Service manual

IntelliVue Patient Monitor

MX400/450/500/550/600/700/800
MX 40 0 / 4 5 0 / 5 0 0 / 5 5 0 Re l e a s e K w i t h Re v . K. 1 x . x x
MX600/ 700/80 0 Release J with Re vison J.xx. xx

Patient Monitori ng
 1 Table of Contents
1 Introduction 13

Safety Information 14
Security Information 15
Introducing the Monitor 16
Devices for Acquiring Measurements 18
Operating and Navigating 27
Operating Modes 36
Understanding Screens 37
Connecting Additional Displays to the Monitor 38
Using the XDS Remote Display 39
Using the Visitor Screen 39
Understanding Profiles 39
Understanding Settings 41
Changing Wave Speeds 42
Freezing Waves 42
Using Labels 44
Entering Measurements Manually 46
Changing Monitor Settings 47
Checking Your Monitor Revision 48
Getting Started 48
Disconnecting from Power 49
Networked Monitoring 50
Using the Integrated PC 50
Using Your Monitor with a Monitor in Companion Mode 52

2 What's New? 55

What's New in Release K.1 (for MX400/450/500/550 only) 55

What's New in Release K.0 55
What's New in Release J.0 56

3 Alarms 59

Visual Alarm Indicators 60

Audible Alarm Indicators 61
Acknowledging Alarms 63
Pausing or Switching Off Alarms 64
Alarm Limits 67
Reviewing Alarms 71
Latching Alarms 72
Testing Alarms 73
Alarm Behavior at Power On 73

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Alarm Recordings 73

4 Patient Alarms and INOPs 75

Patient Alarm Messages 75

Technical Alarm Messages (INOPs) 81

5 Managing Patients and Equipment 105

Patient Concepts 105

Equipment Concepts 105
Managing Patients 106
Managing Equipment 119
Care Groups 126
Information Center Compatibility 132

6 ECG, Arrhythmia, ST and QT Monitoring 133

Skin Preparation for Electrode Placement 133

Connecting ECG Cables 133
Selecting the Primary and Secondary ECG Leads 134
Checking Paced Mode 134
Understanding the ECG Display 134
Monitoring Paced Patients 135
Changing the Size of the ECG Wave 136
Changing the Volume of the QRS Tone 137
Changing the ECG Filter Settings 137
Selecting Positions of Va and Vb Chest Leads (for 6-lead placement) 138
Choosing EASI or Standard Lead Placement 138
About ECG Leads 138
ECG Lead Fallback 139
ECG Lead Placements 139
EASI ECG Lead Placement 145
Capture 12-Lead 146
ECG and Arrhythmia Alarm Overview 149
Using ECG Alarms 151
ECG Safety Information 152
About Arrhythmia Monitoring 154
Switching Arrhythmia Analysis On and Off 154
Choosing an ECG Lead for Arrhythmia Monitoring 155
Atrial Fibrillation Alarm 155
Aberrantly-Conducted Beats 156
Intermittent Bundle Branch Block 156
Understanding the Arrhythmia Display 156
Arrhythmia Relearning 159
Arrhythmia Alarms 160
About ST Monitoring 164
Switching ST or STE On and Off 165
Understanding the ST Display 166

4
Updating ST Baseline Snippets 168
Recording ST Segments 168
About the ST Measurement Points 168
ST Alarms 171
STE Alarms 171
Viewing ST Maps 172
About QT/QTc Interval Monitoring 175
QT Alarms 178
Switching QT Monitoring On and Off 179

7 Monitoring Pulse Rate 181

Entering the Setup Pulse Menu 181

System Pulse Source 181
Switching Pulse On and Off 182
Using Pulse Alarms 182

8 Monitoring Respiration Rate (Resp) 185

Lead Placement for Monitoring Resp 185

Understanding the Resp Display 186
Changing Resp Detection Modes 186
Changing the Size of the Respiration Wave 187
Changing the Speed of the Respiration Wave 188
Using Resp Alarms 188
Changing the Apnea Alarm Delay 188
Resp Safety Information 188

9 Monitoring SpO2 191

SpO2 Sensors 191

Applying the Sensor 191
Connecting SpO2 Cables 192
Measuring SpO2 192
SpO2 Signal Quality Indicator (FAST SpO2 only) 193
Assessing a Suspicious SpO2 Reading 194
Changing the Averaging Time 194
Understanding SpO2 Alarms 194
Pleth Wave 200
Perfusion Numeric 200
Perfusion Change Indicator 200
Setting SpO2/Pleth as Pulse Source 200
Setting Up Tone Modulation 201
Setting the QRS Volume 201
Calculating SpO2 Difference 201

10 Monitoring NBP 203

Introducing the Oscillometric NBP Measurement 203

Preparing to Measure NBP 205

5
Starting and Stopping Measurements 207
Enabling Automatic Mode and Setting Repetition Time 208
Enabling Sequence Mode and Setting Up The Sequence 208
Choosing the NBP Alarm Source 209
Switching Pulse from NBP On/Off 209
Assisting Venous Puncture 210
Calibrating NBP 210

11 Monitoring Temperature 211

Making a Temp Measurement 211

Calculating Temp Difference 212

12 Monitoring Invasive Pressure 213

Setting up the Pressure Measurement 213

Zeroing the Pressure Transducer 215
Adjusting the Calibration Factor 217
Displaying a Mean Pressure Value Only 217
Changing the Pressure Wave Scale 217
Optimizing the Waveform 217
Using the Wave Cursor 217
Non-Physiological Artifact Suppression 218
Choosing the Pressure Alarm Source 218
Calibrating Reusable Transducer CPJ840J6 219
Calculating Cerebral Perfusion Pressure 221
Calculating Pulse Pressure Variation 221
Measuring IAP 222
Measuring Pulmonary Artery Wedge Pressure 222
Editing the Wedge 223
Identifying the Pressure Analog Output Connector 224

13 Monitoring Cardiac Output 225

Hemodynamic Parameters 226

Using the C.O. Procedure Window 226
Accessing the Setup C.O. and Setup CCO Menus 228
Entering the HemoCalc Window 228
Measuring C. O. Using the PiCCO Method 228
Measuring C.O. Using the Right Heart Thermodilution Method 233
Documenting C.O. Measurements 235
C.O. Injectate Guidelines 235
C.O./CCO Curve Alert Messages 236
C.O./CCO Prompt Messages 238
C.O./CCO Warning Messages 238
C.O./CCO Safety Information 239

14 Monitoring Carbon Dioxide 241

Measurement Principles 242

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Measuring CO2 using M3014A or X2 242
Measuring Mainstream CO2 using M3016A 246
Measuring Microstream CO2 using M3015A/B 248
Setting up all CO2 Measurements 250
Understanding the IPI Numeric 252

15 Monitoring Airway Flow, Volume and Pressure 255

Attaching the Flow Sensor 256

Zero Calibration 258
Automatic Purging 258
Manual Purging 259
Gas Compensation 259
Setting up Spirometry 260

16 Monitoring tcGas 263

Identifying tcGas Module Components 263

Setting the tcGas Sensor Temperature 264
Using the tcGas Site Timer 264
Setting the tcGas Barometric Pressure 265
Remembraning the tcGas Transducer 265
Calibrating the tcGas Transducer 265
Applying the tcGas Transducer 267
Finishing tcGas Monitoring 268
Zeroing the tcGas Relative Heat Power 268
TcGas Corrections 268

17 Monitoring Intravascular Oxygen Saturation 271

Selecting a Measurement Label 272

Preparing to Monitor with the M1021A Wide Module 272
Preparing to Monitor with the M1011A Narrow Module 275
Further Information for Both Modules 277

18 Monitoring EEG 279

EEG Monitoring Setup 279

Using the EEG Impedance/Montage Window 280
About Compressed Spectral Arrays (CSA) 282
Changing EEG Settings 283
EEG Reports 284
EEG Safety Information 284
EEG and Electrical Interference 284

19 Monitoring BIS 285

BIS Monitoring Setup 286

BIS Continuous Impedance Check 288
BIS Cyclic Impedance Check 288
BIS Window 289

7
Changing the BIS Smoothing Rate 290
Switching BIS and Individual Numerics On and Off 290
Changing the Scale of the EEG Wave 290
Switching BIS Filters On or Off 290
BIS Safety Information 291

20 Monitoring NMT 293

Stimulation Modes 294

Preparing to Measure NMT 295
Taking NMT Measurements 296
Changing the NMT Measurement Settings 298
Alarms 299
Understanding NMT Numerics 299

21 Guardian Early Warning Scoring 301

Performing the Scoring Procedure 301

Understanding Guardian Early Warning Scoring 303
Viewing EWS Trend Data 304
Using Different Types of Scoring 305

22 Using a Telemetry Device and a Monitor (PIIC only) 307

How Can You Combine Devices? 307

Use Models With Telemetry 309

23 Trends 311

Viewing Trends 311

Setting Up Trends 315
Documenting Trends 319
Trends Databases 319
Screen Trends 320

24 Calculations 325

Viewing Calculations 326

Reviewing Calculations 327
Performing Calculations 327
Entering Values for Calculations 328
Documenting Calculations 329

25 High Resolution Trend Waves 331

Changing the Hi-Res Trend Waves Displayed 331

Hi-Res Trend Wave Scales 331
Hi-Res Trend Waves and OxyCRG 331
Printing Hi-Res Trend Wave Reports 332
Hi-Res Trend Wave Recordings 332

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 26 Event Surveillance 333

Levels of Event Surveillance 333

Event Groups 334
Event Episodes 334
Events Pop-Up Keys 335
Event Triggers 336
The Events Database 339
Viewing Events 340
Annotating Events 342
Documenting Events 342

27 ProtocolWatch 349

SSC Sepsis Protocol 349

28 Recording 357

Paper-Strip Recording 357

Electronic Recording 365

29 Printing Patient Reports 369

Starting Report Printouts 369

Stopping Reports Printouts 371
Setting Up Reports 371
Setting Up Individual Print Jobs 372
Checking Printer Settings 373
Printing a Test Report 374
Switching Printers On or Off for Reports 374
Dashed Lines on Reports 374
Unavailable Printer: Re-routing Reports 374
Checking Report Status and Printing Manually 375
Printer Status Messages 375
Sample Report Printouts 376

30 Using the Drug Calculator 381

Accessing the Drug Calculator 382

Performing Drug Calculations 382
Charting Infusion Progress 385
Using the Titration Table 385
Documenting Drug Calculations 386

31 VueLink Modules 387

Connecting an External Device 388

Changing VueLink Waves and Numerics Displayed 388
Viewing the VueLink Device Data Window 389
Using VueLink Screens 389
Switching VueLink On and Off 389
Alarms/INOPs From External Devices 389

9
Language Conflict with External Device Drivers 390

32 IntelliBridge EC10 391

Connecting an External Device 391

Changing Waves and Numerics Displayed 392
Viewing the IntelliBridge Device Data Window 392
Using Screens with External Device Data 393
Alarms/INOPs from External Devices 393

33 Using Timers 395

Viewing Timers 395

Timer Setup Pop-up Keys 396
Setting Up Timers 396
Displaying a Timer On The Main Screen 397
Displaying A Clock On The Main Screen 398

34 Respiratory Loops 399

Viewing Loops 399

Capturing and Deleting Loops 400
Showing/Hiding Loops 400
Changing Loops Display Size 400
Using the Loops Cursor 400
Changing Loops Type 401
Setting Up Source Device 401
Documenting Loops 401

35 Laboratory Data 403

Viewing Received Data 403

36 Using Batteries 405

Battery Power Indicators 405

Checking Battery Charge 407
When Battery Lifetime is Expired 407
Replacing a Battery 407
Optimizing Battery Performance 408
Battery Safety Information 409

37 Care and Cleaning 411

General Points 411

Cleaning the Equipment 412
Disinfecting the Equipment 412
Sterilizing the Equipment 413
Cleaning, Sterilizing and Disinfecting Monitoring Accessories 413
Cleaning the SO2 Optical Module 413
Cleaning the Recorder Printhead (M1116B only) 413
Cleaning Batteries and the Battery Compartment 414

10
 38 Maintenance and Troubleshooting 415

Inspecting the Equipment and Accessories 415

Inspecting the Cables and Cords 416
Maintenance Task and Test Schedule 416
Troubleshooting 417
Returning Equipment for Repair 417
Disposing of the Monitor 417
Disposing of Empty Calibration Gas Cylinders 418

39 Accessories 419

ECG/Resp Accessories 419

NBP Accessories 423
Invasive Pressure Accessories 426
SpO2 Accessories 429
Temperature Accessories 435
Cardiac Output (C.O.) Accessories 436
Mainstream CO2 Accessories 437
Sidestream CO2 Accessories 437
Mainstream CO2 Accessories (for M3016A) 438
Microstream CO2 Accessories 438
Spirometry Accessories 439
tcGas Accessories 439
EEG Accessories 440
BIS Accessories 440
SO2 Accessories for M1021A 440
SO2 Accessories for M1011A 441
NMT Accessories 441
Recorder Accessories 442
Battery Accessories 442

40 Specifications 443

Indications for Use 443

Restricted Availability 444
Use Environment 444
Manufacturer's Information 444
Symbols 445
Installation Safety Information 447
Monitor Mounting Precautions 455
Altitude Setting 456
Monitor Safety Specifications 456
Physical Specifications 457
Environmental Specifications 458
EMC and Radio Regulatory Compliance 462
Monitor Performance Specifications 464
Interface Specifications 470
Display Specifications 474

11
M4605A Battery Specifications 475
Measurement Specifications 475
Safety and Performance Tests 495

41 Default Settings Appendix 501

Country-Specific Default Settings 501

Alarm and Measurement Default Settings 508
Alarm Default Settings 508
ECG, Arrhythmia, ST and QT Default Settings 509
Pulse Default Settings 512
Respiration Default Settings 513
SpO2 Default Settings 513
NBP Default Settings 514
Temperature Default Settings 514
Invasive Pressure Default Settings 515
Cardiac Output Default Settings 517
CO2 Default Settings 518
Spirometry Default Settings 518
tcGas Default Settings 519
Intravascular Oxygen Saturation Default Settings 519
SvO2 Default Settings 520
ScvO2 Default Settings 520
EEG Default Settings 520
BIS Default Settings 521
NMT Default Settings 521
VueLink Default Settings 522

Index 523

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