M2636B TeleMon B Monitor

Transcription

M2636B TeleMon B Monitor
Instructions for Use
Part Number M2636-9201B
Printed in the U.S.A. January 2003
First Edition
Notice
This document contains proprietary information which is protected by copyright.
All Rights Reserved. Reproduction, adaptation, or translation without prior
written permission is prohibited, except as allowed under the copyright laws.
© Copyright Philips Medical Systems 2001-2003
All rights reserved.
Printed in U.S.A. January 2003
Part No. M2636-9201B
First Edition
Warranty
The information contained in this document is subject to change without notice.
We make no warranty of any kind with regard to this material, including, but not
limited to, the implied warranties or merchantability and fitness for a particular
purpose.
We shall not be liable for errors contained herein or for incidental or
consequential damages in connection with the furnishing, performance, or use of
this material.
Printing History
Printing History
New editions of this document incorporate all material updated since the
previous edition. Update packages may be issued between editions and contain
replacement and additional pages to be merged by a revision date at the bottom
of the page. Pages that are rearranged due to changes on a previous page are not
considered revised.
The documentation printing date and part number indicate its current edition.
The printing date changes when a new edition is printed. (Minor corrections and
updates which are incorporated at reprint do not cause the date to change.) The
document part number changes when extensive technical changes are
incorporated.
All Editions and Updates of this manual and their publication dates are listed
below.
M2636-9001B, First Edition....................................................... December 2001
M2636-9201B, First Edition....................................................... January 2003
About this Book
This document covers the use of TeleMon B, model M2636B, a monitoring
device for use with the Telemetry System Series C.
The document contains information on performing day-to-day tasks and
troubleshooting common problems as well as detailed information about all
clinical applications. It includes lists of information messages and configuration
choices. Your purchased system may not include all the functionality
described in this document.
User information for the TeleMon Monitor is also contained in the TeleMon
Monitor On-line Info. Info focuses on how to complete basic tasks and
troubleshoot problems.
For operating information about the transmitter, ECG and SpO2 measurements,
and the Telemetry System in general, please refer to the Telemetry System Series
About this Book
C User’s Guide. See also the Information Center User’s Guide for operating
information on the Information Center.
Document
Conventions
Warnings
Warning
Warnings are information you should know to avoid injuring patients and
personnel.
Cautions
Caution
Cautions are information you should know to avoid damaging your equipment
and software.
Notes
Note—Notes contain additional information on the Telemetry System usage.
Procedures
Procedures are indicated in the text by the heading “Task Summary” followed
by the following table:
Step
1
2
3
Action
Contents
1. About TeleMon B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
What’s New . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Introducing the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Stand-Alone Monitoring Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
Telemetry Extension Device Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
Safety Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
A Quick Look at TeleMon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Front View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Rear View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8
Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8
The Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
2. Monitor Basics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Powering the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
More About Batteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
Docking & Undocking the Transmitter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Docking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
Undocking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
General Navigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
Online Info . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
Monitor Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
Pacing Safety Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-15
To Change Monitor Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-15
To Save Current Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
To Restore Unit Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
Antenna Range. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
3. Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Measuring ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
ST/AR Arrhythmia Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
ECG Fallback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
Changing Wave or Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
Measuring %SpO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
Displaying the Pleth Wave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Changing the %SpO2 Sample Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Contents-1
Measuring NBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Measurement Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
NBP Safety Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12
NBP Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13
Start/Stop Manual NBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-15
Change Repeat Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16
Select NBP Alarm Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16
Recordings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17
4. Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Recognizing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
Alarm Types & Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
Alarm Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
Alarm Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-7
Alarm Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8
Red & Yellow Alarm Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8
INOP Alarm Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9
Interacting with Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-15
Turning Alarms On/Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-15
Adjusting Alarm Volume. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16
Setting Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16
Silencing an Alarm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-17
Suspending Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18
5. Service Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Service Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accessing Service Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Restoring Standard Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Displaying Demo Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Change Date & Time, Display Contrast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Viewing Transmitter Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5-2
5-2
5-3
5-3
5-4
5-5
6. Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
Testing TeleMon’s Critical Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Test Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disinfecting the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disinfection Safety Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cleaning the NBP Cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Calibrating NBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reconditioning the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents-2
6-2
6-3
6-5
6-5
6-6
6-7
6-8
Changing Date & Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10
Ordering Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10
7. Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
System Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Safety Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
NBP Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
Authorized Europe/
Middle East/Africa Representative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
Electrical Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5
Measurement Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6
SpO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6
NBP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6
Pulse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8
ST/AR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8
HR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10
Additional Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-11
Electro-magnetic Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-11
Explanation of Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-13
A. Sales and Support Offices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
8. Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-i
Contents-3
In this chapter, you’ll find instructions for getting started with the monitor right
away, a brief introduction to the monitor, a summary of general safety
considerations for this product, and a discussion of some key monitor features.
•
•
•
•
•
What’s New. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Introducing the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Safety Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
A Quick Look at TeleMon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
About TeleMon B
1-1
Introduction
1 About TeleMon
B
1
About TeleMon B
What’s New
What’s New
The major new features of TeleMon B are:
New features include:
•
•
•
•
•
•
•
1-2
About TeleMon B
Stand-Alone monitoring; local alarms at TeleMon B (see “Stand-Alone
Monitoring Mode” on page 1-5 and “Alarm Types & Indicators” on page
4-2)
– Local alarms can be configured differently at TeleMon and central
(if centrally monitored)
– Alarm limits and sources can be set by the user
– Alarm limits shown on screen when local alarms are on
– Alarm limits are configurable
– Alarm settings are saved through docking and undocking of
transmitter and are set to unit settings when TeleMon is turned off
and then on
Local alarms for patient and inoperative conditions (INOPS) that
prevent monitoring (see “Stand-Alone Monitoring Mode” on page 1-5 and
“Alarm Types & Indicators” on page 4-2) Alarms include:
– %SpO2
– NBP
– ECG
Alarm sounds can be either Philips or IEC 60601-1-8
Alarms sounds can be disabled by lowering volume to off
Basic arrhythmia analysis, including PVC count see “ST/AR Arrhythmia
Analysis” on page 3-3 and “Service Mode” on page 5-2)
Transmitter configuration capability, including undocked SpO2 sample
rate see “Service Mode” on page 5-2 and “Changing the %SpO2 Sample
Rate” on page 3-9)
Online demo mode assists in user training (see “Displaying Demo Mode”
on page 5-3)
Before You Begin
Before you begin using TeleMon B, be sure you have completed the following
steps:
1. Power the monitor by either:
a. attaching the AC power cord, or
b. installing the battery, attaching the AC power cord, and charging for
up to 4 hours. See “Powering the Monitor” on page 2-2.
2. Review the Safety Messages on page 1-6.
3. Insert the transmitter. See “Docking & Undocking the Transmitter” on
page 2-7.
Note—A functioning battery must be inserted in the transmitter before
docking to enable TeleMon B monitoring. Also, a lead set must be
connected to the transmitter before docking.
Learn Basic Operation
New clinical users should review the Quick Guide before using TeleMon B on a
patient. The Quick Guide gives a brief summary of the most commonly
performed monitoring tasks and can be used as a training tutorial.
Introducing the Monitor
The M2636B TeleMon B Monitor is part of the Telemetry System.
With a docked transmitter, TeleMon B provides local display of two waves—
ECG waveforms, pleth wave or a delayed/annotated arrhythmia wave—and
numerics for heart rate, %SpO2, and NBP. Simultaneously, the docked
transmitter sends the ECG and %SpO2 signal to the Information Center. NBP,
recording, suspend requests, and TeleMon Inops are transmitted through a
unidirectional, RF telemetry link from TeleMon through the transmitter, to the
Information Center. This capability is provided by TeleMon B within the
antenna system coverage area. At the central station, a “docked transmitter”
indication
is displayed to distinguish data being sourced from a
transmitter docked with TeleMon B.
About TeleMon B
1-3
1 About TeleMon B
Before You Begin
When the transmitter is undocked, NBP information is no longer available at
central. The “docked transmitter” symbol reverts to the “telemetry” symbol
, and the NBP parameter will disappear from the Information Center
display.
Central recordings can be initiated manually at TeleMon B. There are no
automatically-generated recordings from TeleMon B.
TeleMon B incorporates functions formerly provided by the Wave Viewer, and
includes context-sensitive online information.
TeleMon B can be powered either by battery or AC line power. Use of the latter
helps to conserve battery life.
The Series C transmitter for either conventional or EASITM leads can be used
with TeleMon B. The communication from the transmitter to the TeleMon B is
via the infrared port on the transmitter. There must be a battery inserted in the
transmitter; TeleMon B does not perform monitoring functions if the transmitter
battery is weak or dead.
Transition to ambulatory monitoring is seamless, given that the same transmitter
continues to source patient data and no user interaction is required to continue
monitoring. The clinician needs only to remove the transmitter from TeleMon B.
TeleMon B can function in two modes: stand-alone monitoring or telemetry
extension.
1-4
About TeleMon B
This mode is a Decentralized model, with Central and Local Alarms, or Local
Alarms Only.
As a stand alone monitor, TeleMon B offers single lead basic arrhythmia, along
with alarming from HR, SpO2, and NBP. All alarm sources and limits can be
individually configured by the user. Alarms are generated and displayed at both
TeleMon B and the Information Center. Data from TeleMon B is transmitted via
radio frequency (RF) to the Information Center in this mode. The system provides
only one-way communication from TeleMon B to Information Center via the
transmitter.
When alarms are enabled, both TeleMon B and Information Center generate
independent alarms based on the patient’s condition. The alarm limits at TeleMon
B and Information Center are independent, and Information Center alarm limits
can be controlled only from central. Users can silence local alarms at TeleMon B;
central alarms can be silenced only from the central station. Though the alarming
is independent between central and TeleMon B, alarms at central can be
temporarily suspended from TeleMon B for 3 minutes.
•
•
Alarms are audible and visible at central and TeleMon B.
Alarms at central and TeleMon B may not be identical because they are
generated separately.
• INOPS (inoperative alerts) continue to be audible and visible at TeleMon.
• If the monitor is out of antenna range, only local alarms can be generated.
No alarms will be available at central.
Note—The alarm algorithm that TeleMon uses is different from the Information
Center’s. Therefore, timing and alarming of events and alarms will be different.
Telemetry
Extension
Device
Mode
This mode is a Central-based model, with Central Alarms Only, Local Alarms
Off.
When local alarms are disabled, TeleMon B functions as a telemetry extension
device. Patient alarms are generated and annunciated at the Information Center
only. There are no audible alarms generated at TeleMon B. TeleMon B displays
information messages; these messages are also displayed in the patient sector at
the Information Center, along with the ECG waveforms and SpO2 and NBP
readings.
•
•
Alarms are audible and visible at central only, not at TeleMon B.
INOPS are audible and visible at central, visible only at TeleMon B (no
sound)
About TeleMon B
1-5
1 About TeleMon B
Stand-Alone
Monitoring
Mode
Safety Messages
•
If the monitor is out of antenna range, there will be no alarms. Inoperative
alerts will continue to be available at TeleMon B.
Safety Messages
The following safety messages inform you about the correct use of this product.
Other important safety information is located throughout this book where
appropriate.
Warnings
Explosion Hazard. Do not use the monitor in the presence of a flammable
anesthetic mixture with air, oxygen or nitrous oxide.
Do not touch the patient, bed, transmitter, or TeleMon during
defibrillation.
Do not use this device during electrosurgery.
Failure on the part of the responsible individual hospital or institution
employing the use of this equipment to implement a satisfactory
maintenance schedule may cause undue equipment failure and possible
health hazards.
If TeleMon is out of antenna range, there is no indication at TeleMon of this
state. In addition, no signal will be received at central, and the message NO
SIGNAL will be displayed at the central.
Although this equipment is shielded against Electromagnetic Interference
(EMI), avoid the use of other electrically radiating devices in close
proximity to this equipment.
Transmitters or TeleMons with transmitters having frequency settings that
are <25 kHz apart interfere with one another at distances of 1-3 feet. This
situation is aggravated by ECG cable proximity. Symptoms include dropout
(at the Information Center), waveform artifact of the ECG (at central and
TeleMon), and screen freeze (at TeleMon). To avoid this situation, maintain
a frequency spacing of >25 kHz between channels or a physical distance of
>1 m (3 ft) between devices.
1-6
About TeleMon B
A Quick Look at TeleMon
Front View
Display
Handle
NBP Connector
Transmitter Recess
Control Panel
Battery Compartment
About TeleMon B
1-7
1 About TeleMon B
U.S. Law restricts this device to sale by or on the order of a physician. This
product is intended for use in health care facilities by trained healthcare
professionals. It is not intended for home use.
Rear View
Vent
NBP Cuff Holder
Power ON/OFF
Switch
Product Label
Upgrade Port
(underneath)
Control
Panel
1-8
AC Power
Connector
(18V DC, 1.83A)
Speaker
All operational interactions except power on/off and the docking/undocking of
the transmitter are performed using the seven keys on the control panel. In
monitoring mode, there are three types of keys:
• Direct Action keys (SILENCE/RECORD, SUSPEND, and NBP) enable immediate actions. The action is defined in the screen text directly
above the key.
• Input keys (
,
, and
) - enable you to navigate through a menu
of choices.
• ? key - provides access to “how to” and other online operational
information during monitor use.
About TeleMon B
SILENCE/
RECORD
SUSPEND
AC Power Status
Keys
On-Line Info
Input Keys
NBP
Battery Charge Status
The function of each key state is described in the following table.
Key
Silence/Record
Screen
Label
Silence
SUSPEND
All Alarms
Silences the current active alarm or INOP
sound on TeleMon
Initiates central recording. A flashing strip
above the label indicates a recording is in
progress.
Suspends all alarms at TeleMon and Central
for 3 minutes.
SUSPEND
at Central
Suspends telemetry alarms at Central for 3
minutes.
xx:xx min to
UN
SUSPEND
Reactivates suspended alarms.
Record
at Central
Suspend
Function
About TeleMon B
1-9
1 About TeleMon B
Below the keys, two indicators provide information on the power status of the
monitor.
Key
?
Input Keys
Screen
Label
none
none
none
NBP
Function
Provides access to “how to” and other
operational information during monitor use.
Displays context sensitive information on
the selected element. Also scrolls and
dismisses info window.
Arrow Keys
• Select an element on the display.
• Select a choice in a task window.
• Adjust a setting, such as an alarm
limit, in increments.
• Activate a selection in Monitor Setup
window.
Check Key
• Opens or closes a window for the
selected element
START
Starts an individual NBP measurement.
STOP
Stops an individual NBP measurement.
Scheduled measurements continue
uninterrupted.
Indicators
The meaning of each indicator state is described in the following table.
Indicator
1-10
About TeleMon B
Meaning
On (Green)
AC power cable is connected to TeleMon
Off
No AC power is connected.
Meaning
On (Yellow) Battery being charged
The Display
On
(Blinking
Yellow)
Initiating communication with the battery, or
error condition
Off
No charging because either no battery or
battery already fully charged
In monitoring mode, the display presents clinical data in graphical and
alphanumeric format on the Main Screen. The general layout of a typical Main
Screen is shown below, with each icon or measurement identified in the
following table.
14
13
1
12
2
3
11
4
10
9
5
8
7
6
About TeleMon B
1-11
1 About TeleMon B
Indicator
Icon/Measurement
1
Alarm Mode
Local Alarms On or Central Alarms Only
2
Alarm Message
Patient alarms are on the left; equipment alarms (INOPs) are to the
right. An up arrow indicates that there is more than one active message.
3
The text EASI is displayed above the primary wave channel when an
EASI transmitter is docked.
4
Lead Label
1mV Calibration Bar
Size of ECG signal
Waves: One or two ECG waves - or - one ECG and one pleth wave
- or - one ECG and one annotated delayed ECG wave
5
Volume of the local alarm tones. Also used to turn local alarms off.
6
Key label describing current function of the Direct Action key directly
below
7
NBP Schedule: NBP measurement rate, or Manual mode. Also used to
turn NBP off.
8
NBP measurement time: time remaining until the next automatic
measurement, or time of the most recent manual measurement.
9
10
1-12
About TeleMon B
A bell with an X through it indicates that the alarm for this
parameter is OFF.
Numerics and Alarm Limits
• Heart Rate (b/min); PVC Count
• SpO2 (% saturation); PULSE (b/min)
• NBP Systolic/Diastolic (Mean) (mmHg)
• NBP Alarm parameter(s)
• SpO2 sample rate that will take effect when the transmitter is
undocked.
Icon/Measurement
Battery icon indicating the remaining minutes of TeleMon battery
power or absence of transmitter battery. When the AC power cord is
not attached, the battery operating time is also displayed.
Plug icon appears when the monitor is operating on AC power (not
shown). For more information, refer to “More About Batteries” on
page 2-4.
12
Monitor Setup displays a menu of general purpose parameters. From
this menu you can select the patient type, turn pacing on/off, initiate
arrhythmia relearning, and save the current settings. Save Current
Settings is password protected.
13
Current Date and Time
14
Patient Category and Pacing Status
About TeleMon B
1-13
1 About TeleMon B
11
Introduction
2
Monitor Basics
In this chapter, you’ll find instructions for powering the monitor, docking and
undocking the transmitter, how to navigate through menus, how to setup the
monitor, and information about antenna coverage. This chapter includes the
following sections:
Powering the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Docking & Undocking the Transmitter . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
General Navigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
Monitor Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
Antenna Range . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
Monitor Basics
2-1
2 Monitor Basics
•
•
•
•
•
Powering the Monitor
TeleMon can be powered by AC power or by a rechargeable battery. The two
indicators on the front panel give you information about the power status. If
TeleMon is connected to an AC power module, the left indicator on the front
panel will be lit, and a plug icon will appear next to the battery gauge on the
upper right corner of the display to indicate that the power module is
connected. The right indicator on the front panel lights when the battery is
being charged, and the battery gauge on the display shows the percentage of
charge available.
While powered only by battery, TeleMon reports the minutes remaining until
discharge next to the battery gauge. This time is calculated by the battery
itself, and fluctuates based on system load, age of battery, and battery percent
charge.
TeleMon uses one rechargeable 10.8V nickel metal hydride (NiMH) battery.
When %SpO2 is being monitored and four NBP measurements are made per
hour, battery life is >3.5 hours. At 25o C (77o F), the typical battery life for the
same configuration is 5 hours.
When TeleMon is powered on, it goes through a self-test routine that tests for
correction functioning of critical system functionality, including battery
charge, the display and alarm sound.(For more information about the self-test,
see “Testing TeleMon’s Critical Functions” on page 2.)
If power is interrupted to the TeleMon and it does not have a battery installed,
TeleMon’s settings revert to the unit settings.
Note—If no time is shown in the date/time area of the display, the coin cell
battery on the processor board may need to be replaced. Check with your
Service Provider for assistance.
Warning
Use only a TeleMon-specific power supply of the appropriate voltage and
amperage for this device. See “Ordering Accessories” on page 6-10 for
accessory information.
2-2
Monitor Basics
Task Summary
To power the monitor, use these directions:
Step
1
Action
Connect the cable between the power supply and TeleMon; then
connect the cable between the power supply and the AC power
source.
2 Monitor Basics
- OR Insert a fully charged the battery - with the CE mark facing up (the
charge indicator facing down)—into the battery compartment. Close
the door.
Insert with CE mark
facing up.
Monitor Basics
2-3
Step
More About
Batteries
Action
2
Turn the On/Off switch to the ON position.
3
Observe the self-test screen for diagnostic messages. If any appear,
contact your service provider for assistance. Otherwise, monitoring
mode begins automatically.
When the Battery gauge on the display indicates a charge of < 25%, the battery
needs to be recharged. Use only batteries supplied by us (see “Ordering
Accessories” on page 6-10). Fully recharging from the shut-off point (15%
remaining capacity as indicated on the battery) takes approximately 4 hours,
with TeleMon ON or OFF. The battery charge is also indicated on the self-test
display upon power-up. Over time, the battery loses its ability to fully charge.
When the battery’s capacity drops by 10%, reconditioning is needed to optimize
battery performance. For more information about battery reconditioning, see
“Reconditioning the Battery” on page 6-8
<25% -Time to Recharge
Attach AC power or use charged battery.
2-4
Monitor Basics
This indicator can apply to the TeleMon battery, the transmitter
battery, or both. Check the informational messages to determine
which battery is low.
If TeleMon battery: Critically Low — The monitor will shut
down in 5 minutes if no action is taken.
Attach AC power or use new battery. After plugging in AC power,
this icon will remain for a short time until battery begins to
charge. If icon remains longer, the battery may need
reconditioning.
has a critically low charge.
If Transmitter battery: Weak battery in transmitter.
Five minutes or less remain until transmitter is disconnected.
Undock the transmitter, and insert fresh battery into transmitter.
Battery reconditioning is required.
For instructions, see “Reconditioning the Battery” on page 6-8.
Monitor Basics
2-5
2 Monitor Basics
Note—No new NBP measurements can be made when the battery
Warning
Do not mutilate or puncture battery; do not dispose of battery in fire. The
battery can burst or explode, releasing hazardous chemicals. Replace
battery with only the type recommended.
If battery leakage should occur, use caution in removing the battery. Avoid
contact with skin. Clean the battery compartment according to instructions
in this manual. (See “Disinfecting the Monitor” on page 6-5.)
Certain failure conditions, such as extended short circuiting, can cause a
battery to overheat during normal use. High temperatures can cause burns
to the patient and/or user, or cause the battery to flame. If TeleMon
becomes hot to the touch, unplug the AC power, turn the device off, and
place it aside until it cools. Then remove and discard the battery. It’s a good
idea to place a piece of tape across the contacts of the battery to prevent
inadvertent shorting. Remove the TeleMon from service and have its
operation checked by qualified service personnel to identify the cause of
overheating.
Recharging
the Battery
To recharge the TeleMon battery, use this procedure:
Step
Action
1
Be sure the battery is in place (inserted in battery compartment with
the connector slots facing up) and the battery door is closed.
2
Plug in the AC power connector.
Recharging starts immediately, and is indicated by a yellow light on
the charge indicator on the control panel. Leave the power cord
connected until the yellow light goes out and the battery gauge
indicates a full charge. This takes approximately 4 hours.
Note—The battery may get warm during charging, particularly as it
approaches full charge. This is normal behavior.
2-6
Monitor Basics
Docking & Undocking the Transmitter
Note—For information about the transmitter battery, see the Telemetry System
Instructions for Use.
Auto Shutoff
If TeleMon is on battery power and the battery is at 15% charge or below,
TeleMon will automatically shut down in 5 minutes. A count down timer
displayed next to the battery gauge shows the time remaining to shutdown. To
stop the shutdown, either plug in the AC power module or swap the battery with
another that has a charge of more than 15%. If the monitor is not connected to
AC power and one battery is replaced with another, the TeleMon will power
down and restart.
Cycling power repeatedly when the battery is critically low may harm
TeleMon or the transmitter. If the battery is critically low, do not attempt
to cycle power (reboot) the monitor until the either the battery has been
replaced or AC power has been applied.
The transition between stationary (docked transmitter) and ambulatory
(undocked transmitter) monitoring is seamless because the transmitter continues
to source ECG and %SpO2 patient data to the central station in both states.
There is no interruption to monitoring, and no user interaction is required to
continue monitoring when switching between states.
Only M2601A Series C and higher transmitters can be docked with TeleMon
Note—The transmitter must have a “good” battery inserted before docking.
TeleMon B does not allow monitoring if the transmitter is docked with a weak
or dead battery. Also, a lead set must be connected to the transmitter before
docking.
Monitor Basics
2-7
2 Monitor Basics
Warning
Docking
When the transmitter is docked:
• The docked icon (
) is displayed in the patient sector at central.
• %SpO2 is sampled at a continuous rate. If a different sampling setting was
programmed into the transmitter prior to docking, that rate will resume
when the transmitter is undocked.
• NBP measurements can be made. The transmitter must be in the docked
position to measure NBP.
Note—The transmitter battery is not recharged when the transmitter is docked.
Task Summary
To dock the transmitter, follow this procedure:
Step
2-8
Monitor Basics
Action
1
Ensure that the transmitter is ready for use with TeleMon. The
transmitter must meet the following criteria:
a. Series C or higher
b. Good battery inserted in the transmitter.
c. Lead set connected.
d. Battery door closed.
e. No obvious soiling or debris.
2
Turn TeleMon ON (move switch to the ON position
).
Step
3
Action
Insert the transmitter with the infrared window up into the docking
recess at the side of TeleMon.
Infrared
Window
2 Monitor Basics
Chest
Diagram
After about 6 seconds, the Transmitter Disconnected message on
the display will be erased and patient data will be displayed at
TeleMon.
4
Verify that Telemon is being actively monitored at central.
The docked symbol
will be displayed at central.
Monitor Basics
2-9
Undocking
Caution
Do not leave a transmitter docked in TeleMon when monitoring is not active.
The transmitter should be removed from TeleMon prior to storing to prevent
battery drainage.
When the transmitter is undocked:
• The undocked icon (
) is displayed in the patient sector
• No new NBP measurements will be made. (Previous NBP values are
stored and available in trends at central.)
• %SpO2 reverts to its sample rate prior to docking or sample rate selected
at TeleMon when the transmitter was docked (Manual, 5-min, 1-min, or
Continuous).
• Alarms are unsuspended at central if in suspend mode. Suspend alarm
capability reverts to the telemetry setting available at central.
• The message Transmitter Disconnected is shown across the Main
Screen, and all parameters and key labels on the display are hidden. The
input keys (
) remain active, however, so you can preconfigure TeleMon without a transmitter.
Most settings are unaffected by undocking/docking. However, when the
transmitter is docked or redocked, the lead selections are set to the following
defaults:
Transitioning from some
leadset to …
Wave 1 Lead
5-wire
II
5-wire EASI
II
3-wire Lead Selection Disabled II
2-10
Monitor Basics
Wave 2 Lead
V
V2
None
Transitioning from some
leadset to …
3-wire Lead Selection Enabled
Wave 1 Lead
Wave 2 Lead
{I, II, or III based on
transmitter setting}
None
Note—When Lead
Selection is enabled
for 3-wire
transmitters, lead
selection at TeleMon
is stored in the
transmitter.
Note—Transmitters must be undocked from TeleMon prior to changing leadsets.
Task Summary
To undock the transmitter, use the following directions.
1
Remove the NBP cuff from the patient, if present.
2
Turn the TeleMon B power switch to Off.
3
Holding the leadset combiner block, pull the transmitter out with
one hand.
Note—There is no release mechanism.
4
Verify undocking at central.
The undocked symbol
the Information Center.
will be displayed in the patient sector at
Monitor Basics
2-11
2 Monitor Basics
See “To Save Current Settings” on page 2-16 and “Changing Wave or Size” on
page 3-7 for more details.
General Navigation
General Navigation
Entering alarm and parameter settings, such as NBP repeat time, is
accomplished using the Input Keys (see “Keys” on page 1-9). The following
process applies to all operations in monitoring mode except Monitor Setup; it is
summarized here for your convenience. For entering patient settings, such as
pacing status, see “Monitor Setup” on page 2-13.
1. Select an element (a) using the arrow keys. The highlighted element is
shown in the active element (b) position at the bottom center of the
display.
2. Open the task window (c) for that element by pressing the check key.
3. Make a choice on the task list using the arrow keys. The selected choice
becomes active immediately.
4. Close the window and save the information by pressing the check key.
a
d
b
2-12
Monitor Basics
c
Monitor Setup
Online Info
The Online Info feature provides TeleMon operating information during active
monitoring.
Press the ? key when no element is active to display Basic Operating
guidelines.
• Press ? when an element (a, b - see diagram) is active to bring up a
window providing a brief description of the function.
• Press ? when a task window (c) is open to show information about that
task. Monitoring will continue uninterrupted. For example, when the
element Wave 1 Lead is highlighted, a lead placement diagram for the
selected lead is shown (d).
Use the ? key to scroll through additional pages.
•
2 Monitor Basics
To exit from Online Info, press the ? key again, or wait 5 seconds until the
window closes automatically.
Monitor Setup
Monitor Setup provides adjustment of two basic monitor settings: Patient Type
and Pacer Detection Status.
Setting
Positions
Patient Type
Adult, Pediatric
Pacer Detection Status
Not Paced, Paced
Warning
Some pace pulses can be difficult to reject. When this happens, the pulses
are counted as a QRS complex, and could result in an incorrect HR and
misdetection of cardiac arrest or some arrhythmias. Keep pacemaker
patients under close observation.
The patient type affects the settings in the NBP measurement algorithm.
Monitor Basics
2-13
Monitor Setup
If Local alarms are on, two controls are also available:
Control
Function
Arrhythmia Relearn
Initiates a relearn of the patient’s primary
ECG waveform by the ST/AR algorithm.
Note—Initiate learning only during periods
of predominantly normal rhythm and when
the ECG signal is relatively noise-free.
Warning
If you initiate learning during
ventricular rhythm the ectopics may be
incorrectly learned as the normal QRS
complex. This may result in missed
detection of subsequent events of V-Tach
and V-Fib.
Save Current Settings
Saves the current settings as the startup
settings for subsequent patients (“unit
defaults”).
Note—The Pacer Detection Status is not
saved and the default setting is Not Paced.
Note—When you select Save Current Settings, a dialog box appears prompting
you to enter the password. When this dialog box is open, you cannot suspend or
unsuspend alarms, silence any active alarms, start a recording at central, nor start
or stop an NBP reading.
2-14
Monitor Basics
Monitor Setup
Pacing
Safety
Messages
Warning
Pacemakers can be susceptible to radio frequency (RF) interference which
may temporarily impair their performance.
The output power of telemetry transmitters and other sources of radio
frequency energy, when used in the proximity of a pacemaker, may be
sufficient to interfere with the pacemaker’s performance. Due to the
shielding effects of the body, internal pacemakers are somewhat less
vulnerable than external pacemakers. However, caution should be exercised
when monitoring any paced patient.
2 Monitor Basics
Consult the pacemaker manufacturer for information on the RF
susceptibility of their products and the use of their products with the
telemetry transmitters.
In order to minimize the possibility of interference, position electrodes,
electrode wires, and transmitter as far away from the pacemaker as
possible.
Caution
During defibrillation, monitoring may be temporarily interrupted or distorted.
After defibrillation, TeleMon will continue to monitor as before; the monitor
settings will not be affected.
The TeleMon NBP may not operate correctly if used or stored outside the
relevant temperature or humidity ranges.
To Change
Monitor
Settings
Note— In the Monitor Setup window, the arrow and check keys behave slightly
differently. Here you must first select the function you want, using the arrow
keys, then activate your choice by pressing the check key. To exit from the
Monitor Setup window, select Main Screen and press the check key.
Monitor Basics
2-15
Monitor Setup
Task Summary
To change the monitor settings, use the following directions:
Step
Action
1
Select the Monitor Setup element and open the task list.
2
Using the arrow keys, highlight the patient type: Adult or Pediatric.
The highlighted choice will turn brown.
3
Press the check mark key to activate your choice.
A check will be displayed in the box next to your choice.
4
Move the highlight to the pacing choice (Patient Paced or Patient
NOT Paced).
5
Press the check key to activate your choice.
6
To exit from Monitor Setup, use the arrow keys to move the
highlight to Main Screen, then press the check key.
Note—You cannot exit from this window by pressing the check key
unless Main Screen is highlighted.
7
To Save
Current
Settings
Then, with the transmitter docked, be sure to check the leads and
wave size, adjusting as necessary, and check the alarm limits.
Caution
Most current settings will survive a power cycle or reboot only if they have been
saved.
When power is recycled, the monitor resets to either the standard unit settings or
current settings that have been saved. The following table lists the standard unit
settings. If these settings are changed, the changes can be saved for use with
other patients. Current settings will survive a power cycle or reboot only if they
have been saved.
2-16
Monitor Basics
Monitor Setup
Entered settings will be retained if the transmitter is undocked and redocked, but
they will not be transferred to the Information Center or stored with the
transmitter. If power is recycled, they will be reset to the standard settings unless
they were saved.
Settings are password protected; see your Service Provider to obtain the
password for your institution. If setting changes are not saved, the changes will
be lost and the monitor will revert to the standard settings.
Standard (Default) Unit Settings
Wave 1 and Wave 2 Size
Local Alarms On/Off
Alarm Volume Level
Alarm Suspend Time
HR Alarm Limits
SpO2 Alarm Limits
NBP Alarm Source
NBP Alarm Limits
NBP Schedule
Ability to Turn Off Alarms
Adult
NOT Paced
II
EASI: V2
5-lead: V
3-lead: None
x1
CareNet: Off (configurable in Service Mode)
IEC/ISO: On (configurable in Service Mode)
5 [58 dB(A)]
3 minutes
High - 120 b/min; Low - 50 b/min
High - 100%; Low - 90%
Systolic
Systolic: High - 150 mmHg; Low - 90 mmHg
Diastolic: High - 120 mmHg; Low - 50 mmHg
Manual
Enabled for US only
Disabled for IEC countries
Monitor Basics
2-17
2 Monitor Basics
Patient Type
Pacing
Wave 1 Lead (Primary Lead)
Wave II Lead
Antenna Range
Task Summary
To save current settings for subsequent patients, use the following procedure:
Step
Action
1
Modify the settings using Steps 1-6 under “To Change Monitor
Settings” on page 2-15.
2
Adjust other settings (such as alarm limits) as necessary.
Note—All screen settings except ECG leads will be preserved.
To Restore
Unit
Settings
3
Under Monitor Setup, select Save Current Settings and press the
check key.
Note—When Save Current Settings is open, you cannot suspend or
unsuspend alarms, start a recording at central, nor start or stop an
NBP reading.
4
Enter the password as prompted using the arrow keys. Start from the
left digit; press the check key to move to the next digit.
5
After the settings are saved and the password window closes, select
Main Screen and press the check key to exit from Monitor Setup.
See “Restoring Standard Settings” on page 5-3.
Antenna Range
When TeleMon B is used with a docked transmitter within the antenna coverage
area, the following physiological and status information is transmitted via the
associated telemetry receiver and mainframe to the Information Center.
•
•
•
2-18
Monitor Basics
ECG waveform and HR value
Pace Pulses (not paced status)
SpO2 value
Antenna Range
•
•
•
•
•
•
•
Pulse Rate (pulse must be on at central)
NBP Values
SpO2 and NBP On/Off
INOPs, including Transmitter Battery INOPs
Transmitter “Docked” status
Alarm Suspend
TeleMon Record
Monitor Basics
2-19
2 Monitor Basics
When TeleMon is used with a docked transmitter outside antenna coverage, the
NO SIGNAL message is displayed at central, and no values, waveforms, or
alarms from TeleMon are available at central. If TeleMon is in Central Alarms
Only mode, no alarms are available for this patient. If Local Alarms are active,
alarms are available at TeleMon only, and current ECG, SpO2, and NBP
measurement values are also available.
Introduction
3
Measurements
In this chapter, you’ll find instructions for measuring ECG, %SpO2, and NBP.
This chapter also discusses making recordings.
•
•
•
•
Measuring ECG. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Measuring %SpO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
Measuring NBP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Recordings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17
Warning
Before monitoring a patient, verify that you have selected the patient type
(Adult or Pediatric) that is suitable for your patient. See “Monitor Setup” on
page 2-13 for directions.
3 Measurements
Note—For all measurements, use only the recommended accessories.
Recommended accessories are listed under “Ordering Accessories” on page 610.
Measurements
3-1
Measuring ECG
Measuring ECG
TeleMon acquires raw ECG sent via the infrared connection from the transmitter
and combines this data into two 4-second ECG waveforms displayed in separate
wave sectors. Wave Sector 1, the top sector, is designated the primary lead and
is used by the ST/AR algorithm for cardiotach derivation and beat classification
of the delayed/annotated wave.
The raw ECG signals are received from a conventional 5- or 3-lead transmitter
as:
• Channel 1 = Lead II
• Channel 2 = Lead III (5-lead only)
• Channel 3 = MCL (5-lead only)
When an EASI transmitter is sourcing the waves, the signal is received as
• Channel 1 = vector 1 (A-I)
• Channel 2 = vector 2 (A-S)
• Channel 3 = vector 3 (E-S)
The label EASI is displayed above the Wave 1 sector when an EASI transmitter
is docked.
TeleMon implements a fixed 0.5 Hz high-pass filter on the ECG signal to
minimize baseline wander and improve baseline recovery.
The scaling of all displayed ECG waves is indicated by a 1 mv calibration bar
drawn to the left of each wave sector.
3-2
Measurements
Measuring ECG
Warning
ST/AR
Arrhythmia
Analysis
FOR ALL PATIENTS
During complete heart block or pacemaker failure (to pace or capture), tall
P-waves (greater than 1/5 of the average R-wave height) may be
erroneously counted by the arrhythmia algorithm, resulting in missed
detection of cardiac arrest.
If you initiate learning during ventricular rhythm, the ectopics may be
incorrectly learned as the normal QRS complex. This may result in missed
detection of subsequent events of V-Tach and V-Fib.
When using EASI ECG monitoring, Relearn happens automatically when
there is a LEADS OFF INOP. If learning takes place during ventricular
rhythm, the ectopics may be incorrectly learned as the normal QRS
complex. This may result in missed detection of subsequent events of VTach and V-Fib. Be sure to check the beat labels and initiate a relearn to
correct.
1. Respond to the INOP message [for example, reconnect the electrode(s)].
2. Ensure that the arrhythmia algorithm is labeling beats correctly.
FOR PACED PATIENTS
Some pace pulses can be difficult to reject. When this happens, the pulses
are counted as a QRS complex, and could result in an incorrect HR and
failure to detect cardiac arrest or some arrhythmias. Keep pacemaker
patients under close observation.
* During complete heart block or pacemaker failure (to pace or capture),
tall P-waves (greater than 1/5 of the average R-wave height) may be
erroneously counted by the arrhythmia algorithm, resulting in missed
detection of cardiac arrest.
* When arrhythmia monitoring paced patient who exhibit only intrinsic
rhythm, the monitor may erroneously count pace pulses as QRS complexes
when the algorithm first encounters them, resulting in missed detection of
cardiac arrest.
Measurements
3-3
3 Measurements
Pacemaker pulses may not be detected when the output of a defibrillator or
telemetry unit is plugged into a bedside monitor. This may result in the
arrhythmia algorithm’s failure to detect pacemaker non-capture or
asystole.
Measuring ECG
For patients who exhibit intrinsic rhythm only, the risk of missing cardiac
arrest may be reduced by monitoring these patients with the low heart rate
limit at or slightly above the basic/demand pacemaker rate. A low heart
rate alarm alerts you when the patient begins pacing. Proper detection and
classification of the paced rhythm can then be determined.
* When an external pacemaker is being used on a patient, arrhythmia
monitoring is severely compromised due to the high energy level in the
pacer pulse. This may result in the arrhythmia algorithm’s failure to detect
pacemaker noncapture or asystole.
The intended use of the ST/AR basic arrhythmia analysis algorithm is to monitor
the patient’s ECG for heart rate and ventricular arrhythmias and to produce
events/alarms simultaneously for one or more ECG leads. The arrhythmia
algorithm is capable of monitoring both paced and non-paced patients in a
clinical environment.
ST/AR provides Heart Rate and PVC Rate numerics. When Local alarms are on,
it also provides alarm detection for the following conditions:
• Asystole
• Vent Fib/Tach
• V Tach
• Extreme Brady
• Extreme Tachy
• High HR
• Low HR
• PVCs > 30/min
• Pacer Not Capturing
• Pacer Not Pacing
Beat classification determined by the ST/AR algorithm is shown on the delayed
wave, which can be displayed in Wave 2 Sector, the lower sector. The
3-4
Measurements
Measuring ECG
annotation can help you determine the appropriateness of the heart rate
determination and the need for relearning.
Annotation
A
I
L
M
N
P
S
V
?
‘
Beat Classification
Color
Artifact
Inoperative
Learning
Missed Beat
Normal
Paced Beat
Supraventricular Premature
Ventricular Premature
Questionable
Pacer Mark
Blue
Red
Red
Red
Blue
Blue
Blue
Red
Red
Blue
When Local alarms are off, Heart Rate and PVC are the only pieces of
information from the basic ST/AR algorithm that are provided at TeleMon.
For more information on the ST/AR algorithm, please see the Information
Center Instructions for Use. Also refer to the ST/AR Arrhythmia Application
Note.
Note—TeleMon’s ST/AR algorithm has fixed inhibitory periods for the yellow
arrhythmia alarms. The inhibitory period for High/Low HR, Pacer Not Capture
(PNC) and Pacer Not Pace (PNP) is five minutes. The inhibitory period for
PVCs/min is ten minutes. The High/Low HR is a rate alarm, PNC/PNP is a beat
detection alarm, and PVCs/min is a PVC alarm; all share the same priority. The
most recently detected alarm will be visually displayed by TeleMon until the
Silence/Suspend key is pressed or a higher (Red) priority alarm is detected.
ECG
Fallback
ECG Fallback monitoring is available for EASI and 5-wire standard transmitters
when Local alarms are on or off. There is no ECG fallback for 3-wire
transmitters.
Measurements
3-5
3 Measurements
When monitoring is initiated at TeleMon or the Wave 1 lead is changed,
TeleMon displays a question mark (?) next to HR and displays “L” on the
annotated wave until the HR is calculated and the rhythm is learned.
Measuring ECG
ECG Fallback for EASI Transmitters
If one of the EASI leads has an INOP condition, no standard leads can be
derived because each lead is a linear combination of all three EASI leads. A lead
off in the primary lead results in a flat line being displayed on TeleMon, and a
LEADS OFF INOP is displayed. After 10 seconds, if the primary lead still
cannot be derived, then one of the directly acquired EASI raw leads (A1, AS, or
ES, depending on availability) will be displayed with the lead label ECG.
Warning
TeleMon automatically initiates arrhythmia Relearning when the lead is
changed during ECG fallback and when then the primary lead becomes
available again after a Leads Off condition. When all leads become
available, TeleMon returns to the original ECG lead selection prior to ECG
fallback.
ECG Fallback for 5-wire Standard Transmitters
For 5-wire standard transmitters, ECG fallback occurs if there is a lead off in the
primary lead for more than 10 seconds. A lead off in the primary lead results in
baseline data on TeleMon, and a LEADS OFF INOP is displayed. After 10
seconds, if the primary lead still cannot be derived, TeleMon will display one of
the directly acquired ECG leads from the transmitter that is not in leads off; it
will be displayed in channel 1 with a lead label ECG.
TeleMon automatically initiates arrhythmia Relearning when the lead is changed
during ECG fallback and when then the primary lead becomes available again
after a Leads Off condition. When all leads are available, TeleMon returns to the
original ECG lead selection prior to ECG fallback for both primary and
secondary wave sectors.
3-6
Measurements
Measuring ECG
Warning
Non-manufacturer supplied accessories and supplies may corrupt the
performance of the equipment. Use only EC-12 compliant electrodes with
this device. Use of electrodes that are non-compliant may provide
erroneous results.
Do not mix transmitter leadsets and transmitter ECG trunk cables. Only
use a 5-wire leadset with a 5-lead trunk cable or a 3-wire leadset with a 3lead trunk cable.
If a 5-wire leadset is plugged into a 3-lead trunk cable, only one lead will
be monitored by both the Information Center and TeleMon, and there will
be no informational notification displayed.
If a 3-wire leadset is plugged into a 5-lead trunk cable, a LEADS OFF
information message will be displayed, and no monitoring will occur at
TeleMon or the Information Center.
Use only one trunk cable per transmitter; do not use additional cables to
extend the cable length.
Use the trunk cable only with the TeleMon device. Do not use with other
telemetry monitoring systems or other bedside monitors.
When local alarms are on, and a non-EC13 compliant signal is present,
false asystole can result; this could lead to a real asystole being ignored.
3 Measurements
Changing
Wave or Size
To change a wave (lead) or waveform size, follow the steps below.
Step
Action
1
Highlight Wave (1or 2) Lead or Wave (1 or 2) Size using the
arrow keys.
2
Press the check key to open the task list.
3
Make a selection using the arrow keys.
4
Press the check key to close the list.
Measurements
3-7
Measuring %SpO2
Measuring %SpO2
TeleMon B can display the %SpO2, Pulse Rate, and a pleth wave acquired
from a patient connected to a docked transmitter. The Pleth wave is displayed
in the Wave 2 channel. The %SpO2 and Pulse Rate are also transmitted via RF
to central for display in the patient sector.
The SpO2 sample rate is automatically set to Continuous while the transmitter
is docked; when the transmitter is undocked, monitoring resumes at the
previous sampling rate.TeleMon B also enables you to change the sample rate
for use with an undocked transmitter.
If there is no transducer attached to a docked transmitter, TeleMon turns
%SpO2 and pulse rate off at TeleMon. At the Information Center, pulse will
be displayed as -?-. The docked transmitter remains in continuous mode, and
if a transducer is inserted into the transmitter, the parameter will automatically
turn on at TeleMon and the information center.
Note—The standard alarm limit settings for %SpO2 shown in the following
table. These limits can be adjusted (see “Setting Alarm Limits” on page 4-16).
There is no alarm associated with Pulse Rate.
%SpO2 Standard Alarm Settings
High Limit (see
Note)
Low Limit
100%
90%
Note—If the SpO2 value is 100% and the High Limit is set to 100, no alarm
will be generated.
Note that the %SpO2 algorithm in TeleMon B differs from the algorithm at
other bedside monitors in that the TeleMon B algorithm does not include
screening of motion artifact in the pleth signal.
If the pulse rate is <30 b/min, the pulse rate numeric shows -?-.
3-8
Measurements
Measuring NBP
Displaying
the Pleth
Wave
To display the pleth wave in channel 2, use the instructions under “Changing
Wave or Size” on page 3-7 and select “Pleth” in Step 3.
Changing
the %SpO2
Sample Rate
When the %SpO2 sample rate is changed at TeleMon B, the sample rate does
not take effect until the window is closed and the transmitter is undocked.
Task Summary
To change the sample rate at the transmitter, use the following procedure.
Step
Action
1
Highlight the %SpO2 Sample Rate element using the arrow keys.
2
3
Select the sample rate using the arrow keys.
4
Wait until the task list is erased, then turn TeleMon off and undock
the transmitter. The new sample rate will be come effective when
the transmitter is undocked.
3 Measurements
Caution
Do not turn TeleMon off until the task list is closed.
5
Press the check key to close the task window.
Measuring NBP
TeleMon measures the blood pressure using the oscillometric method for both
adult and pediatric patients. Two modes of measurement are available:
Measurements
3-9
Measuring NBP
automatic and manual. Each mode displays the diastolic, systolic, and mean
blood pressure.
• In the manual mode, only one measurement is taken.
• In the automatic mode, the measurement is repeated. You can select the
repetition time to be one of the following: 5, 10, 15, 30, 60, 120
minutes.
NBP measurements can be made only when the transmitter is docked with
TeleMon. When the transmitter is undocked, any NBP measurement will be
removed from the TeleMon main screen and the patient window at the
Information Center.
For automatic measurements, the cycle starts immediately when the time is
selected from the task list. The first measurement will be made at the end of
the cycle. A manual measurement can be started between automatic
measurements.
Note— NBP alarms cannot be turned off at the Information Center. You may
see an indication on the information center display that NBP alarms are off,
when in fact they are always on.
Measurement
Limitations
The oscillometric measurement method has some limitations according to the
patient’s condition. The measurement looks for a regular arterial pressure
pulse; in circumstances where the patient’s condition makes this hard to
detect, the measurement becomes unreliable and measurement time increases.
The user should be aware that the following conditions can interfere with the
measurement method, making the measurement unreliable or longer to derive.
In some cases, the patient’s condition will make the measurement impossible.
•
•
•
•
3-10
Measurements
Patient Movement. Measurement may be unreliable or not possible if
the patient is moving, shivering, or having convulsions because these
activities may interfere with the detection of the arterial pressure pulses.
In addition, measurement time may be increased.
Cardiac Arrhythmias. Measurements will be unreliable or may not be
possible if the patient displays cardiac arrhythmias causing an irregular
heart beat. The measurement time may be increased. If the measurement
time exceeds the maximum measurement time, no reading will be made.
Heart-lung Machine. Measurements will not be possible if the patient is
connected to a heart-lung machine.
Pressure Changes. Measurements will be unreliable or may not be
possible if the patient’s blood pressure is changing rapidly over the
period of time during which the arterial pressure pulses are being
analyzed to obtain the measurement.
Measuring NBP
•
•
•
Severe Shock. If the patient is in severe shock or hypothermia,
measurements will be unreliable since reduced blood flow to the
peripheries will cause reduced pulsation of the arteries.
Heart Rate Extremes. Measurements cannot be made at a heart rate of
less than 40 b/min or greater than 300 b/min.
Obese and Edematous Patients. A thick layer of fat or extra-cellular
fluid surrounding a limb tends to dampen oscillations coming from the
artery and stops them from reaching the cuff. Accuracy may be lower
than normal.
Another limitation is the presence of irregular heart rate, erratic oscillometric
signal, or motion artifact. In these cases, the NBP numerics at Telemon will be
preceded by a question mark (?), indicating that physiological conditions
existed that may have interfered with TeleMon’s ability to obtain a reliable
measurement. The patient should be clinically evaluated, and the measurement
repeated as necessary. If any of these conditions exist, evaluate the patient
and (1) re-initiate NBP measurement, (2) discontinue automatic NBP
measurements, or (3) take NBP measurements using a manual method.
Note—Should a measurement with a question mark (?) be obtained, the
questionable nature of the value is not broadcast to the central station or stored
in the historical data.
3 Measurements
Measurements
3-11
Measuring NBP
NBP Safety
Messages
Warning
Do not perform noninvasive blood pressure measurements on patients
with sickle-cell disease or any condition where skin damage has occurred
or is expected.
Use clinical judgement to decide whether or not to perform automatic
blood pressure measurements on patients with severe blood clotting
disorders, because of the risk of hematoma in the limb wearing the cuff.
Do not apply the cuff to a limb that has an intravenous infusion or
catheter in place. This could cause tissue damage around the catheter
when the infusion is slowed or blocked during cuff inflation.
Use only approved cuffs and tubing in order to prevent inaccurate data,
injury, or damage. All specified cuffs and the TeleMon are protected
against the effects of the discharge of a defibrillator.
Prolonged series of non-invasive blood pressure measurements in
automatic mode may be associated with purpura, ischemia, and
neuropathy in the limb wearing the cuff. When monitoring a patient,
examine the extremities of the limb frequently for normal color, warmth,
and sensitivity. If any abnormality is observed, stop the blood pressure
measurements immediately.
Blood pressure readings may be affected by the position of the subject,
his/her physiologic condition, and other factors.
To obtain accurate blood pressure readings, the cuff must be the correct
size and also be correctly fitted to the patient. Incorrect size or incorrect
fitting may result in incorrect readings.
Caution
All specified cuffs and the TeleMon are protected against the effects of the
discharge of a defibrillator.
3-12
Measurements
Measuring NBP
Do not compress or restrict pressure tubes during an NBP measurement.
NBP Setup
Task Summary
To prepare for NBP measurement, follow the steps below:
Step
1
Action
Attach the cuff to the air tubing, making sure that air can pass
through the tubing and that the tubing is not squeezed or kinked.
Warning
Use only approved cuffs and tubing in order to prevent
inaccurate data, injury, or damage.
2
Insert the NBP cable into the NBP connector.
3 Measurements
Measurements
3-13
Measuring NBP
Step
3
Action
Apply the blood pressure cuff to the patient’s arm or leg as follows:
a. Select the appropriate sized cuff for the patient.
– The cuff width should be either 40% of the limb
circumference or 2/3 of the upper arm length. The
inflatable part of the cuff should be long enough to
encircle 50-80% of the limb. The wrong size of cuff may
give false and misleading results. If you do not have the
correct cuff size, use a larger one to minimize error.
b. Ensure that the cuff is completely deflated.
c. Wrap the cuff around the arm, making sure that the
Artery Marker is aligned over the brachial artery.
– Ensure that the cuff is not wrapped tightly around the
limb. Excessive tightness may cause discoloration and
eventual ischemia of the extremities. Also ensure that
the air hose from the monitor to the cuff is not
compressed, crimped, or damaged.
d. Check that the edge of the cuff falls within the range
marked <--->. If it does not, use a larger or smaller cuff
that fits better.
3-14
Measurements
Measuring NBP
Step
4
5
Action
Place the limb used for taking the measurement at the same level as
the patient’s heart. The cuff should not be placed on the same
extremity as the %SpO2 sensor.
Press the START key.
Note—If you are in doubt about the accuracy of any reading(s),
check the patient’s vital signs by an alternative method before
checking the functioning of the monitor.
Start/Stop
Manual NBP
Task Summary
To start or stop a manual NBP measurement, follow the steps below.
Step
1
Action
If an NBP reading is not in progress, START is displayed.
2
3 Measurements
Press START to initiate a reading immediately.
If an NBP reading is in progress, STOP is displayed.
Press STOP to end a reading.
Note—Pressing STOP has no affect on the Auto Mode Timer. To stop a cycle
of measurements, select either Manual or NBP OFF on the NBP Schedule task
list.
Measurements
3-15
Measuring NBP
Change
Repeat Time
Task Summary
To change the NBP automatic repeat time, use manual mode only, or turn the
NBP function off, use the following procedure:
Step
Action
1
Use the arrow keys to select NBP Schedule.
2
Press the check mark to open the task list.
3
Use the arrow keys to select the measurement repeat time, manual
mode, or turn the NBP function off.
Note—For automatic measurements, the timer starts immediately.
The next automatic reading will be taken at the end of the time
period.
4
Select NBP
Alarm Setting
Press the check mark to close the task list. The NBP repeat time will
be saved as a unit setting.
When Local alarms are enabled, the NBP alarm can be based on the systolic,
diastolic or both systolic and diastolic non-invasive pressures. The standard
settings are listed in the following table:
NBP Alarm Limit
3-16
Measurements
Standard
Setting
Systolic High
150 mmHg
Systolic Low
90 mmHg
Diastolic High
120 mmHg
Diastolic Low
50 mmHg
Recordings
Task Summary
To change the NBP Alarming setting, use the following procedure:
Step
Action
1
Highlight the NBP Alarming element using the arrow keys.
2
3
Select the alarm settings using the arrow keys.
4
Press the check key to close the task window. The NPB Alarming
setting will be saved as a unit setting.
Recordings
Delayed timed recordings at central can be initiated at TeleMon. Delayed
recordings follow the settings at central and are recorded where the transmitter
is assigned.
Note—If there is a problem at the recorder, there is no notification at TeleMon.
TeleMon indicates only that the recording request was sent.
Task Summary
To initiate a delayed waveform recording, use the following procedure.
Step
1
Action
Press RECORD at Central to initiate a delayed waveform
recording at the Information Center.
A recording strip icon flashes above the key label to indicate that a
recording is in progress.
Note—Recording requests made while the recording strip icon is
flashing will be ignored.
Measurements
3-17
3 Measurements
Real-time recordings can be initiated only at the central.
Introduction
4
Alarms
In this chapter you’ll find information on TeleMon B’s alarm structure, a list of
alarms, and instructions for responding to alarms.
•
•
•
Recognizing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
Alarm Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8
Interacting with Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-15
4 Alarms
Alarms
4-1
Recognizing Alarms
Recognizing Alarms
TeleMon B provides basic alarming capabilities for both physiological and
technical conditions. Physiological alarms indicate a life-threatening situation or
a less urgent situation such as heart rate beyond limits. Technical alarms or
INOPs (inoperative condition) indicate that the monitor cannot measure or
detect alarm conditions reliably.
TeleMon B can be used in two modes: Local alarms on, or central alarms only.
Alarms and alarm-related controls are available at TeleMon B only when local
alarming is enabled. INOP text is available at all times, regardless of alarm
mode.
Alarm Types
& Indicators
Alarm Types
4-2
Alarms
Alarm conditions are announced in two forms: messages and sounds. Messages
on the screen inform you visually of a condition. See “The Display” on page 111 for the screen position of alarm messages. If multiple alarms are active, an up
arrow (↑) will be displayed to the right of the message area, and messages will
cycle at a rate of one every two seconds. Sounds alert you to a condition in the
monitor. Sounds are generated at TeleMon B only when Local alarms are on
(see “Turning Alarms On/Off” on page 4-15). Only the sound of the most severe
alarm is provided at any one time. The monitor will be configured for either
Traditional sounds or IEC/ISO sounds depending on the geography where it will
be used.
There are six types of alarms; they are listed in the following table in order of
descending priority.
Alarm Type
Alarm Description
*** Red
Patient potentially in life-threatening situation, for
example, “Asystole”
** Yellow
Continuous/non-continuous condition which might
require response by the medical staff but of less critical
importance than red alarms
Recognizing Alarms
Alarm
Indicators
Alarm Type
Alarm Description
** Short Yellow
PVC rate
Less critical than ** Yellow
Severe INOP
Technical defect of a measurement which could cause
harm to the patient’s health. Alarms are automatically
unSUSPENDED during a severe INOP.
Hard INOP
Technical or signal condition which disables the
parameter algorithm that derives numerical values
Soft INOP
Signal condition or measurement state which makes
the result of a parameter algorithm questionable
TeleMon B indicates the priority of an alarm by:
• Alarm sound. Depending on the geography of the clinical institution, the
alarm sounds are configured for Traditional or IEC/ISO standard alarm
sounds.
• Color of the message: red, yellow, or cyan
• Number of stars in the alarm message: three-star ***, two-star **, or none
The following table summarizes the indicators for each alarm type.
Alarm Indicators
Message
*** Red
Traditional Sound: Continuous highpitch rapid tone
IEC/ISO Sound: Repeated bursts of five
rapid high-pitch beeps
Flashing red message; three stars
*** preceding the alarm text
** Yellow
Traditional Sound: Continuous
medium- pitch tone
IEC/ISO Sound: Repeated bursts of
three rapid low-pitch beeps
Flashing yellow message; two
stars ** preceding the alarm text
Alarms
4 Alarms
Sound
4-3
Recognizing Alarms
Alarm Indicators
Sound
Message
** Short Yellow
Traditional Sound: Noncontinuous
medium-pitch tone for about 8 seconds
IEC/ISO Sound: Two rapid low-pitch
beeps
Steady yellow message; two stars
** preceding the alarm text
Severe INOP
Traditional Sound: Continuous highpitch rapid sound
IEC/ISO Sound: Repeated bursts of five
rapid high-pitch beeps
Flashing red message (no stars)
Note—At central, severe INOPs
sound and display in the same
manner as Hard INOPs.
Hard INOP
Traditional Sound: Continuous slow
low-pitch tone
IEC/ISO Sound: Repeated bursts of
three slow low-pitch beeps
Steady cyan message
Soft INOP
None
Steady cyan message
When a yellow ECG alarm is announced audibly and visually, a 5-minute timeout period begins for that alarm. If this alarm condition recurs during the timeout period, it will not be announced audibly.
Other indications include a flashing parameter numeric displayed during an
alarm event for HR, SpO2, NBP, and PVC arrhythmia events. The HR numeric
flashes for Asystole, Vfib/Tach, Brady, Tachy, and HR rate alarms. The PVC
numeric flashes when a Vtach or PVC rate alarm occurs. The flashing stops
only when the condition goes away.
4-4
Alarms
Recognizing Alarms
Alarm
Behavior
Action
Taken
Alarm behavior is summarized in the following tables for ECG alarms, SpO2 &
NBP limit alarms, and INOP alarms.
Alarm
Condition
Yellow ECG
Alarm condition still exists
• Audible alarm silenced.
• Message stops flashing
• Message changes to inverse video
• Numeric flashes
Alarm condition ceases to
exist
• Audible alarm silenced
• All ECG Messages cleared
• Numeric stops flashing
Alarm condition still exists
• Audible alarm
continues
• Message
flashes
• Numeric
flashes
Silenced
Key pressed
No Action
Alarm condition ceases to
exist
Action
Taken
Red ECG
Alarm Condition
Short Yellow ECG
• Audible alarm
continues
• Message flashes
• Numeric flashes
• Audible alarm
silenced after a few
seconds
• Message flashes
• Numeric flashes
• Audible alarm
silenced
• Message flashes
• Numeric flashes
• Audible alarm
silenced after a few
seconds
• Message flashes
• Numeric flashes
Yellow NBP
Yellow SpO2
• Audible alarm silenced.
• Message stops flashing
• Message changes to inverse video
• Numerics stop flashing
Alarm condition
ceases to exist
• Message cleared
Silenced Key
pressed
4 Alarms
Alarm condition still
exists
Alarms
4-5
Recognizing Alarms
Action
Taken
Alarm Condition
• Audible alarm continues
• Message flashes
• Numeric flashes
Alarm condition
ceases to exist
• Message cleared
Alarm
Condition
Severe INOP
Hard INOP
Alarm condition
still exists
• Audible alarm
silenced
• Message continues
• Numeric flashes
(if applicable)
• Audible alarm
silenced.
• Message changes
to inverse video
• No Audible
alarm
Alarm condition
ceases to exist
• Audible alarm
silenced
• Message cleared
• Numeric stops
flashing (if applicable)
• Audible alarm
silenced
• Message cleared
• Numeric stops
flashing
• No Audible
alarm
• Message
cleared
Silence Key
pressed
4-6
Alarms
Yellow SpO2
Alarm condition still
exists
No Action
Action
Taken
Yellow NBP
Soft INOP
Recognizing Alarms
Action
Taken
Alarm
Condition
Severe INOP
Hard INOP
Alarm condition
still exists
• Audible alarm
continues
• Numeric flashes
(if applicable)
• Audible alarm
continues
• Message flashes
• Numeric flashes
• No Audible
alarm
• Numeric
flashes
Alarm condition
ceases to exist
• Audible alarm
silenced
• Numeric flashes
(if applicable)
• Audible alarm
silenced
• Message cleared
• Numeric stops
flashing
• No Audible
alarm
• Message
cleared
No Action
Soft INOP
Suspending alarms or turning off Local alarms silences audible alarms and
clears all alarm messages.
If a severe INOP occurs when alarms are suspended, the alarms will be
unsuspended automatically. The alarm message will be cleared when you initiate
a new NBP measurement.
Alarm
Modes
TeleMon B provides two alarm modes — Local alarms on or off.
When Local alarms are off
The messages CENTRAL ALARMS ONLY and Local Alarms OFF are
displayed at the top left of the screen. Patient alarms are generated, displayed,
recorded, and silenced only at the Information/Surveillance Center, and alarm
adjustments must be made at central. Severe, Hard, and Soft INOPs in the form
of text messages will be available at TeleMon. There is no sound associated with
INOP alarms when Local alarms are disabled. A bell symbol with an X through
it displays next to the volume icon.
Alarms
4-7
4 Alarms
When Local alarming is enabled
The message Local Alarms ON is displayed at the top left of the screen. Alarms
are generated, displayed and silenced at TeleMon B. Alarm adjustments can also
be made at TeleMon B, and user-adjustable alarm limits on all physiological
parameters can be made. TeleMon B provides a Silence key, and the alarm tone
volume can be adjusted over a ten-step range.
Alarm Messages
Warning
The default configuration for IEC is that local alarms are on and cannot be
disabled. The setting to change this is behind the password-protected area
of Service Mode. Only qualified service personnel should change this
setting.
Warning
TeleMon B transmits only numeric values and waveforms to central; it does
not transmit alarm conditions. Alarm limits and arrhythmia settings are set
independently at TeleMon B and central. The algorrithm used for alarms is
different at TeleMon from that used at central. Because of these
independent settings, an alarm may be announced locally but not at central,
or vice versa.
Alarm Messages
Red &
Yellow
Alarm
Messages
The following table lists the possible alarm messages (in order of decreasing
severity) that could appear on TeleMon when local alarms are turned on. They
are displayed in the alarm message area near the top of the display
Note—In the following table, xxx is the parameter limit and yyy is the parameter
value.
TeleMon B Red & Yellow Alarms
4-8
Alarms
Alarm Message
Severity
Explanation
*** ASYSTOLE
Red
No QRS for 4 consecutive seconds
*** BRADY yyy < xxx
Red
HR below extreme Brady HR limit
*** TACHY yyy > xxx
Red
HR above extreme Tachy HR limit
Alarm Messages
TeleMon B Red & Yellow Alarms
Severity
Explanation
*** V-FIB/TACH
Red
Fibrillatory waveform (sinusoidal
wave between 2-10 Hz) for 4
consecutive seconds
*** V-TACH
Red
Sustained run of PVCs accompanied
by a high heart rate
** HR High
Short Yellow
HR above high HR limit
** HR Low
Short Yellow
HR below low HR limit
**NBP High
Yellow
NBP above high limit for systolic or
diastolic pressure
**NBP Low
Yellow
NBP below low limit for systolic or
diastolic pressure
** PACER NOT CAPT
Short Yellow
Missed beat with pace pulse (paced
patient)
** PACER NOT PACE
Short Yellow
Missed beat without pace pulse
(paced patient)
** PVC > yy/min
Short Yellow
PVCs above PVC limit
For more information about PVC
alarms, see “ST/AR Arrhythmia
Analysis” on page 3-3.
**SpO2 High
Yellow
SpO2 value greater than high SpO2
limit
**SpO2 Low
Yellow
SpO2 value lower than low SpO2
limit
The following table lists all of the INOP alarms (in alphabetic order) that could
be displayed on TeleMonB. They appear in the INOP message area at the top
center of the display. Severe INOP text messages are displayed in red, and hard
and soft INOP text is displayed in cyan. All INOP text is displayed whether
Local alarms are on or off. INOP sounds for Severe and HARD INOPs are
Alarms
4-9
4 Alarms
INOP Alarm
Messages
Alarm Message
Alarm Messages
annunciated only when Local alarms are on. There is no audible sound at
TeleMon associated with any INOP message when local alarms are turned off
(under Volume control).
Note—INOP messages at TeleMon are sent to the Information Center, except
where specified in the table.
TeleMonB INOP Alarms
Message
CANNOT ANALYZE
ECG
CHARGE MON BAT
Level
Hard
Hard
Note—Not displayed at
central if Xmtr BATTERY
WEAK INOP is also in
effect, but both INOPs will
be displayed at Telemon.
CHARGE MON BAT
Explanation
ST/Arrhytymia algorithm cannot
reliably analyze the ECG data on
the monitored lead because of noise
or INOP for 2/3 time over last 30
seconds.
Change lead selected for
primary wave.
TeleMon battery has critically low
charge.
Connect to AC power and
charge battery, or insert
battery with >25% charge.
TeleMon will start a 5-minute
shutdown counter, and if no action
is taken to clear the condition,
TeleMon will shutdown the device.
You will not be able to power on
TeleMon unless you connect AC
power and insert a charged battery.
Change electrodes.
Change position of electrodes.
Soft
TeleMon battery is <= 25%.
Connect to AC power and
charge battery, or insert
battery with >25% charge.
Soft
Selectable lead unavailable due to
leads off
Reattach electrode
Hard
Failure in IR link or TeleMon
caused monitor to reboot and
settings to return to default.
Check patient category, paced
setting, alarm limits and NBP
schedule. Reset as needed.
Note—Not displayed at
central if Xmtr BATTERY
WEAK INOP is also in
effect, but both INOPs will
be displayed at Telemon.
CHECK LEADS
Note—INOP not sent to
Corrective Action
information center
CHECK SETTINGS
4-10
Alarms
Alarm Messages
Message
Level
Explanation
Corrective Action
CUFF NOT DEFLATED
Severe
Cuff pressure is greater than a
specified safety limit for a period of
time.
Remove cuff from patient and
disconnect from tubing.
Gently expel any air. [If water
in cuff, replace cuff.]
Reconnect and reapply cuff to
patient.
Note—If the alarms are
suspended, this INOP alarm
unsuspends them at the
Information Center and
TeleMon B. To clear the
message, initiate a new NBP
measurement.
ECG EQUIP MALF
Hard
ECG PC board in the transmitter is
malfunctioning
Replace transmitter.
Contact your service provider.
INVALID LEADSET
Hard
EASI transmitter has a 3-wire
leadset or no leadset attached to it.
Undock transmitter and attach
a 5-wire leadset.
LEADS OFF
Hard
Lead(s) not connected, or 3-wire
leadset is connected to a 5-lead
transmitter trunk cable.
Reconnect lead(s).
Cuff pressure increased above
overpressure safety limits
Remove cuff from patient and
disconnect from tubing.
Gently expel any air. [If water
in cuff, use new cuff.]
Reconnect and reapply cuff to
patient.
Note—If the alarms are
suspended, this INOP alarm
unsuspends them at the
Information Center and
TeleMon B. To clear the
message, initiate a new NBP
measurement.
NBP CUFF OVERPRESS
Severe
Attach 3-lead trunk cable.
4-11
4 Alarms
Alarms
Alarm Messages
Message
NBP EQUIP MALF
Level
Hard
Explanation
The tube in the cuff may be kinked
or disconnected, or there is a
malfunction in the NBP hardware.
Corrective Action
Unkink and/or connect
tubing.
Reconnect the transmitter by
redocking.
Take another measurement. If
problem persists, contact your
service provider.
NBP INTERRUPTED
Hard
The preset maximum time for total
measurement has been exceeded
because of motion artifact or
arrhythmia activity.
Reapply cuff. Ask patient to
refrain from moving during
measurement.
User pressed STOP during
a measurement.
NBP MEASURE FAILED
Hard
No measurement values can be
derived because no pulse or
inconstant pulse is sensed.
Reapply cuff, or choose a new
location.
Reconnect the transmitter by
redocking.
Obtain a manual
measurement. If problem
persists, contact your service
provider.
NBP USE COUNT HIGH
Note—This appears only
Soft
The relative NBP use count has
exceeded count limit detected in
self-test mode.
Contact Service to replace the
NBP module.
Soft
Only basic cardiotach alarms (high/
low limits, asystole, Vfib) are
active.
Turn on arrhythmia in
Monitor Setup (adds alarms
for Vtach, extreme limits,
pacer, and PVC limit.
on the self-test screen.
NO ARRHYTHMIA
4-12
Alarms
Alarm Messages
Message
SPO2 EQUIP MALF
SPO2 ERRATIC
Level
Hard
Hard
Explanation
Corrective Action
Malfunction in the %SpO2
hardware, or transducer/adapter
cable damaged
Change transducer or adapter
cable.
Erratic %SpO2 measurements, often
due to a faulty transducer or
incorrect positioning of the
transducer
Line up light source and
photodetector - they must be
opposite each other and light
must pass through the
arteriolar bed.
May also be caused by optical
shunting if sensor too big or too
small.
If message persists, replace
transmitter.
Reposition transducer to site
with higher perfusion.
Replace transducer or adapter
cable.
Use different sensor with
correct fit.
SPO2 INTERFERENCE
Hard
Cover sensor with non-white
opaque material (for example,
pulse oximeter probe wraps Posey wrap or equivalent) to
reduce ambient light.
Transducer or adapter cable is
damaged.
If message persists, inspect
and replace transducer or
adapter cable as needed.
May also be due to electrical
interference.
Reduce sources of electrical
interference.
May also be generated by a
defective transmitter.
If the above corrective actions
are ineffective, use a different
transmitter, and call service
provider to replace the
defective one.
Alarms
4-13
4 Alarms
Level of ambient light is so high
that the %SpO2 transducer cannot
measure %SpO2 or pulse rate.
Alarm Messages
Message
SPO2 NOISY SIGNAL
Level
Hard
Explanation
Excessive patient movement or
electrical or optical interference is
causing irregular pulse patterns
Corrective Action
Locate sensor at site with less
movement.
Reduce sources of electrical
or optical interference.
If problem persists, contact
your service provider.
SPO2 NON PULSATILE
Hard
Pulse too weak or not detectable
May also be generated by a
defective transmitter.
NPB measurement being made on
the same extremity as %SpO2
Relocate sensor to site with
improved circulation.
Warm area to improve
circulation.
Try another sensor type.
If the problem consists,
contact your service provider.
SPO2 TRANS MALF
Xmtr BATTERY DEAD
Hard
Hard
The %SpO2 transducer is
malfunctioning.
Replace the transducer or
adapter cable.
%SpO2 connector on the transducer
or transmitter is dirty or corroded.
Change the transmitter and
call service to repair.
If the transmitter communicates
with TeleMon, the transmitter was
docked with a dead 9-volt battery.
Undock transmitter and
replace transmitter battery.
Transmitter eprom may be
damaged; ECG monitoring may
stop.
4-14
Alarms
Interacting with Alarms
Message
Level
Xmtr BATTERY WEAK
Hard
Note—Overrides
CHARGE MON BAT
INOP at central, but both
INOPs will be displayed at
Telemon.
Explanation
Transmitter battery has become
weak during monitoring. This
initiates a 5-minute shutdown timer.
Corrective Action
Turn TeleMon Off. Undock
transmitter and replace
transmitter battery.
If transmitter was docked with a
weak 9-volt battery, Xmtr
BATTERY WEAK appears
immediately along with Transmitter
Disconnected. No monitoring
occurs.
XMTR FAIL
Note—INOP not sent to
Hard
Error writing TeleMon data to
transmitter.
Replace transmitter.
Hard
Transmitter malfunctioning
Turn Telemon off and undock
the transmitter. Replace with
a different transmitter.
information center
XMTR MALF
Turning
Alarms On/
Off
To turn Local alarms on or off, use the following procedure:
Step
Action
Using the arrow keys, highlight the Volume icon.
2
Press the check key.
3
Select the Volume level, or Alarms OFF.
4
Press the check key to close the window.
4 Alarms
1
Alarms
4-15
Adjusting
Alarm
Volume
To change the volume of the alarm sound, use the following procedure:
Step
Action
1
Using the arrow keys, highlight the Volume icon.
2
3
Select the alarm volume.
A sample tone will sound to aid you in selecting an appropriate
volume level.
4
Setting
Alarm Limits
Press the check key to close the window.
Alarm limits for ECG, %SpO2, and NBP measurements can be adjusted at
TeleMon when local alarms are enabled. Alarm limits at central cannot be
controlled from TeleMon. If the %SpO2 High Limit is set to 100 and the SpO2
value is 100%, no alarm will be generated.
Note—For standard limit settings, see “To Save Current Settings” on page 2-16.
For alarm limit ranges, please refer to “Measurement Specifications” on page 76 or sections on individual measurements in Chapter 3.
Task Summary
To adjust alarm limits, use the following procedure.
Step
4-16
Alarms
Action
1
Using the arrow keys, select the limit to be changed.
2
3
From the task window, use the arrow keys to choose the limit.
4
Press the check key to close the task window and activate the new
limit.
Note—It is recommended that you power cycle (turn off and then on) the
TeleMon when connecting to a new patient. This causes TeleMon to reestablish
the default alarm settings.
Warning—Refer to “Safety Messages” on page 1-6 for information on
maintaining patient safety.
Silencing an
Alarm
When a Local alarm occurs, the sound can be silenced by pressing the Silence
key. After you silence an alarm, the function of the Silence key quickly reverts
to Record so that you can capture a central recording of the alarm event. The
alarm message remains active on the main screen until one of the following
occurs, at which time the alarm will be reset:
•
•
•
•
•
the physiological alarm condition goes away.
you adjust the alarm limits
you turn the alarms off
you initiate a Relearn (for ST/AR generated alarms only)
you suspend alarms.
Note—Silencing a local alarm does not affect any active alarms at the
Information Center.
Task Summary
To silence a Local alarm, press the SILENCE key.
4 Alarms
Alarms
4-17
Suspending
Alarms
The suspend capability enables you to prevent false alarms during a change of
electrodes or other activity that could cause movement artifact alarms.
Suspending alarms turns telemetry alarms off temporarily for 3 minutes at
central, and if local alarms are enabled, at TeleMon also. The number of minutes
and seconds remaining in the suspend period is displayed above the
UNSUSPEND key label. When alarms are unsuspended, either automatically or
manually, or when the transmitter is undocked, the ST/AR arrhythmia timeouts
are reset.
If a severe INOP occurs, the suspend period will be cancelled and the INOP will
be annunciated.
Task Summary
To suspend alarms, press the SUSPEND All Alarms or SUSPEND at Central
key. This action suspends all telemetry alarms at TeleMon B and central or, if
local alarms are off, at a central only.
To cancel the suspend, press the UNSUSPEND key.
4-18
Alarms
This chapter describes the capabilities of Service Mode.
•
•
•
•
•
Accessing Service Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Restoring Standard Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Displaying Demo Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Change Date & Time, Display Contrast . . . . . . . . . . . . . . . . . . . . . . . . 5-4
Viewing Transmitter Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Note—TeleMon & Transmitter Service functions are covered in the TeleMon B
Service Guide.
Service Mode
5-1
Introduction
5 Service Mode
5
Service Mode
Service Mode
Service Mode
Service mode enables you to perform non-clinical and configuration activities
on the monitor. Some of these functions are password-protected to prevent
inadvertent setting changes. All settings selected in service mode are saved once
you exit the and are retained after a power cycle. Note that you do not need the
transmitter while in Service Mode unless you are configuring a transmitter.
Service mode enables you to:
•
•
•
•
•
Restore standard unit settings
Enter Demo mode
Adjust the display contrast, and date & time.
View transmitter information.
Perform service functions on TeleMon and the transmitter (recommended
for qualified service personnel only).
Note—Alarm sounds and the software that controls alarms are checked during
the TeleMon power-on self test. See ‘Testing TeleMon’s Critical Functions” on
page 6-2 for more information.
Accessing
Service
Mode
Service Mode is accessed through the power-up screen.
Task Summary
To access service mode, use the following instructions:
Step
5-2
Service Mode
Action
1
Turn TeleMon on (with or without a transmitter docked).
2
After the logo displays at the center of the screen, and the message
Push button for Service appears, press the Check button
below the display.
Service Mode
To exit Service Mode:
•
Restoring
Standard
Settings
For more information on display settings, see ‘Monitor Setup” on page 2-13.
When you restore standard settings, all setting revert to the factory default,
except for alarm sound type, NPB calibration date and use count, and the ability
to turn off local alarms.
Task Summary
To restore standard settings, use the following instructions.
Step
1
5 Service Mode
Turn the monitor off.
- or Select Exit from the Device Setup Menu.
Action
From the Device Setup Menu, select Restore Standard Settings.
Caution
Current settings will be lost when standard unit settings are
restored.
Displaying
Demo Mode
2
Press Go.
3
Press Accept or Cancel at the confirmation dialog box.
If you press Accept, a message appears when the restore completes.
4
Press Done to return to the Device Setup menu.
Demo mode facilitates learning how to use TeleMon. It shows sample wave
forms for a 5-lead transmitter and helps you familiarize yourself with the
controls.
Service Mode
5-3
Service Mode
Task Summary
To enter demo mode, follow these instructions.
Step
1
Action
From the General Configuration Menu, select Demo Mode.
Note—Once you enter Demo mode, you must power off and restart
TeleMon to enter monitoring mode.
2
Press Go.
3
Press Accept or Cancel at the confirmation dialog box.
4
To exit Demo mode, power off and restart TeleMon.
Warning
If the transmitter is docked to TeleMon while in Demo Mode, the
transmitter continues to transmit information to the Information Center,
but that information doesn’t display on TeleMon, nor does the demo data go
to the Information Center. While in Demo Mode TeleMon displays only the
pre-programmed demonstration.
Change
Date & Time,
Display
Contrast
This selection allows you to change the contrast of the display to better suit your
viewing conditions. It also allows you to verify or change the date and time.
Task Summary
To adjust the display contrast or work with the date and time, follow these
instructions.
Step
5-4
Service Mode
Action
1
From the General Configuration Menu, select Date & Time,
Display Contrast.
2
Press Go.
Service Mode
Step
Action
Select either Adjust Display Contrast or Set or Verify Time and
Date.
4
To adjust the display contrast: Use the arrow keys to adjust the
contrast. The screen sample displays the result of the selection.
Press Done.
To set the date and time: Use the arrow keys to adjust each number
and use the Next Setting key to move among fields. Press Done
after you complete the changes.
Viewing
Transmitter
Information
This selection allows you to view the current settings of the docked transmitter.
Task Summary
To view the transmitter information, follow these steps.
Step
Action
1
From the General Configuration Menu, select View Transmitter
Information.
2
Press Go.
3
Press View SpO2 Hardware to view the SpO2 hardware
information.
4
If you remove the transmitter and insert a different one, press
Update to update the display with information from the new
transmitter.
5
Press Done to exit.
Service Mode
5-5
5 Service Mode
3
Introduction
6
Maintenance
By performing the maintenance activities described in this chapter, you can keep
your Telemon in the best working condition. This chapter includes the following
sections:
Testing TeleMon’s Critical Functions . . . . . . . . . . . . . . . . . . . . . . . . . 6-2
Disinfecting the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Cleaning the NBP Cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-6
Calibrating NBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-7
Reconditioning the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-8
Changing Date & Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10
Ordering Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10
Maintenance
6-1
6 Maintenance
•
•
•
•
•
•
•
Testing TeleMon’s Critical Functions
TeleMon B provides self-test capabilities for critical functionality at power-on.
This test is run automatically when the unit is turned on, and presents a checklist
of critical components. The self-test should be performed at least once a month.
The self-test includes:
•
•
•
•
•
•
•
•
•
Reporting the application and operating system Software Revision
Numbers
Checking system files to ensure the application software and the operating
system are functioning correctly. The operating system driver returns an
error if the file system is corrupt and will attempt to repair the file system
like a standard PC disk checking mechanism.
Reporting the TeleMon mainboard Hardware Revision Number
Testing the speaker for alarm sounds
Checking the clock
Testing the keypad
Reporting the internal NBP module Software Revision Number, NBP
Calibration status, and Use Count
Reporting the Battery Charge and Battery Reconditioning status
Reporting the Transmitter battery status (if docked)
In addition, since the test results are presented on the display, by implication the
display is also tested.
If during the power-on self-test you do not hear the alarm sound, turn off the
monitor and turn it back on again. If the alarm sound still cannot be heard,
contact your service representative.
6-2
Maintenance
Test Results
Self-Test
Passed
Upon completion of the test, the message “Self-test passed” indicates a
successful test (see the example below).
6 Maintenance
Maintenance
6-3
Self-Test
Failed
6-4
Maintenance
If a problem is detected, the message “Self-test failed!!!” is displayed as shown
below. Follow the instructions on the screen and turn the monitor off then on
again. If the problem persists, call your technical support personnel. An Event
Log in Service Mode allows technical support personnel to view an information
log documenting TeleMon operation.
Disinfecting the Monitor
Disinfecting the Monitor
Disinfection
Safety
Messages
Warning
To prevent fire, provide adequate ventilation and do not permit smoking
when cleaning or disinfecting the equipment.
6 Maintenance
Disconnect line power and remove battery from TeleMon to prevent
electrical shock and accidental turn-on during cleaning.
Exposure of electrical contacts or connections to saline or other liquids is
dangerous. Electrical contacts and connections such as cable connectors,
power supplies, and plug-in connections must be kept clean and dry. Do
not immerse this device in water.
Caution
Do not use any abrasive cleaning materials on any part or component of the
TeleMon. Do not clean any part or component of the TeleMon in any overly
vigorous or abrasive fashion. Using abrasive cleansers and abrasive cleaning
actions will damage the components.
Use only a 10% solution of sodium hypochlorite (bleach) in water as a
cleaning fluid. Do not use any other cleansers, such as betadine.
Remove the battery and any cables or accessories before you clean TeleMon.
Under normal operation, the transmitter recess and TeleMon exterior should
be disinfected between patients.
Maintenance
6-5
Cleaning the NBP Cuff
Task Summary
To disinfect the TeleMon exterior, battery compartment, and transmitter
recess, use the following directions:
Step
Action
1
Turn TeleMon OFF.
2
Disconnect the power cord, and remove the battery.
3
Undock the transmitter, and detach the NBP cable.
4
Wipe the outside surface, the battery compartment, and the
transmitter recess with a pad dampened with a solution of 10%
sodium hypochlorite (bleach) in water.
Do not use any other cleaning agents.
5
Wipe all cleaned surfaces dry with a clean, dry pad.
6
If further cleaning is necessary
a. Lightly spray surfaces with cleaning solution.
b. Scrub down surfaces with a cotton swab, sponge
applicator, or stiff brush. The area under the power
contacts should be carefully cleaned such that all visible
contamination is removed.
c. Tip TeleMon to allow excess fluid to run out of recess
and battery compartment.
d. Wipe cleaned surfaces dry with a clean, dry pad.
Note—Do not immerse the monitor in cleaning solution.
7
Allow TeleMon to air-dry for 1/2 hour before reuse.
Cleaning the NBP Cuff
The cuff can be disinfected by immersion in a decontamination solution of 7085% isopropyl alcohol, but remember to remove the rubber bag if you use this
method. The cuff should not be dry cleaned.
6-6
Maintenance
Calibrating NBP
The cuff can also be machine-washed or hand-washed as recommended by the
manufacturer; the latter method will prolong the service life of the cuff. Before
washing, remove the latex rubber bag and, for machine-washing, close the
Velcro fastening. Allow the cuff to dry thoroughly after washing, then reinsert
the rubber bag
.
6 Maintenance
Calibrating NBP
NBP calibration should be performed once a year or every 10,000
measurements, whichever comes first. The calibration procedure is done in the
Service Mode of TeleMon. See M2636B TeleMon Service Guide for
instructions, or your service provider for assistance.
Maintenance
6-7
Reconditioning the Battery
Warning
Do not use the battery reconditioner in the patient vicinity.
Be sure there is no contact between the patient and the charger, including
no contact from the charger to a medical care giver to the patient.
The Battery Reconditioner can be used for charging or reconditioning the
TeleMon battery. During normal operating conditions, the battery is recharged
while TeleMon is connected to an AC power source. However, over time the
battery loses its ability to fully charge. When the battery’s capacity changes by
10% from the last time it was reconditioned, a microchip inside the battery
indicates that it needs reconditioning to optimize performance.
During the reconditioning process, the battery is discharged, charged, discharged
again, and then charged again.
The following table lists the definition for each LED state on the reconditioner.
LED State
Icon
Definition
Off
No battery detected in bay
Green Flash
Charging
Green Solid
Fully charged
Yellow Flash
Reconditioning
Yellow/Green Flash
Reconditioned and fully charged
Yellow Solid
Standby: battery in bay waiting to be charged
6-8
Maintenance
LED State
Icon
Definition
Error:
• Check the battery reconditioner bays to ensure that
they are clean of foreign objects.
• Ensure that the correct type of battery has been
inserted.
• Check to see if a battery is defective. The
reconditioner indicates an error if a battery reaches
a temperature higher than 65°C (149°F).
Red Flash
Task
Summary
(Recondition)
6 Maintenance
'HWHUPLQLQJZKHQWRUHFRQGLWLRQRUFKDUJHWKHEDWWHU\
The TeleMon monitor checks the battery during self-test, and the display
indicates when the battery needs reconditioning or charging.
To recondition a battery, use the following procedure.
Step
Action
1
Connect the conditioner to power.
a. Plug the power supply into an outlet.
b. Insert other end of the power cable into the power
jack on the conditioner.
2
Insert the battery to be reconditioned into the LEFT bay.
Note—Only the LEFT bay can be used for reconditioning.
3
Press the recondition button. The recondition button is the blue
button with the
symbol.
During reconditioning, the LED flashes yellow. When
reconditioning is complete, the LED flashes between yellow and
green.
Note—Reconditioning a battery can take over twelve hours. When
reconditioning is complete, the battery is fully charged.
Maintenance
6-9
Changing Date & Time
Task
Summary
(Recharge)
To charge a battery using the Reconditioner, use the following procedure.
Step
1
Action
Insert the battery to be charged into either bay.
During charging, the LED flashes green. When charging is
complete, the LED stays green.
Changing Date & Time
The date and time displayed at the upper right of the display can be adjusted in
Service Mode. Refer to ‘Change Date & Time, Display Contrast” on page 5-4
or the M2636B TeleMon Service Guide for directions.
The date/time format is:
Weekday, Month DD, YYYY HH:MM
where the Weekday and Month are spelled out in full. The hours range from 1 to
24. For example, Friday, February 09, 2001 15:32
Ordering Accessories
The performance specifications and tolerance of TeleMon are established using
manufacturer-supplied accessories and supplies. Non-manufacturer-supplied
accessories and supplies may corrupt the performance of the equipment. We
assume no liability for poor performance or injury caused by non-manufacturersupplied accessories and supplies.
6-10
Maintenance
The following accessories are available for use with the TeleMon Monitor.
Description
Order Number
Power Supply
M4792A
10.8V Nickel Metal Hydride Battery NI1030AG,
rechargeable
M4790A
Battery Reconditioner, Universal
M4791A
ECG Transmitter Trunk Cable
M4793A
5-lead IEC
M4794A
3-lead AAMI
M4795A
3-lead IEC
M4796A
ECG/%SpO2 Cable Clip
6 Maintenance
5-lead AAMI
M1509A
3-wire ECG Lead Set
Snap, AAMI for M2601A, 0.7 m (30 inch)
M2590A
Grabber, AAMI for M2601A, 0.7 m (30 inch)
M2591A
Snap, IEC for M2601A, 0.7 m (30 inch)
M2594A
Grabber, IEC for M2601A, 0.7 m (30 inch)
M2595A
5-wire ECG Lead Set
Snap, AAMI for M2601A, 0.7 m (30 inch)
M2592A
Grabber, AAMI for M2601A, 0.7 m (30 inch)
M2593A
Snap, IEC for M2601A, 0.7 m (30 inch)
M2596A
Grabber, IEC for M2601A, 0.7 m (30 inch)
M2597A
Maintenance
6-11
Description
Order Number
Combiner Shield Replacement Kit
3-wire
M2598A
5-wire
M2599A
ECG Electrode Kit
ECG radiotranslucent foam electrode kit, 5/pack,
300/case
M2202A
Paper tape electrodes, 30/pack, 300/case
40489E
Foam electrodes, 5/pack, 300/case
40493D
Foam electrodes, 30/pack, 300/case
40493E
SpO2 Transducer
Reusable Adult Finger
M1191A
Reusable Pediatric/Small Adult Finger
M1192A
Reusable Adult/Pediatric Ear Clip
M1194A
SpO2 Extender Cable (2 meters)
M1941A
Wristband (ten straps per pack)
M1627A
Nellcor Oxisensor™
D-20
M1903B
D-25
M1904B
Adapter Cable for use with Nellcor Oxisensor™
disposable transducers
6-12
Maintenance
M1943A
Description
Order Number
NBP Cuff
40401B
Traditional Multi-Patient—Adult
40401C
Traditional Multi-Patient—Large Adult
40401D
Latex-Free, Long-Life Multi-Patient—Pediatric
M1572A
Latex-Free, Long-Life Multi-Patient—Small
Adult
M1573A
Latex-Free, Long-Life Multi-Patient—Adult
M1574A
Latex-Free, Long-Life Multi-Patient—Large
Adult
M1575A
6 Maintenance
Traditional Multi-Patient—Pediatric
NBP Cuff Connect Tubing
Standard, 1.5m (5 ft)
M1598B
Long, 3.0m (10 ft)
M1599B
OXISENSOR II™ is a trademark of NELLCOR® Incorporated.
Note—Disposable transducers are not available as manufacturer parts in the
USA or Canada. In those countries, contact NELLCOR® Incorporated directly.
Maintenance
6-13
Introduction
7
Specifications
This chapter provides information on regulatory compliance with safety
standards, product specifications and other safety information. It includes the
following sections:
•
•
•
•
•
System Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Electrical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5
Measurement Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6
Additional Safety Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-11
7 Specifications
Specifications
7-1
System Specifications
Intended
Use
TeleMon is indicated for use in the monitoring, recording, and alarming of
multiple physiologic parameters in adult and pediatric patients to gain
information for treatment, to monitor adequacy of treatment, or to exclude
causes of symptoms.
TeleMon is a prescription device for use in healthcare facilities by trained
healthcare professionals. TeleMon is not intended for home use.
Safety
Standards
0123
The M2636B TeleMon B Monitor complies with the Council Directive 93/42/
EEC of 14 June, 1993 concerning medical devices, and carries CE marking
accordingly (CE 0123).
The following accessories and system components are independently CEmarked:
• Power Supply accessory
• Battery and Battery Reconditioner accessory
• Telemetry System
Note—The Battery Reconditioner is not for use in the patient vicinity.
The M2636B TeleMon B also complies with the following international safety
regulations for medical electrical equipment:
• IEC 60601-1/ EN 60601-1
• IEC 60601-1-1/ EN 60601-1-1
• IEC 60601-1-2/ EN 60601-1-2
• CAN/ CSA C22.2 No. 601.1-M90
• UL 2601-1
This CISPR-11 Class A, Group 1 device is not suitable for use in a domestic
establishment or one that is connected directly to the low voltage public mains.
The monitor is a Class 1 device and has an IPX 1 rating (excluding the power
supply). The device has BF and CF applied parts.
The system provides continuous operation when in use.
7-2
Specifications
NBP
Standards
Non-invasive blood pressure measurements determined with this device are
equivalent to those obtained by a trained observer using the cuff/stethoscope
auscultation method, within the limits prescribed by the American National
Standard, Electronic or automated sphygmomanometers. Diastolic values
correspond to Phase 5 Korotkoff sounds.
The NPB portion of the device also meets all relevant parts of the following
safety standards:
• ANSI/AAMI SP10
• IEC 60601-2-30
NBP internal operating software ensures that:
•
•
Authorized
Europe/
Middle East/
Africa
Representative
Maximum cuff inflation time is limited to 60 seconds.
Duration of blood pressure reading is limited to 170 seconds.
Philips Medizinsysteme Böblingen GmbH
Hewlett Packard Str. 2
71034 Böblingen
Germany
FAX: (+49) 7031 464 4297
7 Specifications
Specifications
7-3
Electrical Specifications
Electrical Specifications
Line Power
Power Input
An external power supply is used.
Input
100-250 VAC +6%/-10%; 50-60 Hz +/-6%
Input Power
Average (36 Watts, 64 VA), Max (39 Watts, 81
VA)
Output
18 VDC
Battery
7-4
Specifications
Type
10.8V Nickel Metal Hydride Battery NI1030AG
(NiMH Smart Battery, package style DR 35),
M4790A
Operating Time
Typical 5 hours at 25º C (77º F)
With %SpO2 and NBP measurements 4 times/
hour: up to 3.5 hours
Charge Time
From 15% of capacity to fully charged: 2-3
hours typical at 25º C (77º F), TeleMon on or off
Electrodes
Compatible with EC-12 electrodes only
Environmental Specifications
Environmental Specifications
Operating
Temperature Range
Monitor without NBP Cuff: 0º C to 35º C (32º F
to 95º F)
Monitor with NBP Cuff: 10º C to 35º C (50º F to
95º F)
Altitude Range
Up to 3048 m (10,000 ft.)
Humidity Range
< 90% relative humidity at 35º C (95º F), noncondensing
Shipping & Storage
0º C to 60º C (32º F to 140º F) / without battery
0 to 50º C (32 to 122º F) / with battery
Altitude Range
Up to 3048 m (10,000 ft.)
Humidity Range
< 90% relative humidity, non-condensing
Specifications
7 Specifications
Temperature Range
7-5
Measurement Specifications
In the following tables, the default values for each measurement are denoted in
brackets {}.
SpO2
Item
Range of Values {default}
SpO2 Limit Alarms
High Range: 51 to 100 %SpO2
Low Range: 50 to 99 %SpO2
Adjustment: 1% steps
Alarm Severity: Yellow
Alarm Delay: Maximum 10 seconds after
value goes above the high or below the low
alarm limit.
SpO2 Measurement Range
0 to 100%
Pulse Rate Measurement
30 to 300 b/min
Accuracy: ±2 %
Resolution: 1 b/min
Note—SpO2 pulse rate performance is only
specified to 30 b/min. Below 30 b/min, pulse
rate is displayed as -?-.
(No Alarm Limit)
NBP
7-6
Specifications
Item
Measurement Range
Systolic: 40 to 260 mmHg
Diastolic: 25 to 200 mmHg
Initial Inflation Pressure
Adult: 160 mmHg
Pediatric: 120 mmHg
Maximum Pressure
280 mmHg
Overpressure Safety Limit
300 mmHg (max)
Accuracy
±3 mmHg or 5% of reading (whichever is
greater)
Heart Rate Range
40 to 200 b/min
Cuff Deflation Rate
6 mmHg/step
NBP Alarm Range at
Central
10 to 260 mmHg
Rated Life
30,000 measurement cycles (36/day for 2.3
years)
Cuff Inflation Time
60 sec maximum
Limitations on Use
Not for use on neonates. When used on
patients suffering from cardiac arrhythmias,
information presented will have undefined
accuracy. See safety warning and caution
messages under “Measuring NBP” on page 39.
Auto Mode Repetition
Time
5, 10, 15, 30, 60 or 120 minutes
Measurement Time
(average @ HR > 60 b/
min)
Auto/Manual mode: 30 sec (average)
Auto/Manual mode: 170 sec (maximum)
Specifications
7-7
7 Specifications
Item
Pulse
Item
Default Alarm Limits at
TeleMon
Systolic high limit: 150 mmHg
Systolic low limit: 90 mmHg
Diastolic high limit: 120 mmHg
Diastolic low limit: 50 mmHg
NBP Alarm Ranges at
TeleMon
Systolic high alarm: 15 - 260 mmHg
Systolic low alarm: 10 - 255 mmHg
Diastolic high alarm: 15 - 260 mmHg
Diastolic low alarm: 10 - 255 mmHg
NBP Alarm Delay from
TeleMon B to Central
(Information Center)
< 10 sec
Item
Pulse Measurement Range
30 - 300 b/min
Item
Primary Monitoring Lead
I, {II}, III, AVF, AVL, AVR, V, or MCL
Multi-Lead/Single-Lead
(not configurable)
Single-Lead only
Patient Type
{Adult}, Pediatric
Paced/Not Paced
Paced or {Not Paced}
.
ST/AR
7-8
Specifications
Item
Arrhythmia Alarms
{ON} when local alarms are on, {Off} when
local alarms are off
Note—When local alarms are turned off, there
are no local arrhythmia alarms at TeleMon;
arrhythmia alarms will be present only at the
Information Center.
Heart Rate Range
15 - 300 b/min; if fewer than 15 b/min heart
rate is set to zero
Limit Alarms for Heart
Rate
Heart Rate High Limit: 20 - 300 b/min,
increments of 5 b/min
Heart Rate Low Limit: 15 - 295 b/min,
increments of 5 b/min for heart rates greater
than or equal to 50 b/min; increments of 1 b/
min for heart rates less than 50 b/min;
{fixed at 4sec}
Extreme Brady Min
(not configurable)
{40 b/min; adult & ped}
Extreme Brady Difference
0 to 50 b/min {20 b/min}
Extreme Tachy
(not configurable)
Difference to High Limit: {20 b/min}
Clamping at: {200 b/min; adult}, {220 b/min;
ped}
Vent Tach HR
(not configurable)
Adult:{100 b/min}
Pediatric: {120 b/min}
Vent Tach Run
(not configurable)
High Limit: {>=5 PVCs}
7 Specifications
Asystole
(not configurable)
Specifications
7-9
Item
PVC rate
(not configurable)
High Limit: {30 PVCs/min}
Timeout Period First Level
(not configurable)
Fixed: 5 minutes (used for HR rate & Pace
alarms)
Timeout Period Second
Level (not configurable)
Fixed: 10 minutes (used for PVC rate alarm)
Alarm Reminder
No reminder active in TeleMon
Heart Rate Parameter
Defaults
HR High Limit
{120}
HR Low Limit
{50}
HR
7-10
Specifications
Additional Safety Information
Electromagnetic
Compatibility
The electromagnetic compatibility (EMC) validation of the TeleMon Monitor
included tests performed according to the international standard for EMC with
medical devices. See the Manufacturer’s Declaration of Conformity for details.
During the test program, the TeleMon was subjected to many EMC tests, both
international standard and proprietary tests. During most of the testing, no
anomalies were observed, except for some immunity tests which required
reduced levels of the external influence for compliance.
EN 61000-4-3 specifies that the product be subjected to an electromagnetic field
of 3 V/m over a frequency range of 26 to 1000 MHz with no degradation of
performance. At most of the test frequencies in this specified range, no
anomalies were observed. However, at the product transmit/receive frequency,
and a few others, the radiated field imposed caused interference with a resultant
drop-out of ECG and pleth signal. For frequencies in the range of 108.89 MHz
to 223 MHz a reduced level of 1.0 V/m was met, and in the range of 311 MHz to
601 MHz a reduced level of 1.6 V/m was met, with no anomalies.
IEC 801-2
The IEC 801-2 Electrostatic Discharge Test calls for the product to withstand air
discharges at up to 8 kV, and contact discharges to exposed metal on the
TeleMon or to a nearby metal plate at voltage settings up to 4 kV with no
change of operating state. The Telemon passes the air discharge test and contact
discharge tests at a reduced level. Air discharges of more than 6 kV to the
screws on the rear of the TeleMon housing, or to the bottom of the housing, may
cause an instrument reset, whereby the product goes through Power-on Self-Test
(as if the TeleMon were just powered on). Some settings revert to default
selections. Lower levels of air discharge, or the contact discharge test, may
cause a momentary ECG information message to occur, but with no change of
state.
Avoiding
Electromagnetic
Interference
If electromagnetic interference (EMI) is encountered, there are a number of
actions that can be taken to mitigate the problem.
Specifications
7-11
7 Specifications
EN 61000-4-3
•
•
•
•
7-12
Specifications
Eliminate the source. Possible sources of EMI can be turned off or moved
away to reduce their strength.
Attenuate the coupling. If the coupling path is through the patient leads,
the interference may be reduced by moving and/or rearranging the leads.
If the coupling is through the power cord, plugging the TeleMon into a
different circuit or moving the power supply away from the monitor may
help.
Add external attenuators. If EMI becomes an unusually difficult problem,
external devices such as an isolation transformer or a transient suppressor
may be of help. A service representative or designee can be of help in
determining the need for external devices.
Cellular telephones and other wireless devices are a possible source of
signal interference with patient monitors and telemetry transmitters. Our
recommendation is to keep an operating cell phone at least 30 cm (1 ft)
away from the TeleMon.
Explanation
of Symbols
The following icons can be found on the TeleMon exterior and/or in this User’s
Guide.
Symbol
Explanation
Warning! Consult accompanying documents
(including this User’s Guide) and particularly any
warning messages before use.
0123
This device complies with the Council Directive 93/
42/EEC of 14 June 1993 concerning medical devices.
This device complies with Canadian Standards
Association and nationally recognized testing lab
requirements.
Prescription Device
IPX1
Degrees of protection provided by enclosures;
protected against vertically falling water drops
Applies to the NBP Module; indicates that the module
is Type BF Defibrillation Proof and is designed to
have special protection against electric shocks for
intra-cardiac application, particularly regarding
allowable leakage currents by having an F-type
isolated or floating applied part.
Electrical Power Input
Specifications
7-13
7 Specifications
Applies to the transmitter, indicates that the instrument
is Type CF Defibrillation Proof and is designed to
have special protection against electric shocks for
intra-cardiac application (particularly regarding
allowable leakage current by having an F-type isolated
or floating applied part), and is defibrillator proof.
Power ON
Power OFF
Battery Insertion Port
Date of Manufacture
Direct Current
Contains Nickel Metal Hydride (NiMH) Battery.
Battery must be recycled.
TRANSLATION: FOR NETHERLANDS ONLY.
OTHER COUNTRIES, OMIT THIS SYMBOL &
EXPLANATION.
The following telemetry icons can be displayed at the information center. They
are also found in this User’s Guide.
Symbol
Explanation
Undocked transmitter
Transmitter docked in TeleMon
7-14
Specifications
The following icons can be found on the Battery Reconditioner and in this
User’s Guide.
Symbol
Explanation
No battery detected in bay
LED State: Off
Charging
LED State: Green Flash
Fully charged
LED State: Green Solid
Reconditioning
LED State: Yellow Flash
Reconditioned and fully charged
LED State: Yellow/Green Flash
Standby: battery in bay waiting to be charged
LED State: Yellow Solid
Specifications
7-15
7 Specifications
Error:
• Check the battery reconditioner bays to ensure
that they are clean of foreign objects.
• Ensure that the correct type of battery has been
inserted.
• Check to see if a battery is defective. The
reconditioner indicates an error if a battery
reaches a temperature higher than 65°C
(149°F).
LED State: Red Flash
The following symbols can be found on the M2601A Transmitter.
Symbol
Explanation
Compliance to Council Directive 93/42/EEC
(MDD)
0123
Compliance to Council Directive 1999/5/EC
(R&TTE) when transmitter is used with the
M2611A Battery Extender device. (This
marking is on the M2601A transmitter only.)
Considered Class 2 radio equipment per
Directive 1999/5/EC for which Member
States may apply restrictions on putting the
device into service or placing it on the
market. This device is intended to be
connected to the publicly available interfaces
(PAI) for use throughout the EEA: AT, BE,
DE, DK, ES, FI, FR, GK, IE, IS, IT, LI, LU,
NL, NO, PT, SE, UK
Compliance to Council Directive 1999/5/EC
(R&TTE) when transmitter is used with the
M2636B TeleMon B Monitor. (This marking
is on the M2601A transmitter only.)
IPX0
7-16
Specifications
The M2600A is rated as IPX0 in degrees of
protection provided by enclosures; not
protected against ingress of water.
Please call your local sales office listed in your telephone directory or a regional
office listed below for the location of your nearest sales office.
CORPORATE HEADQUARTERS:
Philips Medical Systems
Netherlands B.V.
Postbus 10.000
5680 DA Best
Netherlands
UNITED STATES:
3000 Minuteman Road
Andover, MA 01810
(800) 934-7372
CANADA:
2660 Matheson Blvd. E.
Mississauga, Ontario L4W 5M2
(800) 291-6743
EUROPE, MIDDLE EAST AND AFRICA:
Philips Medizinsysteme Böblingen GmbH
Cardiac and Monitoring Systems
Hewlett-Packard Str. 2
71034 Böblingen
Germany
Fax: (+49) 7031 463 1552
A-1
Introduction
1 About TeleMon
B
A
Sales and Support Offices
LATIN AMERICA HEADQUARTERS:
5200 Blue Lagoon Drive
9th Floor
Miami, FL 33126
(305) 267-4220
ASIA PACIFIC HEADQUARTERS:
24F Cityplaza One
1111 King’s Road
Taikoo Shing, Hong Kong
(+852) 3197 7777
A-2
Index
A
accessories 6-10
alarm
sounds 4-3
alarms
indicators 4-3
INOP 4-9
limits 4-16
local 4-15
messages 4-8
mode 4-7
patient 1-5
red 4-8
setting limits 4-16
silencing 4-17
suspending 4-18
turning on/off 4-15
types 4-2
volume 4-15
yellow 4-8
antenna range 2-18
arrhythmia
ST/AR algorithm 3-3
arrhythmia relearn 2-14
auto shutoff 2-7
B
battery 2-2
charge indicator 1-10
general information 2-4
inserting 2-3
insertion 2-6
recharging 2-6, 6-10
reconditioning 6-8, 6-9
battery reconditioner
LED state 6-8
bell icon 1-12
C
calibration
NBP 6-7
cellular telephone interference 7-12
changing
contrast 5-4
date 5-4
time 5-4
cleaning
cautions 6-5
contrast 5-4
D
date 5-4
demo mode 5-3
disinfecting 6-5
display details 1-11
display icons 1-12
docking the transmitter 2-7–2-9
E
ECG 3-2
fallback 3-5
information messages 4-11
measuring 3-2
electromagnetic compatibility 7-11
electro-magnetic interference
avoiding 7-11
element 2-12
Index
i
EMC 7-11
EN 61000-4-3 7-11
F
fallback
EASI transmitter 3-6
ECG 3-6
standard transmitter 3-6
front panel
indicators 2-2
I
icons 1-12
IEC 801-2 7-11
ECG 4-11
NBP 4-11
SpO2 4-13
transmitter 4-14
INOP alarms 4-9
K
keys
defined 1-9
M
Main Screen 1-11
maintenance 6-1–6-13
measurement specifications 7-6
measurements 3-1–3-17
messages
alarm 4-8
safety 1-6, 2-15, 3-3
monitor
connecting power supply 2-3
diagrams 1-7
disinfecting 6-5
front panel 1-8
inserting battery 2-3
intended use 7-2
main display 1-11
overview 2-13
ii
Index
powering 2-2, 2-3
setup 2-13
monitor settings
changing 2-15
monitoring
stand-alone 1-5
telemetry extension mode 1-5
monitoring mode
stand-alone 1-5
telemetry extension 1-5
N
NBP
alarm setting selection 3-16
calibration 6-7
cautions 3-12
measurement limitations 3-10
measuring 3-9–3-16
repeat time 3-16
safety warnings 3-12
setup 3-13
standards 7-3
start or stop 1-10
starting and stopping 3-15
NBP cuff
cleaning 6-6
non-invasive blood pressure
measuring 3-9
start or stop reading 1-10
O
on/off switch 1-8
online information 2-13
ordering supplies 6-10
P
pacer detection 2-13
pacing
safety messages 2-15, 3-3
parameters
changing 2-12
patient type 2-13
pleth wave
displaying 3-9
R
range
antenna 2-18
reconditioning the battery 6-8
recording
at central 3-17
restore standard settings 5-3
stand-alone monitoring 1-5
standards
NBP 7-3
safety 7-2
supplies 6-10
suspend alarms 4-18
symbols
battery reconditioner 7-15, 7-16
defined 7-13
information center 7-14
transmitter 7-16
T
S
safety
standards 7-2
safety message
pacing 2-15, 3-3
ST/AR arrhythmia 3-3
safety messages 1-6
save current settings 2-14, 2-16
self-test 6-2
service mode 5-1–5-5
accessing 5-2
setup 2-13
shutdown 2-5
specifications
electrical 7-4
environmental 7-5
measurement 7-6
NBP 7-6
SpO2 7-6
system 7-2
SpO2 3-8
accessories 6-12
alarm settings 3-8
measuring 3-8
SpO2 sample rate
changing 3-9
ST/AR 3-3
task list 2-12
telemetry extension 1-5
time 5-4
transmitter
docked 2-8
undocked 2-10
viewing information 5-5
trunk cable 3-7
U
undocking the transmitter 2-10
unit settings 2-17
restore 2-18
W
wave
changing 3-7
waveform size
changing 3-7
Index
iii

M2636B TeleMon B Monitor

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CRYOTEMP