure is measured, the inflation pressure of the cuff will be
automatically adjusted according to the previous measure. Generally, the initial inflation pressure is 180mmHg
(for the adult mode) or 100mmHg (for the infant mode) or 80 mmHg (for the neonate mode) when it is
powered on. Following that, 50mmHg (for the adult mode) or 30mmHg (for infant mode) or 10mmHg (for the
neonate mode) will be added on the basis of the last measurement of systolic pressure. In this way, when the
blood pressure rises or the subject is changed, the blood pressure meter may fail in giving the result after the
first-time inflation. This monitor will automatically adjust the inflation pressure until the measure is taken,
after that, up to four measures will be allowed.
6. When an adult subject is monitored, the machine may fail in giving the blood pressure measure if the infant or
neonate mode is selected.
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Based on Lamber-Beer law, the light absorbance of a given substance is directly proportional with its density or
concentration. When the light with certain wavelength emits on human tissue, the measured intensity of light after
absorption, reflecting and attenuation in tissue can reflect the structure character of the tissue by which the light
passes. Due to that oxygenated hemoglobin (HbO2) and deoxygenated hemoglobin (Hb) have different absorption
character in the spectrum range from red to infrared light (600nm~1000nm wavelength), by using these
characteristics, SpO2 can be determined. SpO2 measured by this monitor is the functional oxygen saturation -- a
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percentage of the hemoglobin that can transport oxygen. In contrast, hemoximeters report fractional oxygen
saturation – a percentage of all measured hemoglobin, including dysfunctional hemoglobin, such as
carboxyhemoglobin or metahemoglobin.
9.3.2 SpO2 Measurement Restrictions (interference reason)
1. The fingers should be properly placed (see the attached illustration of this instruction manual), or else it may
cause inaccurate measurement result.
2. Make sure that capillary arterial vessel beneath the finger is penetrated through by red and infrared lights.
3. The SpO2 sensor should not be used at a location or limb tied with arterial or blood pressure cuff or receiving
intravenous injection.
4. Do not fix the SpO2 sensor with adhesive tape, or else it may result in venous pulsation and consequential
inaccurate measurement result of SpO2.
5. Make sure the optical path is free from any optical obstacles like adhesive tape.
6. Excessive ambient light may affect the measuring result. It includes fluorescent lamp, dual ruby light, infrared
heater, and direct sunlight etc.
7. Strenuous action of the subject or extreme electrosurgical interference may also affect the accuracy.
8. Please do not use the SpO2 sensor when having the MRI, or burn may be caused by faradism.
9. Always observe the plethysmogram (waveform), which is auto-scaled within the range of 100. The SpO2
reading may be unlikely true when the waveform is not smooth or irregular. If in doubt, rely on your clinical
judgment, rather than the monitor readout
10. A functional tester can not be used to assess the accuracy of the pulse oximeter monitor or a SpO2 sensor.
However, a functional tester, such as SpO2 simulator can be used to check how accurately a particular pulse
oximeter is reproducing the given calibration curve. Before testing the oximeter by a functional tester, please
firstly ask the manufacturer which calibration curve is used, if necessary, request the manufacturer for its
dedicated calibration curve and download it into the tester.
Clinical Limit
1. As the measure is taken on the basis of arteriole pulse, substantial pulsating blood stream of subject is required.
For a subject with weak pulse due to shock, low ambient/body temperature, major bleeding, or use of vascular
contracting drug, the SpO2 waveform (PLETH) will decrease. In this case, the measurement will be more
sensitive to interference.
2. For those with a substantial amount of staining dilution drug (such as methylene blue, indigo green and acid
indigo blue), or carbon monoxide hemoglobin (COHb), or methionine (Me+Hb) or thiosalicylic hemoglobin,
and some with icterus problem, the SpO2 determination by this monitor may be inaccurate.
3. The drugs such as dopamine, procaine, prilocaine, lidocaine and butacaine may also be a major factor blamed
for serious error of SpO2 measurements.
4. As the SpO2 value serves as a reference value for judgment of anemic anoxia and toxic anoxia, the
measurement result of some patients with serious anemia may also present as good SpO2 value.
9.4 Respiration Monitoring
9.4.1 Measuring Principle
The air will be filled into alveolus or be expelled during respiration, and the chest’s volume changes with this
process. Because the conductivity of air is lower than body tissues, the chest’s impedance will be changed by the
inflation. With this specialization, the respiration can be monitored through putting safe current into body and
measuring the change of voltage between the electrodes. The product will transmit the high-frequency current
whose frequency is much higher than ECG frequency (but with the safe current limit) to the ECG electrodes
(placed at the both sides of chest), which can be detect ECG signal and chest’s impedance at the same time, and
the respiratory rate will be measured through impedance method by the software. So the additional electrodes for
respiratory measurement are unnecessary.
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Place the white (RA) and red (LL) electrodes on the cross, if the line between two electrodes in liver area or
heart area, the artificial error may occur.
Respiration monitoring doesn’t support monitoring the patient who do much movement, or may lead to
wrong alarm.
9.5 Temperature Monitoring
The sensor is thermo-resistor type (25℃ 5kΩ) and is supplied with constant micro current. Calculating the
temperature of measured part through measuring the voltage. There is a period responding time, so the accurate
temperature value display after a while. The temperature monitoring can be divided into two measuring method:
measure through body surface temperature and through the temperature inside the body cavity (placed in mouth or
anus).
Normal value: body surface: 36.5℃~37℃; inside body cavity: 36.5℃~37.7℃
Notes:
¾ Attach the TEMP transducer to the patient; generally if the TEMP transducer and skin doesn’t contact closely,
the measured value becomes lower, so for those who have requirement for temperature, add a proper martial to
transducer and fix it with adhesive tape to make them contact firmly.
¾ Especially for pediatric patient, they like sports, pay more attention to the transducer fixing.
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Chapter 10 Troubleshooting
Note: In case of trouble of this machine in service, follow the instructions below to eliminate the problem first. If the
attempt fails, contact the dealer in your local area or the manufacturer.
2. Check whether the lead wires are properly inserted. If no ECG curve displayed, check if the ECG lead wires are
broken.
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Chapter 11 Maintenance
In case of trouble of this machine in the service, follow the instructions below to eliminate the problem first. If
the attempt fails, refer to the dealer in your local area or the manufacturer.
Before using the monitor, the checks below should be carried out:
Check the monitor for any mechanical damage;
Inspect the exposed parts and the inserted parts of all the leads, and the accessories;
Examine all the functions of the monitor that are likely to be used for patient monitoring, and ensure that it is
in good working condition;
Make sure that the monitor is grounded properly.
Pay close attention to the fluctuation of the local power supply voltage. A manostat is recommended when
necessary.
In case any indication of damage about the function of the monitor is detected and proven, it is not allowed to apply it
to the patient for any monitoring. Please contact the local dealer or our company, and we are to offer the best solution as
soon as possible for your satisfaction.
11.1.2 Routine Maintenance
After each maintenance or the yearly maintenance, the monitor can be thoroughly inspected by qualified personnel,
including function and safety examinations. The designed life of this monitor is 5 years. In order to ensure its long
service life, please pay attention to the maintenance.
0 If the hospital fails to carry out a satisfactory maintenance program about the monitor, it may get
disabled and harm the patient’s safety and health.
0 In case of ECG leads damage or aging, please replace the lead.
0 If there is any indication of cable and transducer damage or they deteriorate, they are prohibited from
any further use.
The adjustable units in the monitor such as potentiometer are not allowed to adjust without permission
to avoid unnecessary failures that affect normal application.
It is recommended to use the battery once a month to ensure its strong power supply capacity and long
service life, and recharge it after run out of the power volume.
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11.5 Storage
If the equipment will not be used for long period of time, wipe it clean and keep it in the packaging, which shall be kept
in a dry and good ventilation place free from dust and corrosive gases
Storage environment: ambient temperature: -20~60°C
relative humidity: 10%~95%
atmospheric pressure: 53kPa~106kPa
11.6 Transportation
This monitor should be transported by land (vehicle or railway) or air in accordance with the contractual terms. Do not
hit or drop it with force.
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Chapter 12 Appendix
Over HR limit
Over RR limit
Over PR limit
Over NIBP SYS limit The related parameter value exceeds the preset high/low
alarm limit.
Over NIBP DIA limit
Unable to detect HR ECG cable and leads are connected to monitor and patient
well, but HR is unable to be detected. It may caused by
inconformity HR signal.
Unable to detect SpO2 SpO2 probe is connected to monitor and patient well, but
SpO2 is unable to be detected. It may be caused by inconformity
SpO2 signal.
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“Air leak” —Air moving part, tube or the cuff leak air.
“Signal weak” —Very weak signal because of the cuff, or the patient has very weak pulse
“Over extent” —The measurement range exceeds 255 mmHg (Infant patient over 135 mmHg)
“Over motion” —The repeated measurement due to moving, excessive noise during the stepping inflation and
“System error” —Abnormal condition of CPU, such as register overflow, divided by zero
“Adult” —The blood pressure measuring now is in adult mode. In this case, it is not allowed to monitoring
infant or neonatal patient. Otherwise, there may be serious danger to the infant monitored.
“Infant” —The blood pressure module is now worked in infant measuring mode.
“PROBE OFF” —SpO2 probe fell off
“LEADS OFF” —The ECG electrodes or cable fell off
“DEMO” —The monitor is displaying the demo waveforms, which are generated by the monitor itself.
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No Parameter Message Barometric Pressure and/or gas compensations have not been
The host must set the Barometric Pressure and set since power on. For CO2 to be calculated with the stated
compensations to clear this error; no user intervention accuracy, these values should be set whenever the sensor is
should be required. plugged in.
“Module in Sleep Mode” This bit is set when sensor has been placed in sleep mode.
“Zero In Progress “ A Module Zero is currently in progress.
One of the following conditions exist:
“Sensor Warm Up”
Sensor under temperature
This error condition is normal at startup. This error
Temperature not stable
should clear when the warm up is complete.
Source Current unstable
“Check Sampling Line” This error occurs whenever the pneumatic pressure is outside
Check that the sampling line is not occluded or the expected range.
kinked.
“Zero Required” One of the following conditions exist:
To clear, check airway adapter and clean if necessary. Zero Required;
If this does not correct the error, perform an adapter Zero Required: Zero Error
zero. If you must adapter zero more than once, a
possible hardware error may exist.
The value being calculated is greater than the upper CO2 limit
“CO2 Out of Range”
(150 mmHg, 20.0 kPa, or 19.7 %). The maximum value
If error persists, perform a zero. output is the upper CO2 limit.
Usually caused when the airway adapter is removed from the
“Check Airway Adapter” sensor or when there is an optical blockage on the windows of
To clear, clean airway adapter if mucus or moisture is the airway adapter. May also be caused by failure to perform
seen. If the adapter is clean, perform a Capnostat zero. sensor zero to when adapter type is changed.
This is prompted if the CO2 sensor is not ready for a Capnostat Zero.
If the “Zero Required” and this massage both prompt message both
The Sensor promptone or more of the following conditions may exist:
not Ready • Breaths detected
• Temperature is not stable
• Source Current unstable
• In sleep mode.
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Contraindications
This sensor is contraindicated for use on active patients or for prolonged use.
Instructions for Use
1) With the upper and lower jaws open, place an index finger evenly on the base of the clip. Push the finger tip
against the stop so that it is over the sensor window (A). If an index finger cannot be positioned correctly, or is
not available, other fingers can be used.
2) Note: When selecting a sensor site, priority should be given to an extremity free of an arterial catheter, blood
pressure cuff, or intravascular infusion line.
3) Spread open the rear tabs of the sensor to provide even force over the length of the pads (B).
4) The sensor should be oriented in such a way that the cable is positioned along the top of the hand (C).
5) Plug the sensor into the
oximeter and verify proper
operation as described in
the user manual.
6) Inspect the monitoring site
every 1~2 hours for skin integrity.
7) Before each use, surface-clean sensor and cable with a soft gauze pad by saturating it with a solution such as
70% isopropyl alcohol. If low-level disinfection is required, use a 1:10 bleach solution.
Caution: Do not sterilize by irradiation steam, or ethylene oxide.
Warnings
1) Some factors may affect the accuracy of saturation measurements. Such factors include: excessive patient
motion, fingernail polish, use of intravascular dyes, excessive light, poor blood perfusion in the finger, extreme
finger sizes or improper placement of the sensor.
2) Using the sensor in the presence of bright lights may result in inaccurate measurements. In such cases, cover
the sensor site with an opaque material.
3) The sensor must be moved to a new site at least every 3 hours. Because individual skin condition affects the
ability of the skin to tolerate sensor placement, it may be necessary to change the sensor site more frequently
with some patients. If skin integrity changes, move the sensor to another site.
4) Do not apply tape to secure the sensor in place or to tape it shut; venous pulsation may lead to inaccurate
saturation measurements.
5) Do not immerse sensor as it causes short.
6) Do not use NIBP or other constructing instruments on same appendage as sensor for blood flow interrupted by
NIBP cuff or circulatory patient condition will result in no pulse found or loss of pulse.
7) Do not use the sensor or other oximetry sensors during MRI scanning.
8) Carefully route cables to reduce the possibility of patient entanglement or strangulation.
9) Do not alter or modify the sensor. Alterations or modifications may affect performance or accuracy.
10) Do not use the sensor if the sensor or the sensor cable appears damaged.
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User Manual for Patient Monitor
Contraindications
This sensor is contraindicated for use on active patients or for prolonged use.
Warnings
1) This sensor is for use only with compatible patient monitors or pulse oximeter devices. Use of this sensor with
instruments other than compatibles may result in improper performance.
2) Some factors may affect the accuracy of saturation measurements. Such factors include: excessive patient
motion, fingernail polish, use of intravascular dyes, excessive light, poorly perfused finger, extreme finger
sizes or improper placement of the sensor.
3) The sensor site must be checked for skin integrity at least every 1~2 hours. Because individual skin condition
affects the ability of the skin to tolerate sensor placement, it may be necessary to change the sensor to another
finger.
4) Do not use NIBP or other constructing instruments on same appendage as sensor for blood flow interrupted by
NIBP cuff or circulatory patient condition will result in no pulse found or loss of pulse. Do not use the sensor
during MRI scanning.
5) Carefully route cables to reduce the possibility of patient entanglement or strangulation.
6) Do not alter or modify the sensor. Alterations or modifications may affect performance or accuracy.
7) Do not use the sensor if the sensor or the sensor cable appears damaged.
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User Manual for Patient Monitor
1) With the upper and lower jaws open, place an index finger evenly on the base of the clip. Push the finger tip
against the stop so that it is over the sensor window (A). If an index finger cannot be positioned correctly, or is
not available, other fingers can be used.
2) Note: When selecting a sensor site, priority should be given to an extremity free of an arterial catheter, blood
pressure cuff, or intravascular infusion line.
3) Spread open the rear tabs of the sensor to provide even force over the length of the pads (B).
4) The sensor should be
oriented in such a way
that the cable is
positioned along the top
of the hand (C).
5) Plug the sensor into the oximeter and verify proper operation as described in the user manual.
6) Inspect the monitoring site every 1~2 hours for skin integrity.
7) Before each use, surface-clean sensor and cable with a soft gauze pad by saturating it with a solution such as
70% isopropyl alcohol. If low-level disinfection is required, use a 1:10 bleach solution.
Caution: Do not sterilize by irradiation steam, or ethylene oxide.
Warnings
1) Some factors may affect the accuracy of saturation measurements. Such factors include: excessive patient
motion, fingernail polish, use of intravascular dyes, excessive light, poorly perfused finger, extreme finger
sizes or improper placement of the sensor.
2) Using the sensor in the presence of bright lights may result in inaccurate measurements. In such cases, cover
the sensor site with an opaque material.
3) The sensor must be moved to a new site at least every 3 hours. Because individual skin condition affects the
ability of the skin to tolerate sensor placement, it may be necessary to change the sensor site more frequently
with some patients. If skin integrity changes, move the sensor to another site.
4) Do not apply tape to secure the sensor in place or to tape it shut; venous pulsation may lead to inaccurate
saturation measurements.
5) Do not immerse sensor as it causes short.
6) Do not use NIBP or other constructing instruments on same appendage as sensor for blood flow interrupted by
NIBP cuff or circulatory patient condition will result in no pulse found or loss of pulse.
7) Do not use the sensor or other oximetry sensors during MRI scanning.
8) Carefully route cables to reduce the possibility of patient entanglement or strangulation.
9) Do not alter or modify the sensor. Alterations or modifications may affect performance or accuracy.
10) Do not use the sensor if the sensor or the sensor cable appears damaged.
Our company offers a 6-momth warranty against manufacturing defects for the SpO2 sensors
mentioned above in its undamaged condition.
If you have any question regarding any of SpO2 sensor instructions, please contact
your local dealer.
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User Manual for Patient Monitor
Version 1.7
Revised date October 22, 2012
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