IFU - Efficia CM Series Rel A.01 - English

Efficia CM Series
Patient Monitors
INSTRUCTIONS FOR USE
Release A.01
English
Notice
Proprietary Information
This document contains proprietary information, which is protected by
copyright.
Copyright
Copyright © 2015 Koninklijke Philips N.V.
All Rights Reserved
Trademark Acknowledgements
This software is based in part on the work of the FLTK project
(http://www.fltk.org).
Manufacturer
Philips Medical Systems
3000 Minuteman Road
Andover, MA 01810
(978) 687-1501
Document Number
4535 644 78361
ii Efficia CM Series Instructions for Use

Warranty Disclaimer
The information contained in this document is subject to change without notice.
Philips Medical Systems makes 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. Philips Medical Systems 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
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 that are incorporated at reprint do not cause the date to change.) The
document part number changes when extensive technical changes are
incorporated.
First Edition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .January 2015
Efficia CM Series Instructions for Use iii

Conventions
This section describes the conventions used in this guide.
Text Formatting
The following typographical conventions are used in this guide:
Typeface Usage Example
Bold System keys Press the Main Screen key.

Special bold User interface text Open the System Menu.
Italic Variables, document • <product name>-

titles <hardware configuration>-
<software version>.cfg
• Efficia CM Instructions for
Use
Decimal Points
Because the Efficia monitors use a period (.) to indicate a decimal point in
decimal numbers (for example, 10.0), all decimal numbers in this guide use a
period as a decimal point. Commas are not used as decimal points.
iv Efficia CM Series Instructions for Use

Notes, Cautions, and Warnings
This guide uses the following conventions for Notes, Cautions, and Warnings.
Note — A Note calls attention to an important point in the text.
Caution A Caution calls attention to a condition or possible situation that could

damage or destroy the product or the user’s work.
Warning A Warning calls attention to a condition or possible situation that could

cause injury to the user and/or patient.
Efficia CM Series Instructions for Use v

Explanation of Symbols
This section explains the symbols that appear on the monitor and its packaging.
Note — The symbols that appear on your monitor depend on the monitor model
and its configured options.
Packaging Symbols
The following symbols appear on the monitor’s packaging.
Symbol Description Symbol Description
Keep upright Keep dry
Fragile, handle with 40°C

40°C
max
Temperature limitation
care
max
-20°C
-20°C
min
min
Stacking limit by CE mark

3 number
1014 hPA
max Atmospheric pressure 90%
Humidity limitation
limitation
708 hPA 15%

min
vi Efficia CM Series Instructions for Use

User-Control Symbols
The following symbols appear on and near the user-control buttons on the front
of the monitor.
On/Standby key Charging LED
AC power LED Alarm silence key
NBP key Freeze Waveform key
Record key Trend key
Home key
Efficia CM Series Instructions for Use vii

Measurement Connector Symbols
The following symbols appear next to measurement connectors on the side of
the monitor.
Sidestream CO2 input Sidestream CO2 output

connector connector
Mainstream CO2 Caution, consult

CO 2 connector accompanying
documents
Defibrillator Proof IBP connectors

Type CF applied part IBP I
IBP 2
ECG ECG connector

I 2
Temperature
connectors
SpO2 connector Masimo SET® and

rainbow (red and black
symbol)
NBP connector Cardiac Output

C.O. connector
viii Efficia CM Series Instructions for Use

Follow Instructions for

Use
(Blue safety symbol)
Input/Output Connector Port Symbols

The following symbols appear next to the input/output ports on the rear panel of
the monitor.
Nurse call connector USB port
VGA Output Ethernet port
ECG Out port
Efficia CM Series Instructions for Use ix

Rear Panel Label Symbols
The following symbols appear on the rear panel label of the monitor.
Catalog number Date of manufacture
2013-10
Serial number Unique Device

UDI Identification (UDI)
barcode
Monitor key code Option number

OPT
KC
Manufacturer’s name Rx Only Prescription Use Only

and address (US Federal Law)
ICES-001 Canadian ISM Ingress protection

requirement against vertically
falling water drops
RF interference Caution, consult

accompanying
documents
Compliance with CSA mark

WEEE standard
x Efficia CM Series Instructions for Use

CE mark for radio CE mark
100V-240V ~ 50Hz/60Hz 120VA Input power and fuse Equipotential

rating grounding post
2xT 1.6 AL 250V
Authorized EU Part number for label

EC REP Representative PN
Internal Symbols
The following symbols are located inside the monitor.
Protective earth Dangerous Voltage

(ground)
(Yellow safety symbol)
Efficia CM Series Instructions for Use xi

Regulatory and Safety Specifications
Declaration
The Efficia CM10, CM12, CM100, CM120, and CM150 monitors are Class IIb
medical devices and comply with the requirements of the Council Directive 93/
42/EEC of 14 June 1993 concerning medical devices and carry CE-marking
accordingly.
The radio device used in the Efficia CM10, CM12, CM100, CM120, and
CM150 monitors is in compliance with the essential requirements and other
relevant provisions of Directive 1999/5/EC (Radio Equipment and
Telecommunications Terminal Equipment Directive).
Authorized EU Representative
EC REP
Philips Medizin Systeme Böblingen GmbH
Hewlett-Packard Str. 2
71034 Böblingen
Germany
Australia Sponsor
Philips Healthcare
65 Epping Road, North Ryde
NSW, Australia, 2113
xii Efficia CM Series Instructions for Use

Rx Only
Caution United States Federal Law restricts this device to sale by or on the order of
a physician.
Efficia CM Series Instructions for Use xiii

xiv Efficia CM Series Instructions for Use
Contents
1. Overview
Intended Use and Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Essential Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Contraindications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Monitor Configurations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Efficia CM Series Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
Using the Philips InCenter Site. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8
About Adobe Acrobat Versions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-9
Navigation Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10
2. Basic Operation
The Front Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
CM10 and CM12 Front Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
CM100, CM120, and CM150 Front Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
LEDs and Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
The Rear Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
Setting Up the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
Powering Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
Charging the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
Battery Status Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
Changing the System Date and Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
Standby Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
Deep Sleep Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
Mounting the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
Main Screen Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
Tool Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
Viewing and Acknowledging Notifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
Renaming the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-19
Changing the Layout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-20
Changing the Displayed Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-22
Displaying ECG Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-24
Changing the Displayed Numerics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-24
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-25
Freezing Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-25
Patient ID Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-26
Primary Patient ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-28
Contents-1
Efficia CM Series Instructions for Use
Enabling and Disabling the Admit Patient Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-28
Admitting a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-29
Methods for Entering and Editing Patient IDs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-30
Using a Barcode Scanner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-30
Using the On-screen Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-31
Admitting a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-32
Discharging a Patient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-33
Editing a Patient ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-34
Enabling Night Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-35
Locking the Touch Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-36
Networked Monitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-38
Verifying the Network Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-39
Synchronizing the Date and Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-39
Responding to Requests from the SureSigns Dashboard. . . . . . . . . . . . . . . . . . . . . . . . . . . 2-40
Viewing and Changing System Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-43
Changing System Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-43
Viewing System Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-45
Viewing the Monitor Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-46
Using the Monitor Safely . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-47
3. Alarms
Visual Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Alarm LED and Flashing Numeric Panes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Alarm Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Alarm Icons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Viewing All Active Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Viewing Alarm History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Audible Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Speaker Malfunction Notification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
Latched and Non-Latched Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
Changing Alarm Limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Changing Individual Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
Changing Alarm Limits in the Alarm Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Changing System Alarm Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
Enabling Record on Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
Showing or Hiding Current Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13
Adjusting the Alarm Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
Setting Automatic Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
Restoring Default Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16
Silencing Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17
Contents-2
Audio Pause Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-18
Audio Off Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-18
Audio Off Reminder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-19
Acknowledging Technical Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-19
Testing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-19
Nurse Call System Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-20
Alarms Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-21
4. Monitoring SpO2
Selecting an SpO2 Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-1
Connecting SpO2 Cables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-2
The SpO2 Numeric Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-3
Perfusion Indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-3
Changing SpO2 Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4
Changing the SpO2 Response Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Displaying the Perfusion Indicator Value. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-6
Changing the SpO2 Alarm Limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-6
Configuring the SpO2 Waveform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7
Assessing a Suspicious SpO2 Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-8
Desaturation Alarm (Desat) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-8
SpO2 Alarm Delay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-9
SpO2 Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-11
5. Monitoring NBP
NBP Measurement Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-1
NBP Measurement Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2
Selecting an NBP Cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2
Connecting the Cuff and Hose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-3
The NBP Numeric Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-4
Changing NBP Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-4
Changing the NBP Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-5
Changing the Alarm Limits Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-6
Enabling Automatic NBP Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-7
Starting a Manual NBP Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-8
Starting NBP Interval Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-9
Starting NBP STAT Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-10
Configuring the Initial Inflation Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-11
Changing the NBP Units of Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-13
Stopping an NBP Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-13
Contents-3
Recalculating the NBP Value if the Limb is not at Heart Level . . . . . . . . . . . . . . . . . . . . . 5-14
Using NBP Venous Puncture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-14
Stopping Venous Puncture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-15
Changing the Venous Puncture Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-16
Changing the Venous Puncture Duration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-16
NBP Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-17
6. Monitoring Temperature
Connecting Temperature Probes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2
The Temperature Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3
Changing Temperature Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3
Changing the Temperature Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3
Changing the Temperature Units of Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-4
Temperature Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
7. Monitoring Carbon Dioxide - Sidestream

Selecting CO2 Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Connecting the Sampling Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Removing Exhaust Gases from the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5
The CO2 Numeric Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6
Changing CO2 Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6
Changing the etCO2, imCO2 and awRR Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7
Changing the CO2 Measurement Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8
Enabling or Disabling CO2 Standby Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8
Setting the Humidity Correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10
Changing the CO2 Units of Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10
Configuring the CO2 Waveform. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-11
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-12
Changing the Waveform Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-12
Configuring awRR Apnea Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-13
Sidestream CO2 Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-14
8. Monitoring Carbon Dioxide - Mainstream

Preparing to Measure Mainstream CO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
The CO2 Numeric Pane. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-5
Changing CO2 Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-5
Changing the etCO2, imCO2 and awRR Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-6
Changing the CO2 Measurement Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-7
Enabling or Disabling CO2 Standby Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-7
Changing the CO2 Units of Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-8
Contents-4
Changing CO2 Compensation Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-9
Configuring the CO2 Waveform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-10
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-11
Changing the Waveform Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-11
Configuring awRR Apnea Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-12
Mainstream CO2 Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-13
9. ECG, Arrhythmia and ST Monitoring

About ECG Lead Sets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-1
Configuring the ECG Lead Set on the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-3
Connecting the ECG Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-4
Placing the Electrodes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-4
3-Electrode Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-5
5-Electrode Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-5
10-Electrode Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-6
Skin Preparation for Electrode Placement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-7
Shared ECG Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-7
Selecting a Primary and Secondary Lead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-8
Configuring ECG Waveform Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-9
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-10
Changing the Waveform Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-10
Selecting an ECG Filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-11
Enabling Pace Pulse Detection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-12
Changing Heart Rate Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-14
Changing the Heart Rate Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-15
Adjusting the Heart Rate Volume. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-15
Arrhythmia Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-17
Arrhythmia and ST Intended Use and Indications for Use. . . . . . . . . . . . . . . . . . . . . . . . . .9-17
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-18
Aberrantly-Conducted Beat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-19
Intermittent Bundle Branch Block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-19
Choosing an ECG Lead for Arrhythmia Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-20
Configuring Arrhythmia Analysis Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-21
Selecting the Arrhythmia Analysis Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-21
Configuring the AFib/Irregular Heart Rate Reminder . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-22
Changing the Arrhythmia Alarm Limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-23
Arrhythmia Relearning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-23
Viewing Beat Labels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-24
Rhythm Status Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-25
Viewing Arrhythmia Timeout Periods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-27
Contents-5
Arrhythmia Alarm Chaining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-28
About ST Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-30
The ST Numeric Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-31
Changing ST Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-31
Enable or Disable ST Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-32
Changing the ST Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-32
Adjusting ST Measurement Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-33
The ST View Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-34
Updating the ST Baseline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-34
The ST Map window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-35
ECG Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-36
10. Monitoring Pulse Rate

Changing Pulse Rate Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1
Changing the Pulse Rate Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2
Changing the Pulse Rate Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2
Adjusting the Pulse Rate Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
11. Monitoring Impedance Respiration

Optimizing ECG Lead Placement for Impedance Respiration Measurements . . . . . . . . . 11-2
The Respiration Numeric Pane. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3
Changing Impedance Respiration Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3
Changing the Impedance Respiration Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
Disabling Impedance Respiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
Selecting an Apnea Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Configuring the Impedance Respiration Waveform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7
Changing the Waveform Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8
Selecting a Detection Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9
Respiration Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-13
12. Monitoring Invasive Blood Pressure

Setting Up Disposable Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-2
Purging Air from the Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4
Setting Up Reusable Transducers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
Zeroing the Transducer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-8
Selecting a Pressure Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-11
The IBP Numeric Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-12
Changing IBP Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-12
Changing the IBP Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-13
Contents-6
Changing the IBP Alarm Limits to Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-15
Changing the IBP Units of Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-15
Configuring the IBP Waveform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-16
Displaying Overlapped IBP Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-17
Changing the Waveform Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-17
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-20
IBP Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-20
13. Monitoring Cardiac Output

Setting up C.O. Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-2
Injectate Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-4
The Cardiac Output Numeric Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-4
Changing the Cardiac Output Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-5
Changing the Tblood Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-5
Performing C.O. Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-6
Setting the Computation Constant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-6
Injectate Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-6
Measurement Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-10
Changing the Waveform Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-11
Editing and Saving C.O. Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-11
Cardiac Output Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-13
14. Using the Recorder

Creating Printouts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-1
Recording Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-2
Loading the Recorder Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-3
Configuring Recorder Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-4
15. Viewing Trend Data

Trend Data Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-1
The Trend Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-2
Viewing Tabular Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-3
Changing the Displayed Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-4
Changing the Display Interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-4
Selecting the Most Recent Trend Record . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-5
Viewing NBP Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-6
Changing the Displayed Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-7
Viewing Graphical Trend Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-8
Selecting the Displayed Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-9
Changing the Resolution of the Graphical Trend Data. . . . . . . . . . . . . . . . . . . . . . . . . . . .15-10
Contents-7
Selecting a Location in the Graphical Trend Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-10
Viewing Alarm/Event Trend Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-11
Manually Marking an Event . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-13
Changing the Displayed Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-13
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-14
Viewing Full Disclosure Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-14
Changing the Displayed Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-15
Changing the Waveform Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-16
Selecting a Location in the Full Disclosure Trend Data . . . . . . . . . . . . . . . . . . . . . . . . . . 15-16
Recording Trend Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-18
Recording Tabular Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-19
Recording NBP Trend Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-22
Recording Graphical Trend Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-23
Recording Alarms and Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-24
Recording Full Disclosure Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-25
16. Care and Cleaning

General Guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-1
Cleaning and Disinfecting the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-2
Cleaning and Disinfecting the Cables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-4
Cleaning and Disinfecting the CAPNOSTAT 5 Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-5
General Guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-5
Approved Cleaning Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-6
Cleaning Adapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-7
17. Accessories List

SpO2 Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-2
ECG Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-5
Efficia ECG Cables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-5
Philips ECG Cables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-6
Supported ECG Cables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-8
NBP Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-9
IBP Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-16
Sidestream CO2 Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-19
Mainstream CO2 Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-21
Cardiac Output Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-21
Temperature Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-22
Miscellaneous Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-23
Contents-8
18. Specifications
General Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-1
Safety Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-3
Electrical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-3
Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-4
SpO2 Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-7
SpO2 Accuracy Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-9
NBP Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-17
Oscillometric NBP Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-17
Temperature Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-20
CO2 Sidestream Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-21
CO2 Mainstream Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-26
ECG Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-30
Impedance Respiration Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-33
IBP Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-34
Cardiac Output . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-36
Interface Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-37
Radio Regulatory Compliance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-39
Federal Communication Commission Interference Statement . . . . . . . . . . . . . . . . . . . . . .18-39
Industry Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-40
European Union . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-40
A. Profile Settings
Viewing the Current Profile. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Profile Configurations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2
Profile Alarm Limit Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-11
B. Alarm Specifications
Physiological Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1
Technical Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-11
Visual Only Technical Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-20
Alarm Limit Ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-21
Auto Set Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-26
Adult/Pediatric Auto Set Alarm Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-27
Neonatal Auto Set Alarm Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-30
C. Electromagnetic Compatibility
Instructions for Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
Reducing Electromagnetic Interference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-2
Restrictions for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-2
Contents-9
Emissions and Immunity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C-2
Guidance and Manufacturer’s Declaration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C-3
Recommended Separation Distances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C-7
Contents-10
1
Overview
This chapter provides a brief overview of the Efficia CM Series Patient

Monitors.
Warning Before each use, inspect the monitor and accessories for deterioration or
damage. Replace any damaged equipment or report it to your technical
support team.
CM12
CM10
CM150
CM120
CM100
Overview
Efficia CM Series Patient Monitors Instructions for Use 1-1
Intended Use and Indications for Use
Note — This document includes information on functions and features which

may not be available on all Efficia CM Series patient monitors or may be
available only in selected regions. For information specific to your region,
please contact your local Philips representative.
Intended Use and Indications for Use

The Efficia CM10, CM12, CM100, CM120 and CM150 patient monitors are
indicated for use by healthcare professionals whenever there is a need for
monitoring the physiological parameters of patients.The Efficia CM10, CM12,
CM100, CM120 and CM150 patient monitors are intended for monitoring,
analysis, recording, and alarming of multiple physiological parameters in
healthcare environments for the patient types listed below. Additionally, the
monitors may be used in transport situations within a healthcare facility.
Patient Types
Parameter Adult Pediatric Neonatal
ECG   
Respiration - Impedance   
Respiration - RRa 
Respiration - awRR   
NBP   
SpO2   
SpHb  
SpCO  
Temperature   
CO2   
Overview
1-2 Efficia CM Series Patient Monitors Instructions for Use
Essential Performance
Patient Types
Parameter Adult Pediatric Neonatal
IBP   
Cardiac Output  
Arrhythmia - Cardiotach   
Arrhythmia - Basic  
Arrhythmia - Enhanced  
ST Analysis 
Essential Performance
Under normal operating conditions, the Efficia CM10, CM12, CM100, CM120
and CM150 patient monitors can acquire and display information for each
measurement, provide detection and notification of life-threatening
physiological alarm conditions in the form of audible and visual alarm signals,
and indicate when the described functionality is inoperative.
Normal operating conditions include electromagnetic interference, which is

deemed a typical characteristic of the clinical environment.
Contraindications
The Efficia CM10, CM12, CM100, CM120 and CM150 patient monitors are not
for transport outside the healthcare facility.
Overview
Monitor Configurations
The Efficia CM patient monitors include standard and optional features, based
on the model. The following table lists the five models, the standard features in
each model, as well as optional features. In the table, a solid circle indicates a
standard feature, a hollow circle indicates an optional feature, and NA indicates
the feature is not available for that model.
CM100 CM10 CM120 CM12 CM150

863300 863301 863302 863303 863304
Philips NBP
• • • • •
NBP Venous Puncture o o o o NA
Philips SpO2
• • • • •
Masimo SET SpO21
o o o o o
Masimo Rainbow SpO21

o NA o NA o
3/5-Lead ECG sets

• • • • •
10-Lead ECG sets NA NA
o o o
Basic Arrhythmia Analysis

• • • • •
Enhanced Arrhythmia Analysis
o o o o o
ST Analysis
• • • • •
ST Map NA NA
• o •
Impedance Respiration
• • • • •
Overview
CM100 CM10 CM120 CM12 CM150

863300 863301 863302 863303 863304
IBP (2 channels)
o o o o o
Continuous Temperature
(2 channels)
• • • • •
Full disclosure o o o o o
Oridion Microstream etCO2 o o o o o
Respironics Mainstream etCO2 o o o o o
Cardiac Output NA NA o o o
OxyCRG
• • • • •
Touch screen • o • o •
Barcode scanner for patient ID o o o o o
entry
Recorder o o o o o
Video output
• • • • •
ECG output
• o
• • •
Wireless connectivity to EHR o o o o o
HL7 Data Export

• o • o •
Night Mode
• • • • •
Overview
Efficia CM Series Documentation
CM100 CM10 CM120 CM12 CM150

863300 863301 863302 863303 863304
Dashboard connectivity
• • • • •
Efficia Central Station
connectivity2
• • • • •
Dual battery capability
NA NA • • •
1.
Masimo SET and Masimo Rainbow may not be available in all countries.
2.
The Efficia Central Station may not be available in all countries. Efficia CM series monitors only
connect to the Efficia Central Station. For detailed information, see the Efficia Central Station
Instructions for Use.

Efficia CM Series documentation includes:
• Efficia CM Series Patient Monitors Instructions for Use: Provides

information for day to day operation of the Efficia CM Series monitors.
Also includes safety information, monitor specifications, and a list of
compatible accessories.
Note — For information about purchasing additional copies of the

Efficia CM Series Patient Monitors Instructions for Use, contact the
Philips Customer Care Center.
• Efficia CM10 and CM12 Quick Card and Efficia CM100, CM120, and
CM150 Quick Card: Provide brief descriptions of commonly used
functions.
Overview
• Efficia CM Series with Masimo® Instructions for Use: Provides

information for operation of the Masimo SET® and Masimo rainbow®
SET options on the Efficia CM Series monitors. Includes safety
information, alarm messages, specifications, and a list of compatible
accessories.
The Efficia CM Series documentation CD contains PDF versions of the
following documents:
• Efficia CM Series Patient Monitors Installation and Configuration

Guide: Provides instructions for unpacking, installing, and connecting all
hardware. Includes initial testing and configuration procedures. Also
includes instructions for returning the monitor.
• Efficia CM Series Patient Monitors Service Guide: Provides information
about maintenance, troubleshooting, and performance verification testing
of the monitor.
• Efficia CM Series Patient Monitors Data Export Guide: Provides
detailed information about the syntax and structure of the HL7 messages
that are exported from the monitors.
• Efficia CM Series Patient Monitors Network Configuration Guide:
Provides instructions for configuring your monitor to connect to a network
using a wired LAN connection, a wireless LAN connection, or an RS-232
serial adapter.
Overview
Using the Philips InCenter Site

The Philips InCenter site provides frequent updates to all Efficia CM Series
product documentation and product software.
The Philips InCenter site requires an active registration and password. To

register, go to the InCenter site at: https://incenter.medical.philips.com and click
on the Need help? link on the main page (located under the Email address and
password fields). On the following page, under Software Updates (upper left
corner of the page), click the Click here for Efficia CM patient monitor
account registration link. The Efficia InCenter Registration page appears.
Complete all of the information fields on the page to receive a temporary
password for the InCenter site and instructions for logging in.
Registration for the InCenter site requires the serial number of at least one
Efficia CM Series patient monitor in active use at your facility. The serial
number is found on the product identification label. The product identification
label is located on the rear panel of the monitor.
Serial Number
UDI
KC
Overview
About Adobe Acrobat Versions

Adobe Acrobat Reader version 9.0 must be installed on the PC that is used to
access the Philips InCenter site. Previous versions of Acrobat Reader are not
compatible with the Philips InCenter site, and attempting to access InCenter
with a previous version of Acrobat Reader will result in error messages when
opening documents. Uninstall all previous versions of Acrobat Reader, and then
proceed for a free install of Acrobat Reader 9.0 at: www.adobe.com.
Any version of Adobe Acrobat Professional or Acrobat Elements are also not
compatible with the Philips InCenter site, and error messages will appear when
opening documents with these applications. Acrobat Reader 9.0 must be
installed in addition to Acrobat Professional or Acrobat Elements.
Follow this procedure when accessing documents on the Philips InCenter site.
To access documents on the Philips InCenter site:
1. Exit Acrobat Professional or Acrobat Elements (if open).

2. Start Acrobat Reader 9.0.
3. Open Internet Explorer, and go to the Philips InCenter site. Keep Acrobat
Reader 9.0 open the entire time while accessing the InCenter site.
Overview
Navigation Controls
Navigation Controls
Navigation on the Efficia CM Series patient monitors can be done using a touch
screen or a navigation wheel. The touch screen feature is standard on the
CM100, CM120, and CM150 models and is optional on the CM10 and CM12
models. All Efficia CM Series patient monitors include a navigation wheel. The
following table describes how to use the navigation controls on all models.
Note — If the touch screen feature becomes disabled, the navigation wheel can
still be used to operate the monitor.
Screen
Action Description
Type
Select Touch Touch a button, menu, or list item on the touch

screen to select it.
Non-touch Rotate the wheel to highlight an item and then

press the wheel to select it.
Press Touch Press a front panel key or press the wheel.
Non-touch Press a front panel key or press the wheel.
Enter data Touch Touch the item to display the numeric keypad
using the or the keyboard. Touch the values, and then
keyboard touch OK to close the keypad or keyboard.
Non-touch Press the wheel to display a keyboard. Rotate

the wheel to highlight the text or value, and
then press the wheel to select the value. Select
OK to close the keyboard.
Select or Touch Touch a check box to select or clear it.

clear check
boxes Non-touch Rotate the wheel to highlight a check box and
press the wheel to select or clear a check box.
Overview
Navigation Controls
Screen
Action Description
Type
Scroll Touch Touch a scroll bar arrow to scroll through the

list one segment at a time. Touch and hold the
arrow to quickly scroll through the list. (You
can also use the wheel to scroll and select items
in the list.)
A scroll bar to the right of the list indicates the
current location in the list.
Touch an item to select it.
Non-touch Rotate the wheel to highlight a list and then

press the wheel.
To scroll through the list, rotate the wheel.
To select items in the list, press the wheel.
A scroll bar to the right of the list indicates the
current location in the list.
Overview
Navigation Controls
Overview
2
Basic Operation
This chapter describes how to begin using the Efficia CM Series monitors.
For information on setting up and configuring the monitor, see the Efficia CM
Series Installation and Configuration Guide.
The Front Panel

The following illustrations show the keys and LEDs on the CM10 and CM12
monitors and the CM100, CM120, and CM150 monitors. For descriptions of the
keys and LEDs, see the table in “LEDs and Keys” on page 2-2.
CM10 and CM12 Front Panel

1
2 3 4 5 6 7 8 9 10
Basic Operation
Efficia CM Instructions for Use Instructions for Use 2-1
The Front Panel
CM100, CM120, and CM150 Front Panel

1
2 3 4 5 6 10
LEDs and Keys

The following table contains descriptions of the Efficia CM LEDs and hard
keys.
Number Control Icon Description
1 Alarm LED Flashes red, yellow, or blue when an alarm occurs. If

there are multiple alarms, the alarm LED displays the
color of the highest priority alarm.
2 On/Standby key Press once to turn the monitor on. Press again to
enter Standby mode. In Standby mode, the display is
blank and all monitoring ceases, but the monitor does
not actually turn off.
Press and hold for seven seconds to shut down the
monitor.
Basic Operation
2-2 Efficia CM Instructions for Use
The Front Panel
Number Control Icon Description
3 Battery Charging The battery charging LED changes color based on

LED and Power the charging status of the battery.
LED When lit, the power LED, indicates that the monitor
is connected to an AC power source.
4 Alarm Silence key Press once to pause alarms for 60 seconds; press two
times quickly to pause alarms for a specified period
of time; press and hold for 2 seconds to initiate
Audio Off mode. To turn audio alarms back on, press
the Alarm Silence key.
5 NBP key Press to initiate a single NBP measurement or to start

the first measurement of an NBP interval. If an NBP
measurement is underway and you press this key, the
measurement stops.
6 Freeze key Press to freeze all waveforms. Press again to

unfreeze all waveforms.
7 Record key Press to produce a recording of patient data. The

information provided on the recording is based on
the type of data currently displayed on the screen and
the current settings in the Recorder Settings Menu.
8 Trend key Press to open the Trend display window.
9 Home key Press to close a menu and return to the main screen.
Note — Pressing the Home key saves all changes in
a configuration menu unless the menu has an Apply
button. If a menu has an Apply button, you must
select Apply to save the changes.
10 Navigation wheel Use the navigation wheel to select and change

various settings.
Basic Operation
Efficia CM Instructions for Use 2-3
The Rear Panel
The Rear Panel

The following illustration shows the rear panel on an Efficia CM12 monitor.
Your Efficia CM monitor may look different from the monitor in the illustration
below, but the connectors are the same.
3
4
5 6 7
Basic Operation
The Rear Panel
Number Connector Description
1 Nurse call 3.5 mm phone jack for connection to a nurse call system.
connector
2 USB ports Power USB and Standard USB 2.0, 4-pin connector used
for:
• The optional barcode scanner
• Data export through the optional serial interface
adapter
• Software upgrades
• Exporting trend data
• Exporting and importing configuration settings
For more information, contact your technical support team.
3 VGA port Used for connecting an external LCD display to the

monitor.
Warning
An external display is a secondary display and should be
used for reference only. Perform all diagnostic activities
on the monitor display.
4 Ethernet port 10/100 Base-T Ethernet port used for:

• LAN data export
• Connecting the monitor to the Central Monitoring
System
For more information, contact your technical support team.
5 AC input connector Plug the AC power cord into the AC input connector.
100-240V ~ 50/60Hz 120VA
T 1.6 A 250V
Basic Operation
Setting Up the Monitor
Number Connector Description
6 Equipotential For facilities that require a potential equalization

Grounding Post connection.
7 ECG Output port For synchronized cardioversion.
8 Monitor handle

This section describes how to power up the monitor, charge the battery, and
change the system date and time.
Powering Up
The monitor can operate on AC power or battery power.
Warning To avoid risk of electric shock, this equipment must only be connected to a
supply mains with protective earth.
Do not under any circumstances remove the grounding connector from the
power plug.
The power cord and plug must be intact and undamaged.
Philips recommends that a battery is always installed in the monitor. If the
monitor loses AC power, it resorts to battery power. If an AC power failure
occurs, and the monitor does not contain a battery, monitoring is
interrupted, no alarms sound, and patient data may be lost.
Basic Operation
To power up the monitor:
Step
1 Connect the power cord to the receptacle on the monitor’s rear

panel.
2 Ensure that the AC outlet is properly grounded and supplies the

specified voltage and frequency (100 – 240 VAC, 50 – 60 Hz)
and then connect to an AC power source.
Note — Within the U.S., a hospital-grade outlet connected to
back-up power is recommended.
The green power LED on the front panel lights

when the AC power source is connected. Also,
Power LED the battery indicator on the front panel indicates
the current battery status. For more information,
see “Charging the Battery” on page 2-8.
3 Press the On/Standby key.

The monitor powers up and performs a
self-test. During this self-test, the monitor also
On/Standby
key
tests the speaker; listen for an audible tone to
confirm that the speaker is working properly.
To verify the speaker is working at any time,
see “Testing Alarms” on page 3-19.
If the monitor is in Deep Sleep mode when you press the On/
Standby key, the Alarm LED flashes yellow, blue, and red.
You may also be prompted to change the system date and time
the first time you power up the system. For more information,
see “Changing the System Date and Time” on page 2-10.
If your facility requires a separate potential equalization connection, use the

grounding post on the rear of the monitor. Connect a grounding cable from the
post to the grounding system in your facility.
To remove AC power, disconnect the power cord from the outlet or the monitor.
Do not position the monitor in such a way that it becomes difficut to remove the
power cord.
Basic Operation
Charging the Battery

The type of battery and number of batteries installed in your monitor depend on
the model of your monitor and the options purchased for your monitor.
Your monitor’s battery operating time depends on the number and type of
batteries installed.
Any time the monitor is connected to AC power, the battery is

being charged. When you first receive the monitor, the battery
Charging LED charge may be low. You should connect the monitor to an AC
power source before using it on battery power alone.
If the monitor is connected to AC power, and the power cord is then

disconnected, the monitor automatically resorts to battery power, if the battery is
sufficiently charged. All alarm settings, trend data, and patient information are
preserved.
Note — To ensure that the battery is sufficiently charged, keep the monitor
plugged in to AC power when it is not in use.
Battery Status Indicators

The battery status pane and the Battery Info Menu provide information about
the battery charging status..
Battery Status Pane
The battery status pane on the bottom of the main screen

indicates battery status.
Battery Status
Note — If no battery is installed or the battery is dead, the battery status icon is
empty. If the monitor is plugged into AC power and no battery is installed or the
battery is dead, the battery status icon displays a blank AC plug icon.
Basic Operation
The color of the battery status icon tells you how much charge remains on the
battery:
• Green: The battery is at least 30% charged.

• Yellow: More than 20% charge, but less than 30%. This battery status
triggers the Low Batt technical alarm. The monitor will shut down in
approximately 20 minutes, depending on battery usage.
• Red: Less than 20% charged. This battery status triggers the Extreme
Low Batt technical alarm.The monitor will shut down in approximately 5
minutes, depending on battery usage. Connect the monitor to AC power.
Battery Info Menu
The Battery Info Menu displays detailed information about the charging status
for one battery or for both batteries if your monitor has two:
• Battery 1 or Battery 2: Possible values include:
– Fully Charged: The specified battery is fully charged.
– Charging: If the monitor is plugged into AC power, the current

charge level.
– Remaining: If the monitor is not plugged into AC power, the current
charge level.
– Not Present: If the specified battery slot is empty.
• <x.x> hours remaining (estimated): If your monitor is not plugged into

AC power, the approximate amount of time that you can continue to use
the monitor before recharging.
The remaining information in the Battery Info Menu may help your technical
support team to troubleshoot battery problems.
To open the Battery Info Menu:
• Select the battery status pane.

The Battery Info Menu opens and the current information is displayed.
Basic Operation
Warning Dispose of used batteries in an environmentally responsible manner. Do not

dispose of the battery in normal waste containers. Consult your technical
support team to find out about local arrangements.
Changing the System Date and Time

Use the following procedure to change the system date and time. If the Date/
Time Menu is already open, skip to step 2.
Note — If your system administrator disables the Date/Time Menu, you cannot
change the system date and time.
The following conditions apply to the system date and time:
• If the monitor is networked and your system administrator has enabled

time synchronization, the monitor date and time are automatically
synchronized with the server clock.
• If the monitor is connected to the Central Monitoring System, see the
Instructions for Use for your Central system for information on
synchronizing the monitor’s date and time with the Central.
• The date and time cannot be changed while the monitor is printing or an
NBP measurement is in progress.
• The system clock adjusts for daylight saving time if your system
administrator has configured the system to use a time zone that
automatically adjusts the time for daylight saving time.
Basic Operation
Standby Mode
To change the system date and time:
Step
1 Select the Date/Time pane.
The Date/Time Menu appears.
2 Select the date and time values you want to change.
3 Select the Apply button to save your changes and close the
menu.
You can change the date format (mm/dd/yyyy, dd/mm/yyyy, or yyyy/mm/dd )

in the General tab of the System Menu. For details, see “Viewing and
Changing System Settings” on page 2-43.
Standby Mode
If you press and release the On/Standby key while the monitor is On, the
monitor goes into Standby mode and the following occurs:
• The display goes blank.

• Battery charging continues if the monitor is connected to an AC power
source.
• Monitoring stops.
• If your monitor is connected to the Central Monitoring System, patient
data is not sent to the Central Monitoring System. The message No Data
From Bed is displayed at the Central Monitoring System.
To resume monitoring, press the On/Standby key.
Basic Operation
Deep Sleep Mode
Deep Sleep Mode

The monitor enters Deep Sleep mode when:
• You press and hold the On/Standby key for at least seven seconds.
• The monitor is not connected to an AC power source and
– The system is in Standby mode for over 30 minutes
– The system is in Standby mode and the battery level drops below the
battery low alarm limit
– The system is On and the battery level drops below 500 mAh
In Deep Sleep mode, the display is blank and the system uses minimal power to
maintain the system clock. No measurements are taken, and no alarms sound.
To resume normal monitoring, connect the monitor to an AC power source and

press the On/Standby key to turn the monitor back On.
If you start a new patient, all trend data is cleared and the alarm settings are
restored to default values; if you choose not to start a new patient the alarm
settings remain as they were before the monitor went into Deep Sleep mode and
the trend data remains in memory.
Mounting the Monitor

You can mount the monitor using a variety of mounting accessories, including:
• Bedrail hook
• Roll stand
• Wall mount
For information on mounting the monitor on the roll stand or wall mount, see the
Instructions for Use that comes with the mounting hardware.
Basic Operation
Main Screen Display
To use the bedrail hook, place the hook over a secure horizontal bedrail. Do not
place the monitor in a position where the patient or staff could inadvertently
knock it off the bed.
Caution Properly secure the monitor when in use to avoid injury to patient and
staff.
Route patient cabling to reduce the possibility of tripping, entanglement or
strangulation of the patient,caregiver, or service personnel. To reduce this
risk, Philips recommends the use of the cable management kit. For more
information, see “Miscellaneous Accessories” on page 17-23.
Do not place the monitor in a position where the patient or staff could
inadvertently cause it to fall and be damaged. If the monitor is wall
mounted, do not pull down on the monitor.
If your monitor is mounted on a roll stand, use the handle on the roll stand
to move the monitor. Do not use the monitor handle to move the monitor;
doing so, creates stress on the mounting bracket and could cause the
monitor to fall off the roll stand or tip over.
Disconnect the power cord from the power source before moving the
monitor. Do not pull the power cord to disconnect.
Note — The weight of objects placed in the basket of the roll stand must not
exceed 3.6 kg (8 lb).
Main Screen Display
Note — The illustration in this section shows the main screen on a fully
configured monitor. Your screen may look different, depending on your monitor
configuration.
Basic Operation
Main Screen Display
Numeric System
Panes Toolbar
Waveform
Panes
Date/Time
Pane
Message Monitor Patient Notifications Network Battery

Area Name Pane Pane Pane Status Pane Status Icon
Basic Operation
Main Screen Display
The main screen contains the following basic elements:
• Waveform panes display real-time waveforms for the following

measurements, if available on your monitor: ECG, SpO2, Respiration,
IBP, and CO2. A waveform pane may also contain the NBP list, which is
a graphical or tabular presentation of NBP measurements.
• Numeric panes display measurements as numeric values. Some of the
measurements in the numeric panes also have corresponding waveforms.
• The message area displays short text descriptions of all active alarms.
High-priority alarms pre-empt low-priority alarms. Once the highest
priority alarms have been resolved, the next highest priority alarm
messages appear. If multiple alarms of the same priority occur at the same
time, the alarm messages rotate every 1.5 seconds.
• The monitor name pane displays the name currently assigned to the
monitor. For information on changing the monitor name, see “Renaming
the Monitor” on page 2-19.
• The patient pane displays the patient type and patient ID, if entered.
Select the patient pane to:
– Admit a patient
– Edit existing patient information
– Discharge a patient.
• The system toolbar contains buttons used to access commonly used
functions. The toolbar contains two groups of buttons. To view additional
buttons, select the More button at the bottom of the toolbar.
Available buttons are based on your monitor configuration. If your
monitor is not configured for a particular option, for example, your
monitor does not have a recorder, the Record button does not appear.
Basic Operation
Main Screen Display
The following table provides a brief description of each button in the first
group of buttons in the system toolbar.
First Group of Buttons
Button Icon Select to...

Layout Change the layout of the main screen
Trends View trend data, including alarm

history, for the patient.
Alarm Settings Change alarm limit settings for all

parameters in one screen.
Manual Event Mark an event that can later be viewed

in the Alarm/Event tab of the trend
display.
Record Record patient data
Home Close all open windows and return to

the main screen.
The Home button appears in both
button groups.
More Display the second group of toolbar
buttons.
The More button appears in both
button groups.
Basic Operation
Main Screen Display
The following table provides a brief description of each button in the second
group of buttons in the system toolbar.
Second Group of Buttons
Button Icon Select to...

Manage Patient Admit a patient, discharge a patient or
edit patient information.
System Configure system settings and view

information about the monitor.
NBP Start an NBP Venipuncture cuff

Venipuncture inflation.
Night Mode Place the monitor in night mode.
Home Close all open windows and return to

the main screen.
The Home button appears in both
button groups.
More Display the first group of toolbar
buttons.
The More button appears in both
button groups.
• The notifications pane displays non-urgent system notifications.

• If your monitor is connected to the Central, the Central status pane
indicates the status of the connection to the Central. For more information,
see your Central Instructions for Use.
• Then Network status pane indicates the status of the wired or wireless
network connection.
Basic Operation
Main Screen Display
• The Battery status icon indicates the current charging status of the
battery You can also select the icon to open the Battery Info window,
which provides detailed information about one or both batteries installed
in the monitor.
• The Date/Time pane displays the current date and time. You can also
select the Date/Time pane to change the system date and time.
Tool Tips
When using the navigation wheel to select a button in the main screen, a
description of the selected button appears.
Note — Tool tips do not appear if you are using touch to make selections.
Viewing and Acknowledging Notifications

The Notifications window displays the following system notifications:
• Date/Time Adjusted — The monitor’s date or time has changed. For

more information, see “Synchronizing the Date and Time” on page 2-39.
• Configuration Update Requested — The SureSigns Dashboard server
has sent a remote request to update configuration settings on the monitor.
For more information about SureSigns Dashboard requests, see
“Responding to Requests from the SureSigns Dashboard” on page 2-40
• Software Upgrade Requested — The SureSigns Dashboard server has
sent a remote request to upgrade the monitor software. For more
information about SureSigns Dashboard requests, see “Responding to
Requests from the SureSigns Dashboard” on page 2-40
When a new notification arrives, the notification symbol flashes and displays the
number of notifications that have not been acknowledged. If multiple
notifications of the same type are sent, only the most recent notification appears
in the window.
Basic Operation
Main Screen Display
To open the Notifications window and acknowledge notifications:
Step
1 Select the Notifications pane.
The Notifications window opens. Notifications that have not

been acknowledged are red. Notifications that have been
acknowledged are white.
2 Select the Acknowledge All button. The following occurs:

• The notification symbol stops flashing.
• If present, the Date/Time Adjusted notification is cleared
from the list.
• The Configuration Update Requested and Software
Upgrade Requested messages remain in the list until the
request is canceled from the Dashboard server, the user
rejects the request, or the user accepts the request.
3 Close the window.
Renaming the Monitor

The default monitor name is the monitor serial number. You can change the
default name to something more meaningful, for example, a room number or
some other identifying information, especially if the monitor is connected to the
Central. (See the Instructions for Use for your Central system for more
information about the monitor name.)
To rename the monitor:
Step
1 Select the Monitor Name pane at the bottom of the screen.
2 Select the Rename Monitor option.
A keyboard appears.
Basic Operation
Changing the Layout
3 Select the back key to erase the current name.
4 Enter a new monitor name. The monitor name can be up to 10

characters.
5 Select OK.
The new name appears in the Monitor Name pane.
Changing the Layout

The layout defines the number and placement of waveforms and numerics on the
screen. The available layout options are based on your monitor configuration.
After selecting a layout, you can change the waveforms and numerics that are
displayed in the the selected layout. See “Changing the Displayed Waveforms”
on page 2-22 and “Changing the Displayed Numerics” on page 2-24 for more
information.
Caution If the current layout on your monitor does not display all numeric panes
and an alarm occurs, audible alarms still sound and the alarms with the
highest priority display in the message pane.
The available layout options are based on your monitor configuration. Layout
options include:
• 5 Waveform Layout — Displays five waveforms on the left,

corresponding numeric panes on the right, and additional numerics on the
bottom of the screen.
• 8 Waveform Layout — Displays eight waveforms on the left,
• 12 Waveform Layout — Displays twelve waveforms on the left,
Basic Operation
Changing the Layout
• Short Trend Layout — Displays numeric trends on the left, five

waveforms in the middle, and corresponding numeric panes on the right.
Select a trend pane to open the Short Trend Menu and change the
displayed parameters and the time scale for all displayed trends.
• Large Number Layout — Large numeric panes allow you to see vital
signs from a distance. Contains four numeric panes and the corresponding
waveform below each numeric pane. You can change the displayed ECG
waveform, but cannot change any other waveforms in this layout.
• OxyCRG Layout — Provides a comprehensive review of neonatal status.
Contains three high-resolution trend waveforms: beat-to-beat HR, SpO2,
and compressed impedance respiration. Also contains two waveforms at
the top of the screen and numerics on the right side and along the bottom
of the screen. Select the OxyCRG pane to open the OxyCRG Menu and
change the time scale for the OxyCRG trend waveforms.
• 12 ECG Layout — Displays one long ECG waveform along the top of the
screen, two rows of six shorter ECG waveforms below the top waveform,
and numerics along the right side of the screen. This layout is not
available if the selected ECG Lead Set is 3 Lead or 5 Lead in the ECG
Waveform Menu.
• 7 ECG Layout — Displays one long ECG waveform along the top of the
screen, two rows of three shorter ECG waveforms below the top
waveform, two additional non-ECG waveforms along the bottom, and
numerics along the right side of the screen. This layout is not available if
the selected ECG Lead Set is 3 Lead or 5 Lead in the ECG Waveform
Menu.
• Cascading ECG Layout — Displays one continuous ECG waveform
across the top two waveform panes. When the waveform reaches the end
of the top pane, it continues to the second pane. Also contains three
additional waveform panes and numerics along the right side and bottom
of the screen.
• Large ECG Layout — Displays an enlarged ECG waveform pane at the
top of the screen, three additional waveforms below the large ECG
waveform, and numerics along the right side and bottom of the screen.
Basic Operation
Changing the Layout
To change the screen layout:
Step
1 Select the Layout button.
The Layout Menu opens.
2 Select one of the following options:

• 5 Waveform Layout
• Short Trend Layout
• Large Number Layout
• OxyCRG Layout
• 12 ECG Layout
• 7 ECG Layout
• Cascading ECG Layout
• Large ECG Layout
The Layout Menu closes and the new layout takes effect.
Changing the Displayed Waveforms

Use the following procedure to change the waveforms displayed on the main
screen.
The Select Waveform option — which appears in each waveform’s menu —

contains a list of all available waveforms. Available waveforms are based on
your monitor configuration. If your monitor is not configured for a particular
measurement, for example CO2, that measurement is not available in the Select
Waveform list.
When you select a waveform from the Select Waveform list, the selected
waveform’s menu opens and the corresponding numeric pane also changes.
Basic Operation
Changing the Layout
Note — With the exception of IBP and ECG, only one instance of a
measurement’s waveform can be displayed at one time. For IBP, you can
display an IBP1 and IBP2 waveform. For ECG, you can display up to 12
different ECG waves, one for each ECG lead. Also, one ECG waveform always
appears in the top position. For more information, see “Displaying ECG
Waveforms” on page 2-24.
If your monitor is connected to the Central, see the Instructions for Use for your
Central system for information about displaying waveforms.
To change the displayed waveform:
Step
1 Select the waveform you want to change.
The menu for the selected waveform appears.
2 Select the Select Waveform menu item.
3 Select a waveform from the list.
The menu for the selected waveform opens and the

corresponding numeric pane appears to the right of the
waveform.
4 Optionally, change settings in the selected waveform menu.
5 Close the menu.
Basic Operation
Changing the Layout
Displaying ECG Waveforms

The top waveform pane is always reserved for ECG.
You can display multiple ECG waveforms at one time. The choices in the
Select Waveform list are based on the current lead set:
• 3-electrode lead set: ECG I, ECG II, or ECG III

• 5-electrode lead set: ECG I, ECG II, ECG III, ECG aVR, ECG aVL, ECG
aVF, ECG V, or ECG MCL
• 10-electrode lead set: ECG I, ECG II, ECG III, ECG aVR, ECG aVL, ECG
aVF, ECG V1, ECG V2, ECG V2, ECG V3, ECG V4, ECG V5, or ECG V6.
Changes to the sweep speed of one ECG waveform apply to all of the displayed
ECG waveforms.
Changing the Displayed Numerics
Caution If you change the displayed waveform, the corresponding numeric also
changes.
To change the numeric panes displayed on the main screen:
Step
1 Select the numeric pane you want to change.
The menu for the selected numeric pane appears.
2 Select the Select Measurement menu item.
3 Select a measurement from the list.
The numeric pane displays the selected measurement.
Basic Operation
Changing the Waveform Speed

The Sweep Speed setting determines the speed at which the waveform is drawn
across the screen. Decreasing the wave speed compresses the wave, allowing
you to view a longer time period. Increasing the wave speed expands the
waveform, giving you a more detailed view.
To change the waveform speed:
Step
1 Open the desired waveform menu.
2 Select the Sweep Speed menu item.
3 Select a Sweep Speed from the list of options.

Note — The Sweep Speed options are different for each
waveform.
4 Close the menu.
Freezing Waveforms
Select the Freeze key on the front panel to freeze all waveforms on the screen,
review the frozen waveforms and print them. The frozen waveform view shows
the waveform 13 seconds before and 7 seconds after the Freeze key is selected.
If a high-priority alarm occurs or there is no user interaction for 60 seconds, the

monitor automatically exits Freeze mode.
For information about printing frozen waveforms, see “Creating Printouts” on

page 14-1
Basic Operation
Patient ID Overview
To freeze and review waveforms:
Step
1 Select the Freeze key.

All waveforms are frozen and the Freeze toolbar opens.
2 To review the frozen waveforms, select the View

Waves button.
A Back button and Forward button appear. Vertical
white lines on the waveform display indicate the time relative to
the 20-second view of the frozen waveforms.
3 Select the Back or Forward button to view different points in

time.
4 To unfreeze the waveforms select either the Freeze key or the

Home key.
Patient ID Overview
Your system administrator configures your monitor to display any or all of the
following patient ID input fields in the Admit Patient Menu:
• Medical Record Number (MRN): A unique number used to track and

identify a patient. Maximum length is 20 characters.
• Transaction ID: Also known as a visit ID, the transaction ID is a unique
number used to track a single patient visit. Maximum length is 20
characters.
• First Name, Middle Name, Last Name: The patient’s name. Maximum
length is 15 characters for each name field.
• Location ID: Typically, a description of the physical location of the
Efficia CM monitor, for example a room number. Maximum length is 12
characters.
Basic Operation
Patient ID Overview
Note — If the monitor remains in one location, your system

administrator can configure a default Location ID so that you do not have
to manually enter a Location ID each time you start a new patient.
• Operator ID: The ID of the person using the monitor to measure a
patient’s vital signs. Maximum length is 12 characters.
• Gender: The patient’s gender.
• Age: The patient’s age. Enter the number of years for adult and pediatric
patients or the number of days for neonatal patients.
• Date of Birth: The patient’s date of birth.
Note — The Admit Patient Menu will contain either an Age input field
or Date of Birth input field, but not both
• Height: The patient’s height. For information on changing the height unit
of measurement, see “Viewing and Changing System Settings” on
page 2-43.
• Weight: The patient’s weight. For information on changing the weight
unit of measurement, see “Viewing and Changing System Settings” on
page 2-43.
• Department: The department or care unit in which the monitor is being
used.
• Admit Time: The time the patient was admitted to the monitor.
The available patient ID input fields can only be changed by your system
administrator. In this guide, the term Patient ID is used to refer to any of the
patient ID types listed above.
Your system administrator also specifies whether an ID field is required. An

asterisk appears next to all required patient IDs in the Admit Patient Menu. You
cannot save the patient record until all required input fields are complete.
Basic Operation
Patient ID Overview
Caution Before you begin monitoring, make sure that the correct patient type is
selected. The default alarm limits and initial NBP inflation pressure are
based on the selected patient type.
Primary Patient ID
Your system administrator configures a primary ID. The primary ID must be
either the MRN, Transaction ID, or Location ID.
The selected primary ID is enclosed in brackets in the Admit Patient Menu. To

save a record with an ID, you must enter information in the selected primary ID
field. If you do not enter information in the primary ID field, the record will be
saved as ID Unknown.
Enabling and Disabling the Admit Patient Menu

By default, the Admit Patient Menu appears when you:
• Explicitly choose to open it

• Take the monitor out of Standby mode or Deep Sleep mode
To specify that the Admit Patient Menu appear only when you explicitly choose
to open it:
Step
1 Open the System Menu.
2 Select the General tab.
3 Clear the Enable Admit Patient Menu check box.
4 Close the menu.
Basic Operation
Admitting a Patient
Admitting a Patient
Use one of the following methods to open the Admit Patient Menu and enter
information about the patient:
• Select the patient pane at the bottom of the screen, and then select the
Admit Patient option.
• Select the Manage Patient button from the system toolbar, and then select
the Admit Patient option.
Manage Patient If your monitor is connected to the Central, you can also admit a patient at the
button
Central. See the Instructions for Use for your Central system for information on
admitting patients.
The current patient ID and patient type are displayed in the patient pane.
You do not have to enter a patient ID before you begin monitoring. If you
choose not to enter an ID, the text ID Unknown appears in the patient pane.
Note — Only records that have a primary patient ID can be exported to the
EHR over a LAN or WLAN network.
If you are unsure if a patient ID is required, see your system administrator.
Caution Perform a discharge before admitting a new patient. This ensures that data
from a previous patient is not combined with data from the new patient. It
also ensures that alarm limits, the patient type, and the pace detection
setting return to default settings.
Basic Operation
Admitting a Patient
Methods for Entering and Editing Patient IDs

Your system administrator configures the method for entering patient IDs. You
can enter patient IDs by using one of the following methods:
• A standard barcode scanner that reads each patient ID one at a time

• A programmed barcode scanner that transfers the scanned information to
the appropriate patient ID field
• The on-screen keyboard
Using a Barcode Scanner

Before you begin scanning, make sure that you are familiar with the barcodes
used at your facility.
If your barcode scanner reads individual barcodes one at a time, the monitor
prompts you to scan each patient ID. The scanned information is transferred to
the highlighted patient ID field on the monitor. When the monitor prompts you
to scan a patient ID, you need to know which barcode corresponds with the
highlighted patient ID field.
If your barcode scanner is programmed, the scanned information is

automatically transferred to the corresponding patient ID fields on the monitor.
To get a proper read with the scanner:
• Hold the scanner closer to small barcodes and farther away from large
barcodes.
• Ensure that the patient’s wrist band is lying flat and the barcode is visible.
• Ensure that the barcode is not damaged.
• Pause for at least one second between scans.
Notes
• If the barcode scanner cannot read the barcode, you can unplug the
scanner and use the on-screen keyboard to enter patient IDs.
• If the barcode scanner incorrectly scans the patient ID, the patient
data may not export to the EHR.
Basic Operation
Admitting a Patient
Using the On-screen Keyboard

You can use the on-screen keyboard to enter alphanumeric characters and
special characters.
11 2 3 4 5 6 7 8 9 0 - =
q1 w e r t y u i o p [ ]
a1 s d f g h j k l ; ‘ \
z1 x c v b n m , . / x
Shift Space OK Cancel
Use the on-screen keyboard as you would use a conventional keyboard:
• Enter information by selecting one character at a time.

• Use the Shift button to access uppercase letters and other special
characters.
• Use the Space button to insert a space.
• Use the Back button to erase an incorrect character.
• Select OK to confirm what you have entered and close the keyboard.
• Select Cancel to close the keyboard.
Basic Operation
Admitting a Patient
Admitting a Patient
To admit a patient:
Step
1 Do one of the following:

• Select the patient pane at the bottom of the screen
• Select the Manage Patient button from the system toolbar.
2 Select Admit Patient.
The Admit Patient Menu appears.
3 If the patient type is correct, go to step 4.

To change the patient type, select the Patient Type field, and
then select a patient type. The choices are:
• Adult
• Pediatric
• Neonatal
4 If the Pace Detection status is correct, go to step 5.

To change the Pace Detection status, select one of the
following options:
•  = Pace pulse detection is enabled.
• No  = Pace pulse detection is disabled.
5 Enter one or more patient IDs. An asterisk appears next to every

required field.
Note — The OK button only becomes active when all required
patient ID fields are complete.
6 Verify that all patient information is correct.
Basic Operation
Discharging a Patient
7 When you are done entering IDs, select the OK button.
8 If a message asks whether you want to transfer the existing data

to the new patient, do one of the following:
• Select Yes if this patient was being monitored before you
entered the ID.
• Select No if this patient was not being monitored.
Discharging a Patient
Discharging a patient clears all trend data for the current patient, and resets all
profile settings to their default values.
Use one of the following methods to open the Discharge Patient Menu:
• Select the patient pane at the bottom of the screen, and then select the
Discharge Patient option.
the Discharge Patient option.
If your monitor is connected to the Central, you can discharge a patient at the
bedside monitor or at the Central. See the Instructions for Use for your Central
system for information on discharging a patient at the Central.
To discharge a patient from the monitor:
Step
1 Open the Discharge Patient Menu.
2 Select the Discharge button.
A message asks if you are sure you want to discharge the

patient.
Basic Operation
Editing a Patient ID
3 Verify that you want to discharge the current patient and select
OK to discharge the patient.
The Discharge Patient Menu closes and the patient is cleared

from the patient pane.
Editing a Patient ID
The Edit Patient Menu allows you to edit a patient’s information while
monitoring the patient. You can edit all patient IDs, except the Patient Type and
the primary ID, which are unavailable.
Consider the following when editing patient IDs:
• If the patient ID is ID Unknown, you must use the Admit Patient option
to change the ID. After you change the ID from ID Unknown to a specific
ID, a message asks whether you want to transfer the existing data to the
new patient
• Changing the Pace Detection status from off to on, triggers an arrhythmia
relearn.
• If your monitor is connected to the Central, you cannot edit the patient ID
at the bedside monitor. You can only edit patient IDs at the Central
station.
Use one of the following methods to open the Edit Patient Menu:
• Select the patient pane at the bottom of the screen, and then select the Edit
Patient option.
the Edit Patient option.
Basic Operation
Enabling Night Mode
To edit a patient ID:
Step
1 Open the Edit Patient Menu.
2 Edit one or more of the IDs.
3 Select OK.
4 Select the Update button.
A message asks if you are sure you want to change the patient
ID.
5 Select OK.
The patient ID is updated and the Edit Patient Menu closes.
Enabling Night Mode

Placing the monitor in night mode reduces the screen brightness level, the alarm
volume, and the HR/Pulse tone volume. After placing the monitor in night
mode, you can still change the brightness and volume settings, if necessary.
Your system administrator configures the default night mode settings for alarm
volume, HR/Pulse volume and brightness level.
Note — If your system administrator disables the night mode setting behind the
password, the Night Mode button is unavailable.
Basic Operation
Locking the Touch Screen
To enable night mode:
Step
1 Select the Night Mode button from the toolbar.
A message displays the night mode settings for alarm

volume, HR/Pulse volume and brightness level.
2 Select OK to confirm that you want to place the monitor in night

mode.
The specified volume and brightness settings are activated. The

message **Night Mode** appears at the bottom of the screen.
3 To exit night mode, select the Night Mode button.
The volume and brightness settings return to default values.

You can select the Lock Touch Screen button in the General tab of the System
Menu to temporarily disable the touch screen. Locking the touch screen is useful
when you clean the monitor screen. You can also lock the touch screen to
prevent inadvertent changes to monitor settings.
Warning The screen remains locked until you unlock it. To ensure access to all
necessary functions in an emergency, be sure to unlock the screen when you
no longer need a locked screen.
Basic Operation
Notes
• Locking the touch screen does not disable the keys on the monitor
front panel.
• The touch screen automatically unlocks when the monitor goes into
Standby mode.
To lock or unlock the touch screen:
Step
1 Select the System button in the toolbar.
3 Select the Lock Touch Screen button.
The System Menu closes and the main screen appears. The
message Touch Screen Locked appears at the bottom of the
screen.
4 To unlock the touch screen, use the navigation wheel to open the
System Menu and select the Unlock Touch Screen button.
Basic Operation
Networked Monitors
Networked Monitors
If your monitor is configured to export data to an EHR system, Tabular Trend
records change color to indicate the status of the record.
Color Description
White The record has not been exported.
Green The record has been successfully exported.
Blue The record was not successfully exported. A message

indicating the reason the record was rejected may
appear on the monitor screen.
Central system for information about networked monitors.
Caution If you are using the optional serial interface adapter to export data and you
disconnect the adapter to move the monitor to a different location, make
sure the black sheath completely covers the RS-232 connector after you
reconnect the cable.
Basic Operation
Synchronizing the Date and Time
Verifying the Network Connection

The network status pane indicates the status of the LAN or WLAN network
connection. If the monitor detects a LAN IP address and a WLAN IP address,
the monitor first selects LAN for network communication.
Icon Connection Status
The monitor is currently connected to a wired network.
The monitor is currently connected to a wireless network The

number of bars displayed indicates the signal strength. Four
bars indicates the strongest signal and no bars indicates a
very weak signal.
No icon If the pane is empty, the monitor is not connected to a wired

or wireless network.

If your monitor is configured to export patient data to a hospital EHR server or
HL7 interface server, your system administrator can configure the monitor to
automatically synchronize the clock on the monitor to the clock on the server.
When a time change occurs, a blue line appears in the graphical and tabular
trend displays to indicate when the date/time adjustment occurred. The monitor
will immediately adjust the date and time, unless:
• An NBP or temperature measurement is in progress; the time change will

occur when the measurement is complete.
• A recording is in progress; the time change will occur after recording is
complete.
Basic Operation
If the time difference is greater than 30 seconds, the following also occurs:
• A Date / Time Adjusted message is sent to the Notifications menu.

• In NBP Interval mode, the monitor adds an NBP measurement.
Responding to Requests from the SureSigns Dashboard

The SureSigns Dashboard is an optional service tool for biomedical engineers to
quickly view the status of your monitor, upgrade the monitor software, and
update configuration settings from a remote server. If the monitor is connected
to a SureSigns Dashboard server, the monitor can receive requests to update
configuration settings or upgrade the monitor software over the network.
If the monitor is in Standby mode and you press the On/Standby key, the
monitor turns on and checks for active requests from the SureSigns Dashboard
server. Depending on the type of request, the following messages may appear:
• Configuration Update Requested — The SureSigns Dashboard server

has sent a request to update configuration settings on the monitor.
• Software Upgrade Requested — The SureSigns Dashboard server has
sendt a request to upgrade the monitor software.
Considerations
Before responding to a request from the SureSigns Dashboard server, note the
following:
• If you do not accept the request, the request remains active.

• Depending on the SureSigns Dashboard settings configured by your
system administrator, you may be prompted to confirm the upgrade
request and enter a password. Follow the protocol established in your
facility to enter the required password.
• If you encounter issues during or after an upgrade or configuration update,
contact your technical support team promptly.
Basic Operation
Warning Before you accept a request from the SureSigns Dashboard server:
• Make sure that the monitor is not actively monitoring a patient.
• Make sure that the monitor is connected to AC power and has a fully
charged battery.
After accepting a request from the SureSigns Dashboard server, make sure
the installation or configuration update is complete before you begin
monitoring a patient.
To respond to a SureSigns Dashboard request:
Step

• If the monitor is on and a request message appears in the
message area, press the On/Standby key. Go to step 2.
• If the monitor is in Standby mode, do the following:
– Press the On/Standby key to turn on the monitor.
– When the monitor restarts, a request message
appears in the message area.
– Press the On/Standby key again.
Basic Operation

• If you are not prompted to confirm the request, the upgrade
process starts automatically. Go to step 3.
• If you are prompted, enter the Password, and then select
OK. Select Yes to start the update process.
Note — If you select No, the monitor shuts down and the
request remains active. Press the On/Standby key to restart the
monitor. The request message reappears.
3 After the update starts, status messages appear on the monitor

screen.
Notes —
• During the update process, do not unplug the monitor and
do not press any keys.
• If the process is inadvertently interrupted, contact your
technical support team.
When the update process is complete, the monitor automatically
shuts down and restarts.
4 Before you begin monitoring, do the following:

• Be sure that you are familiar with the changes to the
monitor software.
• Verify that all monitor settings are as expected.
Basic Operation
Viewing and Changing System Settings

The General tab in the System Menu contains several system configuration
settings and a read-only section that provides information about the monitor.
Caution When opening the System Menu, note that the menu covers all waveforms
and numeric panes. All audible and visual alarms remain active. The menu
closes if there is no user interaction for 25 seconds.
Note — The System Menu contains several tabs, including the General tab.
Only the General tab is user-accessible. All other tabs are password-protected.
Changing System Settings

To change system settings:
Step
Basic Operation
3 In the General tab, change any of the following settings:

• Monitor Name— Use this setting to change the monitor
name. You can also change the monitor name in the
monitor name pane. For more information, see “Renaming
the Monitor” on page 2-19.
• Date Format — You can change the monitor’s date format.
Options are mm/dd/yyyy, dd/mm/yyyy, and yyyy/mm/dd.
• Brightness Level — Use this setting to adjust the
brightness of the display. 1 is the darkest setting and 8 is the
brightest.
• Recorder Settings button — Opens the Recorder Settings
Menu, which contains several options for configuring
recordings, including the number and type of waveform on
the recording. For more information about recorder settings,
see Chapter 14, “Using the Recorder.”
• Configuration button — Opens a window that displays the
hardware and software options installed on the monitor. See
“Viewing the Monitor Configuration” on page 2-46.
• Shut Down button — Select to shut down the monitor.
• Default Patient Type — Select a patient type. Each time
you start a new patient, the default patient type is selected
and the alarm settings are restored to the default values for
the specified patient type.
• Height Units — Select the Height units of measurement.
Options are cm and inch.
• Weight Units — Select the Weight units of measurement.
Options are kg and lb
• Enable Admit Patient Menu — Used to enable or disable
the Admit Patient Menu. For information, see “Enabling
and Disabling the Admit Patient Menu” on page 2-28.
• Lock Touch Screen button — Select to lock the touch
screen. For more information, see “Locking the Touch
Screen” on page 2-36.
Basic Operation
Viewing System Settings

To view current system settings:
The read-only information in the General tab includes:
• Serial Number — The monitor’s serial number, which also appears on the
back of the monitor. The serial number is configured in the factory.
• Hardware ID — The version number of the monitor’s main board, front
end board and FPGA.
• Software Version — The software version installed on the monitor.
• LAN MAC Address — The unique LAN MAC address assigned to the
monitor. The MAC address is configured in the factory.
• LAN IP Address — The LAN IP address currently assigned to the
monitor (if the monitor is connected to a LAN network).
• WLAN MAC Address — The unique WLAN MAC address assigned to
the monitor (if the monitor is configured for wireless). The MAC address
is configured in the factory.
• WLAN IP Address — The WLAN IP address currently assigned to the
monitor (if the monitor is connected to a wireless LAN network).
• Language — The language currently configured on the monitor.
• Central Name — The name of the Central, if the monitor is connected to

a Central network.
• Current Profile — The name of the current profile. For more information
about profile settings, see Appendix A, “Profile Settings.”
Basic Operation
Viewing the Monitor Configuration

To view information about your monitor, including the monitor type, and the
measurements and optional features installed on your monitor:
3 Select the Configuration button.

The window that appears displays the monitor type, the monitor
key code and the options installed on your monitor. See the
following list for information on the configuration options.
12ECG = 12-lead ECG FIPS = FIPS security

12Wave = 12 waveform layout HL-7 = HL7 data export
2Batt = Dual Batteries NBP-P = Philips NBP
2IBP = 2 channels of IBP Rec = Recorder
2Spks = Dual Speakers RRa = Masimo rainbow RRa
3/5ECG = 3- and 5-lead ECG SpCO = Masimo rainbow SpCO
Barcode = Barcode scanner input SpHb/SpOC = Masimo rainbow
SpHB/SpOC
CO = Cardiac Output SpO2-M = Masimo SpO2 SET
CO2-C = Respironics (Capnostat) SpO2-P = Philips SpO2
Mainstream CO2
CO2-S = Oridion Sidestream CO2 STMap = ST Map

ECGOut = ECG Output Temp-C = Continuous temperature
EnARR = Enhanced arrhythmia Wless = Wireless
analysis
FDisc = Full Disclosure
Basic Operation
Using the Monitor Safely

The ECG, C.O., SpO2, Temperature and IBP patient applied parts on
the Efficia CM patient monitors are classified as type CF, which
specifies their degree of protection against electrical shock. All are
rated as defibrillator proof.
This monitor is suitable for use in the presence of electrosurgery.
Ensure that the monitor is in working condition before clinical use. If the
accuracy of any measurement does not seem reasonable, first check the patient’s
vital signs by alternative means and then with the monitor to make sure it is
working properly.
If you connect the monitor to any instrument, verify proper operation before
clinical use. Refer to the instrument’s Instructions for Use for full instructions.
Accessory equipment connected to the monitor’s data interface must be certified

according to EN/IEC 60950 for data-processing equipment or EN/IEC 60601-1
for electromedical equipment. All combinations of equipment must be in
compliance with EN/IEC 60601-1 system requirements.
Anyone who connects additional equipment to the signal input port or signal
output port configures a medical system and is therefore responsible to ensure
that the system complies with the requirements of IEC 60601-1:2005 system
requirements. If in doubt, contact the Philips Customer Care Solutions Center or
your local Philips representative.
The monitor and its accessories must be tested by qualified service personnel at
regular intervals to ensure that performance has not been degraded by aging or
environmental conditions. Periodic performance verification tests can be
performed, as described in the Efficia CM Service Guide.
Basic Operation
Warning The wireless radio complies with FCC radiation exposure limits set forth for
an uncontrolled environment. This equipment should be installed and
operated with a minimum distance of 20 cm between the monitor and any
person.
To prevent or minimize burns caused by a defective neutral electrode
connection, use caution when handling electrodes, transducers, and cables in
the presence of high-frequency surgical equipment. Verify that the
equipment is working correctly before each use.
Do not expose the monitor to extreme moisture, such as rain.
Do not place the monitor next to heating or cooling sources.
Explosion Hazard. Equipment not suitable for use in the presence of a
flammable anaesthetic mixture with air or oxygen or nitrous oxide. Oxygen
concentrations must be <25% and partial pressure <27.5 kPa when no other
oxidants are present.
Electric shock hazard. Covers should be removed only by qualified service
personnel. There are no user-serviceable parts inside.
Do not touch the patient, or table, or instruments during defibrillation.
Do not simultaneously touch the patient and any connector pins or contacts.
This could result in excessive leakage current flowing to the patient.
Measurement accuracy may decrease temporarily while performing electro-
surgery or defibrillation. The recovery time is less than 10 seconds. This
does not affect patient or equipment safety.
Do not open the monitor or attempt to change the battery. Incorrect battery
replacement may cause overheating, fire or explosion. If you suspect a
problem with parts within the monitor, contact your technical support team
or Philips representative.
Do not lift the monitor by the power supply cord or patient connections.
Do not use the monitor on more than one patient at a time.
To ensure patient electrical isolation, connect only to other equipment that
provides patient electrical isolation.
If there is any doubt about the integrity of the protective earth conductor
arrangement, operate the device on internal battery power until the AC
power supply protective conductor is fully functional.
Philips recommends the use of a cable wrap to prevent an inadvertent,
partial disconnection of cables.
Basic Operation
Do not use extension cords or adapters of any type to connect the monitor to
electrical outlets.
Do not connect the monitor to an electrical outlet controlled by a wall switch
or dimmer.
LAN cables must meet all local electrical requirements.
Do not use the monitor or SpO2 sensors during magnetic resonance imaging
(MRI) scanning. Induced current could potentially cause burns. The
monitor may affect the MRI image, and the MRI unit may affect the
accuracy of the monitor’s measurements.
If multiple instruments are interconnected or if multiple instruments are
connected to a patient, the sum of the leakage currents may exceed the limits
given in EN/IEC 60601-1 system requirements. Consult your service
personnel to perform required testing before interconnecting instruments.
Do not connect this monitor to any equipment or device, other than those
specified in this guide.
Do not connect the monitor to a multiple socket outlet.
Do not modify this equipment without authorization from Philips. If this
equipment is modified, appropriate inspection and testing must be
conducted to ensure continued safe use of equipment.
Sterilization is not recommended for this monitor, accessories or supplies,
unless otherwise indicated in the Instructions for Use that accompany the
accessories and supplies.
The ingress of particulate matters (solids) causes electrical circuit failure or
failure of applied parts. Periodically inspect for and clean dust from monitor
vents and applied parts.
Use only approved accessories with the Efficia CM monitor. The use of
unapproved accessories can diminish monitor performance or safety. For a
complete list of compatible accessories, see Chapter 17, “Accessories List.”
Also, consult the Instructions for Use that accompany the accessories.
Never reuse disposable transducers, sensors, or accessories that are intended
for single use, or single patient use only. Reuse may compromise device
functionality and system performance and cause a potential hazard.
Basic Operation
Electromagnetic interference may cause disruption of performance. Protect

the monitor from sources of intense electromagnetic radiation. This device is
designed to provide resistance to electromagnetic interference; however,
because of the proliferation of radio-frequency transmitting equipment and
other sources of electrical noise (such as cellular phones, mobile two-way
radios, and electrical appliances) in the healthcare and home environments,
it is possible that high levels of such interference due to close proximity or
strength of a source may result in disruption of performance of this device.
Disruption may be evidenced by erratic readings, cessation of operation or
other incorrect functioning. If this occurs, the site of use should be surveyed
to determine the source of this disruption, and actions taken to eliminate the
source. If you need assistance, contact the Philips Customer Care Solutions
Center or your Philips representative.
Do not dispose of this product (or any part of it) in industrial or domestic
waste. The system may contain hazardous substances that can cause serious
environmental pollution. The system also contains privacy sensitive
information. Philips recommends that you contact your Philips Service
Organization before disposing of this product.
To avoid contaminating or infecting personnel, the environment, or other
equipment, disinfect and decontaminate the monitor before disposing of it in
accordance with your country’s laws. For more information, see the
resources listed below.
Philips Healthcare gives support for:
• Recovery of reusable parts
• The recycling of useful materials by competent disposal companies
• Safe and effective disposal of equipment
For advice and information, contact your Philips Service Organization and
see http://www.healthcare.philips.com/main/about/sustainability/recycling/
index.wpd for more information.
Before disposing of an Efficia CM patient monitor, delete all patient
information. For instructions on deleting patient data, see the Efficia CM
Service Guide.
For disposal of parts and accessories such as thermometers, probe covers,
SpO2 sensors, or CO2 sampling lines, where not otherwise specified, follow
local regulations regarding disposal of hospital waste.
Basic Operation
To protect confidential patient information, do not leave the monitor

unattended.
Passwords restrict access to the system administration and service functions.
Only qualified service personnel can access these functions. The password
does not protect electronic health information (ePHI).
Basic Operation
Basic Operation
3
Alarms
Alarms alert you to conditions that need immediate attention. Alarms are
divided into three severity levels:
• High — Indicates a potentially life-threatening situation. A high-priority

alarm requires an immediate response from the clinician.
• Medium — Indicates a physiological condition that requires prompt
attention. Medium-priority alarms are most often triggered by an alarm
limit violation.
• Low — Most low-priority alarms indicate a problem with the monitor that
needs to be corrected; for example, an alarm indicating that the recorder is
out of paper.
When an alarm event occurs, the monitor issues both a visual and audible alarm.
Visual Alarms
The Efficia CM Series monitors use the following visual alarm indicators: an
alarm LED, flashing numeric panes, alarm messages, and alarm icons. You can
also view a list of all active alarms in the View All Alarms Menu.
Alarms
Visual Alarms
Alarm LED and Flashing Numeric Panes

When an alarm occurs, the alarm LED located on the top of the monitor and the
numeric pane for the alarming measurement change color and flash, based on
the alarm priority. The alarm LED displays the highest alarm priority.
Alarm Priority Color
High Red, flashing
Medium Yellow, flashing
Low Blue, no flashing
A question mark (-?-) in the numeric pane indicates an invalid measurement.
Alarm Messages
Alarm messages appear in the message pane in the bottom left side of the screen.
Alarm messages use the same colors as the alarm LED and flashing numeric
panes described above. For a complete list of alarm messages and descriptions
of each message, see Appendix B, “Alarm Specifications.”
High-priority alarm messages pre-empt lower priority alarm messages. After the
high-priority alarm has been resolved, the lower priority alarm message appears.
If multiple alarms of the same priority occur at the same time, the alarm
messages rotate every 1.5 seconds.
Alarms
Visual Alarms
Alarm Icons
Alarm icons represent the current alarm status. The following table describes
these icons.
Alarm
Description
Icon
The alarm icon with the dashed lines indicates that an alarm
has been temporarily silenced, or paused.
This icon appears when you press the Alarm Silence key once
to pause all active alarms. It also appears in all numeric panes
when you activate the Audio Pause mode to indicate that all
alarms have been temporarily silenced for the specified pause
period.
The alarm icon with the solid lines indicates that the alarm(s)
have been explicitly turned off by the user and will not sound
again until the user explicitly turns them on again.
This icon appears when you disable one or more alarms in the
parameter menus or the Alarm Menu. It also appears in all
numeric panes when you activate the Audio Off mode.
For more information, see “Silencing Alarms” on page 3-17.
Note — If your monitor is connected to a Central station, see the Instructions

for Use for your Central.
Viewing All Active Alarms

The View All Alarms Menu lists all active physiological and technical alarms.
Each entry in the list includes the date and time that the alarm occurred, the
alarm message, and the alarm priority. The most recent alarm appears at the top
of the list.
For any alarms that have not been acknowledged, the associated priority
message will flash until you press the Alarm Silence key.
Alarms
Audible Alarms
To open the View All Alarms Menu:
• Select the message area on the bottom, left side of the screen.
The View All Alarms Menu appears.
Viewing Alarm History

The Alarm/Event tab in the Trend display can store up to 200 alarms and
manual events for the current patient.
For more information about viewing alarm history, see “Viewing Alarm/Event
Trend Data” on page 15-11.
Audible Alarms
The alarm sound and interval depend on the alarm priority. High-priority alarms
beep at a faster rate than the medium-priority and low-priority alarms and also
sound different.
You can change the following audible alarm settings:
• Alarm volume — You can increase or decrease the alarm volume. See
“Adjusting the Alarm Volume” on page 3-14.
• Alarm tones — The Efficia CM Series monitors offer two sets of alarm
tones. Only authorized personnel can change the alarm tone in the
password-protected Alarm Setting Menu.
• Silence alarms — You can pause alarms or silence them indefinitely. See
“Silencing Alarms” on page 3-17
Warning Never disable audible alarms, pause audible alarms, place the monitor in
Audio Off mode, or decrease the alarm volume if this could compromise
patient safety.
Do not rely exclusively on the audible alarm system for patient monitoring.
The most reliable method of patient monitoring requires correct operation
of the monitor and close observation of the patient.
Alarms
Latched and Non-Latched Alarms
Note — When any alarm sounds, all other audible signals, such as the HR/
pulse tone or the NBP complete tone, are muted.
Speaker Malfunction Notification

Your monitor may have one or two speakers, depending on your monitor
configuration. If your monitor has two speakers and one speaker fails, the
monitor continues to use the other speaker. The Speaker (L) Malfunc or
Speaker (R) Malfunc message appears.
If your monitor has one speaker and it fails or if your monitor has two speakers
and both speakers fail, a flashing red/white box with the AUDIO FAILED
message appears at the top of the screen and the Speaker Malfunc message
appears in the message pane.
Warning If the AUDIO FAILED message appears, do not use the monitor and
immediately contact your technical support team for repair.
For information on manually testing the speaker, see “Testing Alarms” on

page 3-19.
Latched and Non-Latched Alarms

When a non-latched alarm occurs, the alarm stops when the condition that
triggered the alarm ends. For example, if a cable becomes disconnected, the
alarm ends when the cable is reconnected. The majority of alarms are non-
latched.
On the other hand, a latched alarm continues even after the condition that
caused the alarm has resolved itself or been acknowledged. A V-Tach alarm is
an example of a latched alarm. If a V-Tach alarm occurs and the heart rhythm
then returns to normal, the alarm will continue to sound to notify the clinician of
the V-Tach event.
Alarms
Changing Alarm Limits
The tables in Appendix B, “Alarm Specifications.” indicate which alarms are

always latched by default.
If the Latch Physiological Alarms option is enabled in the current profile, all
physiological alarms are latched and will continue to sound until you
acknowledge the alarm by pressing the Alarm Silence key.
Warning The default alarm limits on your monitor may be configured for the patient
population in your care area, however, you should always check that the
alarm settings are appropriate for your patient before you start monitoring.
When changing alarm limits:
• Do not use extreme alarm limit values, which will render the alarm
system useless.
• Consider that you many not be present when the patient’s condition
changes and the limits you select will provide the notification of the
change.
Notes
• Default alarm limit values are saved in the profile currently loaded
on your system. See “Profile Alarm Limit Settings” on page A-11
for a list of default alarm limits.
• If your monitor is using a custom profile, see your system
administrator for a list of the default alarm settings used in the
custom profile.
• During the time that you are changing alarm limits, the alarm
system will continue to operate normally.
Alarms
You can change the alarm limits for the current monitoring session by:
• Changing alarm limits for an individual parameter, using the parameter’s

numeric pane menu. See “Changing Individual Alarm Limits” on
page 3-7.
• Opening the Alarm Menu to change some or all of the alarm limits in one
place. See “Changing Alarm Limits in the Alarm Menu” on page 3-9.
The new alarm limits remain in effect for the current monitoring session. The
alarm limits are reset to the values stored in the current profile when you:
• Admit a new patient

• Discharge an existing patient
• Select the Restore Default Alarm Settings button in the Alarm Menu.
Central system for more information about changing alarm limits.
Changing Individual Alarm Limits

To change the alarm limits or disable the alarm for one parameter:
Step
1 Select the desired numeric pane.

The selected parameter menu opens and the current alarm limit
values are displayed.
2 Select the high or low alarm limit.
Up and down arrows appear next to the alarm limit values.
3 Select the up or down arrow to increase or decrease the value.

Note — If using a touch screen, press and hold the arrow to
quickly change the value.
Alarms
4 To disable the audible alarm for the selected parameter, select

the alarm icon next to the alarm limits.
An X appears across the alarm icon. After an
alarm has been disabled, an alarm icon
Alarm Disabled
appears in the numeric pane where the alarm
Icon was disabled.
Notes —
• If the Allow Alarm Disable setting is disabled in the current
profile, you cannot disable audible alarms (the option is
unavailable).
• The Allow Alarm Disable profile setting applies to audible
alarms only. If you disable alarms and a measurement
exceeds the selected high or low alarm limits, the monitor
displays a visual alarm, but no audible alarm sounds. All
other alarms will still produce an audible and visual alarm.
5 Close the menu.

The new alarm limit settings take effect.
Alarms
Changing Alarm Limits in the Alarm Menu

The Alarm Menu contains a General tab and a tab for each parameter on your
monitor. The number of parameter tabs is based on your monitor configuration.
To change alarm limits or disable alarms for one or more parameters:
Step
1 Select the Alarm Settings button in the

system toolbar.
Alarm Settings The Alarm Menu appears. Current alarm
button settings are displayed.
2 Select the desired parameter tab. If the parameter tab is not

visible, select the right arrow button to display additional tabs.
3 Select the high or low alarm limit.

Note — If using a touch screen, press and hold the arrow to
quickly change the value.
Alarms
5 To disable the audible alarm for the selected parameter, select

the alarm icon next to the alarm limits.
An X appears across the alarm icon. After an
alarm has been disabled, an alarm icon
Alarm Disabled
appears in the numeric pane where the alarm
Icon was disabled.
Notes —
• If the Allow Alarm Disable setting is disabled in the current
profile, you cannot disable audible alarms (the option is
unavailable).
• The Allow Alarm Disable profile setting applies to audible
alarms only. If you disable alarms and a measurement
exceeds the selected high or low alarm limits, the monitor
displays a visual alarm, but no audible alarm sounds. All
other alarms will still produce an audible and visual alarm.
6 Close the menu.
The new alarm limit settings take effect.
Alarms
Changing System Alarm Options

Use the General tab in the Alarm Menu to:
• Enable the record on alarm feature

• Show or hide alarm limits
• Adjust the alarm volume
• Set custom alarm limits
• Restore default alarm settings
To open the General tab:
Step
1 Select the Alarm Settings button in the

system toolbar.
Alarm Settings The Alarm Menu appears.
button
Enabling Record on Alarm

You can configure the Efficia CM monitors to automatically generate a
recording when a physiological alarm occurs. After a measurement is taken, and
the monitor determines that the value is outside the alarm limits, the recorder
produces a recording.
An alarm icon and alarm message appear along the bottom of the recording to
indicate the approximate time that the alarm occurred. The measurement that
triggered the alarm is enclosed in a box.
Alarms
To enable the record on alarm feature:
Step
1 Open the Alarm Menu.
3 Select the Record on Alarm check box to select the desired

setting:
 = Record on Alarm is enabled.
No  = Record on Alarm is disabled.
4 Close the menu.
Alarms
Showing or Hiding Current Alarm Limits

By default, the current high and low alarm limits are displayed in each numeric
pane in all layouts, except 8 Waveform Layout and 12 Waveform Layout.
To change the alarm limit display:
Step
3 Select the Display Alarm Limits check box to select the desired
setting:
 = Alarm limits display in the numeric panes
No  = Alarm limits do not display in the numeric panes
4 Close the menu.
5 Optionally, if the current layout is 8

Waveform Layout or 12 Waveform Layout,
select the Layout button and choose a
different layout to display the alarm limits.
Layout button
Note — If you need to continuously monitor with the 8

Waveform Layout or the 12 Waveform Layout, you can quickly
view alarm limits by touching the numeric pane for the
measurement.
Alarms
Adjusting the Alarm Volume
Warning Set the alarm volume based on the environment and ambient noise levels.
Alarm volume should be tested and verified during installation. The alarm
volume should be loud enough to be heard in the intended environment.
Note — The current profile includes a minimum alarm volume, which prevents
you from setting the volume below the specified profile setting.
To increase or decrease the alarm volume:
Step
3 Select the Alarm Tone Volume menu item
5 Close the menu.
Setting Automatic Alarm Limits

You can quickly set alarm limits that are based on an individual patient’s vital
signs measurements. After you take an initial set of measurements, the monitor
calculates an offset and applies it to each value to generate new upper and lower
alarm limits.
The auto set alarm limits remain in effect for the current patient. If you start a
new patient, the alarm limits return to the monitor’s default values.
Note — If the calculated offset value exceeds the alarm limit range, the system
does not change the upper and lower alarm limits.
Alarms
The formulas used for calculating the Auto Set Alarm Limits are listed in
Appendix B, “Alarm Specifications.”
To set automatic alarm limits:
Step
1 To establish a baseline, take an initial set of vital signs

measurements on the patient.
4 Select the Auto Set Alarm Limits button.
5 Press the wheel.

A message asks if you are sure you want to change the alarm
limits.
6 Select OK.
The monitor creates new high and low alarm limits based on the
existing measurements.
Note — The alarm limits change for existing measurements
only; the alarm limits do not change if a parameter was not
measured.
7 Close the menu.
Alarms
Restoring Default Alarm Limits

Select the Restore Default Alarm Settings button to reset all alarm limits,
alarm enable/disable settings, and the alarm volume to the values in the current
profile.
For information on profile settings, see Appendix A, “Profile Settings.”.
To restore default alarm limits:
Step
3 Select the Restore Default Alarm Settings button.

A message asks if you are sure you want to restore the default
settings.
4 Select OK.
The monitor restores all alarm settings to the current profile
values.
5 Close the menu.
Alarms
Silencing Alarms
Silencing Alarms
Warning It is important to understand what the alarm silence duration is before

silencing or pausing alarms.
The following table lists the methods that you can use to silence audible alarms
using the Alarm Silence key on the front panel of the monitor.
Alarm Silence
Key Note — Measurements can be either continuous or aperiodic. Continuous
measurements include SpO2, Heart Rate derived from ECG, Pulse Rate derived
from SpO2, CO2, Respiration, Invasive Blood Pressure, and Temperature.
Aperiodic measurements include NBP and Pulse Rate derived from NBP. The
Alarm Silence key responds differently depending on which type of
measurement is alarming.
To Press the Result

Pause a continuous Alarm Silence key The active alarm is silenced for
alarm for 60 once. 60 seconds. The visual alarm
seconds. indicators continue to flash.
Silence an aperiodic Alarm Silence key The audible and visual alarm
alarm. once. indicators for the active alarm
are silenced and cleared.
Pause all alarms for Alarm Silence key Audible alarms are paused for
a predetermined twice quickly. the Audio Pause period. Visual
time interval. (Audio alarm indicators continue to
Pause mode) flash.
When the Audio Pause period
ends, active alarms sound
again.
Silence all alarms Alarm Silence key All alarms are silenced
indefinitely. (Audio for two seconds. indefinitely. Visual alarm
Off mode) indicators continue to flash.
Alarms
Silencing Alarms
Central system for more information about silencing alarms.
Audio Pause Mode
Note — If the audio pause setting is disabled in the current profile, and you
press the Alarm Silence key two times quickly, the monitor behaves as if you
pressed the Alarm Silence key one time.
If you press the Alarm Silence key two times quickly, the monitor enters Audio
Pause mode. All audible alarms are silenced for one of the following predefined
time intervals: 30, 60, 90, 120, or 180 seconds. The time interval is configured
in the profile settings.
During Audio Pause mode, a white box with the AUDIO PAUSED message
appears at the bottom of the screen and a timer shows the amount of time
remaining until the Audio Pause mode ends.
To end Audio Pause mode, press the Alarm Silence key.
Audio Off Mode
Note — If the audio off setting is disabled in the current profile, you are
prohibited from placing the monitor in Audio Off mode.
When the monitor is placed in Audio Off mode, all alarms are silenced
indefinitely.
If you press and hold the Alarm Silence key for 2 seconds, the monitor enters
Audio Off mode. All audible alarms are silenced until you press the Alarm
Silence key again to end the Audio Off mode.
During Audio Off mode, a red box with the Audio Off message appears at the
To end Audio Off mode, press the Alarm Silence key.
Alarms
Testing Alarms
Audio Off Reminder

When the monitor is placed in Audio Off mode, all alarms are silenced
indefinitely.
If the Audio Off Reminder setting is enabled in the current profile, a sound plays
every three minutes to remind you that the monitor has been placed in Audio Off
mode.
Acknowledging Technical Alarms

When a technical alarm occurs and you press the Alarm Silence key once, the
monitor responds in one of the following ways:
• For many technical alarms, such as Low Batt and ECG Leads Off, the
audible alarm is silenced, but the alarm message will remain in the
message area until the error condition is corrected.
• For all sensor off technical alarms, the audible alarm is silenced and the
error message is cleared.
Testing Alarms
To verify that the audible alarm system is working:
Step
1 With the monitor turned on, make sure that all alarms are enabled
(the monitor is not in Audio Pause or Audio Off mode).
2 Make sure the NBP alarm is enabled (the crossed bell icon does
not appear in the NBP numeric pane).
3 Connect the NBP hose to the NBP input connector, but do not
place the cuff on your arm.
Alarms
Nurse Call System Alarms
4 Press the NBP key on the front panel.
NBP Key
5 Wait for the NBP module to cycle and check that an NBP alarm
message appears and an alarm tone sounds.
6 If you do not get the results in step 5, contact your technical

support team.
Nurse Call System Alarms

A nurse call signal reflects the audio output of the monitor: if the monitor is
sounding an alarm, the nurse call system is signaling.
If your monitor is connected to a nurse call system, note the following:
• When an audible alarm is silenced (Audio Pause or Audio Off) at the

bedside unit, the nurse call system will not alarm.
• If a user disables one or more alarms (through a specific parameter menu
or the Alarm Menu) at the bedside unit, these alarms are also disabled on
the nurse call system.
Note — Your system administrator can change the alarm priority level for the
nurse call signal. For example, if the priority level is set to High in the
password-protected Alarm Settings Menu, only high-priority alarms will sound
on the nurse call system. If it is set to Medium, both high-priority and medium-
priority alarms will sound on the nurse call system.
Alarms
Alarms Safety Information
Caution The monitor detects and responds almost immediately to most out-of-limits
conditions, except when averaging of the physiological signal is required to
reduce unwanted noise signals or when an SpO2 alarm delay time is
enabled. Examples of averaging include respiration rates and
measurements derived from SpO2 signals.
Respond immediately to all alarms, including technical alarms. Some
technical alarms, such as CO2 Occlusion or ECG Leads Off, indicate that
the patient is not currently being monitored.
The alarm volume should be loud enough to be heard within a room or
through a door. Set the volume based on the environment and ambient
noise levels.
The recommended operator position for viewing visual alarms is
approximately ± 15 degrees relative to the center of the monitor display.
Alarms
Alarms
4
Monitoring SpO2
Note — This chapter describes monitoring SpO2 on a monitor with the Philips
SpO2 module. If your monitor has a Masimo SpO2 module, see the Efficia CM
Series with Masimo Instructions for Use.
The Efficia CM monitors use a motion-tolerant signal processing FAST SpO2

algorithm, which produces the following SpO2 measurements:
• Oxygen saturation of arterial blood (SpO2) — The percentage of

oxygenated hemoglobin in relation to the sum of oxyhemoglobin and
deoxyhemoglobin (functional arterial oxygen saturation).
• An SpO2 (pleth) waveform — A visual indication of a patient’s pulse.
• A pulse rate value — The value is derived from the pleth wave, if SpO2 is
the current pulse rate source.
• A perfusion indicator — Indicates the quality of the SpO2 signal.
Selecting an SpO2 Sensor

When selecting a sensor, consider the patient’s weight and activity level,
adequacy of perfusion, availability of sensor sites, need for sterility, and
anticipated duration of monitoring.
You can use two types of SpO2 sensors:
• Reusable sensors can be reused on different patients.

• Disposable sensors must not be reused on different patients, however,
they can be reused or relocated on the same patient.
Monitoring SpO2
Connecting SpO2 Cables
For more information on compatible SpO2 sensors, see Chapter 17, “Accessories
List.”
Caution Do not apply the blood pressure cuff to the same extremity as the one to
which an SpO2 sensor is attached because the cuff inflation disrupts SpO2
monitoring and leads to nuisance alarms.
Note — If the SpO2 measurement is delayed for more than 30 seconds (due to
an excessively noisy signal or because you are trying to measure NBP and SpO2
on the same limb), the SpO2 Extd Update alarm occurs and the SpO2 numeric
pane display alternates between the measurement value and a question mark
(-?-).
Connecting SpO2 Cables

Connect the sensor cable to the SpO2 input connector on the side panel, as
shown in the illustration. If you are using a disposable sensor, plug the sensor
into the adapter cable and plug this cable into the SpO2 input connector. Plug
reusable sensors directly into the input connector.
SpO2 input
connector
Monitoring SpO2
The SpO2 Numeric Pane
The SpO2 Numeric Pane

The following illustration shows the components of the SpO2 numeric pane.
Perfusion
SpO2 %
98
indicator
High and low 100 bar
alarm limits
90
Perfusion
Perf 4.0 indicator
value
SpO2 measurement
Perfusion Indicator
The perfusion indicator value represents the pulsatile portion of the measured
signal caused by the pulsating arterial blood flow. The following table describes
the number of solid segments in the bar and the corresponding perfusion
indicator value.
Number of Segments Perfusion Indicator Value
None < 0.1
1 < 0.3
2 < 0.7
3 < 1.0
4 < 2.0
5 < 3.0
Monitoring SpO2
Changing SpO2 Settings
Number of Segments Perfusion Indicator Value
6 < 4.0
7 < 5.0
8 ≥ 5.0
You can use the perfusion indicator value to determine the quality of the SpO2
measurement:
• Above 1.0 is optimal.

• Between 0.3 and 1.0 is acceptable.
• Below 0.3 is marginal; reposition the sensor or find a better site.
You can configure the monitor so that the perfusion indicator value appears in
the SpO2 numeric pane, as described in “Displaying the Perfusion Indicator
Value” on page 4-6.

Use the SpO2 Menu to:
• Change the SpO2 response mode

• Display or hide the perfusion indicator value
• Change the SpO2 alarm limits
To open the SpO2 Menu:
• Select the SpO2 numeric pane.

The SpO2 Menu appears. Current SpO2 settings are displayed.
Monitoring SpO2
Changing the SpO2 Response Mode

The SpO2 Response setting determines how quickly the monitor reports
changes in SpO2 values.
Note — If the current profile includes an SpO2 Alarm Delay, consider the total
possible delay time when selecting the SpO2 Response setting. For more
information, see “SpO2 Alarm Delay” on page 4-9.
To change the SpO2 response mode:
Step
1 Open the SpO2 Menu and select the SpO2 Response menu
item.

• Slow — Use this setting when motion artifact is an issue.
SpO2 changes are reported more slowly compared to the
other modes.
• Normal — Use this setting for most monitoring situations.
• Fast — Use this setting for special applications (for
example, sleep studies) when you need a fast response. Do
not use the Fast setting if motion artifact is an issue.
3 Close the menu.
Monitoring SpO2
Displaying the Perfusion Indicator Value

You can control whether the perfusion indicator value appears in the SpO2
numeric pane. The perfusion indicator value does not appear by default.
To display or hide the perfusion indicator value:
Step
1 Open the SpO2 Menu.
2 Select or clear the Perfusion Indicator check box:

 = The perfusion indicator value will appear in the SpO2
numeric pane
No  = The perfusion indicator value will not appear in the
SpO2 numeric pane
3 Close the menu.
Changing the SpO2 Alarm Limits

For information on changing the SpO2 alarm limits, see “Changing Alarm
Limits” on page 3-6.
The SpO2 default alarm limits are:
Alarm Limit
Adult Pediatric Neonatal
Increments
SpO2 high limit 100% 100% 95% 1%
SpO2 low limit 90% 90% 85% 1%
Monitoring SpO2
Configuring the SpO2 Waveform
Configuring the SpO2 Waveform
Note — The pleth waveform is normalized to the display area on the screen.
The height of the waveform has no relationship to the actual optical signal
strength.
Use the SpO2 Waveform Menu to change the speed of the SpO2 waveform
To open the SpO2 Waveform Menu:
• Select the SpO2 waveform.

The SpO2 Waveform Menu appears. Current SpO2 waveform settings are
displayed.

The Sweep Speed setting in the SpO2 Waveform Menu determines the speed
at which the waveform is drawn across the screen. For information on changing
this setting, see “Changing the Waveform Speed” on page 2-25.
The Sweep Speed options are:

• 12.5 mm/s
• 25.0 mm/s
• 50.0 mm/s
Monitoring SpO2
Assessing a Suspicious SpO2 Reading
Assessing a Suspicious SpO2 Reading
Warning When the patient’s pulse rate is very low, or strong arrhythmia is present,
the SpO2 pulse rate may differ from the heart rate calculated from ECG.
However, this does not indicate an inaccurate SpO2 value.
Traditionally, pulse rate from SpO2 was compared with heart rate from ECG to
confirm the validity of the SpO2 reading, With newer algorithms, this is no
longer a valid criteria because the correct calculation of SpO2 is not directly
linked to the correct detection of each pulse.
If you doubt the measured SpO2 value, use the pleth wave and perfusion
indicator to assess the signal quality.
Desaturation Alarm (Desat)

The Desaturation alarm is a high-priority alarm that alerts you to a potentially
life-threatening drop in oxygen saturation. The Desat alarm is not configurable;
it is based on the current SpO2 low alarm limit. The Desat alarm limit is fixed at
10 less than the current low limit for adults and pediatric patients and 5 less for
neonates.
If the current profile includes a Desat alarm delay, the Desat alarm does not
sound until the SpO2 value exceeds the Desat alarm limits and the configured
alarm delay time elapses.
Monitoring SpO2
SpO2 Alarm Delay
SpO2 Alarm Delay

If the current profile includes an SpO2 alarm delay time, and the SpO2 value
exceeds the current high or low alarm limits, the monitor does not issue an SpO2
alarm until the specified alarm delay time elapses. For example, if the SpO2
alarm delay time is set to 10 seconds, the monitor will generate an alarm if the
SpO2 value exceeds the high or low alarm limits for more than 10 seconds.
The SpO2 Alarm Delay can be up to 30 seconds for the High/Low setting and
for the Desat setting. If the SpO2 Alarm Delay option is enabled on your
monitor, the current settings are displayed in the SpO2 Menu.
In the following example, the SpO2 settings are configured on the monitor as
follows:
• The SpO2 low alarm limit is 90%.

• The Desat alarm limit is 80% (10 less than the current SpO2 low alarm
limit).
• The SpO2 high/low alarm delay is 10 seconds.
• The SpO2 Desat alarm delay is 10 seconds.
Monitoring SpO2
SpO2 Alarm Delay
100
10 sec
1 2 3
90
4 6 7
80
5 8
SpO2 value (%)
70 10 sec
60
50
10 20 30 40 50
Time (sec)
In the example above:
1. The SpO2 value falls below 90%. The High/Low alarm delay timer starts.
2. The SpO2 value goes above 90% before 10 seconds has elapsed. The
High/Low alarm delay timer resets.
3. The SpO2 value falls below 90%. The High/Low alarm delay timer starts.
4. The SpO2 value remains below 90% for 10 seconds. The SpO2 Low
alarm sounds.
5. The SpO2 value falls below 80%. The Desat alarm delay timer starts.
6. The SpO2 value goes above 80%. The Desat alarm delay timer resets.
7. The SpO2 value falls below 80%. The Desat alarm delay timer starts.
8. The SpO2 value remains below 80% for 10 seconds. The SpO2 Desat
alarm sounds.
Monitoring SpO2
SpO2 Safety Information

The Efficia CM pulse oximeter is calibrated to indicate functional oxygen
saturation.
Warning To minimize risk of damage to the monitor during defibrillation use only
approved supplies.
Never apply an SpO2 sensor at ambient temperatures above 35oC (95oF)
because this can cause severe burns after prolonged application.
Injected dyes, such as methylene blue, or intravascular dyshemoglobins
(methemoglobin and carboxyhemoglobin) can lead to inaccurate
measurements.
Interference can be caused by:
• High levels of ambient light. To avoid this problem, cover the
application site with opaque material.
• Electromagnetic interference.
• Excessive patient movement and vibration.
High oxygen levels can predispose a premature infant to retrolental
fibroplasia. If this is a consideration, do not set the high SpO2 alarm limit to
100%. This is equivalent to switching the alarm off. Transcutaneous SpO2
monitoring is recommended for premature infants receiving supplemental
oxygen.
SpO2 sensors are not sterile and should not be used in a sterile environment.
Do not use disposable sensors on patients who have allergic reactions to the
adhesive.
Do not use the monitor or SpO2 sensors during magnetic resonance imaging
(MRI) scanning. Induced current could potentially cause burns. The
monitor may affect the MRI image, and the MRI unit may affect the
accuracy of the monitor’s measurements.
Monitoring SpO2
High/low alarms and Desat alarms may occur less often when the SpO2
Alarm Delay is on. Check the patient frequently.
If your patient has a very low pulse rate or strong arrhythmia, pulse rate
readings derived from SpO2 may cause nuisance alarms. Use the pleth wave
and perfusion indicator to assess signal quality. If necessary, use a different
method to measure the patient’s pulse rate.
Caution Skin irritations or lacerations can occur if the sensor is attached to one
location for too long. Inspect the application site every two to three hours to
ensure skin quality and correct optical alignment. If the skin quality
changes, move the sensor to another site. Change the application site at
least every four hours.
Sensors are not sterile and should not be used in a sterile environment.
Do not apply the sensor too tightly as this results in venous pulsation. This
can severely obstruct circulation and lead to inaccurate measurements.
Follow the sensor’s Instructions for Use; adhere to all warnings and
cautions.
Check that the light emitter and the photo-detector are directly opposite
each other. All light from the emitter must pass through the patient’s tissue.
Nail polish or nail fungus on the application site may cause inaccurate
results.
Make sure that the sensor is the appropriate size. The sensor should not fall
off, nor should it be too tight.
When applying the M1193A or M1193T neonatal sensor, do not overtighten
the strap.
When using the M1195A infant finger sensor, select a finger or toe with a
diameter of between 7 and 8 mm (0.27" and 0.31").
If a sensor is too loose, it might compromise the optical alignment or fall off.
If it is too tight — because the application site is too large or becomes too
large due to edema — the excessive pressure may cause venous congestion
distally, leading to interstitial edema, hypoxaemia, and tissue malnutrition.
Do not use OxiCliq™ disposable sensors in a high humidity environment,
such as in neonatal incubators or in the presence of fluids, which can
contaminate sensor and electrical connections causing unreliable or
intermittent measurements.
Monitoring SpO2
For neonatal patients, place all sensor connectors and adapter cable
connectors outside the incubator. The humidity in the incubator can cause
inaccurate measurements.
Do not place the sensor on extremities with an arterial catheter or
intravascular venous infusion line.
Do not use more than one extension cable (for example, M1941A). Do not
use an extension cable with Philips reusable sensors or adapter cables with
part numbers ending in -L (which indicates “Long” version).
To avoid electrical interference, position the sensor cable and connector
away from power cables.
To dispose of pulse oximeter equipment or components, follow local
regulations regarding disposal of hospital waste.
Monitoring SpO2
Monitoring SpO2
5
Monitoring NBP
The Efficia CM monitors measure Systolic, Diastolic, and Mean Arterial

Pressure (MAP) by acquiring pressure pulses through a series of controlled
deflation steps of an inflated cuff.
The three types of NBP measurements include:
• Manual — One NBP measurement starts each time you press the NBP
key on the front panel.
• Interval — The monitor automatically takes a series of NBP
NBP key
measurements every n minutes, where n is the number of minutes between
measurements. You can change the specified interval in the NBP Menu.
• STAT — The monitor takes as many NBP measurements as possible
during a 5-minute period, with a pause between each measurement.
NBP Measurement Guidelines

NBP accuracy can be affected by the NBP measurement site, the position of the
patient (standing or lying down), and the patient’s overall physiological
condition.
To obtain the most accurate NBP values, use the following guidelines when
taking NBP measurements:
• The patient should be sitting comfortably, with legs uncrossed, feet flat on
the floor, and back and arm supported.
• The patient should be relaxed and not talking during the measurement
procedure.
Monitoring NBP
Selecting an NBP Cuff
• Wait five minutes before taking the first NBP measurement.

• Position the NBP cuff so that the middle of the cuff is at the level of the
right atrium of the heart.
• Use the correct NBP cuff size.
NBP Measurement Limitations

You cannot measure NBP on patients with heart rate extremes of less than
40 bpm or greater than 300 bpm, or if the patient is on a heart-lung machine.
NBP measurements may be inaccurate or impossible on patients with the

following conditions:
• An irregular arterial pressure pulse

• Cardiac arrhythmias
• Excessive and continuous movement, such as shivering or convulsions
• Rapid blood pressure changes
• Severe shock or hypothermia that reduces blood flow to the peripheries or
any other clinical condition that can affect peripheral circulation
• Obesity, where a thick layer of fat surrounding a limb dampens the
oscillations coming from the artery
• An edematous extremity
Selecting an NBP Cuff

Select an NBP cuff based on the patient’s arm size. After wrapping the cuff
around the patient’s arm, the index line should fall between the two range lines
and the arterial marking should be over the patient’s brachial artery.
A cuff that is too loose or too tight can cause inaccurate measurements. Also, if
the cuff is too loose, it may not deflate properly.
Monitoring NBP
Connecting the Cuff and Hose
You can use two types of NBP cuffs:
• Reusable cuffs can be reused on different patients.

• Disposable cuffs must not be reused on different patients; however, they
can be reused or relocated on the same patient.
For information on compatible NBP cuffs, see xxx
Connecting the Cuff and Hose

Connect the selected cuff to the hose and the hose to the NBP input connector,
as shown in the illustration.
NBP input
connector
Monitoring NBP
The NBP Numeric Pane
The NBP Numeric Pane

The following illustration shows the components of the NBP numeric pane.
Note — If the monitor is configured to derive the pulse rate value from NBP,
the pulse rate appears in the Pulse numeric pane after the measurement is
complete and remains for up to 3 minutes.
Units of measurement NBP interval
NBP mmHg 15 22:15 Time of last

High and low Sys measurement
128/77 (94)
alarm limits 160
(Systolic limits 90
in this example)
Systolic value Diastolic value MAP value
Changing NBP Settings

Use the NBP Menu to:
• Change the NBP alarm limits

• Select whether the Systolic, Diastolic, or MAP alarm limits appear in the
NBP numeric pane
• Enable or disable the Auto Record NBP feature
• Select an NBP measurement interval
• Start and stop STAT measurements
• Configure the initial inflation pressure
Monitoring NBP
• Change the units of measurement

• Configure venous puncture settings (if the NBP Venous Puncture option is
available)
To open the NBP Menu:
• Select the NBP numeric pane.

The NBP Menu appears, and the current settings are displayed.
Changing the NBP Alarm Limits

For information on changing NBP alarm limits, see “Changing Alarm Limits”
on page 3-6.
The NBP default alarm limits are:
Alarm Limit
Increments
Systolic
High limit 160 mmHg 120 mmHg 90 mmHg 1 mmHg

(21.3 kPa) (16.0 kPa) (12.0 kPa) 0.1 kPa
Low limit 90 mmHg 70 mmHg 40 mmHg 1 mmHg

(12.0 kPa) (9.3 kPa) (5.3 kPa) 0.1 kPa
Diastolic

(12.0 kPa) (9.3 kPa) (8.0 kPa) 0.1 kPa

(6.7 kPa) (5.3 kPa) (2.7 kPa) 0.1 kPa
Monitoring NBP
Alarm Limit
Increments
MAP

(14.7 kPa) (12.0 kPa) (9.3 kPa) 0.1 kPa

(9.3 kPa) (6.7 kPa) (3.2 kPa) 0.1 kPa
Changing the Alarm Limits Display

The NBP numeric pane can only display one set of alarm limits at one time.
To choose the alarm limits to display:
Step
1 Open the NBP Menu.
2 On the General tab, select the Limit Display menu item.

• Sys
• Dia
• MAP
4 Close the menu.

The numeric pane displays the selected alarm limits.
Monitoring NBP
Enabling Automatic NBP Recordings

If your monitor has a recorder, you can use the Auto Record NBP option to
generate a printout each time an NBP measurement is taken. This may be useful
when you are taking NBP interval measurements.
To enable automatic printouts:
Step
2 On the General tab, select the Auto Record NBP check box to
select the desired setting:
 = Auto record is enabled
No  = Auto record is disabled
3 Close the menu.
For more information on the monitor’s recording capabilities, see

Chapter 14, “Using the Recorder.”
Monitoring NBP
Starting a Manual NBP Measurement
Starting a Manual NBP Measurement

To start a manual NBP measurement:
Step
1 Place the cuff on the patient.

•Press the NBP key on the front panel.
•Open the NBP Menu and select the Start/Stop NBP
button.
As the cuff inflates, the current inflation pressure appears in the
NBP numeric pane. A chime sounds to indicate that the
measurement is complete.
The NBP values and timestamp remain in the NBP pane for 60
minutes or until a new NBP measurement is started.
3 To stop the NBP measurement in progress, press the NBP key

on the front panel or select the Start/Stop NBP button in the
NBP Menu.
If your monitor is connected to the Central station, see the Instructions for Use
for your Central system for information about NBP measurements.
Monitoring NBP
Starting NBP Interval Measurements

You can configure Efficia CM monitors to measure a patient’s blood pressure at
predefined time intervals. An interval is measured from the start of one NBP
measurement (when the pump starts) to the start of the next measurement.
Considerations
Before taking NBP interval measurements, note the following:
• If configured in the current profile settings, NBP interval measurements

may be aligned with the clock. For example, if you set the interval to 10
minutes, and you press the NBP key at 10:17 to start the interval, the
monitor records the first measurement at 10:17. The next NBP
measurement will begin at 10:20, then 10:30, 10:40, and so on.
If the monitor is not configured to align measurements to the clock, the
measurements in the example above occur at 10:17, 10:27, 10:37, and so
on.
• If time synchronization is enabled and the monitor time changes by more
than 30 seconds, the monitor starts a new NBP measurement.
• If you start a new patient or change the patient type, the interval reverts to
the value in the current profile.
• If the current profile includes a default NBP interval, the monitor enters
NBP Auto Interval mode each time you start a new patient or change the
patient type.
Monitoring NBP
To start NBP interval measurements:
Step
2 On the General tab, select the Auto Interval menu item.
3 Select one of the following options: Off, 1, 2, 3, 5, 10, 15, 30,

60, 90, or 120 minutes.
4 Close the menu.

The Press message flashes in the NBP numeric pane.
5 Press the NBP key on the front panel to begin the first interval
measurement.
The Interval icon and the current interval value
appear in the NBP numeric pane.
Starting NBP STAT Measurements

In STAT mode, the monitor takes as many measurements as possible within a
5-minute period, pausing between each measurement. At the end of the 5-minute
period, the interval setting returns to Off or to the default NBP Interval value
specified in the profile settings.
Note — The pause time between measurements varies with each patient, but the
pressure in the cuff is reduced to less than 15 mmHg for adults and 5 mmHg for
neonates.
In STAT mode, the monitor does not measure pulse rate derived from NBP. A
question mark (-?-) appears in the Pulse numeric pane.
Monitoring NBP
To enable STAT mode:
Step
2 On the General tab, select the Start STAT button.

STAT measurements begin immediately and the Start STAT
button changes to Stop STAT.
3 Close the menu.

STAT The word STAT and the Interval icon appear in
the NBP numeric pane.
To stop STAT measurements, do one of the following:
• Press the NBP key on the front panel.

• Open the NBP Menu and select the Stop STAT button on the General tab.
Configuring the Initial Inflation Pressure

The Initial Inflation Pressure setting specifies the maximum amount that the
cuff will inflate for the first NBP measurement. When you take subsequent NBP
measurements on the same patient, the monitor adjusts the inflation value based
on the patient’s Systolic measurement. Consider the patient’s clinical condition
when changing the Initial Inflation Pressure setting.
The default values for Initial Inflation Pressure are specified in the current
profile.
As the cuff inflates, the current inflation pressure appears in the NBP numeric
pane. After the measurement is complete, the inflation pressure value disappears
and the final MAP value appears in the pane.
Monitoring NBP
To change the initial inflation pressure:
Step
2 On the General tab, select the Initial Inflation Pressure menu

item.
3 Select the desired inflation pressure. The range of values is

based on the current patient type.
4 Close the menu.
If you start a new patient or change the patient type, the Initial Inflation
Pressure reverts to the value specified in the profile settings.
Note — For safety reasons, the cuff automatically deflates if:
• The measurement time exceeds 180 seconds for Adult and Pediatric
patients (90 seconds if the patient type is Neonatal).
• The microprocessor fails.
• The overpressure limit is exceeded.
• Power is lost.
Monitoring NBP
Stopping an NBP Measurement
Changing the NBP Units of Measurement

To change the blood pressure units of measurement:
Step
2 On the General tab, select the NBP Pressure Units menu item.

• mmHg
• kPa
4 Close the menu.
Stopping an NBP Measurement

To stop a manual or interval NBP measurement in progress, do one of the
following:
• Press the NBP key on the front panel.

• Open the NBP Menu and select the Start/Stop NBP button on the
General tab.
Note — If you press the NBP key during an interval measurement, the current
measurement is stopped, but the next scheduled interval measurement will
occur.
Monitoring NBP
Recalculating the NBP Value if the Limb is not at Heart Level
Recalculating the NBP Value if the Limb is not at Heart Level

If the limb is not at heart level while an NBP measurement is in progress,
recalculate the displayed NBP value as follows:
If the limb is Then

Higher than For each centimeter higher, add 0.75 mmHg (0.10 kPa)
heart level or
for each inch higher, add 1.9 mmHg (0.25 kPa)
Lower than For each centimeter lower, deduct 0.75 mmHg (0.10 kPa)
heart level or
for each inch lower, deduct 1.9 mmHg (0.25 kPa)
Using NBP Venous Puncture

If the NBP Venous Puncture (VP) option is available on the monitor, you can
inflate the NBP cuff to cause subdiastolic pressure in the patient’s limb for the
purpose of drawing blood samples.
The following illustration shows the NBP numeric pane in venous puncture
mode:
Units of measurement
NBP mmHg VP 00:52

Remaining
(40)
time in
venous
puncture
mode
Cuff pressure
Monitoring NBP
To start venous puncture:
Step

• Select the NBP Venipuncture .button in the system
toolbar
• Open the NBP Menu, select the Venipuncture tab, and then
select Start VP.
The cuff begins to inflate immediately. The text VP and the cuff
inflation pressure appear in the NBP numeric pane. The timer
shows the amount of time remaining until the venous puncture
mode ends.
On the NBP Menu the Start VP button changes to Stop VP.
2 Follow your facility’s protocol to draw a blood sample.
3 When the timer goes to 00:00, the cuff deflates automatically

and the monitor exits venous puncture mode.
Stopping Venous Puncture

To stop a venous puncture in progress, do one of the following:
• Select the NBP VeniPuncture button in the system toolbar.

• Press the NBP key on the front panel of the monitor.
• On the Venipuncture tab, select Stop VP.
When venous puncture ends, the cuff deflates automatically and the monitor
returns to NBP measurement mode.
Note — If the monitor is in NBP Interval mode when you start a venous
puncture, interval measurements are suspended during the cuff inflation. The
interval measurements resume when venous puncture mode ends.
Monitoring NBP
Changing the Venous Puncture Settings

The VP Pressure setting specifies the maximum amount that the cuff will
inflate during the venous puncture.
To increase or decrease the pressure value:
Step
2 On the Venipuncture tab, select the VP Pressure menu item.
3 Select a number to increase or decrease the pressure.

The new value takes effect immediately.
4 Close the menu.
Changing the Venous Puncture Duration

During venous puncture, the timer in the NBP numeric pane shows the amount
of time remaining until the venous puncture mode ends. The cuff deflates
automatically after the specified time.
To change the maximum length of time the cuff remains inflated during the
venous puncture:
Step
2 On the Venipuncture tab, select the VP Duration menu item.
3 Select the number to increase or decrease the duration.
4 Close the menu.
Monitoring NBP
NBP Safety Information
Caution Do not reuse disposable NBP cuffs.
Warning Do not compress the NBP hose or restrict the pressure. A compressed hose
may cause the cuff to overinflate and result in patient injury, patient
discomfort, or inaccurate readings.
Select the correct patient type for your patient. Do not apply the higher
adult inflation limits and measurement duration to neonatal patients.
Overinflating the cuff may cause patient injury, patient discomfort, or
inaccurate readings.
Do not measure NBP on patients with wounds, sickle-cell disease, or any
condition where skin damage has occurred or is expected to occur.
Continual NBP measurements can cause injury to the patient being
monitored. Weigh the advantages of frequent measurement and/or use of
STAT mode against the risk of injury. Use clinical judgement to decide
whether to perform frequent unattended blood pressure measurements on
patients with severe blood clotting disorders because of the risk of
hematoma in the limb fitted with the cuff.
In some cases, rapid, prolonged cycling of an NBP cuff has been associated
with any or all of the following: ischemia, purpura, or neuropathy. Check
the patient regularly. Apply the cuff according to the directions and check
the cuff site and cuffed extremity regularly when blood pressure is measured
at frequent intervals or over extended periods of time.
Check the patient’s limb to assure that circulation is not constricted.
Constriction of circulation is indicated by discoloration of the extremity.
Check the limb at regular intervals based on the circumstances of the
specific situation.
Do not place the cuff on any extremity where circulation is compromised or
has the potential to be compromised, including an arm on the side of a
mastectomy, extremities being used for intravenous infusion, or when an
arterio-venous (A-V) shunt is present.
Do not apply the blood pressure cuff to the same extremity as the one to
which an SpO2 sensor is attached because the cuff inflation disrupts SpO2
monitoring and leads to nuisance alarms.
Monitoring NBP
Monitoring NBP
6
Monitoring Temperature
The Efficia CM monitors provide the ability to continuously measure

temperature at one or two sites. Temperature measurements are displayed as T1
and T2 on the monitor, corresponding to the two temperature probes. When two
temperature probes are used, the difference between the temperature at each site
is displayed as ΔT, which is calculated as T1 – T2. If the T2 temperature
measurement is greater than the T1 temperature measurement, the ΔT is
negative. If either probe is disconnected, ΔT is not displayed.
Note — Temperature probes begin to measure the ambient temperature as soon

as they are connected. To avoid nuisance alarms, place the probe on the patient
to bring the probe up to body temperature before connecting the cable to the
monitor.
Connecting Temperature Probes
Connecting Temperature Probes

Connect the temperature probe cable or cables to the Temperature input
connectors, on the side panel, as shown in the illustration.
T1 Temperature
input connector
T2 Temperature
input connector
If you are using a disposable probe, plug the probe into the adapter cable
(21082B or 21082A) and plug this cable into the Temperature input connector.
Plug reusable sensors directly into the input connector.
The Temperature Pane
The Temperature Pane

The following illustration shows the components of the Temperature numeric
panes.
Unit of measure Temperature difference

between T1 and T2
Probe T1 oC T2 oC
ΔT 0.0
number
High and
low alarm
limits
39.0
36.0 37.2 39.0
36.0 37.2
Temperature measurement
The T1 and T2 numeric panes are fixed. If the T1 temperature input connector is
not being used and you plug a probe cable into the T2 temperature input
connector, the values will display in the T2 numeric pane.
Changing Temperature Settings

Use the T1 Menu or T2 Menu to:
• Change the T1 or T2 temperature alarm limits

• Change the units of measurement for both T1 and T2 measurements
Changing the Temperature Alarm Limits

For information on changing the Temperature alarm limits, see “Changing
Alarm Limits” on page 3-6.
Changing Temperature Settings
The Temperature default alarm limits are:
Alarm Limit
Increments
Temperature high 39.0°C 39.0°C 39.0°C 0.1°C

limit (102.2°F) (102.2°F) (102.2°F) (0.1°F)
Temperature low 36.0°C 36.0°C 36.0°C 0.1°C

limit (96.8°F) (96.8°F) (96.8°F) (0.1°F)
Note — If you set the Temperature high and low limits within .1o of one
another in Fahrenheit and then change the Temperature units of measurement to
Celsius, the high and low limits may be the same.
Changing the Temperature Units of Measurement

To change the temperature units of measurement:
Step
1 Open the T1 Menu or T2 Menu.
2 Select the Temperature Units menu item.

• °C (Celsius)
• °F (Fahrenheit)
Note The selected unit of measurement is applied to both T1
and T2.
4 Close the menu.
Temperature Safety Information
Warning Use only the specified probes for your monitor.
Do not reuse disposable probes.
Disposable probes that are sterile should be handled accordingly. See the
probe package for a Use By date.
Do not use the thermometer if you see any signs of damage to the probe.
When you take rectal temperature measurements, insert the probe slowly
and carefully to avoid tissue damage.
7
Monitoring Carbon Dioxide -
Sidestream
Note — The Efficia monitor supports

two optional CO2 modules: Sidestream
and Mainstream. For information on
using Mainstream CO2, see
Chapter 8, “Monitoring Carbon Dioxide
- Mainstream.” The Sidestream
connector is shown to the left, and
Mainstream connector is shown to the
Sidestream CO2 right. Mainstream CO2
The Efficia CM patient monitor uses the microMedi™ sidestream etCO2 method
to measure carbon dioxide (CO2). The sidestream measurement method samples
the respiratory gas with a constant flow from the patient’s airway and analyzes it
with a remote CO2 sensor built into the monitor.
Use the CO2 measurement to monitor a patient’s respiratory and ventilation

status. The CO2 measurement produces:
• A CO2 waveform.
• An end tidal (etCO2) value: the CO2 value measured at the end of the
expiration phase.
• An inspired minimum CO2 (imCO2) value: the smallest value measured
during inspiration.
• An airway respiration rate (awRR): the number of breaths per minute,
calculated from the CO2 waveform.
• Apnea alarms based on the awRR.
Monitoring Carbon Dioxide - Sidestream

Selecting CO2 Accessories

In intubated patients, a sample of the respiratory gas is drawn from the patient’s
breathing circuit through an airway adapter and a gas sampling tube. In non-
intubated patients, the gas sample is drawn through a nasal or an oral-nasal
cannula.
When selecting CO2 accessories, consider the following:
• The type of patient (adult, pediatric, or neonatal)

• The patient’s size and weight
• Whether the patient is receiving supplemental oxygen
• The probability that the patient will switch between oral and nasal
breathing
• The condition of the patient (ventilated or not ventilated)
• If the patient is ventilated, whether ventilation is humidified or non-
humidified
• Whether the CO2 monitoring will be short-term or long-term
Note — For best results, use FilterLine Sets (with orange connectors) for short
term monitoring. For long term monitoring, use FilterLine Set H (with yellow
connectors). Follow the directions provided with the sampling line.

To minimize the risk of injury or contamination due to the reuse of a single-use

device, all accessories are for single patient use.
Intubated Patients: Use a Microstream FilterLine® set for non-humidified

ventilation on intubated patients. Use the FilterLine H set for humidified
ventilation.
Non-Intubated Patients: Use a Smart CapnoLine®, which is a combined oral-

nasal FilterLine. Use the Smart CapnoLine O2, a combined oral-nasal O2/CO2
FilterLine, to measure CO2 and for patients who are receiving supplemental
oxygen.
Note — When using an Infant/Neonatal VitaLineTM H Set with an incubator,

position one Nafion® humidity filter inside the incubator and the second Nafion
humidity filter outside the incubator, close to the incubator tubing access door.
For additional information on CO2 accessories, see Chapter 17, “Accessories

List.”

Connecting the Sampling Line
Note — The awRR Apnea Alarm timer begins when the sampling line is
connected to the monitor and the CO2 Hardware option is set to On.
Input
connector
cover
Output
connector
To connect the sampling line:
Step
1 Attach the Luer connector to the CO2 input connector on the

side of the monitor by pushing the socket cover down and
screwing the connector into place.
Screw the sampling line connector clockwise into the CO2 input
connector until it can no longer be turned, to ensure that it is
connected securely to the monitor. This will ensure that gas does
not leak from the connection point and that measurement
accuracy is not compromised.
2 Check that the sampling line is not kinked.

3 Check that CO2 values appear on the monitor display.
4 If you see a CO2 Purging alarm message, this indicates that the
sampling line is being purged to remove an occlusion in the line
or airway adapter. When the occlusion is removed, the message
is cleared.
Note — When the system performs an auto zero, the following occurs:
• The CO2 Auto Zero message appears in the message area.

• A question mark (-?-) appears in the CO2 numeric pane to indicate
that CO2 measurements are suspended during the Auto Zero period.
• The CO2 waveform goes to zero to indicate that CO2 measurements
are suspended during the Auto Zero period.
Disconnect the FilterLine Set during suctioning and nebulizing therapies.
Replace the sampling line according to hospital protocol or when a blockage is

indicated by the device. Excessive patient secretions or a buildup of liquids in
the airway tubing may occlude the sampling line, requiring more frequent
replacement.
Removing Exhaust Gases from the System

When monitoring CO2 on patients who are receiving or have recently received
anesthetics, nitrous oxide, or high concentrations of oxygen, use an exhaust tube
to remove the sample gas to a scavenging system that meets the requirements of
your facility. Attach it to the CO2 output connector. This avoids exposing
medical staff to the anesthetics and reduces the risk of patient cross infection if
the sampled gas is returned to the breathing system..
Note — The gas sample cannot be re-breathed based on the design of the
module.

The CO2 Numeric Pane

The following illustration shows the components of the CO2 numeric pane.
Units of imCO2 high

measure alarm limit
etCO2 high and
etCO2 mmHg imCO2
low alarm limits
1 imCO2 value
33
38 4
25 awRR
30
8 24 awRR value
awRR high
etCO2 value alarm limit
Changing CO2 Settings

Use the CO2 Menu to:
• Change the etCO2, imCO2 and awRR alarm limits

• Change the CO2 measurement time
• Turn on the CO2 module or place it in Standby mode
• Adjust humidity settings
• Change the units of measure
To open the CO2 Menu:
• Select the CO2 numeric pane.

The CO2 Menu appears, and the current settings are displayed.

Changing the etCO2, imCO2 and awRR Alarm Limits

For information on changing the etCO2, imCO2 and awRR alarm limits, see
“Changing Alarm Limits” on page 3-6.
The etCO2, imCO2 and awRR default alarm limits are:
Alarm
Increments
etCO2

(8.0 kPa) (8.0 kPa) (8.0 kPa) 0.1 kPa
(82 cmH2O) (82 cmH2O) (82 cmH2O) 1 cmH2O

(3.3 kPa) (3.3 kPa) (3.3 kPa) 0.1 kPa
imCO2

(0.5 kPa) (0.5 kPa) (0.5 kPa) 0.1 kPa
Low limit NA NA NA NA
awRR
High limit 30 rpm 30 rpm 100 rpm 1 rpm
Low limit 8 rpm 8 rpm 30 rpm 1 rpm

Changing the CO2 Measurement Time

The Max Hold setting specifies whether the CO2 numeric pane displays the
highest CO2 value measured within the configured time period (Max Hold set to
10, 20, or 30 seconds) or the breath-to-breath value (Max Hold set to Off).
To change the CO2 measurement time:
Step
1 Open the CO2 Menu.
2 Select the Max Hold menu item.

• Off — The CO2 pane displays the highest CO2 value from
one breath to the next.
• 10 seconds — The CO2 pane displays the highest CO2
value measured during a 10-second period.
4 Close the menu.
Enabling or Disabling CO2 Standby Mode

The CO2 Hardware option allows you to turn off the CO2 module when you are
not monitoring a patient’s CO2.
Turn off the CO2 module to extend the life of the module and to extend the
length of time between required calibrations.
Note — The CO2 Hardware option appears in both the CO2 waveform pane
and the CO2 numeric pane. The selected setting applies to both panes.

To turn the CO2 module on or place it in Standby mode:
Step
1 Open the CO2 Menu or the CO2 Waveform Menu.
1 Select the CO2 Hardware menu item.

• On
• Standby
If you select Standby, the CO2 waveform pane and the CO2
numeric pane are empty and the CO2 Standby message appears
in both panes.
3 Close the menu.

Setting the Humidity Correction

The Humidity Correction setting corrects the measured etCO2 value to account
for humidity in a patient’s breath.
To change the humidity correction value:
Step
2 Select the Humidity Correction menu item.

• BTPS — Body Temperature Pressure Saturated
• STPD — Standard Temperature Pressure Dry
Note — Use BTPS in most situations. The etCO2 readings in

BTPS mode are about 6 to 12% lower than the readings in
STPD mode.
4 Close the window.
Changing the CO2 Units of Measurement
Note — The CO2 Pressure Units option appears in both the CO2 waveform
pane and the CO2 numeric pane. The selected setting applies to both panes.
To change the CO2 units of measurement:
Step
2 Select the CO2 Pressure Units menu item.

Configuring the CO2 Waveform

• mmHg
• kPa
• cmH20
4 Close the window.

Use the CO2 Waveform Menu to:
• Change the speed of the CO2 waveform

• Change the scale of the CO2 waveform
• Configure awRR apnea alarms
• Turn on the CO2 module or place it in Standby mode. See “Enabling or
Disabling CO2 Standby Mode” on page 7-8.
• Change the CO2 units of measurement. See “Changing the CO2 Units of
Measurement” on page 7-10.
To open the CO2 Waveform Menu:
• Select the CO2 waveform pane.

The CO2 Waveform Menu appears and the current settings are displayed.


The Sweep Speed setting in the CO2 Waveform Menu determines the speed at
which the waveform is drawn across the screen. For information on changing
The CO2 Sweep Speed options are:

• 3.125 mm/s
• 6.25 mm/s
• 12.5 mm/s
• 25.0 mm/s
Changing the Waveform Size

If the displayed CO2 waveform is too small or it is clipped, use the Scale menu
item to adjust the size of the waveform.
To change the display size of the CO2 waveform:
Step
1 Open the CO2 Waveform Menu.
2 Select the Scale menu option.

• 0 – 50 mmHg (0.0 – 6.7 kPa or 0 – 68 cmH20)
• 0 – 100 mmHg (0.0 – 13.3 kPa or 0 – 136 cmH20)
• 0 – 150 mmHg (0.0 – 20.0 kPa or 0 – 204 cmH20)
4 Close the menu.

The selected scale settings appear on the right side of the CO2
waveform pane.

Configuring awRR Apnea Alarms

The awRR Apnea Alarm time defines the length of time between breaths before
generating the awRR Apnea alarm. For example, if the awRR Apnea Alarm
time is set to 20 seconds, and the monitor does not detect a breath for more
than 20 seconds, the monitor sounds an awRR Apnea alarm.
The default time is 20 seconds.
Caution If you are monitoring both ECG and CO2, consider disabling the
impedance respiration option in the Respiration Menu or the Respiration
Waveform Menu. If impedance respiration is enabled, the monitor will
generate both Resp apnea alarms and awRR apnea alarms.
To configure awRR apnea alarms:
Step
2 Select the awRR Apnea Alarm menu item.

• 10 seconds
• 15 seconds
• 20 seconds
• 25 seconds
• 30 seconds
• 35 seconds
• 40 seconds
4 Close the menu.

Sidestream CO2 Safety Information
Warning Do not use the Efficia CM monitor as an apnea monitor.
CO2 measurements are not approved with nuclear spin tomography (MRT,
NMR, NMT) as the function of the monitor may be disturbed.
Carefully route the sampling line to reduce the possibility of patient
entanglement or strangulation.
Do not lift the monitor by the sampling line, as the sampling line could
disconnect from the monitor, causing the monitor to fall on the patient.
etCO2 measurement accuracy may decrease temporarily while performing

electrosurgery or defibrillation. This does not affect patient or equipment
safety.
The etCO2 readings do not always correlate closely with paCO2 values,
especially in patients with pulmonary disease, pulmonary embolism or
inappropriate ventilation.
Loose or damaged connections may compromise ventilation or cause an
inaccurate measurement of respiratory gases. Securely connect all
components and check connections for leaks according to standard clinical
procedures.
Explosion hazard: The monitor is not suitable for use in the presence of
flammable anesthetic mixture with air, oxygen or nitrous oxide.
CO2 values for non-intubated patients using Microstream accessories always
tend to be lower than for intubated patients. If values appear extremely low,
check whether the patient is breathing through the mouth or whether one
nostril is blocked.
When using a sampling line for intubated patients with a closed suction
system, do not place the airway adapter between the suction catheter and
endotracheal tube. This is to ensure that the airway adapter does not
interfere with the functioning of the suction catheter.
When using the CO2 measurement on patients who are receiving or who
have recently received anesthetics, connect the outlet to a scavenging system
or to the anesthesia machine/ventilator to prevent exposure of medical staff
to anesthetics.

The sampling line may ignite in the presence of O2 when directly exposed to
laser, ESU devices, or high heat. When performing head and neck
procedures involving laser, electrosurgical devices or high heat, use with
caution to prevent flammability of the sampling line or surrounding surgical
drapes.
Do not cut or remove any part of the sampling line. Cutting the sampling
line could lead to inaccurate readings.
If too much moisture enters the sampling line (from ambient humidity or
breathing of unusually humid air), the message CO2 Purging will appear in
the message area. If the sampling line cannot be cleared, the message CO2
Occlusion will appear in the message area. Replace the sampling line if the
CO2 Occlusion message appears.
Apnea alarming is suspended while the system performs an auto zero. The
apnea detection timer restarts after the auto zero is complete.

Caution In high-altitude environments, etCO2 values may be lower than values

observed at sea level, as described by Dalton’s law of partial pressures.
When using the monitor in high-altitude environments, it is advisable to
consider adjusting etCO2 alarm settings accordingly.
To protect the monitor from inadvertently drawing in liquids, do not
connect the sampling line until you are ready to begin monitoring. The CO2
pump turns on, and stays on, when the sampling line is connected.
To ensure CO2 measurement accuracy, ask your system administrator to
calibrate the CO2 module as soon as the CO2 Calibration Needed technical
alarm appears. Also check the patient’s vital signs by alternate means and
make sure the monitor is functioning correctly.
The spring-loaded door over the CO2 input connector protects the CO2
module from dust and fluid, which can cause blockages. If the spring-
loaded door is broken, contact your technical support team.
The following conditions may cause inaccurate CO2 measurements:
• Incorrect application of CO2 accessories.
• Using the monitor in environments that do not meet recommended
temperature, humidity, and altitude environments.
• Some patient conditions, such as abnormal pulmonary perfusion or
pulmonary disease.
Excessive ambient light may cause the monitor to display false readings
when the sensor is disconnected from the patient.
If you change the patient type during CO2 measurements, it will take up to
30 seconds for the system to reinitialize.
Only use Microstream® etCO2 sampling lines to ensure the monitor
functions properly. Before use, carefully read the Microstream® etCO2
sampling lines Instructions for Use.
Microstream etCO2 sampling lines are designed for single patient use, and
are not to be reprocessed. Do not attempt to clean, disinfect, sterilize or
flush any part of the sampling line as this can cause damage to the monitor.

8
Monitoring Carbon Dioxide -
Mainstream
Note — The Efficia monitor supports

two optional CO2 modules: Sidestream
and Mainstream. For information on
using Sidestream CO2, see
Chapter 7, “Monitoring Carbon Dioxide
- Sidestream.” The Sidestream connector
is shown to the left, and Mainstream
Sidestream CO2 connector is shown to the right. Mainstream CO2
Warning The use of the M2501A CO2 Sensor is contraindicated (for use) in patients
where the physician or licensed medical practitioner deems it invalidated by
the nature of the patient, procedure or equipment.
The Efficia CM patient monitor uses the mainstream etCO2 method to measure
carbon dioxide (CO2). The mainstream measurement method uses a CO2 sensor
attached to an airway adapter directly inserted into a patient’s breathing system.
Use the mainstream CO2 measurement to monitor a patient’s respiratory and

ventilation status. The CO2 measurement produces:
• A CO2 waveform.
• An end tidal (etCO2) value: the CO2 value measured at the end of the
expiration phase.
• An inspired minimum CO2 (imCO2) value: the smallest value measured
during inspiration. The imCO2 value displays after a 3 mmHg baseline
rise displays for 20 seconds.
Monitoring Carbon Dioxide - Mainstream

Preparing to Measure Mainstream CO2
• An airway respiration rate (awRR): the number of breaths per minute,

calculated from the CO2 waveform.
• Apnea alarms based on the awRR.

The Mainstream CO2 measurement can be used, with appropriate accessories,
with intubated adult, pediatric and neonatal patients.
Warning The mainstream CO2 module is not equipped with automatic barometric
pressure compensation. Before the CO2 measurement is used for the first
time, your system administrator must set the barometric pressure to the
correct value. An incorrect barometric pressure setting will result in
incorrect CO2 readings.
Caution Use only approved accessories. For a list of approved accessories, see
Chapter 17, “Accessories List.”
You must perform a zero each time you use a new type of airway adapter or
whenever required by the system.
Caution Apnea alarming is suspended during the zero process. If a zero is required
while monitoring a patient, keep the patient under close observation until
the zero completes.

To perform a zero:
Step
1 Attach the sensor connector to the CO2 receptacle on the

monitor.
CO2
receptacle
The message CO2 Sensor Warming Up displays in the CO2

waveform pane.

2 Choose the appropriate airway adapter and connect it to the

sensor head.
The airway adapter will mount in either direction, but the
preferred orientation is to have the cable pointing away from the
patient. Check the arrow on the underside of the sensor for
airway alignment.
The airway adapter clicks into place when seated correctly.
Warning
Ensure that the airway adapter is seated correctly. If the
airway adapter is not seated correctly and the airway
adapter is leeching toxic chemicals, the patient may inhale
toxic chemicals.
3 Wait 2 minutes.
The CO2 Sensor Warming Up message clears when the sensor

reaches its operating temperature and a stable thermal condition.
4 Expose the sensor to room air and keep it away from all sources
of CO2, including the ventilator, the patient’s breath and your
own.
6 Select the Zero button.
The Zero in progress... message appears.
7 When you see the message Zero complete, the zero is finished
and you can begin monitoring.
The date and time that the zero completed is displayed in the
CO2 Waveform Menu.
8 Install the airway adapter at the proximal end of the circuit

between the elbow and the ventilator Y-section.


The following illustration shows the components of the CO2 numeric pane.
Units of imCO2 high

measure alarm limit
etCO2 high and
etCO2 mmHg imCO2
low alarm limits
1 imCO2 value
33
38 4
25 awRR
30
8 24 awRR value
awRR high
etCO2 value alarm limit

Use the CO2 Menu to:
• Change the etCO2, imCO2 and awRR alarm limits

• Change the CO2 measurement time
• Turn on the CO2 module or place it in Standby mode
• Change the CO2 units of measure
• Change CO2 compensation settings

To open the CO2 Menu:
• Select the CO2 numeric pane.

The CO2 Menu appears, and the current settings are displayed.
Changing the etCO2, imCO2 and awRR Alarm Limits

For information on changing the etCO2, imCO2 and awRR alarm limits, see
The etCO2, imCO2 and awRR default alarm limits are:
Alarm
Increments
etCO2

(8.0 kPa) (8.0 kPa) (8.0 kPa) 0.1 kPa

(3.3 kPa) (3.3 kPa) (3.3 kPa) 0.1 kPa
imCO2

(0.5 kPa) (0.5 kPa) (0.5 kPa) 0.1 kPa
Low limit NA NA NA NA
awRR
High limit 30 rpm 30 rpm 100 rpm 1 rpm
Low limit 8 rpm 8 rpm 30 rpm 1 rpm

Changing the CO2 Measurement Time

The Max Hold setting specifies whether the CO2 numeric pane displays the
highest CO2 value measured within the configured time period (Max Hold set to
10 or 20 seconds) or the breath-to-breath value (Max Hold set to Off).
To change the CO2 measurement time:
Step
2 Select the Max Hold menu item.

• Off — The CO2 pane displays the highest CO2 value from
one breath to the next.
Note — The Off setting is not recommended due to jitter

and it may cause nuisance alarms.
4 Close the menu.
Enabling or Disabling CO2 Standby Mode

The CO2 Hardware option allows you to turn off the CO2 module when you are
not monitoring a patient’s CO2.
Note — The CO2 Hardware option appears in both the CO2 Menu and the
CO2 Waveform Menu. Changes in one menu apply to the setting in the other
menu.

To turn the CO2 module on or place it in Standby mode:
Step
1 Select the CO2 Hardware menu item.

• On
• Standby
If you select Standby, the CO2 waveform pane and the CO2
numeric pane are empty and the CO2 Standby message appears
in both panes.
3 Close the menu.
Changing the CO2 Units of Measurement
Note — The CO2 Pressure Units option appears in both the CO2 Menu and
the CO2 Waveform Menu. Changes in one menu apply to the setting in the other
menu.
To change the CO2 units of measurement:
Step
2 Select the CO2 Pressure Units menu item.


• mmHg
• kPa
• cmH2O
4 Close the window.
Changing CO2 Compensation Settings

Gas temperature, barometric pressure, and the proportions of O2, N2O and
Helium in the mixture all influence the CO2 measurement. If values seem
inaccurately high or low, check that the monitor is using the appropriate
corrections and adjust the following settings accordingly:
• Barometric Pressure: Your system administrator must configure the

barometric pressure. An incorrect barometric pressure setting will result in
incorrect CO2 readings..
• O2 Compensation (%): The exhaled O2. To estimate the O2
compensation, subtract 5% from the inspired O2 and round to the nearest
number.
• Gas Temp (oC): The approximate temperature of the air exhaled by the
patient. The default value is 35oC. Under normal patient conditions, it is
not necessary to change this setting.
• Balance Gas: The gas that completes the total volume (100%) of the gas
mixture. If N2O is present in the gas mixture, select N2O; if the gas is a
mixture of Helium and Oxygen, select Helium; for a patient breathing
room air, select Room Air.
• Anesthetic Agent (%): If an anesthetic agent is present in the gas mixture,
select the concentration; if no anesthetic agent is present, select 0%.

To change the compensation settings:
Step
2 If necessary, change the compensation settings, as described

above:
• O2 Compensation (%)
• Gas Temp (oC)
• Balance Gas
• Anesthetic Agent (%)
3 Close the menu.

Use the CO2 Waveform Menu to:
• Change the speed of the CO2 waveform

• Change the size of the CO2 waveform
• Configure awRR apnea alarms
• Change the CO2 units of measurement. See “Changing the CO2 Units of
Measurement” on page 8-8.
• Turn on the CO2 module or place it in Standby mode. See “Enabling or
Disabling CO2 Standby Mode” on page 8-7.
• Zero the sensor. See “Preparing to Measure Mainstream CO2” on page 8-2
To open the CO2 Waveform Menu:
• Select the CO2 waveform pane.

The CO2 Waveform Menu appears, and the current settings are displayed.


The Sweep Speed setting in the CO2 Waveform Menu determines the speed at
The CO2 Sweep Speed options are:

• 3.125 mm/s
• 6.25 mm/s
• 12.5 mm/s
• 25.0 mm/s

If the displayed CO2 waveform is too small or it is clipped, use the Scale menu
item to adjust the size of the waveform.
To change the display size of the CO2 waveform:
Step

• 0 – 50 mmHg (0.0 – 6.7 kPa or 0 – 68 cmH20)
• 0 – 100 mmHg (0.0 – 13.3 kPa or 0 – 136 cmH20)
• 0 – 150 mmHg (0.0 – 20.0 kPa or 0 – 204 cmH20)
4 Close the window.

The selected scale settings appear on the right side of the CO2
waveform pane.

Configuring awRR Apnea Alarms

The awRR Apnea Alarm time defines the length of time between breaths before
generating the awRR Apnea alarm. For example, if the awRR Apnea Alarm
time is set to 20 seconds, and the monitor does not detect a breath for more
than 20 seconds, the monitor sounds an awRR Apnea alarm.
The apnea timer begins after the sensor is connected and after three valid breaths
are detected.
The default time is 20 seconds.
To configure awRR apnea alarms:
Step
2 Select the awRR Apnea Alarm menu item.

• 10 seconds
• 15 seconds
• 20 seconds
• 25 seconds
• 30 seconds
• 35 seconds
• 40 seconds
4 Close the window.

Mainstream CO2 Safety Information
Warning Do not use the Efficia CM monitor as an apnea monitor. The respiration
measurement does not recognize obstructive and mixed apneas — it only
indicates when a user-defined time has elapsed since the last detected breath.
Before use, carefully read the Mainstream CO2 Sensor and Airway
Adapters Instructions for Use, which contains important safety, cleaning
and care information.
In the presence of electromagnetic devices (that is, electrocautery), patient
monitoring may be interrupted due to electromagnetic interference.
Electromagnetic fields up to 20 V/m between 80 MHz and 2.5 GHz will not
adversely affect system performance.
Do not measure CO2 in the presence of pharmaceuticals in aerosols.
Electrical Shock Hazard: Always disconnect the CAPNOSTAT 5 CO2 sensor
and allow it to cool to room temperature for 30 minutes before cleaning.
Use only approved cleaner and disinfectants listed in Chapter 16, “Care and
Cleaning.”
Do not use the sensor if it appears to have been damaged. Refer servicing to
qualified service personnel.
If the CAPNOSTAT 5 CO2 sensor fails to respond as described in this
Instructions for Use, do not use it until approved for use by qualified
personnel.
Do not position the sensor cables or tubing in any manner that may cause
entanglement or strangulation. Support the CAPNOSTAT 5 airway adapter
to prevent stress on the endotracheal tube.
If the CO2 waveform appears abnormal, inspect the CO2 airway adapters
and replace if needed.
Monitor the CO2 waveform for elevated baseline. Elevated baseline can be
caused by sensor or patient problems.
The etCO2 readings do not always correlate closely with paCO2 values,
especially in patients with pulmonary disease, pulmonary embolism or
inappropriate ventilation.

Reuse, disassembly, cleaning, disinfecting or sterilizing the single patient use

CO2 airway adapters may compromise functionality and system
performance leading to a user or patient hazard. Performance is not
guaranteed if an item labeled as single patient use is reused.
Loose or damaged connections may compromise ventilation or cause an
inaccurate measurement of respiratory gases. Securely connect all
components and check connections for leaks according to standard clinical
procedures.
Notes
• Nitrous oxide, elevated levels of oxygen, helium and halogenated
hydrocarbons can influence the CO2 measurement.
• Barometric pressure compensation is required to meet the stated
accuracy of the CAPNOSTAT 5 CO2 Sensor.

9
ECG, Arrhythmia and ST Monitoring
An electrocardiogram (ECG) monitors the electrical activity of the heart. The

Efficia CM patient monitors process these electrical signals and present an ECG
waveform on the screen. The monitor can also:
• Compute and display the heart rate in beats per minute.

• Detect an ECG Leads Off condition and then sound an alarm.
• Detect and filter pacemaker-generated signals.
• Perform arrhythmia analysis. For details, see “Arrhythmia Analysis” on
page 9-17.
• Calculate ST segment elevations and depressions. See “About ST
Monitoring” on page 9-30.
• Calculate respiration rate by sensing changes in transthoracic impedance.
For details, see Chapter 11, “Monitoring Impedance Respiration.”
About ECG Lead Sets

When choosing an ECG lead set, consider the number of electrodes and the
ECG standards — AAMI or IEC — used by your facility. You can use the
following types of ECG lead sets with the monitor:
• 3-electrode set with AAMI or IEC color coding


About ECG Lead Sets
The following tables describe AAMI and IEC labels and colors. The electrode
placement illustrations in this chapter use the AAMI labels and colors.
AAMI Label AAMI Color
RA White
LA Black
LL Red
RL Green
V Brown
V1 Brown/Red
V2 Brown/Yellow
V3 Brown/Green
V4 Brown/Blue
V5 Brown/Orange
V6 Brown/Violet
IEC Label IEC Color
R Red
L Yellow
F Green
N Black
C White
C1 White/Red
C2 White/Yellow
C3 White/Green

About ECG Lead Sets
C4 White/Brown
C5 White/Black
C6 White/Violet
After selecting a lead set, you must configure the monitor to use the selected
lead set (3 Lead, 5 Lead, or 10 Lead) as described in the following procedure.
Configuring the ECG Lead Set on the Monitor

Use the following procedure to configure the lead set on the monitor.
Note — If you select 3 Lead, the Secondary Lead setting is unavailable and
the Analysis Mode setting changes to Single Lead.
To configure the ECG lead set:
Step
1 Open any ECG Waveform Menu.
2 Select the ECG Lead Set menu item.

• 3 Lead
• 5 Lead
• 10 Lead
Note — If you change the lead set, the Primary Lead and
Secondary Lead settings return to default values.
4 Close the ECG Waveform Menu.

Connecting the ECG Cable
Connecting the ECG Cable

Select the correct size and type of patient cable. If you are using two-part cables,
attach the electrode cable to the patient cable. Plug the patient cable into the
ECG input connector, as seen in the illustration.
ECG input
connector
Placing the Electrodes

The following figures show the correct placement for the 3-electrode, 5-
electrode, and 10-electrode lead sets. The location of each electrode is the same
for AAMI and IEC leads sets, only the color of the leads and the labels are
different.
Note — If you enable the Resp Apnea alarm, the timer begins as soon as the
leads are connected to the monitor and the patient. For information on
configuring Resp Apnea alarms, see Chapter 11, “Monitoring Respiration.”

3-Electrode Placement
RA LA L
R
LL
F
AAMI IEC
RA LA R L
V C
N F
RL LL
AAMI IEC

Use either the conventional 12 Lead ECG or modified 10-lead ECG placement
(the Mason-Likar Lead System).
RA LA
V1 - V6
V1 - V6
RL LL
RA LA
RL LL
Modified Conventional

Skin Preparation for Electrode Placement
Skin Preparation for Electrode Placement

Before placing electrodes on a patient, follow these steps:
Step
1 Select sites with intact skin and no impairment of any kind.
2 Clip or shave hair from sites as necessary.
3 Wash sites thoroughly with soap and water, leaving no residue.

Do not use ether or pure alcohol because these substances dry
the skin and increase resistance.
4 Dry skin thoroughly by rubbing briskly to increase capillary

blood flow in the tissues.
5 Use ECG skin preparation (abrasive) paper to remove dead skin

cells and to improve the conductivity of the electrode site.
Shared ECG Settings

The following ECG configuration settings are shared between the HR Menu and
the ECG Waveform Menu:
• Analysis Mode.
• Primary Lead and Secondary Lead
• Pace pulse detection
If you change any of these settings in one menu, the change is replicated to the
other menu

Selecting a Primary and Secondary Lead
Selecting a Primary and Secondary Lead

The monitor uses the primary lead and secondary lead to compute Heart Rate
and for beat classification. To configure a secondary lead, the monitor must be
configured for Multi Lead analysis.
To select a primary and secondary lead:
Step
1 Open the HR Menu or the ECG Waveform Menu.
2 Select the Analysis Mode menu item.

• Single Lead
• Multi Lead
Note — If you select Single Lead, the Secondary Lead option
is unavailable.
4 Select the Primary Lead menu item.

Configuring ECG Waveform Settings
5 Select one of the following options. Available options are based

on the current ECG Lead Set setting.
• For 3 Lead: ECG I, ECG II, or ECG III
• For 5 Lead: ECG I, ECG II, ECG III, ECG aVR, ECG aVL,
ECG aVF, ECG V, or ECG MCL
• For 10 Lead: ECG I, ECG II, ECG III, ECG aVR, ECG aVL,
ECG aVF, ECG V1, ECG V2, ECG V2, ECG V3, ECG V4,
ECG V5, or ECG V6
6 Select the Secondary Lead menu item, and then select an

option from the list. See options in step 5.
Note — The Secondary Lead and Primary Lead cannot be
the same.
Note — You can configure the monitor to display multiple ECG waveforms.
For more information about displaying ECG waveforms, see “Displaying ECG
Waveforms” on page 2-24
Use the ECG Waveform Menu to:
• Change the speed of the ECG waveform

• Change the size of the ECG waveform
• Select an ECG filter
• Enable the notch filter
For information on other settings in the ECG Waveform Menu, see the
appropriate section in this chapter.

To open the ECG Waveform Menu:
• Select any ECG waveform on the screen.

The selected ECG Waveform Menu appears, and the current settings are
displayed.

The Sweep Speed setting in the ECG Waveform Menu determines the speed at
this setting, see “Changing the Waveform Speed” on page 2-25. The ECG
Sweep Speed options are:
• 12.5 mm/s
• 25.0 mm/s
• 50.0 mm/s
Note — Changes to the sweep speed of one ECG waveform apply to all of the
displayed ECG waveforms.

If the displayed ECG wave is too small or it is clipped, use the Scale menu item
to adjust the size of the waveform.

To change the display size of the ECG waveform:
Step
1 Open the ECG Waveform Menu.
2 Open the Scale menu

• Auto — The monitor selects the best scale for the current
waveform.
• 4.0 cm/mV
• 2.0 cm/mV
• 1.0 cm/mV
• 0.5 cm/mV
• 0.25 cm/mV
Selecting an ECG Filter

The Filter Mode setting defines how waveforms are smoothed. The selected
filter appears in the ECG waveform pane.
ECG filter options include:

• Monitoring: Use under normal monitoring conditions.
• Filtered: The filter reduces interference to the signal. It should be used if

the signal is distorted by high frequency or low frequency interference.
High frequency interference usually results in large amplitude spikes
making the ECG signal look irregular. Low frequency interference usually
leads to a wandering or rough baseline. In the operating room, the Filter
reduces artifacts and interference from electrosurgical units.
• Diagnostic: Use when diagnostic quality is required. The ECG wave is
displayed so that changes such as R-wave notching or discrete elevation
or depression of the ST segments are visible
Optionally, select the Notch Filter check box to remove line frequency noise,

Enabling Pace Pulse Detection
Caution Be aware that in normal measurement conditions, enabling the filter may
suppress the QRS complexes too much and thus interfere with ECG
analysis.
To select an ECG filter:
Step
1 Open the ECG Waveform Menu.
2 Select the Filter Mode menu.

• Monitoring
• Filtered
• Diagnostic
4 Optionally, select the Notch Filter check box to remove line

frequency noise.

You must enable pace pulse detection when monitoring patients with
pacemakers. You must disable pace pulse detection if your patient does not have
a temporary or implanted pacemaker. The pace pulse detection feature detects
and filters pacemaker-generated signals, so that they are not counted as regular
QRS complexes.
When pace pulse detection is enabled, the pace pulses appear as vertical white
lines above the ECG waveform and the text Pace Detect On appears in the ECG
waveform pane. If pace pulse detection is disabled, the text Pace Detect Off
appears in the ECG waveform pane. The pace pulse indicators only appear on
the top ECG waveform. The default setting is Pace Detect On.

Warning It is very important that pace pulse detection is set correctly for the patient
you are monitoring. Having the wrong pace pulse detection setting will
impact the effectiveness of the arrhythmia algorithm.
If pace pulse detection is turned off for a patient with an implanted
pacemaker, the algorithm will not look for pace pulses. As such, all the paced
beats will not get classified correctly because the pace pulses are not
recognized and thus are used in beat classification. While the atrial paced
beats may be classified as Normal, Ventricular and AV paced beats may get
classified as PVCs and generate false PVC alarms. More important, if the
patient’s implanted pacemaker fails to capture, the arrhythmia algorithm
could mistake the pacer spikes as beats and continue generating a heart rate
and not alarm for pacer not capture or asystole.
If pace pulse detection is turned on for a patient without an implanted
pacemaker, the algorithm’s effectiveness in detecting ventricular beats may
be reduced because the algorithm cannot use the compensatory pause
information following the PVCs for non paced ECG in classification. This
may result in not receiving some PVC alarms.
Note — If the ECG Leads Off alarm condition occurs, pace detection is
disabled until the ECG Leads Off condition is corrected.
Pace pulse detection can be enabled or disabled in the Admit Patient Menu, the
ECG Waveform Menu or in the HR Menu. If you change the pace pulse
detection setting in any of these menus, the change is replicated to the other
menus.

Changing Heart Rate Settings
To enable pace pulse detection:
Step
1 Open the ECG Waveform Menu, the HR Menu or the Admit

Patient Menu.
2 To change the Pace Detection status, select one of the

following options:
•  = Pace pulse detection is enabled.
• No  = Pace pulse detection is disabled.

The following illustration shows the components of the Heart Rate numeric
pane:
Heart rate value
HR bpm
High and low

alarm limits
120
50
85 PVC 2
PVCs/min
Use the HR Menu to:
• Change the Heart Rate, Extreme Tachycardia and Extreme Bradycardia

alarm limits
• Adjust the Heart Rate volume
• Open the Arrhythmia Menu
• Open the ST Menu
For information on other settings in the HR Menu, see the appropriate section in
this chapter.

To open the HR Menu:
• Select the Heart Rate numeric pane.

The HR Menu appears, and the current settings are displayed.
Changing the Heart Rate Alarm Limits

For information on changing the Heart Rate alarm limits, see “Changing Alarm
Limits” on page 3-6.The default alarm limits are:
Alarm
Increments
Heart Rate high limit 120 bpm 160 bpm 200 bpm 1 bpm
Heart Rate low limit 50 bpm 75 bpm 100 bpm 1 bpm
Extreme Tachycardia 140 bpm 180 bpm 220 bpm 1 bpm
Extreme Bradycardia 40 bpm 55 bpm 80 bpm 1 bpm
Adjusting the Heart Rate Volume
Warning When HR/Pulse tone is enabled and ECG is being monitored, the tone is
from the ECG. The tone source cannot be changed.
When HR/Pulse tone is enabled and the tone is from the ECG, there is no
tone modulation for changes in SpO2. If notification of subtle changes in
SpO2 are needed, adjust the SpO2 alarm limits to ensure alarm notification.
Use the HR/Pulse Tone Volume option to adjust the heart rate and the pulse rate
volume.
The HR/Pulse Tone Volume option appears in both the HR Menu and the Pulse
Rate Menu. Changes to the volume setting in either menu applies to both the
heart rate volume and the pulse rate volume. If you are monitoring both heart
rate and pulse rate, the monitor plays the heart rate tone.

To increase or decrease the heart rate and pulse rate volume:
Step
1 Open the HR Menu.
2 Select the HR/Pulse Tone Volume setting and use the up and
down arrows to adjust the volume.
3 Close the HR Menu.
The new volume takes effect immediately.

Arrhythmia Analysis
Arrhythmia Analysis
The Efficia CM patient monitors use the Philips ST/AR arrhythmia algorithm.
The algorithm detects changes in the ECG rhythm, while also providing
continuous patient surveillance and alarm generation.
Arrhythmia and ST Intended Use and Indications for Use

Indicated where the clinician decides to monitor cardiac arrhythmia of adult,
pediatric and neonatal patients and/or ST segment of adult patients to gain
information for treatment, to monitor adequacy of treatment, or to exclude
causes of symptoms.
The intended use of the ST/AR cardiotach is to monitor a neonatal, pediatric or

adult patient’s ECG for heart rate and produce events/alarms for one or two
ECG leads. The cardiotach function is capable of monitoring both paced and
non-paced patients.
The intended use of the ST/AR arrhythmia analysis algorithm is to monitor a

pediatric or adult patient ECG’s for heart rate and ventricular arrhythmias, and
produce events/alarms for one or two ECG leads. The arrhythmia analysis
algorithm is capable of monitoring both paced and non-paced patients.
The intended use of the ST/AR ST analysis algorithm is to monitor an adult

patient’s ECG for ST segment elevation or depression and produce events/
alarms for all possible ECG leads. The ST analysis algorithm is capable of
monitoring paced and non-paced patients.
Note — The ST algorithm does not analyze ventricularly paced or ventricular

ectopic beats.

Arrhythmia Analysis
Overview
Using the ST/AR algorithm, the Efficia CM monitors detect arrhythmia
conditions by comparing ECG data to a set of pre-defined criteria. An alarm can
be triggered by a rate exceeding a threshold (for example, Heart Rate High), an
abnormal rhythm (for example, Ventricular Bigeminy), or an ectopic event (for
example, Pair PVCs).
The different alarms detected and generated by the monitor depend on the
monitor configuration and the level of arrhythmia analysis — Cardiotach,
Basic, or Enhanced — that is enabled.
Additional Alarms Additional Alarms

Cardiotach Alarms with Basic with Enhanced
Arrhythmia Arrhythmia
Asystole Ventricular Fibrillation/ Non-Sustain VT

Extreme Bradycardia Tachycardia Ventricular Rhythm
Extreme Tachycardia Pacer Not Capture Run PVCs High
Heart Rate High Pacer Not Pacing Pair PVCs
Heart Rate Low PVCs High Pause
Missed Beat
SVT
R-on-T PVCs
Ventricular Bigeminy
Ventricular Trigeminy
Multiform PVCs
Atrial Fibrillation
End Atrial Fibrillation
Irregular Heart Rate
End Irregular Heart
Rate

Arrhythmia Analysis
Aberrantly-Conducted Beat
As P-waves are not analyzed, it is difficult and sometimes impossible for the
monitor to distinguish between an aberrantly-conducted supraventricular beat
and a ventricular beat. If the aberrant beat resembles a ventricular beat, it is
classified as ventricular. You should always select a lead where the aberrantly-
conducted beats have an R-wave that is as narrow as possible to minimize
incorrect calls. Ventricular beats should look different from these “normal
beats.” Instead of trying to select two leads with a narrow R-wave, it may be
easier to just select one lead and use single lead arrhythmia monitoring. Extra
vigilance is required by the clinician for this type of patient.
Intermittent Bundle Branch Block

Bundle branch and the other fascicular blocks create a challenge for the
arrhythmia algorithm. If the QRS during the block changes considerably from
the learned normal, the blocked beat may be incorrectly classified as ventricular,
causing false PVC alarms. You should always select a lead where the bundle
branch block beats have an R-wave that is as narrow as possible to minimize
incorrect calls. Ventricular beats should look different from these “normal
beats.” Instead of trying to select two leads with a narrow R-wave, it may be
easier to just select one lead and use single lead arrhythmia monitoring. Extra
vigilance is required by the clinician for this type of patient.

Choosing an ECG Lead for Arrhythmia Monitoring
Choosing an ECG Lead for Arrhythmia Monitoring

It is important to select a suitable lead for arrhythmia monitoring. Guidelines for
non-paced patients are:
R • The QRS should be tall and narrow

(recommended amplitude > 0.5 mV).
• The R-wave should be above or below
T the baseline (but not bi-phasic).
P
• The T-wave should be smaller than 1/3
QS R-Wave height.
• The P-wave should be smaller than 1/5
R-wave height.
For paced patients, in addition to the above:
• The pace pulse should be no wider than the normal QRS.

• The QRS complexes should be at least twice the height of pace pulses.
• The pace pulse should be large enough to be detected, with no re-
polarization.
To prevent detection of P-waves or baseline noises as QRS complexes, the
minimum detection level for QRS complexes is set at 0.15 mV, according to
AAMI-EC 13 and IEC 60601-2-27 specifications. Adjusting the ECG wave size
on the monitor display (gain adjustment) does not affect the ECG signal which is
used for arrhythmia analysis. If the ECG signal is too small, you may get false
alarms for pause or asystole.

Configuring Arrhythmia Analysis Settings

Use the Arrhythmia Menu to:
• Select an arrhythmia analysis level

• Configure the AFib/Irregular Heart Rate Reminder
• Configure arrhythmia alarm limits
• Manually start a relearn
• View beat labels
• View timeout periods
Use one of the following methods to open the Arrhythmia Menu:
• Select any ECG waveform pane, and then select the Arrhythmia button.
The Arrhythmia Menu appears, and the current settings are displayed.
• Select the HR numeric pane, and then select the Arrhythmia button.
The Arrhythmia Menu appears, and the current settings are displayed
Selecting the Arrhythmia Analysis Level

The level of arrhythmia analysis available on your monitor depends on your
monitor configuration. For example, if you did not purchase the Enhanced
arrhythmia analysis option, it us unavailable in the Arrhythmia Analysis list.
To select the level of arrhythmia analysis:
Step
1 Open the ECG Waveform Menu or the HR Menu.
2 Select the Arrhythmia button.
The Arrhythmia Menu opens.

3 Select the Arrhythmia Analysis menu item.

• Cardiotach
• Basic
• Enhanced
5 Close the menu.
Configuring the AFib/Irregular Heart Rate Reminder

The AFib/IHR Reminder setting specifies how often the monitor will issue an
audible reminder after you have acknowledged an AFib or Irregular Heart Rate
alarm.
Note — The AFib/IHR Reminder setting is only available if the Arrhythmia

Analysis level is Enhanced.
To change the Afib/IHR Reminder setting:
Step
1 Open the Arrhythmia Menu.
2 Select the AFib/IHR Reminder menu item.

• 10 min
• 20 min
• 30 min
• 60 min
• 120 min
4 Close the menu.

Changing the Arrhythmia Alarm Limits

You can change the following arrhythmia alarm settings as described in
The default alarm limits are:
Alarm
Increments
PVC/min 10 PVCs/min 5 PVCs/min NA 1 PVC/min
V-Tach Rate 100 bpm 120 bpm NA 1 bpm
V-Tach Count 5 5 NA 1
Vent Rhythm 14 14 NA 1
Run PVCs 2 2 NA 1
SVT Rate 180 bpm 200 bpm NA 1 bpm
SVT Count 5 5 NA 1
Arrhythmia Relearning
When arrhythmia analysis is enabled and a valid ECG signal is first detected, the
arrhythmia algorithm automatically initiates a brief learning period. This is
indicated by a question mark (-?-) in the Heart Rate numeric pane and the
message Learning ECG in the ECG waveform. During this learning period, the
arrhythmia algorithm learns the normal dominant beat for the current patient’s
ECG.
Arrhythmia relearning is triggered whenever you:
• Change the Arrhythmia Analysis setting

• Select or clear the Pace Detection check box
• Start a new patient
• Change the primary or secondary ECG lead
• Manually initiate a relearn
Arrhythmia relearning also occurs when the monitor cannot analyze ECG for
more than 1 minute or it detects an ECG Leads Off error.

To manually initiate relearning:
• Open the Arrhythmia Menu and select the Relearn button.
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.
Viewing Beat Labels

Beat labels tell you how the monitor is classifying beats. Select the Annotation
option to display the following beat labels:
Label Description
A Artifact
B Cardiotach beat
“ Dual Pacer Marker
I INOP
L Learn Beat
M Missing Beat Detection
N Normal Beat
P Paced Beat
? Questionable Unclassified Beat
‘ Single Pacer Marker
S Supra Ventricular Beat
V Ventricular Beat

To display arrhythmia beat labels:
• Open the Arrhythmia Menu and select the Annotation check box.
A beat label appears above each beat in the top ECG waveform. All ECG
waveforms are delayed for 6 seconds and the message Delayed appears in
the top ECG waveform.
The monitor automatically disables annotation mode after 10 minutes.
Annotation mode also ends when you admit or discharge a patient.
Rhythm Status Messages

Rhythm status messages appear in the top ECG waveform pane. Rhythm status
messages indicate the patient’s rhythm. The messages displayed are based on the
level of arrhythmia analysis.
Arrhythmia
Rhythm Description
Level
Asystole No beat detected for a period > the Basic
asystole threshold of 4.0 seconds Enhanced
Vent Fib/Tach Fibrillatory waveform (sinusoidal Basic
wave of 2-10Hz) for 4 consecutive Enhanced
seconds
Learning ECG The algorithm is learning the ECG Basic
beat morphology and has not called Enhanced
Asystole or V-Fib
Learning The algorithm is learning the rhythm Basic
Rhythm of the classified beats Enhanced
V-Tach A run of consecutive beats labeled as Basic
V with run length ≥ V-Tach Run limit Enhanced
AND ventricular HR > the V-Tach
HR limit
Sustained VT Ventricular Tachycardia rhythm for Basic
more than 15 seconds Enhanced

Arrhythmia
Rhythm Description
Level
Vent Rhythm A run of consecutive beats labeled as Enhanced
V with run length > Vent rhythm run
limit AND ventricular HR ≤ V-Tach
HR limit
Vent Bigeminy A dominant rhythm of beats labeled as Enhanced
N, V, N, V, N (N=supraventricular
beat, V=ventricular beat)
Vent Trigeminy A dominant rhythm of beats labeled as Enhanced
N, N, V, N, N, V, N, N
(N=supraventricular beat,
V=ventricular beat)
Paced Rhythm A dominant rhythm of paced beats Basic
Enhanced
Irregular HR An irregular rhythm of beats labeled Enhanced
as N (R-R interval changes greater
than 12.5%)
Sinus Brady A dominant rhythm of SV beats Basic
Sinus Rhythm preceded by P-waves Enhanced
Sinus Tachy
SV Brady A dominant rhythm of SV beats not Basic
SV Rhythm preceded by P-waves Enhanced
SV Tachy
Unknown ECG Rhythm cannot be determined Basic
Rhythm Enhanced

Arrhythmia
Rhythm Description
Level
Cannot Analyze When enhanced or basic arrhythmia is Basic
ECG selected, this alarm condition occurs Enhanced
when the ECG signal cannot be
properly analyzed due to noise or
INOP/Technical conditions. If more
than 2/3 of the time over the last 30
seconds beats are classified as either
noisy or questionable, a “Cannot
Analyze” alarm condition is
generated. When Cardiotach mode is
selected, a Cannot Analyze ECG
alarm condition occurs when the HR
is invalid for more than 20 seconds
Cardiotach Arrhythmia analysis is off in Cardiotach
Cardiotach mode
Viewing Arrhythmia Timeout Periods

Normally, arrhythmia alarms are announced when an alarm condition is
detected. If multiple alarm conditions are present, announcing all of the detected
alarms might be confusing and may hide a more serious condition. Your system
administrator can configure timeout periods in which the audible and visual
indications of alarms are inhibited even though the alarm condition was
detected. These timeout periods are displayed in the Arrhythmia Menu.
Arrhythmia alarms are grouped according to priority/severity. During the

configured timeout period, only the highest priority alarm condition in each
group is announced. Lower priority alarms in the same group are not announced.
Arrhythmia timeout periods are configured for both first- and second-priority
arrhythmia alarms. First-priority (more severe) alarms have shorter timeout
periods, whereas second-priority (less severe) alarms have longer timeout
periods.

Arrhythmia Alarm Chaining

Arrhythmia analysis can detect and generate multiple alarm conditions at one
time, which may be confusing and also hide a more serious condition. For this
reason, arrhythmia alarms are prioritized in alarm chains.
Only the highest priority alarm condition in each chain is announced. Lower
priority alarms in the same chain will not be announced while an alarm is active
or during the configured timeout period. If alarm conditions of equal severity
from different chains are detected, the alarm condition that occurred most
recently is announced.
The following illustration shows the alarm chain priorities.


About ST Monitoring
About ST Monitoring
The monitor performs ST segment analysis on normal and atrially paced beats
and calculates ST segment elevations and depressions. This information is
displayed in the form of ST numerics and snippets on the monitor.
ST analysis is always performed using a dedicated filter which ensures

diagnostic quality. If you are monitoring ECG using an ECG filter mode other
than Diagnostic, the ST segment of the ECG wave may look different from the
ST segment of the ST snipped for the same wave. For diagnostic evaluation of
the ST segment, always switch to Diagnostic filter mode or use the ST snippet.
Warning Some clinical conditions may make it difficult to achieve reliable ST

monitoring, for example:
• If you are unable to get a lead that is not noisy
• If arrhythmias such as atrial fib/flutter are present, which may cause an
irregular baseline
• If the patient is continuously ventricularly paced
• If the patient has left bundle branch block
You should consider switching ST monitoring off if these conditions are
present.
This monitor provides ST level change information; the clinical significance
of the ST level change information should be determined by a physician.
ST segment monitoring is intended for use with adult patients only and is
not clinically validated for use with neonatal and pediatric patients. For this
reason, the default profile setting for ST monitoring on neonatal and
pediatric patients is Off.

The ST Numeric Pane
The ST Numeric Pane

The following illustration shows the components of the ST numeric pane. If
there is not enough space to display all available ST values, the ST values on the
right side of the pane rotate every 3 seconds.
ST values and snippets are based on all available ECG leads. A positive ST
value indicates ST segment elevation; a negative value indicates depression.
The ST Index is the sum of the absolute values for the ST leads V2, V5, and
aVF. You must be using the 12-lead setup to calculate and display the ST Index.
Because it is based on absolute values, it is always a positive number.
ST Index
ST mm ST index 1.2
Values rotate
ST values I - 1.1 MCL 0.2 based on number
for each lead II - 1.5 V 0.9 of leads
III - 0.3
Changing ST Settings
Use the ST Menu to:
• Turn ST Analysis off or on

• Change the ST alarm limits
• Adjust the ST measurement points
• Open the ST View window
• Open the ST Map window

Use any of the following methods to open the ST Menu:
• Select the ST numeric pane

• Select the ST button in the HR Menu
• Select the ST button in the ECG Waveform Menu
Enable or Disable ST Analysis

To enable or disable ST Analysis:
Step
1 Open the ST Menu.
2 Select the ST Settings tab.
3 Select the ST Analysis check box to select the desired setting:

 = ST analysis is enabled.
No  = ST analysis is disabled.
4 Close the menu.
Changing the ST Alarm Limits

For information on changing the ST alarm limits, see “Changing Alarm Limits”
on page 3-6.
The ST default alarm limits are:
Alarm
Increments
High limit for all leads 1.0 mm 1.0 mm NA 0.1 mm
Low limit for all leads -1.0 mm -1.0 mm NA 0.1 mm

Adjusting ST Measurement Points
Caution If using ST analysis, the ST measurement points need to be adjusted when

you start monitoring, and if the patient’s heart rate or ECG morphology
changes significantly, as this may affect the size of the QT interval and thus
the placement of the ST point. Artifactually ST segment depression or
elevation may occur if the isoelectric point on the ST point is incorrectly set.
Always ensure that ST measurement points are appropriate for your
patient.
There are two ways to adjust ST measurement points: Auto and Manual. In
Auto mode, only the ST offset can be changed. In Manual mode, you can adjust
all three measurements points.
To adjust the ST measurement points:
Step
1 Open the ST Menu.
2 Select the Adj. Points tab.
The waveform snippet for the currently selected ECG lead is

displayed. Vertical lines mark the current ISO, J and ST points
in the snippet.
3 To select a different snippet, select a different lead from the list

of leads on the right side of the window.
4 Select the ISO/J point menu item.


• Auto
• Manual
If you select Auto, only the ST Offset option is available. If

you select Manual, the ISO Point, J Point and ST Offset
options are available.
6 Change the ST measurement points:

• ISO Point: -460 ms to 460 ms (in increments of 4 ms)
• J Point: -440 ms to 380 ms (in increments of 4 ms)
• ST Offset: 0 ms to 80 ms (in increments of 20 ms)
7 Select the Apply button.

The new ST points take effect.
The ST View Window

The ST View window shows a current ST snippet and numeric in green and, if
available, an ST baseline snippet and numeric in yellow. The two snippets are in
different colors so that you can differentiate between them easily.
To open the ST View window:
• Open the ST Menu and select the ST View tab.
Updating the ST Baseline

ST analysis requires valid samples to measure and store a snippet. ST snippets
and ST values are updated every minute. If there is artifact in the signal, it may
take longer for an ST snipped and an ST value to appear. The Set New Baseline
button is unavailable until valid ST values are acquired.

To update the ST baseline:
Step
1 Open the ST Menu.
2 Select the ST View tab.
3 Select the Set New Baseline button.

The ST baseline snippet and numeric display in yellow. The
time at which the baseline was set displays in the bottom left
side on the window.
4 To view the baseline snippet and numeric for a different ECG

lead, select the lead from the list of leads on the right side of the
window.
The ST Map window

The monitor can derive a multi-axis portrait (map) from the ST analysis to help
you detect changes in ST values. It displays two planes obtained from a
multilead ECG in a multi-axis diagram, where each axis represents a lead. The
ST value at the J point is given. The position of the axes within the diagram
correspond to the placement of the ECG leads. Each ST value is assigned to
either a limb lead or to a chest lead. Every axis shows the polarity of the lead it
represents. By joining adjacent ST values, the monitor obtains the ST map. The
contour line and the map shading is shown in the same color as the ECG
parameter.
To open the ST Map window:
• Open the ST Menu and select the ST Map tab.

To change the ST Map scale:
• Select the Size Up or Size Down button.

The current scale is displayed on the Lead I and Lead V6 axis.

ECG Safety Information
Warning Do not use damaged ECG leads.

Do not immerse ECG leads completely in water, solvents, or cleaning
solutions because the connectors are not waterproof. Always follow the
Instructions for Use supplied with the accessories.
When you are connecting the electrodes or the patient cable, make sure that
the connectors never come into contact with other conductive parts, or with
earth. In particular, ensure that all of the ECG electrodes are attached to the
patient to prevent them from contacting conductive parts or earth.
For pacemaker patients, the monitor can continue to count pacemaker rate
during cardiac arrest or some arrhythmias. Do not rely entirely upon the
monitor’s alarm. Keep pacemaker patients under close surveillance.
Line isolation monitor transients may resemble actual cardiac waveforms
and thus inhibit heart rate alarms. Such transients may be minimized by
proper electrode and cable placement, as specified in this manual and
electrode directions for use.
ECG cables can be damaged when connected to a patient during
defibrillation. Check cables that have been connected to a patient during
defibrillation for functionality before using them again.
Monitoring with the Pace Detection feature enabled does not normally affect
the monitoring of non-pacemaker patients. However, in some instances, if
the patient does not have a pacemaker, it can be desirable to turn the
detection function Off so that artifacts in the waveform are not mistaken for
a pacemaker signal.
Implanted pacemakers, which can adapt to the Minute Volume, can
occasionally react on the impedance measurement used by patient monitors
for the determination of the Respiration measurement value and execute
pacing with the maximum programmed rate. Not monitoring Respiration in
this instance can prevent this.
When using Electro-Surgical (ES) equipment, place the ECG electrodes
halfway between the ES grounding plate and the ES knife to avoid burning.
Interference from instruments near the patient and Electro-Surgical Unit
interference can cause problems with the ECG wave. See the monitor
specifications for more information.

When using Electro-Surgical equipment, never place ECG electrodes near

the grounding plate of the ES device, as this can cause interference on the
ECG signal.
Electromagnetic interference can cause disruption of performance. Protect
the monitor from sources of intense electromagnetic radiation. This device
has been designed to provide resistance to electromagnetic interference.
However, because of the proliferation of radio-frequency transmitting
equipment and other sources of electrical noise in the health-care and home
environments (such as cellular phones, mobile two-way radios, electrical
appliances) it is possible that high levels of such interference due to close
proximity or strength of a source can result in disruption of performance of
this device. Disruption may be evidenced by erratic readings, cessation of
operation or other incorrect functioning. If this occurs, the site of use should
be surveyed to determine the source of this disruption, and actions taken to
eliminate the source. If assistance is required, contact the Philips Customer
Care Solutions Center or your local Philip’s Representative.
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 arrhythmia monitoring paced patients 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.
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.
Pacemaker pulses may not be detected when the output of a defibrillator is
plugged into a bedside monitor. This may result in the arrhythmia
algorithm’s failure to detect pacemaker non-capture or asystole.
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 non-capture or asystole.

Caution To protect the monitor from damage during defibrillation, for accurate
ECG information, and to protect against noise and other interference, use
only ECG electrodes and cables specified by Philips.

10
Monitoring Pulse Rate
The Efficia CM patient monitors calculate and display a pulse rate value, which
can be derived from either an SpO2 or NBP measurement.
Changing Pulse Rate Settings

The following illustration shows the components of the Pulse Rate numeric
pane:
Pulse rate source

High and low Pulse bpm SpO2
86
(SpO2 in this
alarm limits 120
example)
50
Pulse rate value
Use the Pulse Rate Menu to:
• Change the pulse rate alarm limits

• Change the pulse rate source
• Change the pulse rate volume
To open the Pulse Rate Menu:
• Select the Pulse numeric pane.

The Pulse Rate Menu appears, and the current settings are displayed.

Changing the Pulse Rate Alarm Limits
Note — You can set different alarm limits for each pulse rate source. For more
information, see “Changing the Pulse Rate Source” on page 10-2.
For information on changing the pulse rate alarm limits, see “Changing Alarm
Alarm
Increments
Pulse Rate high limit 120 bpm 160 bpm 200 bpm 1 bpm
Pulse Rate low limit 50 bpm 75 bpm 100 bpm 1 bpm
Changing the Pulse Rate Source

You can configure the monitor to derive the pulse rate value from SpO2 or NBP.
You can also configure the monitor to search automatically for an available
source in the following order: SpO2, then NBP.
If the selected pulse rate source is NBP, note the following:
• The pulse rate value derived from NBP is an averaged value.

• The displayed pulse rate value is static, which means that it displays the
pulse rate value at the time of the last NBP measurement. To determine
the time at which the pulse rate was measured, see the timestamp in the
Tabular Trend menu.
• The pulse rate value remains in the numeric pane for 3 minutes or until a
new NBP measurement begins.

Warning If your patient has a very low pulse rate or strong arrhythmia, pulse rate
readings derived from SpO2 may cause nuisance alarms. Use the perfusion
indicator to assess signal quality. If necessary, use a different method to
measure the patient’s pulse rate.
To change the pulse rate source:
Step
1 Open the Pulse Rate Menu.
2 Select the Pulse Source menu item.

• Auto
• SpO2
• NBP
4 Close the menu.
Adjusting the Pulse Rate Volume
Warning When HR/Pulse tone is enabled and ECG is being monitored, the tone is
from the ECG. The tone source cannot be changed.
When HR/Pulse tone is enabled and the tone is from the ECG, there is no
tone modulation for changes in SpO2. If notification of subtle changes in
SpO2 are needed, adjust the SpO2 alarm limits to ensure alarm notification.
Use the HR/Pulse Tone Volume option to adjust the pulse rate and the heart rate
volume.
The HR/Pulse Tone Volume option appears in both the Pulse Rate Menu and
the HR Menu. Changes to the volume setting in either menu applies to both the
pulse rate volume and the heart rate volume. If you are monitoring both heart
rate and pulse rate, the monitor plays the heart rate tone.

To increase or decrease the pulse rate and heart rate volume:
Step
1 Open the Pulse Rate Menu.
2 Select the HR/Pulse Tone Volume menu item.
3 Select the HR/Pulse Tone Volume setting and use the up and
down arrows to adjust the volume.
4 Close the menu.

The new volume takes effect immediately.
Note — The frequency of the pulse rate tone varies depending on the pulse rate
source. If the source is SpO2, the frequency changes based on the SpO2 level. If
the source is NBP, there is no pulse rate tone because the NBP measurement is
static.1
1.
SpO2 tone modulation is licensed under US patent US 4,653,498 from Nellcor
Puritan Bennett Incorporated, a Tyco Healthcare company.

11
Monitoring Impedance Respiration
Respiration can be measured using one of the following methods:
• Impedance Respiration through ECG. The respiration rate (RR) is

calculated by sensing changes in the trans-thoracic impedance between
the right arm and left leg of the ECG cable set.
• CO2. If your monitor is configured for CO2, you can measure a patient’s
airway respiration rate (awRR). The awRR value is calculated by directly
measuring air movement in and out of the patient’s airway. For more
information on monitoring CO2 and airway respiration rate, see
Chapter 7, “Monitoring Carbon Dioxide - Sidestream” or
Chapter 8, “Monitoring Carbon Dioxide - Mainstream.”
• Acoustic respiration rate (RRa). If you purchased the optional Masimo
rainbow SET module, you can use the Acoustic Respiration Rate (RRa)
measurement to continuously measure a patient’s respiration rate based on
airflow sounds generated during the breathing cycle of inspiration and
expiration. See the Efficia CM for Masimo Instructions for Use for
additional information.
Warning Do not use an OR ECG cable set when monitoring impedance respiration.
Respiration can only be monitored with an ICU ECG cable set. This is
because of the higher internal impedance of the OR cable set, which is
required during electro-surgery.

Optimizing ECG Lead Placement for Impedance Respiration Measurements
Notes
• Correct patient skin preparation techniques for electrode
placement are important for impedance respiration measurements.
Follow the instructions in “Placing the Electrodes” on page 9-4.
• The OxyCRG layout uses Impedance Respiration. The respiration
source is not configurable.
Optimizing ECG Lead Placement for Impedance Respiration

Measurements
When measuring respiration through ECG, you may need to reposition the two
electrodes between which impedance will be measured to avoid the following:
• Cardiac Overlay: Cardiac overlay, which occurs when the respiration

electrodes pick up impedance changes caused by the rhythmic blood flow,
can affect the Respiration waveform. Correct electrode placement can
help to reduce cardiac overlay: avoid the liver area and the ventricles of
the heart in the line between the respiratory electrodes. This is particularly
important for neonates.
• Lateral Chest Expansion: Some
patients, especially neonates, expand
their chests laterally. In these cases, it
is best to place the two respiratory
electrodes in the right midaxillary and
left lateral chest areas at the patient's
maximum point of breathing
movement to optimize the respiratory wave.
• Abdominal Breathing: Some patients with restricted chest movement
breathe mainly abdominally. In these cases, you may need to place the left
leg electrode on the left abdomen at the point of maximum abdominal
expansion to optimize the respiratory wave.

The Respiration Numeric Pane
Note — Repositioning ECG electrodes to achieve better respiration

measurements can result in changes in the ECG waveform and may influence
arrhythmia interpretation.
The Respiration Numeric Pane

The following illustration shows the components of the Respiration numeric
pane.
RESP rpm
30
10 22
High and low alarm limits Respiration measurement
Changing Impedance Respiration Settings

Use the Respiration Menu to:
• Change the Respiration alarm limits

• Enable or disable impedance respiration
• Select an apnea time
To open the Respiration Menu:
• Select the Respiration numeric pane.

The Respiration Menu appears, and the current settings are displayed.

Changing the Impedance Respiration Alarm Limits

For information on changing the impedance respiration alarm limits, see
The impedance respiration default alarm limits are:
Alarm
Increments
Respiration high 30 rpm 30 rpm 100 rpm 1 rpm

limit
Respiration low 8 rpm 8 rpm 30 rpm 1 rpm

limit
Disabling Impedance Respiration

Impedance respiration is enabled by default. If you do not want to monitor
impedance respiration on your patient, you can disable it in the Respiration
Menu or the Respiration Waveform Menu.
Note — If you disable impedance respiration, the impedance apnea alarm is

also disabled.
To disable impedance respiration:
Step
1 Open the Respiration Menu or the Respiration Waveform

Menu.
2 Select the Impedance Resp menu item.

3 Select Disable.
The message Resp Disabled appears in the Respiration numeric

pane and the Respiration waveform pane.
4 Close the menu.
Selecting an Apnea Time

The Apnea Alarm time defines the length of time between breaths before a
Resp Apnea alarm is generated.
The Apnea Alarm setting appears in both the Respiration Menu and the
Respiration Waveform Menu. If you change the Apnea Alarm setting in one
menu, the change is replicated to the other menu. To change both the Apnea
Alarm setting and the apnea Detection Mode, open the Respiration Waveform
Menu. For more information about apnea Detection Mode, see “Selecting a
Detection Mode” on page 11-9.
To change the Apnea Alarm time in the Respiration Menu:
Step
1 Open the Respiration Menu.
2 Select the Apnea Alarm menu item.


• Off
• 10 seconds
• 15 seconds
• 20 seconds
• 25 seconds
• 30 seconds
• 35 seconds
• 40 seconds
Note — If you select Off, the message Apnea Off appears in the
Respiration numeric pane.
4 Close the menu.

Configuring the Impedance Respiration Waveform

Use the Respiration Waveform Menu to:
• Change the speed of the Respiration waveform

• Change the scale of the Respiration waveform
• Enable or disable impedance respiration. See “Disabling Impedance
Respiration” on page 11-4 for more information.
• Select an apnea detection mode. See “Selecting a Detection Mode” on
page 11-9
To open the Respiration Waveform Menu:
• Select the Respiration waveform.

The Respiration Waveform Menu appears. Current Respiration
waveform settings are displayed.
Note — If the message Resp Disabled appears in the Respiration waveform

pane, open the Respiration Waveform Menu and select Enable from the
Impedance Resp menu item.

The Sweep Speed setting in the Respiration Waveform Menu determines the
speed at which the waveform is drawn across the screen. For information on
changing this setting, see “Changing the Waveform Speed” on page 2-25. The
Respiration Sweep Speed options are:
• 6.25 mm/s
• 12.5 mm/s
• 25.0 mm/s
• 50.0 mm/s


If the displayed Respiration waveform is too small or it is clipped, use the Scale
menu item to adjust the size of the waveform.
Warning If the Detection Mode is set to Manual, check the apnea threshold after you
change the Scale setting. For more information on setting the apnea
threshold, see “Manual Detection Mode” on page 11-9.
To change the display size of the Respiration waveform:
Step
1 Open the Respiration Waveform Menu.

• x4
• x2
• x1
• x1/2
4 Close the menu.

Selecting a Detection Mode

The apnea detection mode can be either automatic or manual. Auto mode is
appropriate for most situations.
Auto Detection Mode
In Auto mode, the monitor adjusts the detection level automatically, depending
on the wave height and the presence of cardiac artifact. Note that in Auto mode:
• The detection level (a dotted line) is not displayed on the waveform.

• The algorithm expects a heart rate and therefore needs at least 3 electrodes
attached to the patient.
• If you are monitoring respiration with only two electrodes, the detection
algorithm becomes less sensitive which may result in reduced breath
detection performance.
Use Auto mode for situations where:
• The respiration rate is not close to the heart rate.

• Breathing is spontaneous, with or without continuous positive airway
pressure (CPAP).
• Patients are ventilated, except patients with Intermittent Mandatory
Ventilation (IMV).
Manual Detection Mode
In Manual mode you must set the Respiration detection level. Use the dotted
detection level line in the Respiration waveform to determine when the desired
level is reached.
The Resp Apnea alarm sounds if no breaths break the threshold for the selected
apnea time.

For example, assume you set the apnea time to 15 seconds. In the following
illustration, the apnea timer begins when the downstroke of the wave crosses the
apnea threshold line. If the wave continues to fall below the threshold for more
than 15 seconds, the Resp Apnea alarm sounds.
Apnea timer starts here RESP Apnea alarm is

generated here
15 seconds
RESP
Manually-set Apnea Respiration Waveform Pane

Threshold
When adjusting the threshold line for apnea detection, consider the patient's
current breathing pattern, and that the breathing pattern may change over time.
For example, some patients may not breathe as deeply at night, so their breath
may no longer cross the threshold line, resulting in false apnea alarms. It may be
necessary to adjust the Apnea Threshold in these situations.
Use Manual mode for situations where:
• The respiration rate and the heart rate are close.

• Patients have Intermittent Mandatory Ventilation.
• Respiration is weak. Try repositioning the electrodes to improve the
signal.

Warning If you set the threshold too low in Manual detection mode, the monitor is
more likely to detect artifact and miss an apnea event. If you set the
threshold too high, you may get false apnea alarms.
In Manual detection mode, the position of the threshold does not change
when you start a new patient. The threshold stays where it was last placed.
You must always check the placement of the threshold when you start a new
patient.
Caution It is possible for the monitor to detect respiration and still sound the Resp
Apnea alarm if the Apnea Threshold is set too high. Check the Scale setting
of the respiration waveform and the placement of the Apnea Threshold.
Cardiac overlay can in certain situations trigger the respiration counter.
This may lead to a false indication of a high respiration rate or an
undetected apnea condition. If you suspect that cardiac overlay is being
registered as breathing activity, raise the detection level above the zone of
cardiac overlay. If the Respiration wave is so small that raising the
detection level is not possible, you may need to optimize the electrode
placement as described in “Optimizing ECG Lead Placement for
Impedance Respiration Measurements” on page 11-2.
To configure respiration apnea settings:
Step
1 Attach the ECG electrodes.
2 Display the Respiration waveform pane and verify that you have
a viable respiration waveform:
• If the waveform is too small or too large, adjust the Scale
setting in the Respiration Waveform Menu.
• If necessary, adjust the placement of the ECG electrodes.
3 Open the Respiration Waveform Menu.
4 Select the Apnea Alarm menu item.


• Off
• 10 seconds
• 15 seconds
• 20 seconds
• 25 seconds
• 30 seconds
• 35 seconds
• 40 seconds
Note — If you select Off, the message Apnea Off appears in
the Respiration numeric pane, and the Apnea Threshold option
is unavailable.
6 Select the Detection Mode setting.

• Auto
• Manual

• If you selected Auto, close the menu.
• If you selected Manual, proceed to step 9.
9 Select the Set Threshold button.
The Respiration Waveform Menu closes and a scrollbar

appears in the Respiration waveform pane.
RESP
Warning — To minimize the possibility of a missed apnea

event, check the position of the apnea threshold periodically.

Respiration Safety Information
10 Use the up and down arrows to the right of the waveform to

move the threshold up or down.
11 Close the menu.
Warning The Efficia CM patient monitors are not apnea monitors. The respiration
measurement does not recognize obstructive and mixed apneas — it only
indicates when a user-defined time has elapsed since the last detected breath.
The safety and effectiveness of the respiration measurement method in the

detection of apnea, particularly in premature and infant patients, has not
been established.
Implantable pacemakers, which are minute ventilation rate adaptive, can

occasionally interact with the impedance measurement of cardiac monitors
causing the pacemakers to pace at their maximum.
Keep patients under close surveillance when monitoring respiration.

Respiration signals are sensitive to interference from radiated
electromagnetic signals. Although unlikely, radiated electromagnetic signals
from sources external to the patient and monitor might cause inaccurate
respiration readings.


12
Monitoring Invasive Blood Pressure
The Efficia CM monitors measure dual-channel invasive blood pressure (IBP) of the
following types:
• Arterial Blood Pressure — ABP

• Arterial Blood Pressure (alternative) — ART
• Aortic pressure — Ao
• Central Venous Pressure — CVP
• Intracranial pressure — ICP
• Left atrial pressure — LAP
• Non-specific pressure — P
• Pulmonary Artery Pressure — PAP
• Right atrial pressure — RAP
• Umbilical arterial pressure — UAP
• Umbilical venous pressure — UVP
The monitor displays IBP measurements as real-time waveforms and numeric values.
You can display the IBP1 and IBP2 waveforms overlapped. When the IBP waveforms
are overlapped, the number pane display alternates between the IBP1 and the IBP2
values.
In this chapter, the <pressure> notation is used to indicate the type of pressure that is
currently active.

Setting Up Disposable Transducers

Use the procedure in this section to set up the system using a disposable transducer or
follow your hospital’s protocol.
Note — If you do not zero the pressure before you begin monitoring, the monitor does
not display a value, but displays the message <Pressure> Zero - Required.
To set up a pressure measurement using a disposable transducer:
Step
1 Connect the transducer cable to the IBP1 or IBP2 input connector on

the side panel of the monitor, as shown below.
Note — Note which channel, IBP1 or IBP2, the cable is connected to

and make setting changes in the corresponding pressure menus.
IBP1 input IBP2 input

connector connector
2 Attach the cable to the transducer.

3 Prepare a collapsible I.V. solution bag by extracting all air from the
bag. If heparinizing, add heparin prior to air removal.
Caution
If an air-free solution source is not used (that is, air is not extracted
from the bag), air may be forced into the monitoring line when the
solution is exhausted.
4 Close the clamp on the administration set and remove the protective
cap from the administration set spike. Insert the spike carefully into the
I.V. solution bag.
Caution
To prevent inadvertent puncture of the I.V. solution bag, insert the
spike carefully using a twisting motion.
5 Insert the I.V. solution bag into the pressure administration cuff.
6 Hang the pressure administration cuff from the I.V. pole.
7 With the administration set clamp closed, gently squeeze the drip
chamber and fill the drip chamber approximately 1/2 full.
8 Open the clamp on the administration set.

Purging Air from the Lines

If using a pole mount, follow this procedure to purge air from the lines or follow your
hospital’s protocol:
Step
1 Attach the transducer to the reusable pole mount.
2 Turn the zero reference stopcock “off” to patient. Remove the cap from
the side port of the zero reference stopcock.
3 Activate the fast flush mechanism of the continuous flush device and
fill the transducer slowly (gravity prime only) until air-free. Flush the
fluid through the transducer and side port of the stopcock.
4 Turn the handle of the zero reference stopcock “off” to its side port.
Place a nonvented cap onto the side port of the stopcock.
5 Repeat step 2 through step 4 for any additional stopcocks.

6 Remove the cover at the patient connector and flush the rest of the
patient line.
Place a nonvented cover onto the patient connector.
Note — Take special care to ensure no air is trapped in any
components of the fluid pathway. The monitoring system must be totally
air-free for maximum performance, that is, optimal dynamic response.
7 Pressurize the I.V. solution source to 300 mmHg. Close the clamp on
the pressure cuff.
Caution
Make certain the drip chamber does not completely fill during
pressurization. Air should remain in the drip chamber so that the
continuous flush rate can be verified following a fast flush.
Pulling a vacuum to purge bubbles from the lines is not
recommended. This practice may entrain air or release air from
the solution.
If the line is primed in a forward manner under pressure, care
must be taken to assure the maximum pressure specification.
If using a patient mount, follow this procedure to purge air from the lines:
Note — Patient mounting of a squeeze flush device is not recommended with the flush
clip attached to the device as it may result in inadvertent activation of the fast flush
mechanism by patient movement. If patient mounting is desired, the flush clip must be
removed.
Step
1 Turn the zero reference stopcock “off” to the patient. Remove the
vented cap from the side port of the zero reference stopcock.
Note — Hold the transducer assembly so that the fluid flows upward,
that is perpendicular to the floor.

2 Activate the fast flush mechanism of the continuous flush device and
fill the transducer slowly (gravity prime only) until air-free. Flush the
fluid through the transducer and side port of the stopcock.
3 Turn the handle of the zero reference stopcock “off” to its side port.
Place a nonvented cap onto the side port of the stopcock.
4 Repeat step 1 through step 3 for any additional stopcocks.
5 Remove the cover at the patient connector and flush the rest of the
patient line.
Place a nonvented cover onto the patient connector.
Note — Take special care to ensure no air is trapped in any
components of the fluid pathway. The monitoring system must be totally
air-free for maximum performance, that is, optimal dynamic response.
6 Pressurize the I.V. solution source to 300 mmHg. Close the clamp on
the pressure cuff.
Caution
Make certain the drip chamber does not completely fill during
pressurization. Air should remain in the drip chamber so that the
continuous flush rate can be verified following a fast flush.
Pulling a vacuum to purge bubbles from the lines is not
recommended. This practice may entrain air or release air from
the solution.
If the line is primed in a forward manner under pressure, care
must be taken to assure the maximum pressure specification.
7 Position the transducer onto the patient and secure the strap.
8 Tape down components as desired.

Setting Up Reusable Transducers
Setting Up Reusable Transducers

Use the procedure in this section to set up the system using a reusable transducer or
follow your hospital’s protocol.
Note — If you do not zero the pressure before you begin monitoring, the monitor does
not display a value, but displays the message <Pressure> Zero - Required.
To set up a pressure measurement using a reusable transducer:
Step
1 Connect the transducer cable to the IBP1 or IBP2 input connector on

the side panel of the monitor, as shown below.
Note — Note which channel, IBP1 or IBP2, the cable is connected to

and make setting changes in the corresponding menus.
IBP1 input IBP2 input

connector connector
2 Remove the protection cap from the transducer and slide it down the
cable.

Zeroing the Transducer
3 Fill and flush the tubing system (dome interconnecting tubing,

stopcocks). Do this before attaching the dome and the tubing system to
the transducer, since all parts can be viewed and manipulated more
easily.
To minimize the formation of bubbles, use fluid at room temperature or
above and fill the system slowly. The assembled and filled tubing
system should be free of bubbles, and the dome diaphragm should not
be distended.
4 Mount the disposable dome on the transducer (keep the filled dome
vented to atmospheric pressure).
There should be no liquid between the dome and the transducer. (Apply
vaseline or grease to the transducer diaphragm only when measuring
negative pressure below -10 mmHg.)
5 Mount the transducer at the level where the pressure is to be measured.

The monitor requires a valid zero to ensure accurate pressure readings. To do this, you
must zero the transducer and the pressure measurement. Zero the transducer in
accordance with your hospital policy as follows:
• At least once a day

• When you use a new transducer or tubing
• When you reconnect the transducer cable to the monitor
• If you suspect that the pressure readings are incorrect

To zero the pressure measurement:
Step
1 Turn the zero reference stopcock “off” to the patient and remove the
non vented cap for the side port which opens the zero reference
stopcock to air.
Note — The air-fluid interface of the zero reference stopcock should
be at or near the right atrial (mid-axillary) level.
2 Select the <pressure> waveform.

The <Pressure> Waveform Menu opens.
3 Select the <Pressure> Zero button.

A tone sounds to indicate that the zero has started and the message
<Pressure> Zero - In Progress appears in the waveform pane.
4 Look in the waveform pane for the message, <Pressure> Zero -

Complete, turn the zero reference stopcock “off” to the side port.
Replace the nonvented cap.
If you see an error message, see the following section, Troubleshooting
the Zero, for more information.

Troubleshooting the Zero
If the zero is unsuccessful, an error message appears in the waveform pane. The
following table lists the error messages and the corrective actions to take.
Message Corrective Action
Unable to Zero - Noisy Check the transducer connection and try again.
Signal Make sure the stopcock is off the patient and open
to air.
Unable to Zero - No Make sure that the transducer is connected and try
Transducer again. If this fails, exchange the adapter cable and
try again. If this fails, exchange the transducer.
Unable to Zero - Pulsatile Make sure the stopcock is off the patient and open
Pressure to air and try again.
Unable to Zero - Timed Out Try selecting the <Pressure> Zero button again. If
this fails, replace the transducer and adapter cable,
and contact your service personnel.
Unable to Zero - Excessive Make sure that the stopcock is open to atmosphere,
Offset not to the patient, and the stopcock is vented. Then
try again. If this fails, the hardware may be faulty.
Replace the adapter cable and try again. If it fails,
replace the transducer and try again. If it still fails,
contact your service personnel.

Selecting a Pressure Type
Selecting a Pressure Type

When you select an IBP pressure type, the monitor uses the alarm limits for the selected
pressure and changes the color of the associated numeric values and waveform.
Note — The IBP Label option appears in both the IBP numeric menu and IBP
waveform menu. Changes in one menu apply to the setting in the other menu.
To select an IBP pressure type for each channel:
Step
1 Select the IBP numeric pane or the IBP waveform pane.
2 Select the Label menu item.
3 Note — When you select a label for one IBP channel, you cannot
select the same label in the other IBP channel.
Select one of the following options:

• ABP
• CVP
• ART
• Ao
• ICP
• LAP
• P
• PAP
• RAP
• UAP
• UVP
4 Close the menu.

The IBP Numeric Pane
The IBP Numeric Pane

The following illustration shows the components of an IBP numeric pane. In this
example, the pane contains ABP numeric values.
Currently
selected
pressure type ABP mmHg Units of
measure
High and low
alarm limits
SYS
160 128/77
(systolic limits
in this example)
90
(94)
Systolic value MAP value Diastolic value
Changing IBP Settings

Use the IBP Menu accessed through the numeric pane to:
• Change the IBP label. See “Selecting a Pressure Type” on page 12-11.
• Change the IBP alarm limits
• Select the limits to display: Systolic, Diastolic, or Mean
• Change the units of measurement
To open the IBP Menu:
• Select the IBP numeric pane

The IBP menu appears and the current settings are displayed.

Changing the IBP Alarm Limits
Caution Accuracy values for supported IBP transducers are for IBP values up to 300
mmHg (40 kPa or 408 cmH2O), however the alarm limits can be adjusted up to 359
mmHg (47.9 kPa or 488 cmH2O).
For information on changing the IBP alarm limits, see “Changing Alarm Limits” on
page 3-6.
All IBP alarm limits can be changed in increments of 1 mmHg (0.1kPa or 1 cmH2O).
High Low High Low High Low

Systolic: 160 mmHg 90 mmHg 120 mmHg 70 mmHg 90 mmHg 55 mmHg
• ABP
(21.3 kPa) (12.0 kPa) (16.0 kPa) (9.3 kPa) (12.0 kPa) (7.3 kPa)
• Ao
(218 (122 (163 (95 (122 (75
• ART cmH2O) cmH2O) cmH2O) cmH2O) cmH2O) cmH2O)
• P
• UAP
Diastolic: 90 mmHg 50 mmHg 70 mmHg 40 mmHg 60 mmHg 20 mmHg
• ABP
• Ao
(122 (68 (95 (54 (82 (27
• ART cmH2O) cmH2O) cmH2O) cmH2O) cmH2O) cmH2O)
• P
• UAP
Mean: 110 mmHg 70 mmHg 90 mmHg 50 mmHg 70 mmHg 35 mmHg
• ABP
• Ao
(150 (95 (122 (68 (95 (48
• ART cmH2O) cmH2O) cmH2O) cmH2O) cmH2O) cmH20)
• P
• UAP


Mean: 10 mmHg 0 mmHg 4 mmHg 0 mmHg 4 mmHg 0 mmHg
• CVP
• ICP
(14 (0 (5 (0 (5 (0
• LAP cmH2O) cmH2O) cmH2O) cmH2O) cmH2O) cmH2O)
• RAP
• UVP
PAP Systolic 35 mmHg 10 mmHg 60 mmHg 24 mmHg 60 mmHg 24 mmHg

(48 (14 (82 (33 (82 (33
cmH2O) cmH2O) cmH2O) cmH2O) cmH2O) cmH2O)
PAP Diastolic 16 mmHg 0 mmHg 4 mmHg – 4 mmHg 4 mmHg – 4 mmHg

(2.1 kPa) (0.0 kPa) (0.5 kPa) (– 0.5 kPa) (0.5 kPa) (– 0.5 kPa)
(22 (0 (5 (– 5 (5 (– 5
PAP Mean 20 mmHg 0 mmHg 26 mmHg 12 mmHg 26 mmHg 12 mmHg

(27 (0 (35 (16 (35 (16

Changing the IBP Alarm Limits to Display

The IBP numeric pane can only display one set of IBP alarm limits at one time.
To choose the alarm limits to display:
Step
1 Open the IBP Menu.
2 Select the Limit Display menu item.

• Sys
• Dia
• Mean
4 Close the menu.
The numeric pane displays the select alarm limits.
Changing the IBP Units of Measurement
Note — The IBP Pressure Units option appears in both the IBP Menu and the IBP
waveform Menu. The selected setting applies to both panes.
To change the IBP units of measurement:
Step
1 Open the IBP Menu or the IBP Waveform Menu.
2 Select the IBP Pressure Units menu item.

Configuring the IBP Waveform

• mmHg
• kPa
• cmH2O
4 Close the menu.

Use the <Pressure> Waveform Menu to:
• Display overlapped IBP waveforms

• Change the waveform speed
• Change the waveform scale
• Change the IBP label. See “Selecting a Pressure Type” on page 12-11
• Zero the pressure (see “Setting Up Reusable Transducers” on page 12-7)
• Change the IBP units of measurement. See “Changing the IBP Units of
Measurement” on page 12-15

Displaying Overlapped IBP Waveforms

You can display the IBP1 and IBP2 waveforms overlapped. When the IBP waveforms
are overlapped, the number pane display alternates between the IBP1 and the IBP2
values.
To display overlapped IBP waveforms:
Step
1 Select any waveform.
The selected waveform menu appears.
2 Select the Select Waveform menu item.
3 Select Overlapped IBP.
The IBP Waveform Menu appears.
4 Optionally, change settings in the IBP Waveform Menu.
5 Close the menu.
Changing the Waveform Scale

If the displayed waveform is too small or it is clipped, use the Scale menu option to
adjust the size of the waveform.
Warning If you select Auto as the Scale, the scale adjustment is dynamic. Changes in the
patient's blood pressure may not be obvious from the waveform.

To change the display size of the IBP waveform:
Step
1 Open the IBP Waveform Menu.
2 Select the Scale menu item.
3 Select a scale option. Available options are listed in the following table.
4 Close the menu.

The following table lists the scale options for each type of IBP using different units of
measure.
IBP Waveform
mmHg kPa cmH2O
Selection
ABP Auto Auto Auto

Ao -10-20 -1.3-2.7 -14-27
ART 0-50 0.0-6.7 0-68
P 0-100 0.0-13.3 0-136
UAP 0-150 0.0-20.0 0-204
0-200 0.0-26.7 0-272
0-250 0.0-33.3 0-340
0-300 0.0-40.0 0-408
CVP Auto Auto Auto

ICP -20-0 -2.7-0.0 -27-0
LAP -10-0 -1.3-0.0 -14-0
PAP -5-0 -0.7-0.0 -7-0
RAP 0-10 0.0-1.3 0-14
UVP 0-20 0.0-2.7 0-27
0-30 0.0-4.0 0-41
0-40 0.0-5.3 0-54
0-50 0.0-6.7 0-68

IBP Safety Information

The Sweep Speed setting in the IBP Waveform Menu determines the speed at which the
waveform is drawn across the screen. For information on changing this setting, see
“Changing the Waveform Speed” on page 2-25.
The IBP Sweep Speed options are:
• 3.125 mm/s
• 6.25 mm/s
• 12.5 mm/s
• 25.0 mm/s
Warning It is the responsibility of the user to ensure that a zero procedure is done at the
recommended intervals, otherwise there will be no recent, valid zero value for the
instrument to use.
Do not reuse disposable pressure transducers.
Use only approved accessories to ensure accurate IBP measurements.
Invasive pressure alarms are turned off while the transducer is zeroing. The alarms
turn back on after the zeroing is finished.
To avoid degrading isolation and electrical safety of the monitor, make sure that all
leads and transducers connected to the monitor do not come in contact with
grounded surfaces or other electrical cables or components.

Caution During defibrillation, the pressure values may be temporarily interrupted or

distorted. After defibrillation, monitoring will continue as before.
Position any intravenous fluids so that they cannot accidentally spill on the device.
If liquid is spilled on the equipment and you believe the liquid may have gotten
inside the monitor, contact your technical support team, who can verify the
performance and safety of the unit. If liquid gets inside the transducer, the
transducer and IBP measurement may fail.
The disposable transducers and pressure domes are sterile and should be handled
accordingly. See the package for a Use By date.


13
Monitoring Cardiac Output
The Cardiac Output (C.O.) measurement invasively measures cardiac output

using a technique called right heart thermodilution. This can be used to
determine the flow rate of a system by introducing a cold solution into the
system and measuring the resulting drop in temperature at a downstream site.
The temperature change is displayed as a curve in the C.O. Procedure Menu,
and the monitor calculates the C.O. value from this curve. The C.O. value is
inversely proportional to the area under the curve.
Warning • As cardiac output varies continuously, a series of measurements must

be carried out to achieve a reliable C.O. average value. Always use the
average of multiple thermodilution measurements for therapy
decisions.
• Cardiac Output has not been validated for neonatal patients.
In the right heart thermodilution method, a fluid of known volume and

temperature is injected into the right atrium through the proximal port of a
pulmonary artery (PA) (Swan-Ganz) catheter. The injectate bolus mixes with the
blood in the right ventricle and the change in blood temperature is measured
with a thermistor at the distal end of the catheter in the pulmonary artery.
The cardiac output measurement is based on the selection and application of the
appropriate Swan-Ganz catheter for the patient and which must be performed by
qualified medical professionals

Setting up C.O. Measurements

The following diagram shows the C.O. setup using an in-line injectate
temperature probe.
1. Efficia CM monitor
2. C.O. interface cable
3. Remote switch (not
supported)
4. Thermistor connector
of C.O. cable
5. Thermistor port on
catheter
6. Swan Ganz (PA)
catheter
7. Injectate temperature
probe housing for in-line
(Co-Set) temperature
8. Injectate syringe
9. Closed-system
injectate temperature
probe connection site

To set up C.O. measurements
Step
1 Follow your hospital standards to avoid unintentional extraction

of the C.O. catheter. Secure the cable using the mounting clip
shipped with each C.O. interface cable. You may also find it
helpful to loop the C.O. interface cable, tape the loop, and
attached it to the undersheet of the patient’s bed using a safety
pin.
2 Connect the cardiac output cable to the monitor. Connect the

desired injectate temperature probe to the cable. (It may be an
ice bath probe or in-line injectate temperature probe.)
3 Set up the cardiac output supplies and injectate fluids (fluids,

syringes, and so on) according to the manufacturer's guidelines
and hospital protocol.
4 Plug the thermistor connection cable of the PA catheter into the

thermistor connector.
5 If using an in-line injectate temperature probe, connect the

injectate temperature probe to the injectate temperature probe
housing.
If using an ice-bucket style injectate temperature probe, place
the probe in the ice-bucket along with the fluid-filled syringes.
If using ambient temperature place the probe as per your policy.
Note — If no injectate temperature probe is used, the
temperature must be entered manually before performing a
cardiac output measurement.

Ellficia CM Instructions for Use 13-3
The Cardiac Output Numeric Pane
Injectate Temperature
If you are using the closed system method, the injectate temperature is measured
at the time of injection by the temperature probe in the injectate temperature
probe housing.
If you are using the ice-bath setup, the injectate temperature probe and the
injectate are both placed in an ice-bath and the probe measures the temperature
of the contents of the ice bucket.
An advantage of using the injectate temperature probe (either closed or open) is

that it will automatically populate in the C.O. Procedure Menu. If you choose
not to use a probe, you must manually enter the value. An inaccurate
temperature value will affect the accuracy of the C.O. measurements.
The Cardiac Output Numeric Pane

The following illustration shows the components of the Cardiac Output numeric
pane.
Time of last mean
C.O value
TbloodoC C.O l/min 04:34

39.0
Tblood high and

36.0
36.9 2.45
low alarm limits
Tblood measurement Mean C.O.value

Changing the Cardiac Output Settings
Changing the Cardiac Output Settings

Use the C.O. Menu to:
• Change the C.O. Tblood alarm limits

• Select the catheter type you are using for the procedure and open the C.O.
Procedure Menu.
To open the C.O. Menu:
• Select the C.O. numeric pane.

The C.O. Menu appears. Current settings are displayed.
Changing the Tblood Alarm Limits

For information on changing the Tblood alarm limits, see “Changing Alarm
The Tblood default alarm limits are:
Alarm
Increments
Tblood high limit 39oC 39oC 39oC 0.1oC
Tblood low limit 36oC 36oC 36oC 0.1oC

Performing C.O. Measurements

This section provides information about configuring C.O. settings and describes
how to perform C.O. measurements
Setting the Computation Constant

The computation Constant (K value) is a correction factor defined by the swan
ganz catheter manufacturer to adjust for the temperature gain change as the
injectate fluid moves from injection site to the measurement site on the catheter.
To ensure accurate readings, select the correct computation constant before

starting a C.O. measurement. The computation constant value can be found in
the documentation supplied with the catheter you are using. The computation
constant is based on the injectate volume, injectate temperature and catheter
type.
If your catheter type is listed in the Catheter Type list, you must enter an
injectate volume in the C.O. Procedure Menu. You must also enter an injectate
temperature if you are not using an injectate temperature probe. The
computation constant is automatically populated.
If your catheter type is not listed in the Catheter Type list, select Other. In the
C.O. Procedure Menu, you must manually enter a computation constant that
matches the volume and temperature of the injectate to be used.
Injectate Guidelines
Consistently perform injection during the same phase of the respiration cycle to
get consistency in results and avoid the varying influence of respiration on the
cardiac output values.
The greater the injectate volume and the colder the temperature, the more
accurate the measurement. Reduced injectate volume or higher injectate
temperature may reduce the specified accuracy and require additional trials to
improve accuracy.

To ensure the greatest measurement accuracy for adult patients, use a cold
injectate (<8°C) of 10 ml volume, if not contra-indicated by the patient’s
condition. Your choice of injectate volume should be based on the injectate
temperature and the patient’s cardiac output.
The use of injectate with a temperature less than 8°C lower than the blood
temperature may cause incorrect values for the thermodilution.
To perform C.O. measurements:
Step
1 Open the C.O. Menu.
2 Select the Catheter Type menu item.
3 Select one of the following options. If your catheter type is not

listed, select Other.
• 096F6
• 131F7
• 132F5
• 831HF75
• Other
4 Select the C.O. Measurement button.
The C.O. Procedure Menu appears.

• If you selected a catheter type of Other, enter the
Computation Constant value, which can be found in the
documentation supplied with the catheter. Proceed to step
8.
• If you selected a specific catheter type in the C.O. Menu,
the computation constant value for the selected cathether
appears in the Computation Constant field. You cannot
change the computation constant value. Proceed to step 6.


• If you are using an injectate temperature probe that
measures the injectate temperature, the value appears in the
Injectate Temp field. You cannot change the injectate
temperature value. Proceed to step 7.
• If your injectate temperture probe does not measure the
injectate temperature, enter a value in the Injectate Temp
field.
7 Enter an Injectate Volume. The choices are: 10 ml, 5 ml, 3 ml,

and 1 ml.
8 When you see the Ready for new measurement message

below the waveform, select the Start Measurement button.

9 When you see the message Inject now, inject the solution into
the right atrial port of the Swan-Ganz catheter in 4 seconds or
less for a 10 ml bolus.
The Measurement in Progress... message appears.
At the end of the measurement, the Measurement Complete

message appears, and the thermodilution curve, cardiac output,
Tblood, and Tinj values appear. The Please wait to start next
measurement... message appears.
For information about C.O. measurement error messages, see

“Measurement Errors” on page 13-10.
10 When you see the Ready for new measurement message,

repeat the procedure until you have completed the
measurements you want to perform. You can perform a
maximum of six measurements before editing.
If you perform more than six measurements, the measurement
highlighted in red or the oldest measurement is automatically
deleted.
Note — To ensure accurate results, the blood temperature and
the injectate temperature should return to pre-injection levels
before starting a new measurement trial. Typically this is 1 -2
minutes from the previous measurement trial
11 Edit the saved measurements, as described in “Editing and

Saving C.O. Measurements” on page 13-11.

Measurement Errors
Numerous factors can influence the accuracy of the cardiac output values:
intracardiac shunts, valvular insufficiency, intrathoracic pressure changes, rapid
blood temperature changes and arrhythmias. Follow your institution’s policies
and protocols for performing a cardiac output measurement
During the C.O. measurement, the monitor may detect errors and then discard
the measurement.
Noisy Baseline
If the monitor detects a noisy baseline after you select the Start Measurement
button, the Noisy Baseline message appears. If the noise continues for 25
seconds, the Measurement Failed - Noisy Baseline message appears and the
measurement is discarded.
A noisy baseline can be caused by any of the following:
• Interference from a ventilator

• Interference from an infusion pump. Infusions of significant volume
through the central line should be paused at least 30 seconds before the
first thermodilution measurement in a series and should not recommence
until the measurement series is competed.
• Injections administered through the central line during a measurement.
• Electrical interference. Check for infusion pumps connected to the central
catheter, cables parallel to the thermodilution cable, electrocautery. Make
sure all devices are properly grounded.
• Patient or catheter movement during measurement.
• The stopcock to the injectate syringe is not closed after the injection.
• The catheter is rinsed during measurement.

Measurement Failed
If a C.O. measurement fails, the Measurement Failed message appears and the
measurement is discarded.
A Measurement Failed message may occur for many reasons, including a faulty
injection technique, an invalid injectate temperature, or a delayed injection.
Changing the Waveform Scale
Note — You cannot change the scale during a cardiac output measurement.
If the blood temperature waveform in the C.O. Procedure Menu is too small or
clipped, you can change the scale. To change the scale:
• Select the Scale menu item and select one of the following options:
– 0.5 oC
– 1.0 oC
– 1.5 oC
– 2.0 oC
Editing and Saving C.O. Measurements

The Edit C.O. Menu displays up to six trials (measurement curves) with the trial
number and the C.O value, injectate temperature, injectate volume, and the
computation constant under the thermodilution curve.
It is important to identify and reject erroneous measurements, as the monitor

uses all the measurement trial values you do not reject to calculate the averaged
cardiac output.

To edit the measurements:
Step
1 In the C.O. Procedure Menu, select the Edit C.O. button.
The Edit C.O. Menu appears. For each trial, the trial number,
C.O value, injectate temperature, injectate volume, and the
computation constant appear under the thermodilution curve.
2 Review the trials. Consider the similarity of the values and the
shape of the C.O. curve. A normal C.O. curve has one smooth
peak and returns to the temperature baseline level after the peak.
3 Select the trials you want to delete.
A red box appears around each of the trials selected for deletion.
The monitor recalculates the mean C.O. value each time you
select a trial for deletion. The calculated value appears above
the Save button.
Select the trial again to deselect it.
4 Select the Save button to discard the unwanted trials and save
the mean value to the C.O. numeric pane on the main screen.
The time at which the mean value was calculated appears in the
C.O. numeric pane. The mean value is displayed for 60 minutes.

Cardiac Output Safety Information
Warning • C.O. measurement accuracy may be affected by degraded invasive

pressure, a rapid decrease in body temperature, or arrhythmias.
• Make sure the computation constant for the measurement is
appropriate to the injectate volume, injectate temperature and catheter
type used.
• Do not use the Cardiac Output interface cable in Magnetic Resonance
Imaging (MRI) applications.
• Do not use an arterial catheter in the arteria femoralis when it is
contraindicated for example, with patients who have an aortic graft.
Caution Temperature blood alarms are suppressed for one minute after the C.O.
measurement is started. Making the alarms inactive during this procedure
prevents false alarms.


14
Using the Recorder
This chapter describes how to perform the following tasks using the optional recorder:
• Create a printout
• Configure recording options
• Load the recorder paper
• Configure the recorder settings
Note — The CM10 and CM12 monitors have a Record key on the front panel and a
Record button in the system toolbar. You can use either the Record key or the Record
button to initiate recordings.
Warning Printed and exported patient records contain patient IDs and patient data. Ensure
that the printed or exported data is handled according to your facility’s electronic
protected health information (ePHI) guidelines.
Only authorized personnel should be allowed to view, handle, store, or transmit

patient data.
Creating Printouts
The behavior of the recorder depends on the context in which it is used.
To print a recording from the main screen, do one of the following:
• Select Record to produce a recording of current waveform data and all vital signs
measurements.
• Hold Record for 2 seconds to generate a continuous recording of all current data.
Using the Recorder

Recording Options
The recorder continues printing until you select Record again to stop the
recording.
To print a recording in Freeze mode:
Step
1 Select Record .
The Frozen Record Settings Menu appears.
2 Select the waveforms to include on the printout and then select Record.
To stop recording at any time, select Record again.
Use the Waveform Print option in the Recorder Settings Menu to select the length of
printed waveforms. See “Configuring Recorder Settings” on page 14-4.
Recording Options
You can also use the recorder to perform the following functions:
• Automatically generate a printout when a physiological alarm occurs. See

“Enabling Record on Alarm” on page 3-11.
• Initiate a printout each time an NBP measurement is taken. See “Enabling
Automatic NBP Recordings” on page 5-7.
• Print out NBP, graphic, and tabular trend data. See “Recording Trend Data” on
page 15-18.
• Print out an alarm event or alarm history. See “Recording Trend Data” on
page 15-18.
Using the Recorder

Loading the Recorder Paper
Loading the Recorder Paper
Caution Use only Philips-supplied paper. Using the wrong paper can damage the recorder.
If the paper is inserted incorrectly, no data is printed.
To load the paper in the recorder:
Step
1 Press the paper eject button on the left side of the recorder door to
open the door. If the door does not open completely, pull it
toward you.
2 Remove the empty paper core.
3 Place a new roll in the holder so that the end comes from the back
over the top of the roll and slide the paper through the slot in the
door.
Eject button
Recorder
paper
Recorder
door
Using the Recorder

Configuring Recorder Settings
4 Pull the loose edge to remove any slack and close the recorder
door.
5 Select Record to verify that the paper is loaded correctly.

Use the Recorder Settings in the System Menu to configure the following:
• Recorder speed
• ECG gain
• Length of the recorded waveforms as the Waveform Print setting
• Number and type of waveforms recorded
To configure the recorder settings:
Step
1 Select System .
The System Menu appears.
2 On the General tab, select Recorder Settings.

The Recorder Settings Menu appears.
Using the Recorder

3 Select the Recorder Speed.

The options are:
• 6.25 mm/s
• 12.5 mm/s
• 25.0 mm/s
• 50.0 mm/s
Note — When you record OxyCRG data, the recorder speed is always
12.5 mm/s, regardless of the recorder speed setting. When you enable
the Record on Alarm option, the recorder speed is always 25 mm/s,
regardless of the recorder speed setting.
4 Select the ECG Gain.

The options are:
• Auto — the wave recording uses the same scale as the monitor
display
• 5 mm/mV — 5 millimeters per millivolt scale
5 Select the Waveform Print.

The length of the printed waveform options are:
• 7 seconds — The printout contains the values that occurred
7 seconds after the recording is initiated.
• 20 seconds — The printout contains the values that occurred
7 seconds before and 13 seconds after the recording is initiated.
6 Select the Number of Real-Time Waves to print.

The options are:
1–4
Using the Recorder

7 Select the Real-Time Wave 1 to print.

The options are:
• Primary ECG
• Secondary ECG
• ECG I
• ECG II
• ECG III
• ECG aVR
• ECG aVL
• ECG aVF
• ECG V
• ECG MCL
8 Select the Number of Full Disclosure Waves to print.

The options are:
1–4
9 Select Full Disclosure Wave 1.

The options are:
• ECG I
• ECG II
• ECG III
• ECG aVR
• ECG aVL
• ECG aVF
• ECG V
• ECG MCL
Using the Recorder

10 Select Full Disclosure Wave 2.

The options are:
• SpO2
• ECG I
• ECG II
• ECG III
• ECG aVR
• ECG aVL
• ECG aVF
• ECG V
• ECG MCL
• IBP1(ABP)
• IBP2(PAP)
• CO2
11 Close the System Menu.
Using the Recorder

Using the Recorder

15
Viewing Trend Data
Trend data is useful for assessing a patient’s progress over a period of time. The
trend database can store and display the following information:
• The time at which each set of measurements was recorded

• All physiological parameters that are available on the monitor
• All physiological alarm events
For information about creating printouts of trend data, see “Recording Trend
Data” on page 15-18.
Note — The CM10 and CM12 monitors have a Trend key on the front panel
and a Trend button in the system toolbar. You can use either the Trend key or
the Trend button to open the Trend display.
Trend Data Overview

The trend database can store up to 240 hours (10 days) of trend data for a single
patient. After 240 hours, the oldest data is deleted to make room for newer data.
The Full Disclosure option, which also appears in the Trend display window,
can store up to 48 hours of waveform data and corresponding numeric values for
the current patient.
A trend record is defined as the data that is captured from the time you start a
new patient until you either shut down the monitor or admit a different patient.
When you start a new patient, all current patient data is cleared from the trend
database.
Continuous measurements (for example, SpO2 and Respiration) are captured and
stored in the trend database every 15 seconds; aperiodic measurements (for
example, NBP) are recorded at the time that the measurement is started.
Viewing Trend Data

Efficia CM Series Instructions for Use 15-1
The Trend Display
The Trend Display

You can view trend data in the following formats:
• Tabular trend view

• NBP trend view
• Graphical trend view
• Alarm history view
• Full Disclosure view (if installed)
To open the Trend display:
• Select Trends .
The Trend display appears. The Alarm/Events tab opens by default.
Caution Note that the trend display menu covers most of the screen. Two waveforms
and two numeric panes appear at the top of the screen. You can change the
displayed waveforms and numeric panes.
All audible and visual alarms remain active.
By default, the trend display remains active for 3 minutes if no other user
interaction occurs.
Note — Your system administrator can change the default trend display
timeout period in the password-protected System Menu.
When the Trend display is open, two real-time waveforms and two real-time
parameters are visible at the top of the screen. You can change the waveforms or
parameters that appear by selecting the numeric pane and selecting the
parameter from the list. The top waveform must be ECG.
If a high-priority alarm occurs while the trend display is open, the monitor will
close the trend display and return to the layout that was active before the trend
display was opened.
Viewing Trend Data

15-2 Efficia CM Series Instructions for Use
Viewing Tabular Trends
If the clock on your monitor is synchronized with the clock on the network
server or the clock on the Central, and the time on the monitor is adjusted, a blue
line appears in the graphical and tabular trend displays.

The Tabular Trend tab displays patient data in a tabular format of columns and
rows. The following illustration shows the Tabular trend display.
Date/Time HR (bpm) NBP(mmHg) Pulse(bpm) RESP(rpm) ABP (mmHg awRR(rpm)

2014/09/22 13:34:00 60 -/-(-) - 15 119 / 80 (93) -
2014/09/22 13:33:45 60 -/-(-) - 15 119 / 80 (93) -
2014/09/22 13:33:30 60 -/-(-) - 10 119 / 80 (93) -
2014/09/22 13:33:15 60 -/-(-) - 15 119 / 80 (93) -
2014/09/22 13:33:00 100(NBP) 15 -
60 120/80(93) 119 / 80 (93)
2014/09/22 13:32:45
60 -/-(-) - 15 119 / 80 (93) -
2014/09/22 13:32:30
60 -/-(-) - 15 119 / 80 (93) -
2014/09/22 13:32:15
60 -/-(-) - 15 119 / 80 (93) -
2014/09/22 13:32:00
60 -?-/-?-(-?-) - 15 119 / 80 (93) -
2014/09/22 13:31:45
60 -/-(-) - 15 119 / 80 (93) -
2014/09/22 13:31:30
2014/09/22 13:31:15 60 -/-(-) - 15 119 / 80 (93) -
The most recent measurement is displayed in the top row of the Tabular trend
display. Each row begins with the date and time at which the measurements
were taken, followed by the measurement values.
A question mark (-?-) in a row indicates an invalid measurement and a dash (-)
indicates that the parameter was not measured. Any measurement that exceeds
alarm limits is enclosed in a box.
A horizontal, dashed blue line between rows indicates a gap in monitoring. A

horizontal, solid blue line indicates that a date/time adjustment of more than
60 seconds occurred.
Viewing Trend Data

If a continuous measurement exceeds alarm limits, and the value then returns to
normal, the value recorded in the tabular trend record at the time that the alarm
occurred may differ from the current value displayed in the numeric pane.
Changing the Displayed Parameters

The Tabular Trend tab can display all of the parameters that are available on the
monitor. If a parameter is selected in the Tabular Trend Settings Menu that is
not currently being measured, the column header appears in the Tabular Trend
tab but the column displays a dash. If a parameter is not selected in the Tabular
Trend Settings Menu, the column for that parameter does not appear in the
Tabular Trend tab.
Note — You cannot change the order in which the parameters are displayed.
Use the scroll bars at the bottom and side of the display to view parameters.
To change the displayed parameters:
Step
1 In the Trend display, select the Tabular Trend tab.
2 Select Settings.
The Tabular Trend Settings Menu opens. All available
parameters (based on your monitor’s configuration) are listed.
3 Select or clear the check boxes next to each parameter.
4 Close the Tabular Trend Settings Menu.
Changing the Display Interval

The monitor stores all continuous measurements in the trend database every
15 seconds and all aperiodic measurements (for example, NBP) at the time the
measurement is started. You can configure the Tabular trend display to show all
measurements (every 15 seconds) or you can select a different interval value.
Viewing Trend Data

To change the display interval in the Tabular trend display:
Step
2 Select the Interval list and select one of the following options:
15 sec, 1 min, 3 min, 5 min, 10 min, 15 min, 30 min, 60 min,
90 min, or 120 min.
Selecting the Most Recent Trend Record

You can select the Go To button in the Tabular trend display to specify the date
and time of the trend record to appear at the top in the tabular trend.
Step
2 Select Go To.
The Enter Date/Time window opens. The time range and the
total number of hours of available trend data appear in the
window.
3 Select the entry field.
4 In the window that appears, select a date and time within the
available range and select OK.
5 Select OK to close the Enter Date/Time window.

The record with the date and time that you selected appears in
the top row of the tabular trend display.
Viewing Trend Data

Viewing NBP Trends
Viewing NBP Trends

The NBP Trend tab displays all NBP measurement values for the current patient
in a tabular format of columns and rows. The most recent data appears in the top
row of the NBP Trend tab. Each row contains the date and time of the NBP
measurement and all other measurements recorded at the time the NBP
measurement occurred.
Date/Time NBP(mmHg) HR (bpm) SpO2(%) Pulse(bpm) RESP(rpm) PAP (mmHg)
2014/09/22 14:10:00 120/80(93) 60 98 100(NBP) 15 24 / 10 (14)

2014/09/22 14:05:00 120/80(93) 60 99 100(NBP) 15 24 / 10 (14)
2014/09/22 14:00:00 120/80(93) 60 98 100(NBP) 15 24 / 10 (14)
2014/09/22 13:55:00 120/80(93) 60 98 100(NBP) 15 24 / 10 (14)
2014/09/22 13:50:00 120/80(93) 60 -?- 100(NBP) 15 24 / 10 (14)
2014/09/22 13:45:00 120/80(93) 60 99 100(NBP) 15 24 / 10 (14)
A question mark (-?-) in a row indicates an invalid measurement and a dash (-)
indicates that the parameter was not measured. Any measurement that exceeds
alarm limits is enclosed in a box.
A horizontal, solid blue line between rows indicates that a date/time adjustment
of more 60 seconds occurred.
Use the scroll bars at the bottom and side of the display to view parameters.
Viewing Trend Data

Viewing NBP Trends
Changing the Displayed Parameters

The NBP Trend tab can display all available parameters. If you select a
parameter in the NBP Trend Settings Menu that is not currently being
measured, the column header appears in the NBP Trend tab, but the column
displays a dash. If a parameter is not selected in the NBP Trend Settings Menu,
the column for the parameter does not appear in the NBP Trend tab.
Step
1 In the Trend display, select the NBP Trend tab.
2 Select Settings.
The NBP Trend Settings Menu opens.
3 Select or clear the check boxes next to each parameter. All

available parameters (based on your monitor’s configuration) are
listed.
4 Close the NBP Trend Settings Menu.
Viewing Trend Data

Viewing Graphical Trend Data

The Graphical Trend tab displays patient data in a line graph format. Parameter
values are plotted vertically along the y-axis of the graphical display and a time
range appears along the x-axis. The most recent measurements appear on the
right side of the graph and the data scrolls to the left, so the oldest data appears
on the far left side of the graph.
HR 114
(bpm)
HR 98
60
Parameter 82
labels 66
50
09/25/2014 09:30:00
NBP
(mmHg)
Sys 130
120
Dia
80 90
MAP
93 50
09/25/2014 12:15:00 09/25/2014 08:15:00
Color-coded dot Cursor line marks a Scroll to the Scroll up and

indicates alarm specific point in time left to view down to view
older data measurements
Parameter labels appear on the left side of the graph. Use the vertical scroll bar
to scroll through the parameter graphs. Use the horizontal scroll bar to move the
graphical display forward or backward in time. The timestamps on the bottom of
the graphical display indicate the time range of the currently displayed trend
data. The displayed time range is based on the current Time Scale setting.
If a physiological alarm occurs, a small dot appears along the bottom of the
graph. The color of the dot indicates the alarm priority: red for high priority,
yellow for medium priority, and blue for a low priority alarm.
Viewing Trend Data

NBP and Pulse measurements, which are aperiodic measurements, appear as

data points, or dots, in the Graphical Trend display. The NBP Systolic value is a
pink dot, Diastolic is a yellow dot, and MAP is a green dot. The Pulse value is a
red dot.
A vertical, solid blue line indicates that a date/time adjustment of more than 60
seconds occurred.
A vertical, solid white cursor line spans the measurements in the graph and
marks a specific point in time in the database. If you move the cursor across the
time line, the values measured at the cursor time appear in the left side of the
graph.
Selecting the Displayed Parameters

The Graphical Trend tab can display all available parameters. If a parameter is
selected in the Graphical Trend Settings Menu, but that parameter is not
currently being measured, the graph is blank. If a parameter is not selected in the
Graphical Trend Settings Menu, the parameter label and graph do not appear in
the Graphical Trend tab.
Step
1 In the Trend display, select the Graphical Trend tab.
2 Select Settings.
The Graphical Trend Settings Menu opens. All available
parameters (based on your monitor’s configuration) are listed.
3 Select or clear the check boxes next to each parameter.
4 Close the Graphical Trend Settings Menu.
Viewing Trend Data

Changing the Resolution of the Graphical Trend Data

Changing the Time Scale setting in the Graphical Trend Menu increases or
decreases the resolution of the data in the graphical display.
To change the time scale:
Step
2 Select the Time Scale list and select one of the following
options: 4 hr, 8 hr, 12 hr, or 24 hr.
The graphical trend display changes.
Selecting a Location in the Graphical Trend Data

A vertical, solid white cursor line spans the measurements in the graph and
marks a specific point in time in the database. If you move the cursor across the
time line, the values measured at the cursor time appear in the left side of the
graph.
You can select the Go To button in the Graphical Trend tab to specify a date
and time in the Graphical trend data.
To select a location in the graphical trend data:
Step
2 Select Go To.
window.
Viewing Trend Data

Viewing Alarm/Event Trend Data
4 In the window that opens, select a date and time within the
available range, and select OK.

The solid, vertical, white cursor line appears at the right side of
the graphical trend display, and the selected date and time
appears to the left of the cursor line. The values measured at the
cursor time appear in the left side of the graph.

The Alarm/Event tab displays all physiological alarms and events for a specific
patient in a tabular format of columns and rows. The most recent alarm appears
in the top row of the display.
Each alarm entry includes the following information:
• The date and time the alarm occurred.

• The alarm message and associated value for the physiological alarm.
• The alarm priority level. The Priority is color-coded: red for high priority,
yellow for medium priority, and blue for a low-priority alarm.
The Alarm/Event tab can store up to 200 alarms and manual events for the
current patient. If the total number of alarms/events exceeds 200, the oldest
alarm or event is deleted.
Caution To prevent the loss of alarm/event records, use the optional recorder to
print the alarm/event records before the oldest data is deleted.
Viewing Trend Data

Date/Time Alarm Description Priority

09/22/2014 20:30:00 SpO2 High, SpO2=97 % Medium
09/22/2014 18:14:00 T1 Low, T1=25.2 °C Low
09/22/2014 18:06:34 Manual Event
ECG II HR 60 bpm
SpO2 97 %
1.0mv NBP -/-(-) mmHg
SpO2
Pulse 70 bpm
Resp 30
awRR - rpm
RESP etCO2 - mmHg
The pane below the list of alarms displays up to three waveforms that
correspond to the time that the alarm occurred. You can select the waveforms to
appear in the Alarm History Settings Menu. Each waveform shows activity
7 seconds before the alarm event occurred and 13 seconds after the alarm
occurred. A vertical, solid white line in the waveform pane marks the time that
the alarm event occurred.
When you highlight an alarm in the list, the measurement values that were valid
when the alarm occurred appear in a pane to the right of the waveforms.
If an alarm record is rejected by the EHR server, the alarm date and time and the
alarm description are shown in blue. Error messages appear below the
measurement values.
Viewing Trend Data

Manually Marking an Event

You can mark an event to create a record of a patient’s condition, including the
patient’s vital signs, alarm conditions and associated waveforms, at the time the
event was marked.
Caution If the total number of alarms and events exceeds 200, critical alarm records
may be deleted. To prevent the inadvertent loss of alarm records, use
discretion when manually marking events.
You can also use the optional recorder to print the alarm/event records
before the oldest data is deleted.
To mark an event:
• Select the Manual Event button .

A message appears indicating that the event was marked. To view the
event, see “Viewing Alarm/Event Trend Data” on page 15-11.

The monitor can display three waveforms in the Alarm/Event tab.
Note — You cannot change the order in which the waveforms are displayed.
To change the displayed waveforms:
Step
1 In the Trend display, select the Alarm/Event tab.
2 Select Settings.
The Alarm History Settings Menu opens. All available
waveforms (based on your monitor’s configuration) are listed.
3 Select up to 3 waveforms.
4 Close the Alarm History Settings Menu.
Viewing Trend Data

Viewing Full Disclosure Data

The Sweep Speed setting determines the speed at which the waves are drawn
across the screen. Decreasing the wave speed compresses the waves, allowing
Step
2 Select Settings.
The Alarm History Settings Menu opens.
3 Select the Sweep Speed list and select one of the following
options:
• 12.5 mm/s
• 25.0 mm/s
4 Close the Alarm History Settings Menu.

The Full Disclosure tab displays waveforms and parameters for the current
patient for up to 48 hours. The tab is divided in two panes. The waveforms
appear on the left side of the screen and the parameter list appears on the right
side of the screen.
In the waveform pane, a vertical solid white cursor line marks a specific point in
time in the database.
The monitor stores full disclosure data in 10-minute segments.
Viewing Trend Data

ECG II 09/22/2014 20:30:00
HR 60 bpm
1.0mv
SpO2 97 %
SpO2 NBP -/-(-) mmhg
Pulse 70 bpm
Resp 30
09/22/2014 20:30:00 awRR - rpm
RESP
etCO2 - mmHg
Cursor line marks a

specific point in time

The monitor can display all available waveforms in the Full Disclosure tab.
Note — You cannot change the order in which the waveforms are displayed.
To change the displayed waveforms:
Step
1 In the Trend display, select the Full Disclosure tab.
2 Select Settings.
The Full Disclosure Settings Menu opens. All available
waveforms (based on your monitor’s configuration) are listed.
3 Select or clear the check boxes next to each waveform.
4 Close the Full Disclosure Settings Menu.
Viewing Trend Data


The Sweep Speed setting determines the speed at which the waves are drawn
across the screen. Decreasing the wave speed compresses the waves, allowing
Step
1 Open the Full Disclosure Settings Menu.
2 Select the Sweep Speed list and select one of the following
options:
• 12.5 mm/s
• 25.0 mm/s
3 Close the Full Disclosure Settings Menu.
Selecting a Location in the Full Disclosure Trend Data

A vertical, solid white cursor line spans the waveforms in the graph and marks a
specific point in time in the database. If you move the cursor across the time
line, the values measured at the cursor time appear in the left side of the graph.
You can select the Go To button in the Full Disclosure tab to specify a date and
time in the Full Disclosure data.
To select a location in the Full Disclosure trend data:
Step
2 Select Go To.
window.
Viewing Trend Data

4 In the window that opens, select a date and time within the
available range, and select OK.

The solid, vertical, white cursor line appears at the right side of
the graphical trend display, and the selected date and time
appears to the left of the cursor line. The values measured at the
cursor time appear in the left side of the graph.
Viewing Trend Data

Recording Trend Data
Warning Printed patient records contain patient IDs and patient data. Ensure that the
printed data is handled according to your facility’s electronic protected
health information (ePHI) guidelines. Only authorized personnel should be
allowed to view, handle, store, or transmit patient data.
Note — For information about configuring recorder settings and loading the
recorder paper, see Chapter 14, “Using the Recorder.”
If your monitor has a recorder, you can create paper strip recordings by selecting
the Record button in the trend display tabs. You can record the following trend
data for a single patient:
• Tabular trend data

• NBP trend data
• Graphical trend data
• Alarm history
• Full disclosure
Viewing Trend Data

Recording Tabular Trends

You can select the Record button in the Tabular Trend tab to send the patient’s
tabular trend data to the recorder.
To record tabular trend data:
Step
2 Select Record.
The Record Menu opens.
3 Select a range of trend records to print.

The options are: Most Recent, 1 hour, 2 hours, 4 hours,
8 hours, or 12 hours
If you select Most Recent, the printout contains only the most
recent trend record in the trend database For an example, see
“Single Record Printout Format” on page 15-20.
The number of records in the printout depends on the
configured display interval. For example, if the display interval
is 10 minutes and you select 1 hour in the Record Menu, the
printout contains six records that are 10 minutes apart. For a
example, see “Multiple Records Printout Format” on
page 15-21.
4 A printout is sent to the recorder.
Viewing Trend Data

Single Record Printout Format
A single record printout contains one trend record that includes the patient ID,
patient type, monitor name, date and time, and all parameters. A question mark
(-?-) indicates an invalid measurement and a dash (-) indicates that the parameter
was not measured. A measurement that exceeds alarm limits is enclosed in a
box.
CN00000001
MR012345
John
R
Smith
Bed001
Adult
09/18/2014 15:25:00
HR 60 bpm
SpO2 -?- %
NBP(S) - mmHg
NBP(D) - mmHg
NBP(M) - mmHg
Pulse 85(SpO2) bpm
RESP 10 rpm
PAP(S) 24 mmHg
PAP(D) 10 mmHg
PAP(M) 14 mmHg
ABP(S) 119 mmHg
ABP(D) 80 mmHg
ABP(M) 93 mmHg
awRR - rpm
etCO2 - mmHg
Viewing Trend Data

Multiple Records Printout Format
A printout that contains multiple trend records contains the patient ID, patient
type, monitor name, date and time, and all valid and invalid parameters. The
parameters are printed in the same order that they appear on the screen, left to
right. The most recent records are at the top of the printout and the oldest
records are at the bottom. A question mark (-?-) indicates an invalid
measurement and a dash (-) indicates that the parameter was not measured. A
measurement that exceeds alarm limits is enclosed in a box.
12/30/2014 Date/Time HR(bpm) SpO2(%) NBP(mmHg) Pulse(bpm) RESP(rpm) PAP(mmHg)

10:11:00
CN31000183 05/10/2014 10:10:45 60 98 -/-(-) 80 (SpO2) 15 24/10(14)
MR0123456 05/10/2014 10:10:30 60 99 -/-(-) 83 (SpO2) 10 24/10(14)
Adult 05/10/2014 10:10:15 60 98 -/-(-) 88 (SpO2) 15 24/10(14)
05/10/2014 10:10:00 60 98 -/-(-) 80 (SpO2) 15 24/10(14)
05/10/2014 10:09:45 60 98 -/-(-) 84 (SpO2) 15 24/10(14)
05/10/2014 10:09:30 60 98 -/-(-) 80 (SpO2) 15 24/10(14)
05/10/2014 10:09:15 60 98 -?-/-?-(-?-) 88 (SpO2) 15 24/10(14)
05/10/2014 10:09:00 60 99 -/-(-) 89 (SpO2) 15 24/10(14)
Viewing Trend Data

Recording NBP Trend Data

You can select the Record button in the NBP Trend tab to send the NBP trend
data to the recorder.
To record NBP trend data:
Step
1 In the Trend display, select the NBP Trend tab.
2 Select Record.
3 Select a range of NBP trend records to print.

The options are: Most Recent, 1 hour, 2 hours, 4 hours,
8 hours, or 12 hours
If you select Most Recent, the printout contains only the most
recent NBP trend record in the trend database. For an example,
see “Single Record Printout Format” on page 15-20.
The number of records in the printout depends on the
configured display interval. For example, if the display interval
is 10 minutes and you select 1 hour in the Record Menu, the
printout contains six records that are 10 minutes apart. For a
example, see “Multiple Records Printout Format” on
page 15-21.
Viewing Trend Data

Recording Graphical Trend Data

You can select the Record button in the Graphical Trend tab to send the
graphic trend data to the recorder.
To record graphical trend data:
Step
2 Select Record.
3 Select a time range of the graphic trend data to record.

The options are: 30 minutes, 1 hour, 2 hours, or 4 hours.
4 A printout is sent to the recorder. The recorder speed is

12.5 mm/s. The length of the printed paper strip is
approximately 10 cm, regardless of the time range selected.
Graphical Trend Printout Format
A graphical trend printout data contains the patient ID, patient type, monitor
name, date and time, and the graphical trend of the two parameters currently
visible on the Graphical Trend tab.
12/30/2014 SpO2 100

10:29:27 % 98
CN00000001 96
94
12345
92
Adult 90
160
NBP
130
mmHg
90
50
-30min -20min -10min
Viewing Trend Data

Recording Alarms and Events

You can select the Record button on the Alarm/Event tab to send a list of the
alarms to the recorder.
To record the alarms and events listed in the Alarm/Event tab:
Step
2 Select an alarm.
3 Select Record.
4 Select a time range of alarm data to record.

The options are: Single Record, 1 hour, 2 hours, 4 hours,
8 hours, or 12 hours.
Single Record Alarm Printout Format
The single record alarm printout contains the patient ID, patient type, monitor
name, date and time, the measurement values at the time that the selected alarm
event occurred, and waveforms showing the activity before and after the
selected alarm event occurred. Each waveform shows activity seven seconds
before the alarm event occurred and 13 seconds after the alarm event occurred.
Viewing Trend Data

The following illustration shows a sample printout for a single SpO2 High alarm
event.
12/30/2014 SpO2 100

10:29:27 % 98
CN00000001 96
94
12345
92
Adult 90
160
NBP
130
mmHg
90
50
-30min -20min -10min
Alarm History Printout Format
The alarm history printout contains the patient ID, patient type, monitor name,
date and time, and the list of all alarms that occurred starting with the
highlighted alarm record to the selected time range. The printout does not
include waveforms.
12/30/2014
Date/Time Alarm Priority
04:17:27
CN00000001 01/14/2014 04:15:29 HR High, HR = 80 bpm Medium
12345 01/14/2014 04:14:59 SpO2 High, SpO2 = 93% Medium
Adult 01/14/2014 04:14:49 Resp Rate High, RESP = 30 rpm Medium
Recording Full Disclosure Data

You can select the Record button on the Full Disclosure tab to send waveforms
and parameters for the current patient to the recorder.
You can specify which Full Disclosure waveforms to include in the printout on
the Full Disclosure Settings Menu. For more information, see “Viewing Full
Disclosure Data” on page 15-14.
Viewing Trend Data

To record the full disclosure data for the current patient:
Step
2 Select Record.
A printout is sent to the recorder.
Full Disclosure Printout Format
A full disclosure printout contains the patient ID, patient type, monitor name,
date and time, the measurement values at the time indicated by the solid, white
vertical cursor line, and waveforms showing the activity before and after the
cursor time.
Viewing Trend Data

16
Care and Cleaning
To clean or disinfect your Efficia CM monitor, use only the approved cleaning agents
listed in this chapter.
For information on how to clean or disinfect accessories, see the instructions for use
provided with the accessory.
General Guidelines
Keep the monitor, cables, and accessories free of dust and dirt. Periodically inspect the
monitor vents for dust and clean the vents if necessary. After you clean and disinfect the
monitor, check it carefully and do not use it if you see signs of deterioration or damage.
If you need to return any equipment to Philips, clean and disinfect it first.
Caution It is the responsibility of the hospital to determine the appropriate cleaning

protocol for each care unit.
Do not use unapproved cleaning or disinfecting agents. Even small quantities of
some cleaning agents will damage the monitor.
Do not use abrasive cleaners or strong solvents such as acetone or acetone-based
compounds. The warranty does not cover damage caused by using unapproved
substances.
Follow these general precautions:
• Always dilute cleaning agents according to the manufacturer’s instructions or
use the lowest possible concentration.
• Do not allow liquid to enter the case. Do not immerse any part of the equipment
in liquid.
Care and Cleaning

Cleaning and Disinfecting the Monitor
• Do not pour liquid onto the system. If you spill liquid on the exterior of the
monitor, use a clean cloth to dry the monitor. If you believe the liquid may have
gotten inside the monitor, contact your technical support team, who can verify
the performance and safety of the unit.
• Do not use abrasive material (such as steel wool or silver polish).
• Do not autoclave, steam sterilize, or ultrasonically clean the monitor or cables.
• Do not use bleach on the electrical contacts or connectors.

To clean the monitor:
Step
1 Dampen a soft cloth with mild soap and water.
2 Wring any excess moisture from the cloth and gently clean the monitor at
room temperature.
Care and Cleaning

To disinfect the monitor:
Step
1 Dampen a soft cloth with any of the following solutions:

• Isopropyl alcohol (70% solution in water)
• Sodium hypochlorite (chlorine bleach, 10% solution in water)
• Quaternary ammonium chloride compounds (<1%)
• Hydrogen peroxide (<5%) with phosphoric acid (<5%)
• Peracetic acid (<1%) with Hydrogen peroxide (<1%)
• Sodium dichloroisocyanurate solid (48% before dilution)
• Ethylene glycol monobutyl ether (1% – 5%) with isopropanol (17%)
• n-Alkyl dimethyl benzyl ammonium chloride (8.1%) before dilution
with didecyl dimethyl ammonium chloride (8.7%) before dilution
• Diethylene glycol butyl ether (5 – 10%)
• Sodium dodecylbenzenesulfonate solid (20% before dilutions)
2 Wring any excess moisture from the cloth and wipe the monitor at room
temperature.
Care and Cleaning

Cleaning and Disinfecting the Cables
Cleaning and Disinfecting the Cables
Caution Do not use alcohol to clean the cables. Alcohol can cause the cables to become
brittle and fail.
For information on cleaning accessories, see the Instructions for Use that ships with
the accessory.
To clean the cables:
Step
1 Dampen a soft cloth with alcohol-free hand soap.
2 Wring any excess moisture from the cloth and gently clean the
cables.
3 Clean the areas again with a damp cloth moistened with water
only.
To disinfect the cables:
Step
1 Dampen a soft cloth with sodium hypochlorite (chlorine bleach),

3% solution in water.
Caution: Sodium hypochlorite may discolor the cable.
2 Wring any excess moisture from the cloth and gently clean the
cables.
3 Clean the areas again with a damp cloth moistened with water
only.
Care and Cleaning

Cleaning and Disinfecting the CAPNOSTAT 5 Sensor
Warning Unplug the sensor and allow to cool to room temperature for 30 minutes before
cleaning.
Use only approved cleaners and disinfectants listed in “Approved Cleaning Agents”
on page 16-6.
Do not use abrasive cleaners or strong solvents.
Small quantities of unapproved cleaners may damage product, shorten lifetime, or
cause safety hazards.
Keep all cleaning agents away from the CAPNOSTAT 5 CO2 Sensor’s electrical
connections.
The manufacturers’ warranty does not cover damage caused by using unapproved
cleaners.
General Guidelines
Keep the sensor, its cable, and accessories free of dust and dirt. After cleaning and
disinfecting, check the equipment carefully. Do not use if you see any signs of
deterioration or damage.
If you need to return any equipment, clean and disinfect it first.
Use these general precautions:
• Always dilute cleaning agents according to the manufacturer’s instructions or use

the lowest possible concentration.
• Do not immerse any part of the sensor in liquid.
• Do not pour liquid on the sensor.
• Do not use abrasive material (such as steel wool or silver polish).
• Do not autoclave, steam sterilize, or ultrasonically clean the sensor or its cable.
• Do not use cleaners on electrical contacts or connectors.
Care and Cleaning

Cleaning the outside of the CAPNOSTAT 5 CO2 Sensor and its cable:
• Use a cloth dampened with any of the approved cleaning agents listed below.
• Wipe down with a clean water-dampened cloth to rinse and dry before use. Ensure
that the sensor windows are clean and dry before reuse.
Approved Cleaning Agents

The following cleaners have been tested and are approved for cleaning the
CAPNOSTAT 5 CO2 Sensor.
Caution Only use the approved cleaners. The use of unapproved cleaners will cause damage
to the sensor and void the warranty.
• Isopropyl alcohol ≥70%

• A 10% aqueous solution of 6% chlorine bleach
• Steris Coverage® Spray HB
• Clinell Wipes®
• PDI Sani Cloth Bleach®
• PDI Super Sani Cloth AF®
• PDI Sani Cloth HB Wipes™
• Speedy Clean™
• Tuffie™
• Tuffie 5™
• Accel TB RTU
• Bacillol 30 Foam
• Bacillol AF
• Caltech-Dispatch 5200 Wipes
• Hydrogen Peroxide
• Meliseptol
Care and Cleaning

• Metrex CaviWipes 1
• Oxivir TB Wipes
• PDI Sani-Cloth Plus Germicidal Wipes
• PDI Super Sani Cloth
• Revital-Ox Resert™ XL HLD
• Sporox™ II Sterilizing & Disinfecting Solution
• Viraguard® Isopropanol 70%
• Virex Tb
• Wipes Plus® Disinfecting Wipes (Item # 74402)
Cleaning Adapters
Disposable adapters:
• Treat all single patient use airway adapters in accordance with institutional
protocol for single patient use items.
• DO NOT insert any object, such as a brush, into the CAPNOSTAT 5 CO2 airway
adapter. Irreparable damage may occur to the CO2 windows.
Reusable adapters:
• Treat all reusable airway adapters in accordance with institutional protocol for
single patient use items.
• Clean by rinsing in a warm soapy solution followed by soaking in a liquid
disinfectant:
– Isopropyl alcohol 70%.
– 10% aqueous solution of chlorine bleach.
– Glutaraldehyde 2.4% solution such as Cidex®
– Peracetic Acid such as Perasafe or Steris System 1®.
• Rinse thoroughly with sterile water and dry.
Care and Cleaning

• The Neonatal Reusable Airway Adapters are not intended for use with steam
sterilization.
• Before reusing the adapter, ensure the windows are dry and residue free and that
the adapter has not been damaged during handling or the cleaning/disinfecting
process.
Care and Cleaning

17
Accessories List
This chapter lists accessories that are compatible with the Efficia CM patient
monitors. Not all accessories are available in all countries.
Note — The accessory list is subject to change. For the latest information on
supported accessories, contact your authorized Philips representative or refer to
www.healthcare.philips.com.
Accessories List
SpO2 Accessories
SpO2 Accessories
Note — This section describes SpO2 accessories that are compatible with a
monitor with Philips SpO2. For a list of sensors that are compatible with
Masimo SpO2, see the Efficia with Masimo® Instructions for Use.
Philips Efficia Sensors
Note — Do not use Efficia SpO2 sensors with an adapter cable.
Patient Cable Use With This

Description Part Number
Category Length Extension Cable
Adult Finger sensor, for patient size 3m 989803160631 NA

>110 lb (50kg)
Adult Finger sensor, for patient size 2m 989803160621 M1941A (2 m)

33 lb – 110 lb (15 kg – 50 kg)
Pediatric Finger glove 1.5 m 989803160611
Accessories List
SpO2 Accessories
Philips Reusable Sensors
Caution Do not connect extension cables to SpO2 sensors with a part number that
ends in L (for example, M1191BL).
Patient Cable Part Use With This

Description
Category Length Number Cable
Adult Finger sensor, for patient 2m M1191B Extension Cable

size >110 lb (50kg) M1941A (2 m)
Pediatric/small Finger sensor, for patient 1.5 m M1192A

adult size 33 lb – 110 lb (15 kg –
50 kg)
Neonatal Foot/hand sensor, for patient 1.5 m M1193A

size 2.2 lb – 8.8 lb (1 kg –
4 kg)
Adult Ear clip sensor, for patient 1.5 m M1194A

size > 88 lb (40 kg)
Infant Finger sensor, for patient 1.5 m M1195A

size 8.8 lb – 33 lb (4 kg –
15 kg)
Adult Finger clip, for patient size 3m M1196A

>88 lb (40 kg)
Adult Finger clip, for patient size 2m M1196S

>88 lb (40 kg)
Adult Finger sensor, for patient 3m M1191BL No extension cable

size >110 lb (50 kg)
Accessories List
SpO2 Accessories
Patient Cable Part Use With This

Description
Category Length Number Cable
Adult Finger sensor, for patient 45 cm M1191T Adapter Cable

size > 110 lb (50 kg) M1943A (1.1 m) or
M1943AL (3 m)
Pediatric Finger sensor, for patient 45 cm M1192T
size 33 lb – 110 lb (15 kg –
50 kg)
Neonatal Foot/hand sensor, for patient 90 cm M1193T

size 2.2 lb – 8.8 lb
(1kg – 4 kg)
Pediatric/Adult Finger sensor, for patient 90 cm M1196T

size > 88 lb (40 kg)
Philips Disposable Sensors
Patient Part Use With This

Description
Category Number Adapter Cable
Adult/Pediatric Finger sensor, for patient size > 44 lb M1131A M1943A (1.1 m)
(20 kg) or
Infant Digit sensor for patient size 7 lb – 22 lb M1132A M1943AL (3 m)

(3 kg – 10 kg)
Neonatal/Infant/ Foot/hand sensor for neonate; big M1133A

Adult toe/thumb for infant; finger for adult.
Neonate patient size, < 7 lb (3 kg); Infant
patient size, 22 lb – 44 lb (10 kg – 20 kg);
Adult patient size, > 88 lb (40 kg)
Neonatal/Infant/ Adhesive-free foot/hand sensor for M1134A

Adult neonate; big toe/thumb for infant; finger
for adult.
Neonate patient size, < 7 lb (3 kg); Infant
patient size, 22 lb – 44 lb (10 kg – 20 kg);
Adult patient size, > 88 lb (40 kg)
Accessories List
ECG Accessories
ECG Accessories
Note — Trunk cables are not interchangeable. When ordering new lead sets,
make sure you have the compatible trunk cable, as listed in the tables below.
Efficia ECG Cables

One Piece Sets
AAMI Part IEC Part

Description Cable Length
Number Number
3-Lead, grabber 989803160731 989803160741 2.5 m
3-Lead, snap 989803160751 989803160761 2.5 m
5-Lead, grabber 989803160771 989803160781 2.5 m
5-Lead, snap 989803160791 989803160801 2.5 m
3-Lead Sets
AAMI Part IEC Part Use With This

Description
Number Number Trunk Cable
Grabber 989803160651 989803160661 989803160641
Snap 989803160671 989803160681
5-Lead Sets

Description
Grabber 989803160691 989803160701 989803160641
Snap 989803160711 989803160721
Accessories List
ECG Accessories
Philips ECG Cables

3-Lead Sets

Description
General use/ICU, grabber M1671A M1672A 989803170171 for

OR use
General use/ICU, snap M1673A M1674A
M1669A
General use/ICU miniclip M1622A – for General use
(lead length 0.45m)
General use/ICU miniclip M1624A M1626A

(lead length 0.7m)
OR, grabber M1675A M1678A M1669A
5-Lead Sets

Description
General use/ICU, grabber M1968A M1971A 989803170181 for

OR use
General use/ICU, snap M1644A M1645A
M1668A for
General use/ICU miniclip M1647A M1648A General use
OR, grabber M1973A M1974A M1668A
Accessories List
ECG Accessories
10-Lead Sets1
Description Part Number Cable Length
General use/ICU M1663A 2.0 m
General use/ICU M1949A 2.7 m
Disposable 3-Lead Sets

Description
Bedside, single patient AAMI 989803173121 989803170171 for

use, grabber OR use
Bedside, single patient IEC 989803174201 M1669A for

use, grabber General use
Disposable 5-lead Sets

Description
Bedside, single patient AAMI 989803173131 989803170181 for

use, grabber OR use
Bedside, single patient IEC 989803174211 M1668A for

use, grabber General use
1.
Efficia CM120 and CM150 only.
Accessories List
ECG Accessories
Supported ECG Cables

One Piece Sets
AAMI Part IEC Part

Description Cable Length
Number Number
3-Lead, grabber, general 989803143181 989803143171 2.5 m

use/ICU
5-Lead, grabber, general 989803143201 989803143191

use/ICU
Accessories List
NBP Accessories
ECG Electrodes
Silver/silver chloride sensor, foam, pre-gelled (5/pack, 300/case) 40493D
Silver/silver chloride sensor, foam, pre-gelled (30/pack, 300/case) 40493E
Adult, solid gel, snap, foam 989803148801
Adult, radiolucent, foam 989803148821
Soft cloth, solid gel, small 989803192541
NBP Accessories
Reusable Value Care Cuffs
Patient
Limb Bladder
Category/Cuff Part Number Hose
Circumference Width
Type
Large Adult 34.0 cm to 43.0 cm 16.0 cm 989803160861 989803160881 (1.5 m)
Adult, 27.0 cm to 35.0 cm 13.0 cm 989803160851 or

Extra-long 989803160891 (3.0 m)
Adult 27.0 cm to 35.0 cm 13.0 cm 989803160841
Small Adult 20.5 cm to 28.0 cm 10.5 cm 989803160831
Pediatric 14.0 cm to 21.5 cm 8.0 cm 989803160821
Infant 10.0 cm to 15.0 cm 5.5 cm 989803160811
Accessories List
NBP Accessories
Multi Care Cuffs
Patient
Limb Bladder
Circumference Width
Type
Thigh 42.0 cm to 54.0 20.0 cm 989803183371 M1598B (1.5 m)

cm or
Large Adult 34.0 cm to 43.0 16.0 cm 989803183361 M1599B (3.0 m)
cm
Adult, 27.0 cm to 35.0 13.0 cm 989803183351

Extra-long cm
Adult 27.0 cm to 35.0 13.0 cm 989803183341

cm
Small Adult 20.5 cm to 28.0 10.5 cm 989803183331

cm
Pediatric 14.0 cm to 21.5 8.0 cm 989803183321

cm
Infant 10.0 cm to 15.0 5.5 cm 989803183311

cm
Accessories List
NBP Accessories
Reusable Comfort Care Cuffs
Patient
Limb Bladder
Circumference Width
Type
Thigh 42.0 cm to 54.0 cm 20.0 cm M1576A M1598B (1.5 m)
Large Adult, 34.0 cm to 43.0 cm 16.0 cm M1575XL or

Extra-long M1599B (3.0 m)
Large Adult 34.0 cm to 43.0 cm 16.0 cm M1575A
Adult, Extra-long 27.0 cm to 35.0 cm 13.0 cm M1574XL
Adult 27.0 cm to 35.0 cm 13.0 cm M1574A
Small Adult, 20.5 cm to 28.0 cm 10.5 cm M1573XL

Extra-long
Small Adult 20.5 cm to 28.0 cm 10.5 cm M1573A
Pediatric 14.0 cm to 21.5 cm 8.0 cm M1572A
Infant 10.0 cm to 15.0 cm 5.5 cm M1571A
Accessories List
NBP Accessories
Reusable Easy Care Cuffs
Patient
Limb Bladder
Circumference Width
Type
Thigh 44 cm to 56 cm 21 cm M4559B M1598B (1.5 m)
Large Adult, 35 cm to 45 cm 17 cm M4558B or

Large Adult 35 cm to 45 cm 17 cm M4557B
Adult, Extra-long 27.5 cm to 36 cm 13.5 cm M4556B
Adult 27.5 cm to 36 cm 13.5 cm M4555B
Small Adult 20.5 cm to 28.5 cm 10.6 cm M4554B
Pediatric 14 cm to 21.5 cm 8.0 cm M4553B
Infant 10 cm to 15 cm 5.5 cm M4552B
Accessories List
NBP Accessories
Disposable Gentle Care Cuffs
Patient
Limb Bladder Part
Category/Cuff Hose
Circumference Width Number
Type
Thigh 44 cm to 56 cm 21 cm M4579B M1598B (1.5 m)
Large Adult, 35 cm to 45 cm 17 cm M4578B or

Large Adult 35 cm to 45 cm 17 cm M4577B
Adult, Extra-long 27.5 cm to 36 cm 13.5 cm M4576B
Adult 27.5 cm to 36 cm 13.5 cm M4575B
Small Adult 20.5 cm to 28.5 cm 10.6 cm M4574B
Pediatric 14 cm to 21.5 cm 8.0 cm M4573B
Infant 10 cm to 15 cm 5.5 cm M4572B
Disposable Adult/Pediatric Cuffs
Patient
Limb Bladder
Circumference Width
Type
Thigh 42 cm to 54 cm 20 cm M1879A M1598B (1.5 m)
Large Adult 34 cm to 43 cm 16 cm M1878A or

M1599B (3.0 m)
Adult 27 cm to 35 cm 13 cm M1877A
Small Adult 20.5 cm to 28 cm 10.5 cm M1876A
Pediatric 14 cm to 21.5 cm 8.0 cm M1875A
Infant 10 cm to 15 cm 5.5 cm M1874A
Accessories List
NBP Accessories
Disposable Neonatal Cuffs (Safety Connector)1
Limb Bladder
Cuffs Part Number Hose
Circumference Width
Size 1 3.1 cm to 5.7 cm 2.2 cm M1866B M1596C (1.5 m)
Size 2 4.3 cm to 8.0 cm 2.8 cm M1868B or

M1597C (3.0 m)
Size 3 5.8 cm to 10.9 cm 3.9 cm M1870B
Size 4 7.1 cm to 13.1 cm 4.7 cm M1872B
Size 5 Infant 10.0 cm to 15 cm 5.5 cm M1873B
Disposable Soft Neonatal Cuffs (Safety Connector)2
Limb Bladder
Cuffs Part Number Air Hose
Circumference Width
Size 1 3.1 cm – 5.7 cm 2.2 cm M1866S M1596C (1.5 m)
Size 2 4.3 cm – 8.0 cm 2.8 cm M1868S or

M1597C (3.0 m)
Size 3 5.8 cm – 10.9 cm 3.9 cm M1870S
Size 4 7.1 cm – 13.1 cm 4.7 cm M1872S
Size 5 Infant 10.0 cm – 15.0 cm 5.5 cm M1873S
1. The safety connector cuffs and air hoses may not be available in all countries. Check with your local sales organization.
2.
The safety connector cuffs and air hoses may not be available in all countries. Check with your local sales organization.
Accessories List
NBP Accessories
Disposable Single Care Cuffs
Patient
Limb Bladder
Circumference Width
Type
Large Adult 35.0 cm to 45.0 cm 17.0 cm 989803182321 M1598B (1.5m) or

M1599B (3m)
Adult, 27.5 cm to 36.0 cm 13.5 cm 989803182311
Extra-long
Adult 27.5 cm to 36.0 cm 13.5 cm 989803182301
Small Adult 20.5 cm to 28.5 cm 10.6 cm 989803182291
Pediatric 14.0 cm to 21.5 cm 8.0 cm 989803182281
Accessories List
IBP Accessories
IBP Accessories
Reusable Transducers
Reusable pressure transducer 5μ V/V/mmHg sensitivity CPJ840J6
Single use sterile domes (50/case) CPJ84022
Disposable Transpac®4 Transducers, Single Line
152 cm, two 3-way stopcocks 989803177901
23 cm, one 3-way stopcock 989803179871
61 cm, one 4-way stopcock 989803181141
Disposable Transpac®4 Transducers, Multi-Line
183 cm, four 3-way stopcocks 989803177911
Disposable Transpac®4 Neonatal Transducers
31 cm, three 3-way stopcocks 989803179851
46 cm, three 3-way stopcocks 989803179881
Accessories List
IBP Accessories
Disposable Transpac®4 Transducers with Safeset™, Single Line
152.0 cm, one cannula sampling port, in-line reservoir 989803179761
152.0 cm, two cannula sampling ports, in-line reservoir 989803179781
152.0 cm, two Luer sampling ports, in-line reservoir 989803179791
61.0 cm, one cannula sampling port, in-line reservoir 989803179861
Disposable Transpac®4 Transducer Kits with Safeset™, Multi Line
213.0 cm, two cannula sampling ports, in-line reservoir 989803179801
213.0 cm, two Luer sampling ports, in-line reservoir 989803179811
Disposable Transpac®4 Transducers, Premium Stripe
152.0 cm, red premium stripe tubing 989803181211
183.0 cm, red/blue premium stripe tubing 989803181241
Disposable Safeset™ System Kit
152.0 cm tubing, one in-line sampling port, 10ml in-line reservoir 989803180851
213.0 cm tubing, two in-line sampling ports, 10ml in-line reservoir 989803179891
Accessories List
IBP Accessories
Reusable Transpac®4 Transducer Cables
TRANSPAC 4 cable, 3.0 m 989803177921
TRANSPAC 4 cable, 4.5 m 989803179941
TRANSPAC 4 cable, 4.5 m, bulk package 989803179951
TRANSPAC 4 cable, trifurcated, 4.5 m 989803179961
Disposable Transpac®4 Transducer Kit Accessories
3-position transducer mount, reusable 989803177931
Transducer holder for iv pole, reusable 989803177941
Single transducer mount, reusable 989803179911
SAFESET mounting bracket, reusable 989803179901
SAFESET shielded blunt cannula 989803179921
SAFESET shielded blunt cannula w/ blood tube holder 989803179931
Transducer simulator 989803180861
Accessories List
Sidestream CO2 Accessories
Intubated Filterlines
Patient Category Description Part Number
Adult/Pediatric FilterLine set M1920A
Adult/Pediatric FilterLine H set M1921A
Infant/Neonatal FilterLine H set M1923A
Adult/Pediatric VitaLine H set 989803159571
Infant/Neonatal VitaLine H set 989803159581
Adult/Pediatric FilterLine set, long 989803160241
Adult/Pediatric FilterLine H set, long 989803160251
Infant/Neonatal FilterLine H set, long 989803160261
Non-Intubated Oral/Nasal FilterLines
Patient
Category
Adult/Intermediate Smart CapnoLine M2526A
Pediatric Smart CapnoLine M2524A
Adult/Intermediate Smart CapnoLine O2, oral-nasal cannula M2522A
Pediatric Smart CapnoLine O2, oral-nasal cannula M2520A
Adult Smart CapnoLine O2, oral-nasal cannula, long 989803160281
Pediatric Smart CapnoLine O2, oral-nasal cannula, long 989803160271
Adult Smart CapnoLine plus, long 989803160301
Accessories List
Patient
Category
Adult Smart CapnoLine H O2, oral-nasal 989803177951
Adult Smart CapnoLine H O2, oral-nasal, long 989803177961
Pediatric Smart CapnoLine H O2,oral-nasal 989803177971
Pediatric Smart CapnoLine H O2, oral-nasal, long 989803177981
Adult1 Smart CapnoLine Guard 989803178031
Adult1 Smart CapnoLine Guard O2 989803178041
Adult1 Smart CapnoLine Guard O2, long 989803178051

1. For
any patient that requires and can tolerate a 60 Fr Bite Block, as recommended by the attending physician.
Non-Intubated Nasal Filterlines
Adult CapnoLine H O2, nasal M4680A
Pediatric CapnoLine H O2, nasal M4681A
Infant/Neonatal CapnoLine H O2, nasal 989803178001
Adult NIV Line M4686A
Pediatric NIV Line M4687A
Infant/Neonatal CapnoLine, nasal 989803178021
Adult CapnoLine H, nasal M4689A
Infant/Neonatal CapnoLine H, nasal M4691A
Infant/Neonatal CapnoLine H, nasal, long 989803178011
Adult CapnoLine O2 989803179101
Accessories List
Mainstream CO2 Accessories
Pediatric CapnoLine O2 989803179121
Adult CapnoLine O2, long 989803179111
Mainstream CO2 Accessories
Patient
Category
Adult/Pediatric CO2 sensor M2501A
Adult/Pediatric Airway adapter, reusable M2513A
Infant/Neonatal Airway adapter, reusable M2516A
Adult/Pediatric Airway adapter, disposable M2533A
Infant/Neonatal Airway adapter, disposable M2536A
Cardiac Output Accessories
Cardiac output interface cable M1642A
Temperature probe, reusable, 2.4 m M23001A
Temperature probe, reusable, 0.5 m M23001B
Temperature probe, ice bath M23002A
Accessories List
Temperature Accessories
Temperature Accessories
Reusable Probes
Esophageal/rectal probe (12 Fr) 21075A
Flexible esophageal/rectal probe (10 Fr) 21076A
Attachable skin surface probe 21078A
Disposable Probes
Use with this

Description Size Part Number
adapter
Skin surface probe NA 21091A 21082B (1.5 m)
Esophageal/rectal probe 9 Fr M1837A or

21082A (3.0 m)
Esophageal/rectal probe 12 Fr 21090A
Esophageal stethoscope probe 12 Fr 21093A
Foley 14 Fr M2255A
Foley 16 Fr 21096A
Foley 18 Fr 21097A
Accessories List
Miscellaneous Accessories
2D barcode scanner (includes mounting arm for use with roll stand) 989803147821
2D HS-1 barcode scanner (includes mounting arm for use with roll stand) 989803176611
Cable management kit 989803148841
Cable hook kit 989803195551
Lithium ion battery, 3-cell battery pack 989803189981
Lithium ion battery, 9-cell battery pack 989803194541
Roll stand 989803176601
Roll stand mounting kit 989803195541
Recorder paper (5 rolls) 989803136891
Serial interface adapter 989803159601
Wall mount, 6-inch 989803195561
Wall mount, 10-inch 989803195571
Accessories List
Accessories List
18
Specifications
General Specifications
Parameter Specification
Size
Dimensions CM10: 22 cm( H) x 27 cm(W) x 17 cm(D)

CM12: 25cm( H) x33 cm(W) x 18 cm(D)
CM100: 22 cm( H) x 27 cm(W) x 17 cm(D)
CM120: 25cm( H) x33 cm(W) x 18 cm(D)
CM150: 30 cm(H) x41 cm(W) x 18 cm(D)
Weight (with no battery) CM10: < 3.3 kg (7.0 lbs)

CM12: < 5.0 kg (11.0 lbs)
CM100: < 3.3 kg (7.0 lbs)
CM120: < 5.0 kg (11.0 lbs)
CM150: < 6.7 kg (14.5 lbs)
Display
Touch Screen LCD with 5-wire resistive touch screen
Non-touch Screen WXGA LCD display
Screen Size CM10 and CM100: 10.1 in.

CM12 and CM120: 12.1 in.
CM150: 15.6 in.
Specifications
General Specifications
Resolution CM10, CM12, CM100, and CM120:1280

active pixels/line, 800 active lines/frame
CM150: 1366 active pixels/line, 768 active
lines/frame
Viewing Angle The side-to-side viewing angle of the

display is approximately ± 15 degrees
Audio Range 45 dB – 85 dB ± 3 dB tolerance

(Alarms and information
signals)
System Response Time 1 second
System Response Time (from See the Instructions for Use for your
bedside to Central) Central.
Specifications
Safety Standards
Safety Standards
EN/IEC 60601-1, EN/IEC 60601-1-2, EN/IEC 60601-1-8, EN/IEC 60601-2-

27, EN/ IEC 80601-2-30, IEC 60601-2-34, IEC 60601-2-49, EN/ISO 80601-
2-55, EN/ISO 80601-2-61, EN/IEC 62366, EN/IEC 62304, EN/IEC 60601-1-
6, EN/ISO 80601-2-56
Protection Class Class I, internally powered equipment, per

EN/IEC 60601-1
Degree of Protection Type CF defibrillator-proof: per EN/IEC

60601-1
IPX1 Ingress protection against vertically
falling water drops
Mode of Operation Continuous
Protection Against Hazards of Equipment is not suitable for use in the

Ignition of Flammable presence of a flammable anaesthetic mixture
Anaesthetic Mixtures with air or oxygen or nitrous oxide, per
IEC 60601-1.
Electrical Specifications
Power Sources
Internal Battery 9-cell or 3-cell Lithium ion Smart Battery

10.8V – 11.1V
Specifications
Battery Operating Time • 6 hours for 2 9-cell batteries

(New, fully charged • 4 hours for 1 9-cell battery
batteries, while • 1 hour for 1 3-cell battery
monitoring ECG, SpO2
and 15-minute NBP
interval measurement)
Battery Charge Time < 5 hours for a fully discharged 9-cell or 3-

cell battery to be charged to the 90% level
Power Supply Internal, 100 VAC - 240 VAC line voltage
Power Consumption < 75 Watts
Frequency 50/60 Hz
Environmental Specifications
Caution The monitor might not meet performance specifications if stored or used
outside the specified temperature, humidity, and altitude ranges.
Mechanical Shock Complies with the mechanical shock

requirement in ISO 9919/IEC 80601-2-61
standards for use within the healthcare
facility. Test conditions include:
• Peak Acceleration: 150 m/s2 (15.3g)
• Duration: 11 ms
• Pulse shape: half sine
• Number of shocks: 3 shocks per
direction per axis (18 total)
Specifications
Mechanical Vibration Complies with the mechanical vibration

requirement in ISO 9919/IEC 80601-2-61
standards for use within the healthcare
facility. Test conditions include:
• Frequency range: 10 Hz to 2000 Hz
• Resolution: 10 Hz
• Acceleration amplitude:
10 Hz to 100 Hz 1.0 (m/s2)2/Hz.
100 Hz to 200 Hz -3 dB/octave
200 Hz to 2000 Hz 0.5 (m/s2)2/Hz
• Duration: 10 min per each
perpendicular axis (3 total)
Thermal
Operating Temperature 10oC to 40oC (50o F to 104o F)
Storage Temperature -20oC to 50oC (-4o F to 122o F)
Transport Temperature -20oC to 40oC (-4o F to 104o F)
Humidity
Operating Humidity 15% to 90% RH, non-condensing
Storage Humidity 15% to 90% RH, non-condensing
Transport Humidity 15% to 90% RH, non-condensing
Atmospheric Pressure
Operating Atmospheric 0 m to 3,000 m (0 ft to 9,842 ft) above sea

Pressure level
1,013 mbar to 701 mbar (101 kPa to 70 kPa)
Storage Atmospheric 0 m to 3,000 m (0 ft to 9,842 ft) above sea

Pressure level
1,013 mbar to 701 mbar (101 kPa to 70 kPa)
Specifications
Transport Atmospheric 701 hPA to 1013 hPA

Pressure
Electromagnetic Meets the IEC 60601-1-2:2007 standard

Compatibility
Specifications
SpO2 Specifications
SpO2 Specifications
The update rate for the SpO2 value and Pulse Rate is typically 1 second. Data
averaging and other signal processing on the displayed and transmitted data
values of SpO2 and Pulse Rate is controllable by the user-selectable SpO2
Response Mode: Slow (20 seconds), Normal (10 seconds), and Fast (5
seconds).
Depending on the magnitude of difference between the alarm limit and the
displayed value, the alarm signal generation delay may be from 1 second to the
value of the response time (5, 10, or 20 seconds), plus any additional configured
alarm delay time. If an SpO2 Ext Update technical alarm occurs, the
physiological alarm response time is proportionately longer. If the system is
configured for SpO2 Alarm Delay, the alarm generation is delayed by the
configured time.
Because pulse oximeter equipment measurements are statistically distributed,

only approximately two-thirds of pulse oximeter equipment measurements can
be expected to fall within the ± Arms value measured by a CO-oximeter.
SpO2 Measurement Range 0% – 100%
SpO2 Resolution 1%
Pulse Rate Measurement Range 30 bpm – 300 bpm
Pulse Rate Resolution 1 bmp
SpO2 Accuracy1 Range Accuracy
Philips Reusable Sensors
M1191B, M1191BL, M1192A 70% – 100% ± 2%
M1193A, M1194A, M1195A, 70% – 100% ± 3%

M1196A, M1191T, M1192T,
M1196S, M1196T
M1193T (Neonatal) 70% – 100% ± 4%
Specifications
SpO2 Specifications
Philips Disposable Sensors
M1131A, M1133A, M1134A 70% – 100% ± 3%

(Neonatal)
M1132A, M1133A, M1134A 70% – 100% ± 2%

(Adult/Infant)
Efficia Sensors
989803160631, 989803160621, 70% – 100% ± 3%

989803160611
Pulse Rate Accuracy 2% or 1 bpm, whichever is

greater
Wavelength Range2 500 nm to 1000 nm for all

specified sensors
Maximum Optical Output Power ≤ 15mW for all specified

sensors
1. Sensor
accuracy was obtained by performing controlled hypoxia studies on healthy, non-
smoking adult volunteers (according to EN ISO 9919). The SpO2 readings have been
compared to CO-oximeter measurements on arterial blood samples. To represent the general
population, data from at least 10 subjects (male and female) with a wide range of skin color
was taken to validate SpO2 accuracy.
2.
Information about wavelength ranges can be useful for clinicians performing photodynamic
therapy.
Specifications
SpO2 Specifications
SpO2 Accuracy Specifications

The SpO2 accuracy was validated in human studies against arterial blood sample
reference measured with a CO-oximeter. In a controlled desaturation study,
healthy adult volunteers with saturation levels between 70% and 100% SaO2
were studied as recommended in ISO 9919:2005.
Note — A functional tester cannot be used to assess the accuracy of a pulse

oximeter monitor. However, it can be used to demonstrate that a particular
pulse oximeter monitor reproduces a calibration curve that has been
independently demonstrated to fulfill a particular accuracy specification.
The results of the study are shown below. Representative sensors were tested to
cover all of the compatible SpO2 sensors. All representative sensors were tested
with 12 healthy adult subjects with the following characteristics:
• Six male subjects and six female subjects

• Age range of the subjects: 19 to 39 years
• Skin tone: from light to dark brown
For each sensor, more than 300 blood samples were available for comparison,
equally spread over the range from 70% to 100% SaO2.
The Arms (SpO2 Accuracy [root mean square]) values shown below, especially
in the sub-ranges from 70-80%, 80-90% and 90-100% SaO2, represent the
results of this study.
Because pulse oximeter measurements are statistically distributed, only about

two-thirds of the measurements can be expected to fall within the specified
accuracy compared to CO-oximeter measurements.
In addition to calculating the Arms values over the range from 70% to 100%
SaO2 as required by the international standards for pulse oximeters ISO 9919,1,2
the desaturation study data was evaluated according to the method Agreement
1. ISO 9919:2005: Medical electrical equipment - Particular requirements for the basic
safety and essential performance of pulse oximeter equipment for medical use.
2. ISO 80601-2-61:2011: Medical electrical equipment - Part 2-61: Particular
requirements for basic safety and essential performance of pulse oximeter
equipment.
Specifications
SpO2 Specifications
Between Methods of Measurement with Multiple Observations Per Individual

described by Bland and Altman.1
The graphical plots show all of the data points for the sensor and device
combinations according to the Bland and Altman method.
The tables show the Arms values measured in the study using the specified
sensor with the pulse oximetry board that is used in the Efficia CM patient
monitors.
M1191A
The Philips sensor M1191A was tested as representative of the Philips sensors
M1191AL and M1192A.
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.40 1.81 1.00 1.22
N = 332, between subject variance = 0.294, within-subject variance = 1.456
Upper 95% Limit

= +3.08
SpO2 - SaO2 (%SpO2)
Mean Difference
= +0.48
Lower 95% Limit

= -2.11
BGA Reference (%SaO2)
1. Bland,
J. Martin and Altman, Douglas G., (2007) Agreement Between Methods of
Measurement with Multiple Observations Per Individual, Journal of
Biopharmaceutical Statistics, 17:4, 571-582
Specifications
SpO2 Specifications
M1191B
The Philips sensor M1191B was tested as representative of the Philips sensor
M1191BL.
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.25 1.24 1.14 1.32
N = 331, between-subject variance = 0.463, within-subject variance = 1.131
Upper 95% Limit

= +2.43
SpO2 - SaO2 (%SpO2)
Mean Difference
= -0.05
Lower 95% Limit

= -2.52
M1193A
The Philips sensor M1193A was tested as representative of the Philips sensor
M1195A.
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.59 2.15 1.33 1.25
Specifications
SpO2 Specifications
Upper 95% Limit

= +3.39
SpO2 - SaO2 (%SpO2)
Mean Difference
= +0.24
Lower 95% Limit

= -2.90
M1194A
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.42 1.39 1.41 1.44

SpO2 - SaO2 (%SpO2)
Upper 95% Limit

= +2.44
Mean Difference
= -0.34
Lower 95% Limit

= -3.12
Specifications
SpO2 Specifications
M1196A
M1196S and M1196T.
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.90 2.82 1.33 1.35
Upper 95% Limit

= +3.10
SpO2 - SaO2 (%SpO2)
Mean Difference =
-0.52
Lower 95% Limit =

-4.14
M1191T
The Philips sensor M1191T was tested as representative of the Philips sensor
M1192T.
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.50 2.13 1.15 0.99
Specifications
SpO2 Specifications
Upper 95% Limit

= +3.09
SpO2 - SaO2 (%SpO2)
Mean Difference =
+0.13
Lower 95% Limit

= -2.82
M1193T
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.80 2.72 1.46 0.98
Upper 95% Limit

= +3.70
SpO2 - SaO2 (%SpO2)
Mean Difference
= +0.08
Lower 95% Limit

= -3.54
Specifications
SpO2 Specifications
M1131A
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.81 2.53 1.57 1.29
Upper 95% Limit

SpO2 - SaO2 (%SpO2)
= +3.38
Mean Difference
= -0.22
Lower 95% Limit

= -3.82
M1133A
M1132A and M1134A.
SaO2 range (%) 70-100 70-80 80-90 90-100
Arms value (%) 1.50 1.76 1.61 1.16
Specifications
SpO2 Specifications
Upper 95% Limit =

SpO2 - SaO2 (%SpO2)
+3.36
Mean Difference =
+0.68
Lower 95% Limit =

-2.01
989803160611
SaO2 range (%) 67-100 90 - 100 80-<90 70 -<80 60 - <70
Arms value (%) 2.0 2.0 1.8 2.2 2.4
Specifications
NBP Specifications
989803160621 and 989803160631
SaO2 range (%) 67-100 90 - 100 80-<90 70 -<80 60 - <70
Arms value (%) 1.7 1.4 1.3 2.0 3.1
NBP Specifications
Oscillometric NBP Measurement

This monitor uses the oscillometric method for measuring NBP. In adult and
pediatric mode, the blood pressure measurements determined with this device
comply with the American National Standard for Electronic or Automated
Sphygmomanometers (ANSI/AAMI SP10-1992) in relation to mean error and
standard deviation, when compared to intra-arterial or auscultatory
measurements (depending on the configuration) in a representative patient
population. For the auscultatory reference, the fifth Korotkoff sound was used to
determine the diastolic pressure.
Specifications
NBP Specifications
In neonatal mode, the blood pressure measurements determined with this device
comply with the American National Standard for Electronic or Automated
Sphygmomanometers (ANSI/AAMI SP10-1992) in relation to mean error and
standard deviation, when compared to intra-arterial measurements in a
representative patient population. The NBP measurement is suitable for use in
the presence of electrosurgery and during the discharge of a cardiac defibrillator
according to IEC 601-2-30:1999/EN 60601-2-30:2000.
The Philips NBP parameter module was evaluated against the ausculatory
reference method following the requirements of the ANSI/AAMI SP10:2002,
EN/IEC 81060-2:2009, and EN1060-4:2004 standards. The NBP parameter was
tested under clinical conditions on pregnant women to ensure its accuracy in this
patient population. For the auscultatory reference, the fifth Korotkoff sound was
used to determine the diastolic pressure. Patients with pre-eclampsia were not
explicitly addressed in this study nor were they excluded.
Oscillometric devices measure the amplitude of pressure changes in the

occluding cuff as the cuff deflates from above systolic pressure. The amplitude
suddenly increases as the pulse breaks through the occlusion in the artery. As the
cuff pressure decreases further, the pulsations increase in amplitude, reach a
maximum (which approximates to the mean pressure), and then diminish.
Studies show that, especially in critical cases (arrhythmia, vasoconstriction,

hypertension, shock), oscillometric devices are more accurate and consistent
than devices using other noninvasive measuring techniques.
A physician must determine the clinical significance of the NBP information.
Accuracy is determined using devices based on Philips NBP technology.
Technique Oscillometric using stepwise deflation pressure
Adult Measurement Range
Systolic 30 mmHg – 270 mmHg (4.0 kPa– 36.0 kPa)
Diastolic 10 mmHg – 245 mmHg (1.3 kPa – 32.7 kPa)
MAP 20 mmHg – 255 mmHg (2.7 kPa – 34.0 kPa)
Specifications
NBP Specifications
Pediatric Measurement Range
Systolic 30 mmHg – 180 mmHg (4.0 kPa – 24.0 kPa)
Diastolic 10 kPa – 150 mmHg (1.3 kPa – 20.0 kPa)
Neonatal Measurement Range
Systolic 30 mmHg – 130 mmHg (4.0 kPa – 17.0 kPa)
Diastolic 10 mmHg – 100 mmHg (1.3 kPa – 13.3 kPa)
Blood Pressure Accuracy Maximum Standard Deviation: ≤ 8 mmHg

Maximum Mean Error: ± 5 mmHg
Pulse Rate Range 40 bpm – 300 bpm
Pulse Rate Accuracy • 40 bpm – 100 bpm: ± 5 bpm

• 101 bpm – 200 bpm: ± 5% of reading
• 201 bpm – 300 bpm: ± 10% of reading
Initial Cuff Inflation • Adult: 160 mmHg (21.3 kPa)

• Pediatric: 140 mmHg (18.7 kPa)
• Neonatal: 100 mmHg (13.3 kPa)
Initial Inflation Pressure • Adult: 100 mmHg – 280 mmHg in 10

Range mmHg steps (13.3 kPa – 37.4 kPa in 1.3
kPa steps)
• Pediatric: 80 mmHg – 190 mmHg in 10
mmHg steps (10.7 kPa – 25.3 kPa in 1.3
kPa steps)
• Neonatal: 60 mmHg – 140 mmHg in 10
mmHg steps (8.0 kPa – 18.7 kPa in 1.3
kPa steps)
Specifications
Temperature Specifications
Temperature Specifications
Measurement Range 25oC to 45oC (77°F to 113°F)

for all measurement
sites
Mode of Operation Direct mode
Accuracy For probes:

21075A, 20176A, 21078A, 21091A, M1837A,
21096A, 21097A, M2255A
± 0.2oC
For probes:
21090A, 21093A, 21094A, 21095A
± 0.1oC
Heating Transient ≤ 150 sec

Response Time
Cooling Transient ≤ 150 sec

Response Time
Specifications
CO2 Sidestream Specifications

Capnography is a non-invasive method for monitoring the level of carbon
dioxide in exhaled breath (etCO2) to assess a patient’s ventilatory status.
Microstream capnography modules use Microstream non-dispersive infrared
(NDIR) spectroscopy. Infrared spectroscopy is used to measure the
concentration of molecules that absorb infrared light. Because the absorption is
proportional to the concentration of the absorbing molecule, the concentration
can be determined by comparing its absorption to that of a known standard. The
Microstream etCO2 sampling lines deliver a sample of the inhaled and exhaled
gases from the ventilator circuit or directly from the patient at 50 ml/min
sampling flow rate. Moisture and patient secretions are extracted from the
sample, while maintaining the shape of the CO2 waveform.
The capnography module is intended to provide professionally-trained

healthcare providers with continuous, non-invasive measurement and
monitoring of carbon dioxide concentration of the expired and inspired breath
and respiration rate. It is intended for use with neonatal, pediatric, and adult
patients in hospitals, hospital-type facilities, and intra-hospital transport.
Measurement Range 0 mmHg – 150 mmHg
Data Sample Rate Waveform sampling, 20 samples per second
Flow Rate 50 ml/min –7.5 + 15 ml/min, flow measured by

volume.
Note — If the module cannot hold the flow
within the specified range, the module will stop
measuring, enter Failure Mode, and set the
appropriate status bits
CO2 Waveform 0.1 mmHg

Resolution
etCO2 and imCO2 1 mmHg

Displayed Resolution
Specifications
Initialization Time The time between powering up the monitor and

presenting the first reading is typically 40
seconds; maximum 3 minutes
CO2 Response Time The total response time for adults/pediatrics is

approximately 3.9 seconds, for 10% to 90%
changes in CO2 concentration. Calculated as
follows:
Delay time + Rise time + System response time
CO2 Delay time: 2.7 seconds (typical)
CO2 Rise time: 0.2 seconds (typical)
Monitor response time: 1.0 second
The maximum CO2 response time (with a
standard-length FilterLine) is 5.3 seconds
(typical).
Notes —
• Adult/Pediatric Long FilterLines and Long
Smart CapnoLines have a maximum CO2
response time of 6.9 seconds (typical).
• For information on CO2 response time for
infant/neonatal patients, see “CO2
Response Time for Infant/Neonatal
Accessories” on page 18-25.
Calibration Interval • First calibration at 1,200 hours of use or

after one year, whichever comes sooner.
• After the first calibration, once a year or
after 4,000 hours, whichever comes
sooner.
Auto Zero Interval Once per hour (typical)
Leak Tightness < 250 mBar/min when a 30% vacuum is

invoked on the flow system.
Specifications
CO2 Accuracy 0 mmHg – 38 mmHg: ±2 mmHg

39 mmHg – 99 mmHg: ± (5% of reading +
0.08% for every 1 mmHg above 38 mmHg)
100 mmHg – 150 mmHg: ± (5% of reading +
0.08% for every 1 mmHg above 38 mmHg)
As soon as a CO2 reading is presented, the
measurement is accurate to the above
specifications.
Notes —
• Accuracy applies for breath rates up to 80
bpm. For breath rates above 80 bpm,
accuracy is ±4 mmHg or ±12% of reading,
whichever is greater for etCO2 values
greater than 18 mmHg. To achieve the
specified accuracies for breath rates above
60 bpm, use the FilterLine H set for infant/
neonatal patients.
• The accuracy specification is maintained
to within 4% of the values indicated in the
presence of interfering gases.
Drift of Measurement The periodic auto zero function compensates

Accuracy for drifts between components, changes in
ambient temperature, and barometric
conditions. This automatic process eliminates
variances that might otherwise cause
measurement drift. Therefore, the module does
not exhibit drift.
Respiration Rate Range 0 rpm to 150 rpm
Specifications
Respiration Test Method Breaths are simulated for use in respiration rate
measurement with a system which uses a tank
of N2 (representing no CO2 for inhalation) and
a tank of CO2 (of the %CO2 required for the
particular test). A control board, which is
triggered by a computer, uses solenoids to
switch the module input between the 2 tanks of
gas, creating a gas CO2 square wave. This
system can create simulated breaths over the
full required range of specified respiration
rates.
Respiration Rate • ±1 rpm in the range of 0 rpm – 70 rpm

Accuracy • ±2 rpm in the range of 71 rpm – 120 rpm
• ±3 rpm in the range of 121 rpm – 150 rpm
Automatic Barometric The monitor is equipped with automatic

Pressure barometric pressure compensation.
Effects of Cyclical Will operate within specifications with

Pressure overpressure and underpressure from a
ventilation system as follows:
• Overpressure: +100 cmH2O
• Underpressure: –20 cmH2O
Note — With high over pressures close to the
upper limit, the module may enter into a
blockage mode in order to safeguard the
module from damage.
The capnography component of this product is covered by one or more of the

following US patents: 6,428,483; 6,997,880; 6,436,316; 7,488,229;
7,726,954 and their foreign equivalents. Additional patent applications
pending.
Specifications
CO2 Response Time for Infant/Neonatal Accessories
Total
Rise Time Delay Time System
Part Number Description
(typical) (typical) Time
(typical)
989803159581 VitaLine H Set intubated 240 ms 5.3 s 6.5 s

circuit
989803160261 FilterLine H Set Long 240 ms 3.0 s 4.2 s

intubated circuit
989803178001 CapnoLine H O2 non- Up to 310 ms Up to 5.9 s 7.2 s

intubated dual-purpose
circuit
989803178011 CapnoLine H Long non- Up to 320 ms Up to 5.9 s 7.2 s

intubated single-purpose
circuit
989803178021 Nasal FilterLine non- Up to 250 ms Up to 4.0 s 5.3 s

intubated ventilation (standard
single-purpose circuit length)
M1923A FilterLine H Set intubated 180 ms 2.7 s 3.9 s

circuit
M4691A CapnoLine H non- Up to 250 ms Up to 4.0 s 5.3 s

intubated single-purpose
circuit
Specifications
CO2 Mainstream Specifications

The CAPNOSTAT 5 CO2 Sensor (M2501A) is used for the continuous
measurement of CO2 and respiratory rate. The sensor measures CO2 by using
the infrared absorption technique. The principle is based on the fact that CO2
molecules absorb infrared (IR) light energy of specific wavelengths, with the
amount of energy absorbed being directly related to the CO2 concentration.
When an IR beam is passed through a gas sample containing CO2, the electronic
signal from the photo detector (which measures the remaining light energy) is
measured. This signal is then compared to the energy of the IR source and
adjusted to accurately reflect CO2 concentration in the sample.
The CAPNOSTAT 5 CO2 Sensor’s response to a known concentration of CO2

is stored at the factory in the sensor’s memory. A reference channel accounts for
optical changes in the sensor, allowing the system to remain in calibration
without user intervention.
CO2 Measurement Range 0 mmHg – 150 mmHg

0 kPa – 20 kPa
0 cmH2O – 204 cmH2O
imCO2 Measurement 3 mmHg – 50 mmHg

Range
(based on lowest reading
over last 20 seconds)
Data Sample Rate Waveform sampling, 20 samples per second
CO2 Waveform 0.1 mmHg

Resolution
etCO2 and imCO2 1 mmHg

Displayed Resolution
Initialization Time Full specification etCO2 measurement displays

after warm up, in less than 2 minutes
Specifications
CO2 Response Time CO2 Response Time (Rise time + System time)
is less than 2 seconds:
• CO2 rise time is < 60 ms
• System response time is 1 second
Calibration Interval No calibration required.
Auto Zero Interval No auto zero. Zero procedure required when

changing the airway adapter. See “Preparing to
Measure Mainstream CO2” on page 8-2 for
more information.
Specifications
CO2 Accuracy ± 2 mmHg of 0 to 40 mmHg

(gas temperature at 35oC) ± 5% of reading in the range 41 to 70 mmHg
± 8% of reading in the range of 71 to 100
mmHg
± 10% of reading in the range of 101 to 150
mmHg
Notes —
• No degradation due to respiration rate or
I:E ratio
• Accuracy is affected by temperature and
barometric pressure.
• Accuracy specification will be maintained
for halogenated anesthetic agents present
at accepted MAC (Minimum Alveolar
Concentration) clinical levels.
• Xenon: The presence of Xenon in the
exhaled breath will negatively bias Carbon
Dioxide values by an additional 5 mmHg
at 38 mmHg.
• Desflurane: The presence of Desflurane in
the exhaled breath at concentrations
greater than 5% will positively bias
Carbon Dioxide values by up to an
additional 3 mmHg at 38 mmHg.
• Ethanol, Isopropanol, Acetone, Methane:
CO2 accuracy will not be affected by the
presence of 0.1% ethanol, 0.1%
isopropanol, 0.1% acetone or 1%
methane.
• Full accuracy specifications will be
maintained for all non-condensing
humidity levels.
Specifications
• In the presence of interfering gases, the

CO2 measurement meets the ISO
80601-2-55 accuracy requirements. It
represents an additional error of ± 4
mmHg in the range of 0 to 40 mmHg (at
sea level).
Note: Additional error based on the
consideration that interfering gas
compensation is properly set.
Drift of Measurement • Short term drift (4 hours of use): Does not

Accuracy exceed 0.8 mmHg
• Long term drift (120 hour period): Retains
accuracy specification
Respiration Rate Range 0 bpm to 150 bpm
Respiration Test Method Respiration rate accuracy was verified by using

a solenoid test setup to deliver a square wave of
known CO2 concentration to the device. 5%
and 10% CO2 concentrations were used and
respiration rate was varied over the range of the
device. Pass/Fail criteria was comparison of the
respiratory rate output from the sensor to the
frequency of the square wave. etCO2
measurements at those rates were compared to
the CO2 readings under static flow conditions.
Respiration Rate ±1 bpm

Accuracy
Automatic Barometric The mainstream CO2 module is not equipped

Pressure with automatic barometric pressure
compensation. The barometric pressure is
configured by the system administrator.
Specifications
ECG Specifications
ECG Specifications
Heart Rate Range Adult: 15 bpm – 300 bpm

Pediatric and Neonatal: 15 bpm – 350 bpm
Heart Rate Accuracy ± 1% or ± 1 bpm, whichever is greater
Bandwidth Normal Monitoring: 0.67 Hz – 40 Hz

Filtered Monitoring: 0.67 Hz – 20 Hz
Extended Monitoring: 0.05 Hz – 100 Hz
Note — The Efficia CM monitors comply
with AAMI EC-13/IEC 60601-2-27 in
Normal Monitoring mode only.
Leads CM10 and CM100: 3-lead and 5-lead

CM12, CM120, and CM150: 3-lead, 5-lead
and 10-lead
Display Sweep Speeds 12.5 mm/s, 25.0 mm/s, and 50.0 mm/s
Pacemaker Detection Indicator on waveform display, user

selectable
ECG size (sensitivity) 4.0, 2.0, 1.0, 0.5, 0.25 cm/mV or Auto
Lead-off Condition Detected and displayed
Input Impedance >2.5 MΩ
Common Mode Rejection >86 dB (with 51 kΩ/47nF imbalance)

Ratio (CMRR)
Input Signal Range ± 5 mV
Specifications
ECG Specifications
ECG Standards
ECG Arrhythmia Supplemental Information as required by AAMI

EC13
Respiration Excitation <250 µA, 37 kHz nominal

Waveform
Time to Alarm for < 5.0 seconds

Tachycardia
Tall T-wave Rejection Tested to a T-wave amplitude of 1.8 mV

Capability
Heart Rate Averaging Three different methods are used:

Method • Normally, heart rate is computed by averaging
the 12 most recent R to R intervals.
• For runs of PVCs, up to 8 R to R intervals are
averaged to compute the HR.
• If each of 3 consecutive R to R intervals is
greater than 1200 ms (that is, rate less than 50
bpm, 80 bpm for neonates), then the 4 most
recent Rto R intervals are averaged to
compute the HR.
Response Time of HR change from 80 bpm to 120 bpm: 10 seconds

Heart Rate Meter to maximum
Change in Heart Rate HR change from 80 bpm to 40 bpm: 10 seconds
maximum
Heart Rate Meter Provides correct heart rates, as follows:

Accuracy and • Ventricular bigeminy: 80 bpm
Response to Irregular
Rhythm • Slow alternating ventricular bigeminy: 60 bpm
• Rapid alternating ventricular bigeminy: 120
bpm
• Bidirectional systoles: 90 bpm
Accuracy of Input Methods A and B were used to establish overall

Signal Reproduction system error and frequency response.
Specifications
ECG Specifications
ECG Arrhythmia Supplemental Information as required by AAMI

EC13
Time to Alarm for < 10 seconds

Cardiac Standstill
Time to Alarm for Low < 10 seconds

Heart Rate
Time to Alarm for < 10 seconds

High Heart Rate
Pacemaker Pulse Meets AAMI EC13 using test method A

Rejection Rejects ± 2mV to ± 700m V
Pulse widths 0.1 to 2.0 ms
With no overshoot
Pacer Pulse Detector With a 5mV input, a minimum slew rate of 1V/s
Rejection of Fast ECG RTI will trigger the pace pulse detector
Signals
Specifications
Impedance Respiration Specifications
Impedance Respiration Specifications
Technique Trans-thoracic impedance
Measurement Range 3 – 150 respirations per minute (rpm)
Resolution 1 respiration per minute (rpm)
Accuracy • ± 1 rpm in the range of 3 – 120 rpm

• ± 2 rpm in the range of 121 to 150 rpm
Respiration Excitation <250 µA, 37 kHz nominal

Waveform
ECG Leads Used RA to LL
Display Sweep Speeds 6.25, 12.5, 25, and 50 mm/s
Lead Off Condition Detected and displayed
Maximum Alarm Delay The delay of the respiration alarm after the
actual RR falls outside the alarm limits
depends on the difference between the RR and
the limit, as well as the strength of the
respiration waveform. The graph below shows
the maximum delay in the case of minimum
difference and low waveform strength.
Specifications
IBP Specifications
Maximum Alarm Delay

200
180
160
140
120
Sec
100
80
60
40
20
0
0 20 40 60 80 100 120 140
RPM
IBP Specifications
Measurement Range -40 mmHg – 360 mmHg
Input Sensitivity 5μ V/V/mmHg
Zero Static Offsets Up to ± 200 mmHg with ± 1 mmHg accuracy
Gain Accuracy ± 1% with drift less than 0.05%/oC
Transducer Load Memscap Load impedance: 200 to 2000 Ω

Impedance Memscap Output impedance: ≤ 3000 Ω
Transcap Load impedance: 300 to 700 Ohms
Transcap Output impedance: 300 to 1,000
Ohms
Overall Accuracy ± 4% of reading or ± 4 mmHg, whichever is

(including transducer) greater
Specifications
IBP Specifications
Volume displacement of 0.2 mm3/100 mmHg

CPJ840J6
Warmup time of < 15 seconds.

equipment and transducer
Specifications
Cardiac Output
Cardiac Output
Measurement Range Cardiac Output – 0.00 l/min to 20.00 l/min

Tblood – 27.0oC to 43.0oC
Tinj – 0.00oC to 27oC
Resolution C.O. – 0.01 l/min

Tblood – 0.1oC
Tinj – 0.1oC
Tbc – 0.1oC
Measurement Accuracy Cardiac Output – ± 5% or 0.2 l/min (whichever

is greater for C.O. ≤ 10 l/min)
Tblood – ± 0.1oC
Tinj – ± 0.1oC
Response Time Cardiac Output – < 25 seconds after starting

measurement
Tblood – < 1 second
Tinj – < 1 second
Tblood Curve – < 1 second
Specifications
Interface Specifications
Nurse Call Alarm output
Connector 3.5 mm phone jack, N.O and N.C contacts
Contact rating ≤ 1A @ < 25VAC

≤ 1A @ < 60VDC
Isolation 1.5 kV
Delay time < 1 sec
ECG Out
Bandwidth 1 Hz – 100 Hz +0/-3db
Gain 500 mV (1 mV ECG signal produces an

output of 0.5 V)
Delay time < 35 mSec referenced to the ECG input
Connector 1/4 in. insulated phone jack
Connector wiring ECG Out + (tip)

n/c (ring)
ECG Out – (sleeve)
Pacemaker pulses No pacemaker pulses
Data output Ethernet port

USB port, via the optional Serial Interface
Adapter
Wireless
Software upgrade USB port
Barcode scanner connection USB port
Specifications
Wireless interface Compliant with WiFi data rates 802.11a,

802.11b, 802.11g, and 802.11n
Compliant to standards 802.11a, 802.11b,
802.11g, 802.11n, 802.11d, 802.11e,
802.11h, and 802.11i
Antenna The antenna in the monitor has been tested

with the following specifications:
• Form Factor: PCB trace

• Type: Dipole
• Maximum Gain: 2.0 dBi (2.4 - 2.5
GHz)
• Maximum Gain: 3.9 dBi (5.15 - 5.35
GHz)
• Maximum Gain: 4.0 dBi (5.6 GHz)
Specifications
Radio Regulatory Compliance
Federal Communication Commission Interference Statement

This equipment has been tested and found to comply with the limits for a
Class A digital device, pursuant to Part 15 of the FCC Rules. These limits are
designed to provide reasonable protection against harmful interference in a
residential installation. This equipment generates, uses, and can radiate radio
frequency energy and, if not installed and used in accordance with the
instructions, may cause harmful interference to radio communications. However,
there is no guarantee that interference will not occur in a particular installation.
If this equipment does cause harmful interference to other device, radio or
television reception, which can be determined by turning the equipment off and
on, the user is encouraged to try to correct the interference by one of the
following measures:
1. Reorient or relocate the receiving antenna.

2. Increase the separation between the affected equipment and monitor, or
monitor and receiver.
3. Connect the equipment into an outlet on a circuit different from that to
which the receiver is connected.
4. Consult the IT department, service personnel, or biomedical engineer for
help.
Caution FCC Caution: Any changes or modifications not expressly approved by the
party responsible for compliance could void the user’s authority to operate
this equipment.
This device complies with Part 15 of the FCC Rules. Operation is subject to the
following two conditions: (1) This device may not cause harmful interference,
and (2) this device must accept any interference received, including interference
that may cause undesired operation.
This device is restricted to indoor use when operated in the 5.15 to 5.25 GHz
frequency range.
Specifications
FCC requires this product to be used indoors for the frequency range 5.15 to
5.25 GHz to reduce the potential for harmful interference to co-channel Mobile
Satellite systems.
This device does not permit operations on channels 116-128 (5580 – 5640 MHz)
for 11na and 120-128 (5600-5640 MHz) for 11a which overlap the 5600 -5650
MHz band.
Note — FCC Radiation Exposure Statement: This equipment complies with

FCC radiation exposure limits set forth for an uncontrolled environment. This
equipment should be installed and operated with minimum distance 20cm
between the radiator & your body
Industry Canada
Warning RF Radiation Hazard Warning

To ensure compliance with FCC and Industry Canada RF exposure
requirements, this device must be installed in a location where the antennas
of the device will have a minimum distance of at least 20 cm from all
persons.
European Union
This device complies with the essential requirements of the R&TTE Directive
1999/5/EC. The following test methods have been applied in order to prove
presumption of conformity with the essential requirements of the R&TTE
Directive 1999/5/EC:
• EN60950-1:2006+A11+A1+A12:2011
Safety of Information Technology Equipment
• EN 62311: 2008 / Article 3(1)(a) and Article 2 2006/95/EC)
Assessment of electronic and electrical equipment related to human
exposure restrictions for electromagnetic fields (0 Hz-300 GHz)
• EN 300 328 V1.8.1: 2012-06
Specifications
Electromagnetic compatibility and Radio spectrum Matters (ERM);

Wideband transmission systems; Data transmission equipment operating
using wide band modulation techniques; Harmonized EN covering the
essential requirements of article 3.2 of the R&TTE Directive
• EN 301 893 V1.7.1: 2012-06
Broadband Radio Access Networks (BRAN); 5 GHz high performance
RLAN; Harmonized EN covering the essential requirements of article 3.2
of the R&TTE Directive
• EN 301 489-1 V1.9.2: 2011
ElectroMagnetic Compatibility (EMC) standard for radio equipment and
services; Part 1: Common technical requirements
• EN 301 489-17 V2.2.1 2012
ElectroMagnetic Compatibility (EMC) standard for radio equipment; Part
17: Specific conditions for Broadband Data Transmission Systems
This device is a 2.4 GHz wideband transmission system (transceiver), intended
for use in all EU member states and EFTA countries, except in France and Italy
where restrictive use applies.
In Italy the end-user should apply for a license at the national spectrum
authorities in order to obtain authorization to use the device for setting up
outdoor radio links and/or for supplying public access to telecommunications
and/or network services.
This device may not be used for setting up outdoor radio links in France and in
some areas the RF output power may be limited to 10 mW EIRP in the
frequency range of 2454 – 2483.5 MHz. For detailed information the end-user
should contact the national spectrum authority in France.
Hereby, Philips declares that this monitor is in compliance with the essential
requirements and other relevant provisions of Directive 1999/5/EC.
Specifications
Specifications
A
Profile Settings
Profiles are predefined monitor configurations that can be used for different
monitoring situations. The monitor ships with the following three default
profiles:
• Operating Room (OR)

• General Ward (GW)
• Intensive Care Unit (ICU)
The default profile settings cannot be changed, however, your system
administrator can create up to three customized profiles for different care
settings.
Profile settings are password protected. Only your system administrator can load
a profile on the system and create custom profiles.
Viewing the Current Profile

To determine which profile is currently loaded on the system:
Step
1 Select the System button.
3 View the Current Profile setting.
Profile Settings
Efficia CM Instructions for Use A-1
Profile Configurations
The following table lists the default configurations of the default profiles, GW,
ICU, and OR.
If your monitor is using a custom profile, see your system administrator for a list
of the default settings used in the custom profile.
Parameter GW ICU OR
Tone Volume Alarm 4 4 2
Minimum 2 2 1
HR/Pulse 0 0 3
Alarm Audio pause duration 120 seconds 120 seconds 120 seconds
Latch physiological alarms Off Off Off
Allow alarm disable On On On
Allow audio off Off Off Off
Audio off reminder Off Off Off
Record on alarm Off Off Off
Display alarm limits On On On
All alarm limits See “Profile Alarm Limit Settings” on

page A-11.
Profile Settings
A-2 Efficia CM Instructions for Use
Parameter GW ICU OR
Recorder Speed 25.0 mm/s 25.0 mm/s 25.0 mm/s
ECG Gain 10.0 mm/mV 10.0 mm/mV 10.0 mm/mV
Waveform length 7 seconds 7 seconds 7 seconds
Real-time wave selection 1 1 1
Real-time wave 1 Primary ECG Primary ECG Primary ECG
Real-time wave 2 NA/blank NA/blank NA/blank
Full disclosure wave 2 2 2

selection
Full disclosure wave 1 ECG II ECG II ECG II
Full disclosure wave 2 SpO2 SpO2 SpO2
Full disclosure wave 3 NA/blank NA/blank NA/blank
Full disclosure wave 4 NA/blank NA/blank NA/blank

ECG Sweep speed 25.0 mm/s 25.0 mm/s 25.0 mm/s
Scale 5.0 cm/mV 5.0 cm/mV 5.0 cm/mV
Filter mode Monitoring Monitoring Filtered
Notch filter Off Off On
Lead set 5-Lead 5-Lead 5-Lead
Primary lead ECG II ECG II ECG II
Secondary lead ECG V or V1 ECG V or V1 ECG V or V1
HR alarm audible Yes Yes Yes
Profile Settings
Parameter GW ICU OR
Arrhythmia analysis Adult: Adult: Adult:

Enhanced (if Enhanced (if Enhanced (if
available) or available) or available) or
Basic Basic Basic
Pediatric: Pediatric: Pediatric:
Basic Basic Basic
Neonatal: Neonatal: Neonatal:
Cardiotach Cardiotach Cardiotach
Analysis mode Multi lead Multi lead Multi lead
ECG waveform selection I, II, III, V (or I, II, III, V (or I, II, III, V (or
for alarm history V1) V1) V1)
Arrhythmia TimeOut 1st 3 minutes 3 minutes 3 minutes
Arrhythmia TimeOut 2nd 10 minutes 10 minutes 10 minutes
AFib/IHR Reminder 30 minutes 30 minutes 30 minutes
ST analysis Adult: On Adult: On Adult: On

Pediatric: Off Pediatric: Off Pediatric: Off
Neonatal: Off Neonatal: Off Neonatal: Off
ST Audible alarm Yes Yes Yes
ISO/J point detection Auto Auto Auto
ISO Point -80 ms -80 ms -80 ms
J Point 48 ms 48 ms 48 ms
ST Offset 60 ms 60 ms 60 ms
Profile Settings
Parameter GW ICU OR
Impedance Impedance resp Enable Enable Disable
respiration
Sweep speed 6.25 mm/s 6.25 mm/s 6.25 mm/s
Scale x1 x1 x1
Detection mode Auto Auto Auto
Threshold 1 ohm (or 1 ohm (or 1 ohm (or

64 LSB at 64 LSB at 64 LSB at
x1 scale) x1 scale) x1 scale)
Audible alarm Yes Yes Yes
Apnea alarm 20 seconds 20 seconds Off

SpO2 Sweep speed 25.0 mm/s 25.0 mm/s 25.0 mm/s
SpO2 Audible alarm Yes Yes Yes
SpO2 high/low alarm 0 second 0 second 0 second

delay
SpO2 desat alarm delay 0 second 0 second 0 second
SpO2 response Normal Normal Normal
Perfusion indicator On On On
Profile Settings
Parameter GW ICU OR
NBP Default NBP interval Off Off Off
Align interval to clock Yes Yes Yes
Default initial inflation Adult: Adult: Adult:

pressure 160 mmHg 160 mmHg 160 mmHg
140 mmHg 140 mmHg 140 mmHg

Default VeniPuncture Adult: Adult: Adult:

pressure 60 mmHg 60 mmHg 60 mmHg
Default VeniPuncture Adult/ Adult/ Adult/

duration Pediatric: Pediatric: Pediatric:
170 seconds 170 second 170 second
85 seconds 85 seconds 85 seconds
Limit display Sys Sys Sys
Auto print NBP Off Off Off
NBP pressure units mmHg mmHg mmHg
NBP audible alarm Yes Yes Yes
NBP list display mode Graphical Graphical Graphical
NBP list time scale 1 hour 1 hour 1 hour
Profile Settings
Parameter GW ICU OR
IBP IBP1 sweep speed 25 mm/s 25 mm/s 25 mm/s
IBP2 sweep speed 25 mm/s 25 mm/s 25 mm/s
Overlap IBP Sweep speed 25 mm/s 25 mm/s 25 mm/s
IBP1 label ABP ABP ABP
IBP2 Label PAP PAP PAP
IBP1 Scale ABP, ART, ABP, ART, ABP, ART,

Ao, P, UAP: Ao, P, UAP: Ao, P, UAP:
0 mmHg – 0 mmHg – 0 mmHg –
CVP, ICP, CVP, ICP, CVP, ICP,
LAP, PAP, LAP, PAP, LAP, PAP,
RAP, UVP: RAP, UVP: RAP, UVP:
IBP2 Scale ABP, ART, ABP, ART, ABP, ART,

Overlap IBP1 Scale ABP, ART, ABP, ART, ABP, ART,

Profile Settings
Parameter GW ICU OR
Overlap IBP2 Scale ABP, ART, ABP, ART, ABP, ART,

IBP pressure units mmHg mmHg mmHg
Audible alarm (all IBP Yes Yes Yes

labels)
Limit display (all IBP Sys Sys Sys

labels)
Temperature Audible alarm Yes Yes Yes
(T1 and T2
Temperature units °C °C °C
Profile Settings
Parameter GW ICU OR
CO2 Sweep speed 6.25 mm/s 6.25 mm/s 6.25 mm/s
Scale 0 mmHg – 0 mmHg – 0 mmHg –

CO2 audible alarm Yes Yes Yes
awRR audible alarm Yes Yes Yes
awRR apnea alarm 20 seconds 20 seconds 20 seconds
CO2 pressure units mmHg mmHg mmHg
CO2 hardware Standby Standby Standby
Max hold 20 seconds 20 seconds 20 seconds
Humidity correction BTPS BTPS BTPS

(Sidestream)
Balance gas (Mainstream) Room air Room air Room air
O2 Compensation 16% 16% 16%

(Mainstream)
Anesthetic agent 0.0% 0.0% 0.0%

(Mainstream)
Gas temperature 35 °C 35 °C 35 °C
(Mainstream)
Cardiac output Tblood audible alarm Yes Yes Yes
Layout Default Adult/ Adult/ 8 waveform
Pediatric: Pediatric:
5 waveform 5 waveform
Neonatal: Neonatal:
OxyCRG OxyCRG
Layout configure See Changing the Layout on page...
Profile Settings
Parameter GW ICU OR
Trend Tabular trend display 15 minutes 5 minutes 15 seconds
interval
Tabular trend display HR, NBP, HR, NBP, HR, NBP,

parameter selection SpO2, Pulse, SpO2, Pulse, SpO2, Pulse,
RESP, RESP, RESP,
etCO2, etCO2, etCO2,
awRR, ABP, awRR, ABP, awRR, ABP,
PAP PAP PAP
NBP trend display HR, NBP, HR, NBP, HR, NBP,

RESP, RESP, RESP,
PAP PAP PAP
Graphic trend display time 8 hours 8 hours 4 hours

scale
Graphic trend display HR, NBP, HR, NBP, HR, NBP,

RESP, RESP, RESP,
PAP PAP PAP
Alarm history waveform 25 mm/s 25 mm/s 25 mm/s

sweep speed
Alarm history display ECG II, V (or ECG II, V (or ECG II, V (or
waveform selection V1), SpO2 V1), SpO2 V1), IBP1
Full disclosure waveform 25 mm/s 25 mm/s 25 mm/s

sweep speed
Full disclosure display ECG II, V (or ECG II, V (or ECG II, V (or
waveform selection V1), SpO2, V1), SpO2, V1), SpO2,
RESP, CO2, RESP, CO2, RESP, CO2,
ABP, PAP ABP, PAP ABP, PAP
Profile Settings
Profile Alarm Limit Settings
Parameter GW ICU OR
Pulse Audible alarm Yes Yes Yes
Pulse source Auto Auto Auto

The following table lists the default alarm limit settings in the three default
profiles. The alarm limit settings are the same for the three default profiles. You
can change alarm limit settings, but the settings will return to the default profile
values when you admit a patient, discharge a patient or select the Restore
Default Alarm Settings button in the Alarm Menu
If your monitor is using a custom profile, see your system administrator for a list
of the default alarm settings used in the custom profile.
Heart Rate High 120 bpm 160 bpm 200 bpm
Heart Rate Low 50 bpm 75 bpm 100 bpm
Pulse Rate High 120 bpm 160 bpm 200 bpm

(SpO2)
Pulse Rate Low 50 bpm 75 bpm 100 bpm

(SpO2)
Pulse Rate High 120 bpm 160 bpm 200 bpm

(NBP)
Pulse Rate Low (NBP) 50 bpm 75 bpm 100 bpm
NBP Sys High 160 mmHg 120 mmHg 90 mmHg

(21.3 kPa) (16.0 kPa) (12.0 kPa)
NBP Sys Low 90 mmHg 70 mmHg 40 mmHg

(12.0 kPa) (9.3 kPa) (5.3 kPa)
Profile Settings
NBP Dia High 90 mmHg 70 mmHg 60 mmHg

(12.0 kPa) (9.3 kPa) (8.0 kPa)
NBP Dia Low 50 mmHg 40 mmHg 20 mmHg

(6.7 kPa) (5.3 kPa) (2.7 kPa)
NBP MAP High 110 mmHg 90 mmHg 70 mmHg

(14.7 kPa) (12.0 kPa) (9.3 kPa)
NBP MAP Low 70 mmHg 50 mmHg 24 mmHg

(9.3 kPa) (6.7 kPa) (3.2 kPa)
39oC 39oC 39oC

Temperature High
(102.2 ◦F) (102.2 ◦F) (102.2 ◦F)
36oC 36oC 36oC

Temperature Low
(96.8 ◦F) (96.8 ◦F) (96.8 ◦F)
SpO2 High 100 % 100 % 95 %
SpO2 Low 90 % 90 % 85 %
RRa High 30 rpm 30 rpm NA
RRa Low 8 rpm 8 rpm NA

etCO2 High (8.0 kPa) (8.0 kPa) (8.0 kPa)
(82 cmH2O) (82 cmH2O) (82 cmH2O)

etCO2 Low (3.3 kPa) (3.3 kPa) (3.3 kPa)
(34 cmH2O) (34 cmH2O) (34 cmH2O)

imCO2 High (0.5 kPa) (0.5 kPa) (0.5 kPa)
(5 cmH2O) (5 cmH2O) (5 cmH2O)
Profile Settings
Respiration High 30 rpm 30 rpm 100 rpm
Respiration Low 8 rpm 8 rpm 30 rpm
awRR High 30 rpm 30 rpm 100 rpm
awRR Low 8 rpm 8 rpm 30 rpm
ABP Sys High 160 mmHg 120 mmHg 90 mmHg

Ao Sys High (21.3 kPa) (16.0 kPa) (12.0 kPa)
ART Sys High (218 cmH2O) (163 cmH2O) (122 cmH2O)
P Sys High
UAP Sys High
ABP Sys Low 90 mmHg 70 mmHg 55 mmHg

Ao Sys Low (12.0 kPa) (9.3 kPa) (7.3 kPa)
ART Sys Low (122 cmH2O) (95 cmH2O) (75 cmH2O)
P Sys Low
UAP Sys Low
ABP Dia High 90 mmHg 70 mmHg 60 mmHg

Ao Dia High (12.0 kPa) (9.3 kPa) (8.0 kPa)
ART Dia High (122 cmH2O) (95 cmH2O) (82 cmH2O)
P Dia High
UAP Dia High
ABP Dia Low 50 mmHg 40 mmHg 20 mmHg

Ao Dia Low (6.7 kPa) (5.3 kPa) (2.7 kPa)
ART Dia Low (68 cmH2O) (54 cmH2O) (27 cmH2O)
P Dia Low
UAP Dia Low
ABP Mean High 110 mmHg 90 mmHg 70 mmHg

Ao Mean High (14.7 kPa) (12.0 kPa) (9.3 kPa)
ART Mean High (150 cmH2O) (122 cmH2O) (95 cmH2O)
P Mean High
UAP Mean High
Profile Settings
ABP Mean Low 70 mmHg 50 mmHg 35 mmHg

Ao Mean Low (9.3 kPa) (6.7 kPa) (4.7 kPa)
ART Mean Low (95 cmH2O) (68 cmH2O) (48 cmH2O)
P Mean Low
UAP Mean Low
CVP Mean High 10 mmHg 4 mmHg 4 mmHg

ICP Mean High (1.3 kPa) (0.5 kPa) (0.5 kPa)
LAP Mean High (14 cmH2O) (5 cmH2O) (5 cmH2O)
RAP Mean High
UVP Mean High
CVP Mean Low 0 mmHg 0 mmHg 0 mmHg

ICP Mean Low (0.0 kPa) (0.0 kPa) (0.0 kPa)
LAP Mean Low (0 cmH2O) (0 cmH2O) (0 cmH2O)
RAP Mean Low
UVP Mean Low
PAP Sys High 35 mmHg 60 mmHg 60 mmHg

(4.7 kPa) (8.0 kPa) (8.0 kPa)
(48 cmH2O) (82 cmH2O) (82 cmH2O)
PAP Sys Low 10 mmHg 24 mmHg 24 mmHg

(1.3 kPa) (3.2 kPa) (3.2 kPa)
(14 cmH2O) (33 cmH2O) (33 cmH2O)
PAP Dia High 16 mmHg 4 mmHg 4 mmHg

(2.1 kPa) (0.5 kPa) (0.5 kPa)
(22 cmH2O) (5 cmH2O) (5 cmH2O)
PAP Dia Low 0 mmHg -4 mmHg -4 mmHg

(0.0 kPa) (-0.5 kPa) (-0.5 kPa)
(0 cmH2O) (-5cmH2O) (-5cmH2O)
Profile Settings
PAP Mean High 20 mmHg 26 mmHg 26 mmHg

(2.7 kPa) (3.5 kPa) (3.5 kPa)
(27 cmH2O) (35 cmH2O) (35 cmH2O)
PAP Mean Low 0 mmHg 12 mmHg 12 mmHg

(0.0 kPa) (1.6 kPa) (1.6 kPa)
(0 cmH2O) (16 cmH2O) (16 cmH2O)
Tblood High 39oC 39oC 39oC
Tblood Low 36oC 36oC 36oC
ST High 1.0 mm NA NA
ST Low -1.0 mm -1.0 mm NA
Extreme Brady 40 bpm 55 bpm 80 bpm
Extreme Tachy 140 bpm 180 bpm 220 bpm
PVC/min High 10 5 NA
VTach HR: 100 bpm HR: 120 bpm NA

Run: 5 Run: 5
Vent Rhythm 14 14 NA
RUN PVCs 2 2 NA
SVT HR: 180 bpm HR: 200 bpm NA

Run: 5 Run: 5
Profile Settings
Profile Settings
B
Alarm Specifications
This appendix describes all physiological and technical alarms. It also contains
alarm limit ranges and the formulas use for calculating the Auto Set Alarm
limits.
For information on alarm defaults, see “Profile Alarm Limit Settings” on

page A-11
Physiological Alarms
The following table lists all physiological alarm messages and provides a
description of each alarm. The alarms are grouped by parameter.
Latched
Alarm Message Priority Cause
(Yes or No)
Arrhythmia/HR Alarms
AFib Medium No An irregular rhythm of beats labeled
as N AND variability in PR intervals
AND P-wave variability (for adult
patient category only)
Asystole High Yes No beat detected for a period > the
asystole threshold of 4.0 seconds
End AFib Medium No Atrial Fibrillation no longer detected
for the Afib end delay time (For adult
patient category only)
Efficia CM Instructions for Use B-1
Latched
(Yes or No)
End Irregular HR Medium No Irregular HR rhythm no longer
detected for the irregular HR end
delay time
Extreme Brady High Yes Heart Rate less than the Extreme
Brady limit
Extreme Tachy High Yes Heart Rate greater than the Extreme
Tachy limit
HR High Medium No The Heart Rate value has exceeded the
high alarm limit.
HR Low Medium No The Heart Rate value has dropped
below the low alarm limit
Irregular HR Medium No An irregular rhythm of beats labeled
as N (R-R interval changes greater
than 12.5%)
Missed Beat Medium No No beat detected for a period > 1.75 of
the average R-R interval for HR <120,
OR no beat detected for > 1 second
with HR >120. (Paced mode Off)
Multiform PVCs Medium No The occurrence of two differently
shaped beats labeled as Vwithin the
last 60 beats AND each occurring at
least twice within the last 300 beats
Non-Sustain VT Medium No A run of consecutive beats labeled as
V with run length < the V-Tach Run
limit AND ventricular HR > V-Tach
HR limit
Pacer Not Capt Medium No No beat detected for a period of > 1.75
of the average R-R interval AND pace
pulse(s) detected (Paced mode On)
B-2 Efficia CM Instructions for Use
Latched
(Yes or No)
Pacer Not Pacing Medium No No beat detected for a period of > 1.75
of the average R-R interval AND no
pace pulse(s) detected (Paced mode
On)
Pair PVCs Medium No Two consecutive beats labeled as V
between 2 beats not labeled as V
Pause Medium No No beat detected for a period > the
pause threshold of 2.5 seconds.
PVC/min High Medium No Within 1 minute, the number of beats
labeled as V> the PVCs /min limit
R-onT PVCs Medium No For HR <100, a beat labeled as V with
R-R interval <1/3 of the average of the
R-R interval followed by a
compensatory pause > 1.25 of the
average R-R interval OR 2 such beats
labeled as V without a compensatory
pause occurring within 5 minutes of
each other.
Note When HR >100, 1/3 of the R-
R interval is too short for detection.
Run PVCs High Medium No A run of > 2 consecutive beats labeled
as V with run length ? Vent Rhythm
run limit AND ventricular HR ? V-
Tach HR limit
SVT Medium No A run of consecutive beats labeled as
S with run length ? SVT run limit
AND ventricular HR > SVT HR limit
Vent Bigeminy Medium No A dominant rhythm of beats labeled as
N, V, N, V, N (N=supraventricular
beat, V=ventricular beat)
Latched
(Yes or No)
Vent Fib/Tach High Yes Fibrillatory wave (sinusoidal wave
between 2-10 Hz) for 4 consecutive
seconds
Vent Rhythm Medium No A run of consecutive beats labeled as
V with run length > Vent rhythm run
limit AND ventricular HR ? V-Tach
HR limit
Vent Trigeminy Medium No A dominant rhythm of beats labeled as
N, N, V, N, N, V, N, N
(N=supraventricular beat,
V=ventricular beat)
V-Tach High Yes A run of consecutive beats labeled as
V with run length ? V-Tach Run limit
AND ventricular HR > the V-Tach HR
limit
ST Alarms
ST High Medium No The ST value has exceeded the high
alarm limit.
ST Low Medium No The ST value has dropped below the
low alarm limit.
ST Multi Medium No High/Low ST limits violated for
contiguous ECG leads. Two
contiguous ST leads are exceeding
elevation or depression limits for > 60
seconds. Both lead violations.
Latched
(Yes or No)
Impedance Respiration Alarms

HR = RR Low No If both the Heart Rate and Respiration
Rate are derived from ECG, and the
Heart Rate is approximately the same
as the Respiration value, the HR = RR
alarm sounds to indicate that the
Respiraton value may be unreliable.
Reposition the ECG electrodes.
For more information, see
“Optimizing ECG Lead Placement for
Impedance Respiration
Measurements” on page 11-2
Resp Apnea High Yes Respiration has not been detected for
longer than the time specified in the
RESP Apnea Alarm field.
Resp Rate High Medium No The respiration value has exceeded the
high alarm limit.
Resp Rate Low Medium No The respiration value has dropped
below the low alarm limit.
Airway Respiration (awRR) Alarms

awRR Apnea High Yes Respiration has not been detected for
longer than the time specified in the
awRR Apnea Alarm field.
awRR High Medium No The respiration value has exceeded the

high alarm limit.
awRR Low Medium No The respiration value has dropped
Latched
(Yes or No)
NBP Alarms
NBP(D) High Medium No The NBP Diastolic value has exceeded
the high alarm limit.
NBP(D) Low Medium No The NBP Diastolic value has dropped
NBP(M) High Medium No The NBP MAP value has exceeded the
high alarm limit.
NBP(M) Low Medium No The NBP MAP value has dropped
NBP(S) High Medium No The NBP Systolic value has exceeded
NBP(S) Low Medium No The NBP Systolic value has dropped
IBP Alarms
Ao(D) High Medium No The Ao Diastolic value has exceeded
Ao(D) Low Medium No The Ao Diastolic value has dropped
Ao(M) High Medium No The Ao Mean value has exceeded the
high alarm limit.
Ao(M) Low Medium No The Ao Mean value has dropped
Ao(S) High Medium No The Ao Systolic value has exceeded
Ao(S) Low Medium No The Ao Systolic value has dropped
Latched
(Yes or No)
ABP(D) High Medium No The ABP Diastolic value has exceeded
ABP(D) Low Medium No The ABP Diastolic value has dropped
ABP(M) High Medium No The ABP Mean value has exceeded
ABP(M) Low Medium No The ABP Mean value has dropped
ABP(S) High Medium No The ABP Systolic value has exceeded
ABP(S) Low Medium No The ABP Systolic value has dropped
ART(D) High Medium No The ART Diastolic value has
exceeded the high alarm limit.
ART(D) Low Medium No The ART Diastolic value has dropped
ART(M) High Medium No The ART Mean value has exceeded
ART(M) Low Medium No The ART Mean value has dropped
ART(S) High Medium No The ART Systolic value has exceeded
ART(S) Low Medium No The ART Systolic value has dropped
CVP(M) High Medium No The CVP Mean value has exceeded
CVP(M) Low Medium No The CVP Mean value has dropped
Latched
(Yes or No)
ICP(M) High Medium No The ICP Mean value has exceeded the
high alarm limit.
ICP(M) Low Medium No The ICP Mean value has dropped
LAP(M) High Medium No The LAP Mean value has exceeded
LAP(M) Low Medium No The LAP Mean value has dropped
P(D) High Medium No The P Diastolic value has exceeded
P(D) Low Medium No The P Diastolic value has dropped
P(M) High Medium No The P Mean value has exceeded the
high alarm limit.
P(M) Low Medium No The P Mean value has dropped below
the low alarm limit.
P(S) High Medium No The P Systolic value has exceeded the
high alarm limit.
P(S) Low Medium No The P Systolic value has dropped
PAP(D) High Medium No The PAP Diastolic value has exceeded
PAP(D) Low Medium No The PAP Diastolic value has dropped
PAP(M) High Medium No The PAP Mean value has exceeded the
high alarm limit.
PAP(M) Low Medium No The PAP Mean value has dropped
Latched
(Yes or No)
PAP(S) High Medium No The PAP Systolic value has exceeded
PAP(S) Low Medium No The PAP Systolic value has dropped
RAP(M) High Medium No The RAP Mean value has exceeded
RAP(M) Low Medium No The RAP Mean value has dropped
UAP(D) High Medium No The UAP Diastolic value has
UAP(D) Low Medium No The UAP Diastolic value has dropped
UAP(M) High Medium No The UAP Mean value has exceeded
UAP(M) Low Medium No The UAP Mean value has dropped
UAP(S) High Medium No The UAP Systolic value has exceeded
UAP(S) Low Medium No The UAP Systolic value has dropped
UVP(M) High Medium No The UVP Mean value has exceeded
UVP(M) Low Medium No The UVP Mean value has dropped
Latched
(Yes or No)
Philips SpO2 Alarms

SpO2 Desat High Yes The oxygen saturation value has
dropped dangerously low. The SpO2
Desat alarm sounds when the SpO2
value is 10 less than the current low
limit for adult and pediatric patients
and 5 less for neonatal patients.
SpO2 High Medium No The SpO2 value has exceeded the high
alarm limit.
SpO2 Low Medium No The SpO2 value has dropped below
CO2 Alarms (Sidestream and Mainstream)

etCO2 High Medium No The etCO2 value has exceeded the
high alarm limit.
etCO2 Low Medium No The etCO2 value has dropped below
imCO2 High Medium No The inspired CO2 value has exceeded
Pulse Alarms
Pulse High Medium No The pulse value has exceeded the high
alarm limit.
Pulse Low Medium No The pulse value has dropped below the
low alarm limit.
Temperature Alarms
T1 High Medium No The T1 temperature value has
T1 Low Medium No The T1 temperature value has dropped
Technical Alarms
Latched
(Yes or No)
T2 High Medium No The T2 temperature value has
T2 Low Medium No The T2 temperature value has dropped
Cardiac Output Alarms

Tblood High Medium No The blood temperature value has
Tblood Low Medium No The blood temperature value has
dropped below the low alarm limit.
Technical Alarms
The following table lists all technical alarm messages and provides a description
of each alarm. The alarms are grouped by or parameter.
Arrhythmia/HR Alarms
ECG Leads Off Low Not all required leads for ECG monitoring are
connected. Check the ECG connections and
make sure that the electrodes are attached.
ECG Equip Malfunc Low ECG equipment malfunction. Contact your
technical support team to check the error log for
details.
Technical Alarms
CO2 Sidestream Alarms

CO2 Auto Zero Low The CO2 automatic zero calibration is in
progress.
CO2 Calibration Needed Low The CO2 module should be calibrated after
1,200 hours of operation. After the first
calibration, calibrate once a year, or after 4,000
hours, whichever comes first.
Contact your technical support team if you see
this message.
CO2 Equipment Malfunc Low CO2 equipment malfunction. Contact your
details.
CO2 No Tubing High The CO2 filter line is not connected.
CO2 Occlusion Low The sampling line or exhaust tube is blocked.
The CO2 pump will stop drawing the air sample
into the monitor for analysis. Disconnect and
reconnect the sampling line. If the message still
appears, replace the sampling line with a new
one. The pump will resume operation when the
new sampling line is connected or the occlusion
is cleared.
CO2 Out of Range Low The CO2 value is outside the CO2 measurement
range.
CO2 Purging Low The CO2 filter line is being purged to remove an
occlusion in the line or airway adapter. If the
occlusion is removed, the message disappears.
Technical Alarms
CO2 Mainstream Alarms

CO2 Check Airway Adapter High Problem with the CO2 airway adapter. May be
caused by any of the following:
• The adapter is not securely plugged in.
• An optical blockage on the windows of the
airway adapter.
• The adapter type was changed, but no zero
was performed.
• The airway adapter contains mucus or
moisture. Clean the adapter and perform a
zero.
CO2 Incompatible Sensor Low Incompatible sensor. Replace with a compatible
sensor.
CO2 No Sensor High The CO2 sensor is disconnected from the
monitor
CO2 Out of Range Low The CO2 value is outside the CO2 measurement
range.
CO2 Sensor Malfunc Low Malfunction of the CO2 sensor. Contact your
details.
CO2 Sensor Over Temp Low The temperature of the CO2 sensor is greater
than 40oC (104o F). If the problem persists,
contact your technical support team.
Philips SpO2 Alarms

SpO2 Equip Malfunc Low SpO2 equipment malfunction. Contact your
details.
SpO2 Erratic Low Erratic SpO2 measurement. Often due to a faulty
sensor, incorrect application, or incorrect
positioning of sensor.
Technical Alarms

SpO2 Extd. Update Low The update period of the displayed SpO2 is
extended because an NBP measurement is being
taken on the same limb.
SpO2 Interference Low The level of ambient light or electrical
interference is so high that it prevents SpO2/
Pulse Rate from being measured reliably.
SpO2 Low Perf Low SpO2 accuracy may be compromised due to very
low perfusion.
SpO2 No Sensor Low The SpO2 sensor is disconnected from the
monitor.
SpO2 Non-Pulsatile High The pulse is too weak for the algorithm to detect
the physiological pulse or the sensor is no longer
attached to the patient.
SpO2 Noisy Signal Low Excessive patient movement or electrical
interference is causing irregular pulse patterns.
SpO2 Sensor Malfunc Low Malfunction of the SpO2 sensor or sensor cable.
Contact your technical support team to check
the error log for details.
SpO2 Sensor Off Patient Low The SpO2 sensor is no longer attached to the
patient.
Technical Alarms
NBP Alarms
NBP Air Leak Low The monitor cannot adjust pressure. This may be
due to leakage or an internal NBP module
problem.
NBP Artifact Low The monitor cannot correct the pressure to the
intended value within the time limit, or the
monitor requires too many pressure correction
attempts to adjust the pressure to the intended
value.
This may be due to excessive patient movement,
leakage, or a problem with extreme edematous
patients.
NBP Equip Malfunc Low NBP equipment malfunction. Contact your
details.
NBP Hose Blocked Low The monitor has detected a defect in the
pneumatic system, such as valves, tubing, or
plug.
NBP Loose Cuff Low The NBP cuff cannot inflate to the target value
within the limits of the selected patient size.
May be caused by a pump defect, leakage, or
disconnected cuff.
NBP Measurement Failed Low The monitor is unable to complete an NBP
measurement.
NBP Out of Range Low The NBP value is outside the NBP measurement
range.
Technical Alarms

NBP Overpressure High The NBP cuff pressure exceeds the overpressure
safety limits:
• 300 mmHg (40.0 kPa) for adult or pediatric
patients
• 150 mmHg (20.0 kPa) for neonatal patients
This error is caused by a sudden rise in pressure
if the cuff is squeezed or bumped.
The monitor cannot take any more NBP
readings until the alarm is acknowledged.
NBP Timeout Low The NBP cuff deflation lasts longer than the
limits of the selected patient size, or the
measurement time exceeded 180 seconds for
adult/pediatric patients and 90 seconds for
neonatal patients.
This may be due to extreme bradycardia or
excessive artifacts.
NBP Weak Signal Low The monitor could not derive a blood pressure
measurement. This may be due to excessive
artifacts, extremely weak pulse signal, incorrect
patient size setting, or the blood pressure
measurement is out of range.
IBP Alarms
<Pressure> Equip Malfunc Low Equipment malfunction of the specified invasive
pressure. Contact your technical support team to
check the error log for details.
<Pressure> Out of Range Low The invasive pressure value is outside the
measurement range.
<Pressure> No Transducer Medium The transducer is not connected.
Technical Alarms

<Pressure> Non-pulsatile High The waveform for the specified invasive
pressure is less than 3 mmHg (0.4 kPa) for 4
seconds. Check the catheter and connections to
the patient.
Temperature Alarms
<Temp> Equip Malfunc Low T1 or T2 equipment malfunction. Contact your
details.
<Temp> Out of Range Low The T1 or T2 temperature value is outside the
measurement range.
<Temp> Probe Low The T1 or T2 temperature probe has become
Disconnected disconnected.
Cardiac Output Alarms

C.O. Equip Malfunc Low Cardiac Output equipment malfunction. Contact
your technical support team to check the error
log for details.
Tblood Probe Disconnect Low The transducer or catheter has become
disconnected.
Tblood Out of Range Low The Tblood value is outside the measurement
range.
Battery Alarms
Battery Comm Error Low Battery communication error. Contact your
Extreme Low Batt High This is the second low battery alarm. Plug in the
monitor as soon as possible. When the Extreme
Low Batt alarm sounds, the remaining operating
time is up to 5 minutes, depending on usage. If
silenced, this alarm will sound again in 60
seconds.
Technical Alarms

Low Batt Low This is the first low battery alarm. When the
Low Batt alarm sounds, the remaining operating
time is up to 20 minutes, depending on usage.
Unsupported Battery Low The battery installed in the monitor is not
supported. Contact your technical support team.
Unsupported Battery Config Low Your monitor will not operate correctly with a
3-cell battery. You monitor requires a 9-cell
battery.
When this alarm occurs, the recorder on your
unit is disabled. Contact your technical support
team.
Recorder Alarms
Recorder Door Open Low The recorder door is open and must be closed to
work properly.
Recorder Not Installed Low The optional recorder is not installed in your
monitor.
Recorder Out of Paper Low The recorder is out of paper.
Miscellaneous Alarms
Configuration Update Failed Low A configuration update request from the remote
Dashboard server has failed. Contact your
Loss of Monitoring Low Indicates that the monitor has shut itself down
and then rebooted, due to an internal error. The
Loss of Monitoring message appears to inform
you that some patient data may have been lost.
No Central Monitoring Low Lost network connection to the Central. No data
is being sent to the Central.
Technical Alarms

No SD Card Low The internal SD card used to store Full
Disclosure data is not installed. Full Disclosure
data will not be saved.
Contact your technical support team.
SD Card Corrupted Low The internal SD card used to store Full
Disclosure data is corrupt.
Contact your technical support team.
Software Upgrade Failed Low A software upgrade request from the remote
Dashboard server has failed. Contact your
Speaker Malfunc Low Both speakers have malfunctioned. The alarm is
visual only because the speakers may be broken.
Contact your technical support team to check
the error log for details.
Speaker (L) Malfunc Low The left speaker has malfunctioned. If the right
speaker is still working, the system generates
both a visual and audible alarm. Contact your
details.
Speaker (R) Malfunc Low The right speaker has malfunctioned. If the left
speaker is still working, the system generates
both a visual and audible alarm. Contact your
details.
System Error Low Stop using the monitor.
Contact your technical support team for
assistance. To provide the error code to your
technical support team, select the message area
to display the View All Alarms Menu. Note the
number in parenthesis for this error message
Wireless Malfunc Low Wireless firmware cannot be loaded.
Visual Only Technical Alarms
Visual Only Technical Alarms

The following table lists the technical alarm messages that appear in the
message area, but do not generate an audible alarm.

Cannot Analyze ECG Low When enhanced or basic arrhythmia is selected,
this alarm condition occurs when the ECG
signal cannot be properly analyzed due to noise
or INOP/Technical conditions. If more than 2/3
of the time over the last 30 seconds beats are
classified as either noisy or questionable, a
“Cannot Analyze” alarm condition is generated.
When Cardiotach mode is selected, a Cannot
Analyze ECG alarm condition occurs when the
HR is invalid for more than 20 seconds
Cannot Analyze ST Low The ST algorithm cannot generate a valid ST
value. Possible causes are large variations in the
measured ST values for consecutive beats, or
ventricular paced beats. Review the ECG signal
quality and the ST measurement points.
If the patient has a ventricular pacemaker, ST
analysis is not possible.
Alarm Limit Ranges
Alarm Limit Ranges

The following table lists the user-adjustable ranges for all physiological alarms.

ABP Dia High 55 mmHg – 359 mmHg 45 mmHg – 359 mmHg 22 mmHg – 359 mmHg
Ao Dia High (7.3 kPa – 47.9 kPa) (6.0 kPa – 47.9 kPa) (2.9 kPa – 47.9 kPa)
ART Dia High
(75 cmH2O – 488 (61 cmH2O – 488 (30 cmH2O – 488
P Dia High cmH2O) cmH2O) cmH2O)
UAP Dia High
ABP Dia Low -39 mmHg – 85 mmHg -39 mmHg – 65 mmHg -39 mmHg – 55 mmHg
Ao Dia Low (-5.2 kPa – 11.3 kPa) (-5.2 kPa – 8.7 kPa) (-5.2 kPa – 7.3 kPa)
ART Dia Low
(-53 cmH2O – 116 (-53 cmH2O – 88 (-53 cmH2O – 75
P Dia Low cmH2O) cmH2O) cmH2O)
UAP Dia Low
ABP Mean High 75 mmHg – 359 mmHg 55 mmHg – 359 mmHg 40 mmHg – 359 mmHg
Ao Mean High (10.0 kPa – 47.9 kPa) (7.3 kPa – 47.9 kPa) (5.3 kPa – 47.9 kPa)
ART Mean High
(102 cmH2O – 488 (75 cmH2O – 488 (54 cmH2O – 488
P Mean High cmH2O) cmH2O) cmH2O)
UAP Mean High
ABP Mean Low -39 mmHg – 105 mmHg -39 mmHg – 85 mmHg -39 mmHg – 65 mmHg
Ao Mean Low (-5.2 kPa – 14.0 kPa) (-5.2 kPa – 11.3 kPa) (-5.2 kPa – 8.7 kPa)
ART Mean Low
(-53 cmH2O – 143 (-53 cmH2O – 116 (-53 cmH2O – 88
P Mean Low cmH2O) cmH2O) cmH2O)
UAP Mean Low
ABP Sys High 95 mmHg – 359 mmHg 75 mmHg – 359 mmHg 60 mmHg – 359 mmHg
Ao Sys High (12.7 kPa – 47.9 kPa) (10.0 kPa – 47.9 kPa) (8.0 kPa – 47.9 kPa)
ART Sys High
(129 cmH2O – 488 (102 cmH2O – 488 (82 cmH2O – 488
P Sys High cmH2O) cmH2O) cmH2O)
UAP Sys High
Alarm Limit Ranges

ABP Sys Low -39 mmHg – 155 mmHg -39 mmHg – 145 mmHg -39 mmHg – 85 mmHg
Ao Sys Low (-5.2 kPa – 20.7 kPa) (-5.2 kPa – 19.3 kPa) (-5.2 kPa – 11.3 kPa)
ART Sys Low
(-53 cmH2O – 211 (-53 cmH2O – 197 (-53 cmH2O – 116
P Sys Low cmH2O) cmH2O) cmH2O)
UAP Sys Low
CVP Mean High 2 mmHg – 359 mmHg 2 mmHg – 359 mmHg 2 mmHg – 359 mmHg
ICP Mean High (0.3 kPa – 47.9 kPa) (0.3 kPa – 47.9 kPa) (0.3 kPa – 47.9 kPa)
LAP Mean High
(3 cmH2O – 488 (3 cmH2O – 488 (3 cmH2O – 488
RAP Mean High cmH2O) cmH2O) cmH2O)
UVP Mean High
CVP Mean Low -39 mmHg – 8 mmHg -39 mmHg – 2 mmHg -39 mmHg – 2 mmHg
ICP Mean Low (-5.2 kPa – 1.1 kPa) (-5.2 kPa – 0.3 kPa) (-5.2 kPa – 0.3 kPa)
LAP Mean Low
(-53 cmH2O – 11 (-53 cmH2O – 3 (-53 cmH2O – 3
RAP Mean Low cmH2O) cmH2O) cmH2O)
UVP Mean Low
PAP Dia High -2 mmHg – 359 mmHg -2 mmHg – 359 mmHg -2 mmHg – 359 mmHg
(-0.3 kPa – 47.9 kPa) (-0.3 kPa – 47.9 kPa) (-0.3 kPa – 47.9 kPa)
(-3 cmH2O – 488 (-3 cmH2O – 488 (-3 cmH2O – 488
cmH2O) cmH2O) cmH2O)
PAP Dia Low -39 mmHg – 14 mmHg -39 mmHg – 2 mmHg -39 mmHg – 2 mmHg
(-53 cmH2O – 19 (-53 cmH2O – 3 (-53 cmH2O – 3
PAP Mean High 2 mmHg – 359 mmHg 14 mmHg – 359 mmHg 14 mmHg – 359 mmHg
(0.3 kPa – 47.9 kPa) (1.9 kPa – 47.9 kPa) (1.9 kPa – 47.9 kPa)
(3 cmH2O – 488 (19 cmH2O – 488 (19 cmH2O – 488
Alarm Limit Ranges

PAP Mean Low -39 mmHg – 18 mmHg -39 mmHg – 24 mmHg -39 mmHg – 24 mmHg
(-53 cmH2O – 24 (-53 cmH2O – 33 (-53 cmH2O – 33
cmH2O cmH2O cmH2O
PAP Sys High 12 mmHg – 359 mmHg 26 mmHg – 359 mmHg 26 mmHg – 359 mmHg
(16 cmH2O – 488 (35 cmH2O – 488 (35 cmH2O – 488
PAP Sys Low -39 mmHg – 30mmHg -39 mmHg – 55 mmHg -39 mmHg – 55 mmHg
(-53 cmH2O – 41 (-53 cmH2O – 75 (-53 cmH2O – 75
etCO2 High 32 mmHg – 149 mmHg 32 mmHg – 149 mmHg 32 mmHg – 149 mmHg
(44 cmH2O – 203 (44 cmH2O – 203 (44 cmH2O – 203
etCO2 Low 1 mmHg – 70 mmHg 1 mmHg – 75 mmHg 1 mmHg – 75 mmHg
(0.1 kPa – 9.3 kPa) (0.1 kPa – 10 kPa) (0.1 kPa – 10 kPa)
(1 cmH2O – 95 (1 cmH2O – 102 (1 cmH2O – 102
Extreme Brady NA NA NA
High
Extreme Brady 15 bpm – 114 bpm 15 bpm – 154 bpm 15 bpm – 194 bpm
Low
Extreme Tachy 56 bpm – 300 bpm 81 bpm – 300 bpm 81 bpm – 350 bpm
High
Extreme Tachy NA NA NA
Low
Heart Rate High 55 bpm – 299 bpm 80 bpm – 299 bpm 80 bpm – 349 bpm
Alarm Limit Ranges

Heart Rate Low 16 bpm – 115 bpm 16 bpm – 155 bpm 16 bpm – 195 bpm
imCO2 High 2 mmHg – 20 mmHg 2 mmHg – 20 mmHg 2 mmHg – 20 mmHg
(3 cmH2O – 27 (3 cmH2O – 27 (3 cmH2O – 27
imCO2 Low NA NA NA
NBP Diastolic 55 mmHg – 244 mmHg 55 mmHg – 149 mmHg 22 mmHg – 99 mmHg
High
NBP Diastolic 11 mmHg – 85 mmHg 11 mmHg – 65 mmHg 11 mmHg – 55 mmHg
Low
NBP MAP High 65 mmHg – 254 mmHg 55 mmHg – 159 mmHg 26 mmHg – 119 mmHg
NBP MAP Low 21 mmHg – 105 mmHg 21 mmHg – 85 mmHg 21 mmHg – 65 mmHg
NBP Systolic 95 mmHg – 269 mmHg 75 mmHg – 179 mmHg 45 mmHg – 129 mmHg
High
NBP Systolic 31 mmHg – 155 mmHg 31 mmHg – 120 mmHg 31 mmHg – 85 mmHg
Low
Pulse Rate High 55 bpm – 299 bpm 80 bpm – 299 bpm 80 bpm – 299 bpm
(Philips SpO2)
Pulse Rate Low 31 bpm – 115 bpm 31 bpm – 155 bpm 31 bpm – 195 bpm
(Philips SpO2)
Pulse Rate High 55 bpm – 299 bpm 80 bpm – 299 bpm 80 bpm – 299 bpm
(NBP)
Pulse Rate Low 41 bpm – 115 bpm 41 bpm – 155 bpm 41 bpm – 195 bpm
(NBP)
PVC Rate High 1 – 99 1 – 99 NA
Alarm Limit Ranges

PVC Rate Low NA NA NA
Respiration 10 rpm – 149 rpm 10 rpm – 149 rpm 35 rpm – 149 rpm
High
(Impedance)
Respiration Low 4 rpm – 25 rpm 4 rpm – 25 rpm 4 rpm – 95 rpm

(Impedance)
High
(Mainstream)

(Mainstream)
High
(Sidestream)

(Sidestream)
Run PVCs High 2 – 99 2 – 99 NA

Run PVCs Low NA NA NA
SpO2 High 50% – 100% 50% – 100% 31% – 100%
(Philips)
SpO2 Low 0% – 99% 0% – 99% 0% – 99%

(Philips)
ST High -19.9 mm – 20.0 mm -19.9 mm – 20.0 mm NA

ST Low -20.0 mm – 19.9 mm -20.0 mm – 19.9 mm NA
SVT High Rate: 15 bpm – 300 Rate: 15 bpm – 300 NA
bpm bpm
Count 3 – 99 Count 3 – 99
SVT Low NA NA NA
Tblood High 36.1°C – 42.9°C 36.1°C – 42.9°C 36.1°C – 42.9°C
Auto Set Alarms

Tblood Low 26.8°C – 38.9°C 26.8°C – 38.9°C 26.8°C – 38.9°C
Temperature 36.1°C – 44.9°C 36.1°C – 44.9°C 36.1°C – 44.9°C
High
(97.0°F – 112.8°F) (97.0°F – 112.8°F) (97.0°F – 112.8°F)
Temperature 25.1°C – 38.9°C 25.1°C – 38.9°C 25.1°C – 38.9°C
Low
(77.2°F – 102.0°F) (77.2°F – 102.0°F) (77.2°F – 102.0°F)
Vent Rhythm 3 – 99 3 – 99 NA
High
Vent Rhythm NA NA NA
Low
V-Tach High Rate: 15 bpm – 300 Rate: 15 bpm – 300 NA

bpm bpm
Count: 3 – 99 Count: 3 – 99
V-Tach Low NA NA NA
Auto Set Alarms

The following tables list the formulas used for calculating the Auto Set Alarm
Limits. The Auto Set Alarm Limits option is available in the Alarm Menu.
If the calculated offset value exceeds the alarm limit range, the system does not
change the upper and lower limits. For NBP and IBP, if any of the Sys, Dia, or
Mean offset values exceed the alarm limits, the limits are not adjusted.
Auto Set Alarms
Adult/Pediatric Auto Set Alarm Calculations

The following table lists the formulas used for calculating the Auto Set Alarm
Limits for adult and pediatric patients.
Parameter Adult/Pediatric Lower Limit Adult/Pediatric Upper Limit

etCO2 0 mmHg – 32 mmHg (0 kPa – 4.3 kPa) 0 mmHg – 32 mmHg (0 kPa – 4.3 kPa)
(0 cmH2O – 44 cmH2O): No change (0 cmH2O – 44 cmH2O): No change
32 mmHg – 35 mmHg: 29 mmHg 32 mmHg – 35 mmHg: 41 mmHg
(4.3 kPa – 4.7 kPa): (3.9 kPa) (4.3 kPa – 4.7 kPa): (5.5 kPa)
(44 cmH2O – 48 cmH2O): (39 cmH20) (44 cmH2O – 48 cmH2O): (56 cmH20)
35 mmHg – 45 mmHg: etCO2 – 6 mmHg 35 mmHg – 45 mmHg: etCO2 – 6 mmHg
(4.7 kPa – 6.0 kPa): (etCO2 – 0.8 kPa) (4.7 kPa – 6.0 kPa): (etCO2 + 0.8 kPa)
(48 cmH2O – 61 cmH2O): (etCO2 – 8 (48 cmH2O – 61 cmH2O): (etCO2+ 8
cmH20) cmH20)
(6.0 kPa – 6.4 kPa):(5.2 kPa) (6.0 kPa – 6.4 kPa): (6.8 kPa)
(61 cmH2O – 65 cmH2O): (53 cmH20) (61 cmH2O – 65 cmH2O): (69 cmH2O)
> 48 mmHg (6.4 kPa) (65 cmH20): > 48 mmHg (6.4 kPa) (65 cmH2O):
No change No change
Extreme HR Low limit -20 or 15 bpm NA
Bradycardia (whichever is greater )
Extreme NA HR High limit +20 or 350 bpm
Tachycardia (whichever is lower)
Heart Rate HR x 0.8 or 16 bpm (whichever is HR x 1.25 bpm or 299 bpm (whichever
(ECG) greater) is smaller)
IBP Diastolic Diastolic x .68 + 6 mmHg Diastolic x .86 x 32 mmHg
(ABP, Ao,
Diastolic x .68 +0.8 kPa Diastolic x .86 x 4.3 kPa
ART, P, UAP)
Diastolic x .68 + 8 cmH2O Diastolic x .86 x 44 cmH2O
IBP Mean Mean x .68 + 8 mmHg Mean x .86 + 35 mmHg
(ABP, Ao,
Mean x .68 + 1.1 kPa Mean x .86 + 4.7 kPa
ART, P, UAP)
Mean x .68 + 11 cmH2O Mean x .86 + 48 cmH2O
Auto Set Alarms

IBP Systolic Systolic x .68 + 10 mmHg Systolic x .86 + 38 mmHg
(ABP, Ao,
Systolic x .68 + 1.3 kPa Systolic x .86 + 5.1 kPa
ART, P, UAP)
Systolic x .68 + 14 cmH2O Systolic x .86 + 52 cmH2O
IBP Mean Mean -4 mmHg (within -2 mmHg – Mean + 4 mmHg (within 10 mmHg –
(CVP, ICP, 4 mmHg) 20 mmHg)
LAP, RAP,
UVP) Mean -0.5kPa (within -0.3 kPa – 0.5 Mean + 0.5 kPa (within 1.3 mmHg –
kPa) 2.7 mmHg)
Mean -5 cmH2O (within -3 cmH2O – Mean + 5 cmH2O (within 14 cmH2O –
5 cmH2O) 27 cmH2O)
IBP (PAP) Diastolic - 6 mmHg (within 0 mmHg – Diastolic + 6 mmHg (within 10 mmHg
Diastolic 4 mmHg) – 24 mmHg)
Diastolic -0.8 kPa (within 0 kPa – 0.5 Diastolic + 0.8 kPa (within1.3 kPa –
kPa) 3.2 kPa)
Diastolic -8 cmH2O (within 0 cmH2O Diastolic + 8 cmH2O (within 14
– 5 cmH2O) cmH2O – 33 cmH2O)
IBP (PAP) Mean -6 mmHg (within 0 mmHg – Mean +6 mmHg (within 20 mmHg –
Mean 8 mmHg) 28 mmHg)
Mean -0.8 kPa (within 0.0 kPa – Mean +0.8 kPa (within 2.7 kPa –
1.1 kPa) 3.7 kPa)
Mean - 8 cmH2O (within 0 cmH2O – Mean + 8 cmH2O (within 27 cmH2O –
11 cmH2O) 38 cmH2O)
IBP (PAP) Systolic - 6 mmHg (within 10 mmHg – Systolic + 10 mmHg (within 35 mmHg
Systolic 16 mmHg) – 45 mmHg)
Systolic -0.8 kPa (within 1.3 kPa – 2.1 Systolic + 1.3 kPa (within 4.7 kPa –
kPa) 6.0 kPa)
Systolic -8 cmH2O (within 14 cm H2O Systolic + 14 cmH2O (within 48 H2O
– 22 cmH2O) – 61 cmH2O)
imCO2 NA 20 mmHg (2.7 kPa)(27 cmH2O)
NBP Diastolic x 0.68 mmHg + 6 mmHg Diastolic x 0.86 mmHg + 32 mmHg
Diastolic
Diastolic x .68 kPa + 0.8 kPa Diastolic .86 kPa + 4.3 kPa
Auto Set Alarms

NBP MAP MAP x 0.68 mmHg + 8 mmHg MAP x 0.86 mmHg + 35 mmHg
MAP .68 kPa + 1.1 kPa MAP .86 kPa + 4.7 kPa
NBP Systolic Systolic x 0.68 mmHg + 10 mmHg Systolic x 0.86 mmHg + 38 mmHg
Systolic x 0.68 kPa + 1.3 kPa Systolic x .86 kPa + 5.1 kPa
Pulse Rate Pulse x 0.8 or 41 bpm (whichever is Pulse x 1.25 or 299 bpm (whichever is
(NBP) greater) smaller)
Pulse Rate Pulse x 0.8 or 31 bpm (whichever is Pulse x 1.25 or 299 bpm (whichever is
(SpO2) greater) smaller)
PVC/Min NA Same as default alarm limit
Respiration awRR x 0.5 or 4 rpm (whichever is awRR x 1.5 or 30 rpm (whichever is
(CO2) greater) smaller)
Respiration RR x 0.5 or 4 rpm (whichever is RR x 1.5 or 30 rpm (whichever is
(Impedance) greater) smaller)
Run PVCs NA Same as default alarm limit
SpO2 Same as default alarm limit Same as default alarm limit
ST ST -2 mm (within - 4 mm – 0 mm) ST +2 mm (within 0 mm – 4 mm)
SVT NA Same as default alarm limit
Tblood Tblood - 0.5 Tblood +0.5
Temperature Temp - 0.9°F Temp + 0.9oF
Temp - 0.5°C Temp + 0.5oC
Vent Rhythm NA Same as default alarm limit
V-Tach NA Same as default alarm limit
Auto Set Alarms
Neonatal Auto Set Alarm Calculations

The following table lists the formulas used for calculating the Auto Set Alarm
Limits for neonatal patients.
Parameter Neonatal Lower Limit Neonatal Upper Limit

etCO2 0 mmHg – 32 mmHg (0 kPa – 4.3 kPa) 0 mmHg – 32 mmHg (0 kPa – 4.3 kPa)
(0 cmH2O – 44 cmH2O):No change (0 cmH2O – 44 cmH2O): No change
(44 cmH2O – 48 cmH2O): (39 cmH20) (44 cmH2O – 48 cmH2O): (56 cmH20)
35 mmHg – 45 mmHg: etCO2 – 6 mmHg 35 mmHg – 45 mmHg: etCO2 + 6 mmHg
(4.7 kPa – 6.0 kPa): (etCO2 – 0.8 kPa) (4.7 kPa – 6.0 kPa): (etCO2 + 0.8 kPa)
(48 cmH2O – 61 cmH2O): (etCO2 – 8 (48 cmH2O – 61 cmH2O): (etCO2+ 8
cmH20) cmH20)
(61 cmH2O – 65 cmH2O): (53 cmH20) (61 cmH2O – 65 cmH2O): (69 cmH2O)
> 48 mmHg (6.4 kPa) (65 cmH20): > 48 mmHg (6.4 kPa) (65 cmH2O):
No change No change
Extreme HR Low limit -20 or 15 bpm NA
Bradycardia (whichever is greater )
Extreme NA HR High limit +20 or 350 bpm
Tachycardia (whichever is lower)
Heart Rate HR - 30 HR + 40
(ECG)
within 80 bpm – 100 bpm within 80 bpm – 210 bpm
IBP Diastolic Diastolic -15 (within 20 mmHg – 40 Diastolic +15 (within 55 mmHg –
(ABP, Ao, mmHg) 75 mmHg)
ART, P, UAP)
Diastolic -2 (within 2.7 kPa – 5.3 kPa) Diastolic +2 (within 7.3 kPa –
Diastolic -20.4 (within 27 cmH2O – 10.0 kPa)
54 cmH2O) Diastolic +20.4 (within 75 cmH2O –
102 cmH2O)
Auto Set Alarms

IBP Mean Mean -15 (within 35 mmHg – Mean +15 (within 65 mmHg –
(ABP, Ao, 45 mmHg) 75 mmHg)
ART, P, UAP)
Mean -2 (within 4.7 kPa – 6.0 kPa) Mean +2 (within 8.7 kPa – 10.0 kPa)
Mean -20 (within 48 cmH2O – Mean +20.4 (within 88 cmH2O –
61 cmH2O) 102 cmH2O)
IBP Systolic Systolic -15 (within 45 mmHg – Systolic +15 (within 90 mmHg –
(ABP, Ao, 60 mmHg) 115 mmHg
ART, P, UAP)
Systolic -2 (within 6.0 kPa – 8.0 kPa) Systolic +2 (within 12.0 kPa –
Systolic -20.4 (within 61 cmH2O – 15.3 kPa)
82 cmH2O) Systolic +20.4 (within 122 cmH2O –
156 cmH2O)
IBP Mean Mean -3 mmHg (within 0 mmHg – Mean + 4 mmHg (within 6 mmHg –
(CVP, ICP, 4 mmHg) 10 mmHg)
LAP, RAP,
UVP) Mean -0.4 kPa (within 0 kPa – 0.5 kPa) Mean + 0.5 kPa (within 0.8 kPa –
Mean -4 cmH2O (within 0 cmH2O – 1.3 kPa)
5 cmH2O) Mean + 5 cmH2O (within 8 cmH2O –
14 cmH2O)
IBP (PAP) Diastolic -3 mmHg (within -4 mmHg – Diastolic +3 mmHg (within 2 mmHg –
Diastolic 0 mmHg) 6 mmHg)
Diastolic -0.4 kPa (within -0.5 kPa – Diastolic +0.4 kPa (within 0.3 kPa –
0 kPa) 0.8 kPa)
Diastolic -4 cmH2O (within -5 cmH2O Diastolic +4 cmH2O (within 3 cmH2O
– 0 cmH2O) – 8 cmH2O)
IBP (PAP) Mean -8 mmHg (within 6 mmHg – Mean +8 mmHg (within 28 mmHg –
Mean 18 mmHg) 40 mmHg)
Mean -1.1 kPa (within 0.8 kPa – Mean +1.1 kPa (within 3.7 kPa –
2.4 kPa) 5.3 kPa)
Diastolic -11 cmH2O (within - Diastolic +11 cmH2O (within
8 cmH2O – 24 cmH2O) 38 cmH2O – 54 cmH2O)
Auto Set Alarms

IBP (PAP) Systolic - 8 mmHg (within 12 mmHg – Systolic + 10 mmHg (within 35 mmHg
Systolic 22 mmHg) – 60 mmHg)
Systolic -1.1 kPa (within 1.6 kPa – Systolic + 1.3 kPa (within 4.7 kPa –
2.9 kPa) 8.0 kPa)
Systolic -11 cmH2O (within 16 cm Systolic + 14 cmH2O (within 48 H2O
H2O – 30 cmH2O) – 82 cmH2O)
imCO2 NA 20 mmHg (2.7 kPa) (27 cmH2O)
NBP Diastolic -15 (within 20 mmHg – Diastolic +15 (within 55 mmHg –
Diastolic 40 mmHg) 75 mmHg)
Diastolic -2 (within 2.7 kPa – 5.3 kPa) Diastolic +2 (within 7.3 kPa –
10.0 kPa)
NBP MAP MAP -15 (within 35 mmHg – MAP +15 (within 65 mmHg –
45 mmHg) 75 mmHg)
MAP -2 (within 4.7 kPa – 6.0 kPa) MAP +2 (within 8.7 mmHg –10.0 kPa)
NBP Systolic Systolic -15 (within 45 mmHg – Systolic +15 (within 90 – 115 mmHg)
60 mmHg) Systolic +2 (within 12.0 – 5.3 kPa)
Systolic -2 (within 6.0 kPa – 8.0 kPa)
Pulse Rate Pulse -30 (within 80 bpm – 100 bpm) Pulse +40 (within 180 bpm – 210 bpm)
(NBP)
Pulse Rate Pulse -30 (within 80 – 100 bpm) Pulse +40 (within 80 – 210 bpm)
(SpO2)
PVC/Min NA Same as default alarm limit

Respiration awRR -50 (within 25 – 40) awRR +25 (within 75 – 95)
(CO2)
Respiration RR x 1.5 or 30 rpm (whichever is RR + 25 within 75 - 95

(Impedance) smaller)
Run PVCs NA Same as default alarm limit
SpO2 Same as default alarm limit Same as default alarm limit
Auto Set Alarms

ST ST – 2 mm (within -4 mm – 0 mm) ST + 2 mm (within 0 mm – 4 mm)
SVT NA Same as default alarm limit
Tblood Tblood - 0.5 Tblood + 0.5
Temperature Temp - 0.9°F Temp + 0.9oF
Temp - 0.5°C Temp + 0.5oC
Vent Rhythm NA Same as default alarm limit
V-Tach NA Same as default alarm limit
Auto Set Alarms
C
Electromagnetic Compatibility
This appendix lists the tests and compliance levels that make the Efficia CM patient
monitors suitable for use in the specified electromagnetic environment according to
IEC 60601-1-2:2007.
Instructions for Use

Medical electrical equipment can either generate or receive electromagnetic interference.
This product has been evaluated for electromagnetic compatibility (EMC) with the
appropriate accessories according to IEC 60601-1-2:2007, the international standard for
EMC for medical electrical equipment. This IEC standard has been adopted in the
European Union as the European Norm, EN 60601-1-2:2007.
Radio frequency (RF) interference from nearby transmitting devices can degrade
performance of the product. Electromagnetic compatibility with surrounding devices
should be assessed prior to using the product.
Fixed, portable, and mobile radio frequency communications equipment can also affect
the performance of medical equipment. See your service provider for assistance with the
minimum recommended separation distance between RF communications equipment
and the product.
The cables, sensors/transducers, and other accessories for which compliance is claimed
are listed in this manual.
Warning • Use of accessories, transducers, and cables other than those specified may
result in increased emissions and/or decreased immunity of the Efficia CM
patient monitors.
• The Efficia CM patient monitors should not be used adjacent to or stacked
with other equipment. If adjacent or stacked use is necessary, the monitor
should be observed to verify normal operation in the configuration in which it
is used.
Efficia CM Series Instructions for Use C-1
Reducing Electromagnetic Interference
The Efficia CM patient monitors and associated accessories can be susceptible to
interference from other RF energy sources and continuous, repetitive, power line bursts.
Examples of other sources of RF interference are other medical electrical devices,
cellular products, information technology equipment, and radio/television transmission.
If interference is encountered, as demonstrated by artifact on the ECG or dramatic
variations in physiological parameter measurement values, attempt to locate the source.
Assess the following:
• Is the interference due to misplaced or poorly applied electrodes or sensors? If so,

re-apply electrodes and sensors correctly according to directions in the product’s
Instructions for Use.
• Is the interference intermittent or constant?
• Does the interference occur only in certain locations?
• Does the interference occur only when in close proximity to certain medical
electrical equipment?
• Do parameter measurement values change dramatically when the AC line cord is
unplugged?
Once the source is located, attempt to attenuate the interference by distancing the
product from the source as much as possible. If assistance is needed, contact your
Restrictions for Use

Artifact on ECG and other physiological waveforms caused by electromagnetic
interference should be evaluated by a physician or physician authorized personnel to
determine if it will negatively impact patient diagnosis or treatment.
Emissions and Immunity

The Efficia CM patient monitors are designed and evaluated to comply with the
emissions and immunity requirements of international and national EMC standards. For
detailed information regarding declaration and guidance, see Table C-1 through
Table C-4.
C-2 Efficia CM Series Instructions for Use
The EMC standards state that manufacturers of patient-coupled equipment must specify
immunity levels for their systems. See Table C-2 and Table C-3 for this detailed
immunity information. See Table C-4 for recommended minimum separation distances
between portable and mobile communications equipment and the product.
Immunity is defined in the standard as the ability of a system to perform without

degradation in the presence of an electromagnetic disturbance. Degradation in system
performance is a qualitative assessment which can be subjective.
Caution should, therefore, be taken in comparing immunity levels of different devices.

The criteria used for degradation is not specified by the standard and can vary with the
manufacturer.
Guidance and Manufacturer’s Declaration

The Efficia CM patient monitors are intended for use in the electromagnetic
environment specified in the following tables. The customer or the user of the product
should verify that it is used in such an environment.
Table C-1 Electromagnetic Emissions
Emissions Test Compliance Electromagnetic Environment Guidance
RF emissions Group 1 Efficia CM Patient Monitors may contain an internal

CISPR 11 radio which emits RF energy. Including these radio
modules, total RF emissions are very low and not
likely to cause any interference in nearby electronic
equipment.
RF emissions Class A The Efficia CM monitors are suitable for use in a

CISPR 11 Hospital Environment, who's power is not directly
connected to the public low-voltage power supply
Harmonic emissions Class D network.
IEC 61000-3-2
Voltage Complies
fluctuations/flicker
emissions
IEC 61000-3-3
Table C-2 Electromagnetic Immunity (ESD, EFT, Surge, Dips and Magnetic Field)
IEC 60601 Compliance Electromagnetic Environment -

Immunity Test
Test Level Level Guidance
Electrostatic + 6 kV contact + 6 kV contact Floors should be wood, concrete, or

discharge (ESD) + 8 kV air + 8 kV air ceramic tile. If floors are covered
IEC 61000-4-2 with synthetic material, the relative
humidity should be at least 30%.
Electrical fast + 1 kV + 1 kV
transient/burst differential mode differential
IEC 61000-4-4 +2 kV common mode
mode +2 kV common
mode
Surge + 1 kV + 1 kV Mains power quality should be that

IEC 61000-4-5 differential mode differential of a typical hospital environment.
+ 2 kV common mode
mode + 2 kV common
mode
Voltage dips, < 5% UT < 5% UT

short (> 95% dip in UT) (> 95% dip in
interruptions, and for 0.5 cycle UT) for 0.5 cycle
voltage variations
on power supply
input lines 40% UT 40% UT
(60% dip in UT) (60% dip in UT)
IEC 61000-4-11 for 5 cycles for 5 cycles
70% UT 70% UT
(30% dip in UT) (30% dip in UT)
for 25 cycles for 25 cycles
< 5% UT < 5% UT
(> 95% dip in UT) (> 95% dip in
for 5 sec UT) for 5 sec
Table C-2 Electromagnetic Immunity (ESD, EFT, Surge, Dips and Magnetic Field)
IEC 60601 Compliance Electromagnetic Environment -

Immunity Test
Test Level Level Guidance
Power frequency 3 A/m 3 A/m Power frequency magnetic fields

(50/60 Hz) should be at levels characteristic of a
Magnetic field typical location in a typical hospital
IEC 61000-4-8 environment.
Note — UT is the AC mains voltage prior to application of the test level.
Table C-3 Electromagnetic Immunity (RF Radiated and Conducted)
Immunity IEC 60601 Compliance Electromagnetic Environment -

Test Test Level Level Guidance
Portable and mobile RF

communications equipment should be
used no closer to any part of the Efficia
CM patient monitors, including cables,
than the recommended separation
distance calculated from the equation
applicable to the frequency of the
transmitter.
Conducted RF 3 Vrms 3 V rms Recommended Separation Distance

IEC 61000-4-6 0.15 to 80 MHz 3.5
d = ------- P ; 0.150 to 80 MHz
3
Table C-3 Electromagnetic Immunity (RF Radiated and Conducted)
Immunity IEC 60601 Compliance Electromagnetic Environment -

Test Test Level Level Guidance
Radiated RF 3 V/m 3 V/m 3.5

d = ------- P ; 80 to 800 MHz
IEC 61000-4-3 80 to 2500 MHz 3
7
d = --- P ; 800 to 2500 MHz
3
where P is the maximum output power

rating of the transmitter in watts (W)
according to the transmitter
manufacturer and d is the recommended
separation distance in meters (m).
Field strengths from fixed RF
transmitters, as determined by an
electromagnetic site survey,a should be
less than the compliance level in each
frequency range.b
Interference may occur in the vicinity of
equipment marked with the following
symbol:
a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile
radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To
assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If
the measured field strength in the location in which the Efficia CM patient monitor is used exceeds the applicable RF
compliance level above, the Efficia CM patient monitor should be observed to verify normal operation. If abnormal
performance is observed, additional measures are necessary, such as re-orienting or relocating the monitor.
b Signal levels above 1V/m in the 1215 – 1240 MHz band may disrupt wireless communications from the Efficia CM
Patient Monitor if the operating channel in the 2.4 GHz band is at twice the frequency.
Recommended Separation Distances
The Efficia CM patient monitors are intended for use in an electromagnetic environment
in which radiated RF disturbances are controlled. The customer or the user of the
product can help prevent electromagnetic interference by maintaining a minimum
distance between portable and mobile RF communications equipment (transmitters) and
the product as recommended below, according to the maximum output power of the
communications equipment.
Table C-4 Recommended Separation Distances Between Portable and Mobile RF

Communication Equipment and the Efficia CM Patient Monitors
Frequency of 800 MHz to 2.5

150 kHz to 80 MHz 80 to 800 MHz
Transmitter GHz
3.5 3.5 7
Equation d = ------- P d = ------- P d = --- P
3 3 3
Rated Maximum
Separation Separation Separation
Output Power of
Distance (d) Distance (d) Distance (d)
Transmitter
(meters) (meters) (meters)
(Watts)
0.01 0.12 0.12 0.23
0.1 0.37 0.37 0.74
1 1.17 1.17 2.33
10 3.69 3.69 7.38
100 11.67 11.67 23.33
For transmitters rated at a maximum output power not listed above, the separation distance d can be
estimated, in meters, using the equation in the corresponding column, where P is the maximum
output power rating of the transmitter in watts according to the transmitter’s manufacturer.
These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
Index
A latched and non-latched, 3-5
silencing, 3-17
abberantly-conducted beat, 9-19
AC power, 2-5 testing, 3-19
viewing all, 3-3
accessories, 17-23
viewing current, 15-11
cardiac output, 17-21
ECG, 17-5 visual, 3-1
Anesthetic Agent, Mainstream CO2, 8-9
IBP, 17-16
apnea
Mainstream CO2, 17-21
awRR Apnea Alarm, 7-13
miscellaneous, 17-23
Sidestream CO2, 7-13
NBP, 17-9
arrhythmia analysis
Sidestream CO2, 17-19
about, 9-17
SpO2, 17-2
alarm chaining, 9-28
temperature, 17-22
alarms, 9-17, 9-18
Admit Patient Menu
changing alarm limits, 9-22, 9-23
enabling and disabling, 2-28
choosing an ECG lead, 9-19, 9-20
admitting a patient, 2-29
configuring, 9-21
AFib/IHR Reminder, configuring, 9-22
Indications for Use, 9-17
alarm chaining, arrhythmia analysis, 9-28
Intended Use, 9-17
alarm history, viewing, 3-4
rhythm status messages, 9-25
alarm icons, 3-3
timeout periods, 9-27
alarm limit defaults, A-11
arrhythmia analysis alarms
alarm limit ranges, B-21
basic arrhythmia alarms, 9-18
alarm limits
cardiotach alarms, 9-18
automatic, 3-14
enhanced arrhythmia alarms, 9-18
changing individual alarms, 3-7
arrhythmia analysis level
changing several, 3-9
selecting, 9-21
restoring, 3-16
arrhythmia relearning, 9-23
showing or hiding, 3-13
audible alarms, 3-4
alarm messages, 3-2
alarm options Audio Off mode, 3-18
Audio Off reminder, 3-19
changing, 3-11
Audio Pause mode, 3-18
Alarm Settings button, 2-16
alarm volume, changing, 3-14 Auto Recordt NBP, 5-7
Auto Set Alarm Limits
alarm, malfunction, 3-5
formulas, B-11
alarm/event trend data, 15-11
changing displayed waveforms, 15-13
changing the waveform speed, 15-14
alarms
and nurse call system, 3-20
audible, 3-4
Index-1
auto set alarm limits, B-26 guidelines, 16-1
automatic alarm limits, 3-14 the monitor, 16-2
awRR, alarm limits, 7-7, 8-6 CO2
specifications, 18-21, 18-26
B CO2 Menu, 7-6, 8-5
CO2 Waveform Menu, 7-11
Balance Gas, Mainstream CO2, 8-9
computation constant, cardiac output, 13-6
barcode scanner, 2-30
Configuration settings, 2-44
getting a proper read, 2-30 connectors, rear panel, 2-4
Barometric Pressure, Mainstream CO2, 8-9
contraindications, 1-3
battery
Current Profile, 2-45
charging, 2-8
disposal, 2-10
Battery Info Menu, 2-9 D
battery status indicators, 2-8 date and time, changing, 2-10
battery status pane, 2-8 Date Format setting, 2-44
beat labels Deep Sleep mode, 2-12
descriptions, 9-24 default alarm limits
viewing, 9-24 restoring, 3-16
Brightness Level setting, 2-44 Default Patient Type setting, 2-44
Desaturation alarm, 4-8
C disinfecting
cables, 16-4
C.O. Menu, 13-5
CAPNOSTAT sensor, 16-6
cardiac output the monitor, 16-3
editing measurements, 13-11
documentation list, 1-6
injectate guidelines, 13-6
injectate temperature, 13-4
measurement errors, 13-10 E
overview, 13-1 ECG
performing measurements, 13-6 electrode placement, 9-4
safety information, 13-13 enabling pace pulse detection, 9-12
saving measurements, 13-11 skin preparation for electrodes, 9-7
setting the computation constant, 13-6 ECG cables, connecting, 9-4
setting up, 13-2 ECG lead placement
settings, 13-5 for respiration, 11-2
cardiac output waveform ECG lead set
changing the scale, 13-11 configuring on monitor, 9-3
Central Name, 2-45 ECG lead sets, 9-1
Central Status pane, 2-17 selecting primary lead, 9-8
charging the battery, 2-8 selecting secondary lead, 9-8
cleaning
cables, 16-4
CAPNOSTAT sensor, 16-6
Index-2
ECG output port, 2-6 grounding post, 2-6
ECG safety information, 9-36
ECG waveform H
changing the size, 9-10
Hardware ID, 2-45
changing the speed, 9-10
heart rate
selecting a filter, 9-11
adjusting the volume, 9-15
settings, 9-9
alarm limits, 9-15
ECG waveforms, 2-24
Edit C.O. Menu, 13-11 Height Units, changing, 2-44
Home button, 2-16
electromagnetic compatibility, C-1
Humidity Correction option, 7-10
Enable Admit Patient Menu setting, 2-44
Essential Performance statement, 1-3
etCO2, alarm limits, 7-7, 8-6 I
Ethernet port, 2-5 IBP
events changing alarm limits, 12-13
marking, 15-13 changing displayed alarm limits, 12-15
viewing current, 15-11 changing units of measurement, 12-15
configuring, 12-12
F purging lines, 12-4
safety information, 12-20
freezing waveforms, 2-25
front panel setting up disposble transducers, 12-2
setting up reusable transducers, 12-7
CM10 and CM12, 2-1
zeroing guidelines, 12-8
CM100, CM120, and CM150, 2-2
full disclosure zeroing the transducer, 12-8
IBP accessories list, 17-16
about, 15-14
IBP waveform
changing the displayed waveforms, 15-15
changing the waveform speed, 15-16 changing the scale, 12-17
finding records, 15-16
overlapped, 12-17
recording, 15-25
IBP Waveform Menu, 12-16
imCO2, alarm limits, 7-7, 8-6
G InCenter, accessing, 1-8
Gas Temp, Mainstream CO2, 8-9 Indications for Use statement, 1-2
graphical trends initial inflation pressure, 5-11
changing the resolution, 15-10 injectate temperature, cardiac output, 13-4
recording, 15-23 Intended Use statement, 1-2
selecting the displayed parameters, 15-9 intermittent bundle branch block, 9-19
viewing, 15-8
graphicala trends K
finding trend records, 15-10
keyboard, on-screen, 2-31
keys
descriptions, 2-2
Index-3
L Manage Patient button, 2-17
Manual Event button, 2-16
LAN IP Address, 2-45
marking an event, 15-13
LAN MAC Address, 2-45
message area, 2-15
Language setting, 2-45
monitor confguration, viewing, 2-46
latched alarms, 3-5
monitor configurations, 1-4
layout
monitor name pane, 2-15
changing, 2-20
Monitor Name setting, 2-44
options, 2-20
monitor name, changing, 2-19
Layout button, 2-16
More button, 2-16
LEDs, descriptions, 2-2
Lock Touch Screen button, 2-44 mounting options, 2-12
M N
main screen navigation controls, 1-10
NBP
components, 2-15
alarm limits, 5-5
overview, 2-13
Mainstream CO2 Auto Record, 5-7
changing units of measurement, 5-13
changing the awRR apnea time, 8-12
configuring inflation pressure, 5-11
changing the measurement time, 8-7
changing units of measurement, 8-8 displaying alarm limits, 5-6
measurement limitations, 5-2
settings, 8-5
Standby setting, 8-7 setting intervals, 5-9
settings, 5-4
zeroing, 8-3
STAT measurements, 5-10
Mainstream CO2 compensation settings
Anesthetic Agent, 8-9 stopping a measurement, 5-13
NBP accessories list, 17-9
Balance Gas, 8-9
NBP cuff
Barometric Pressure, 8-9
Gas Temp, 8-9 connecting, 5-3
reasons for deflation, 5-12
O2 Compensation, 8-9
selecting, 5-2
Mainstream CO2 waveform
changing the size, 8-11 NBP measurement interval, 5-9
NBP Menu, 5-4
NBP trends
changing the displayed parameters, 15-7
recording, 15-22
viewing, 15-6
NBP Venipuncture button, 2-17
NBP Venous Puncture
stopping, 5-15
NBP venous puncture
settings, 5-16
starting, 5-14
Index-4
Network Status pane, 2-17 Record button, 2-16
Night Mode button, 2-17 Record on Alarm, enabling, 3-11
noisy baseline, 13-10 recorder
notifications options, 14-2
acknowledging, 2-18 overview, 14-1
viewing, 2-18 recorder paper
numeric panes, changing, 2-24 loading, 14-3
nurse call system and alarms, 3-20 Recorder Settings, 2-44
recorder settings, configuring, 14-4
O relearning arrhythmia, 9-23
reminder, Audio Off, 3-19
O2 Compensation, Mainstream CO2, 8-9 renaming the monitor, 2-19
on-screen keyboard, 2-31
respiration
auto detection mode, 11-9
P changing alarm limits, 11-4
pace pulse detection, enabling, 9-12 disabling impedance respiration, 11-4
patient IDs manual detection mode, 11-9
overview, 2-26 overview, 11-1
primary patient ID, 2-28 safety information, 11-13
patient pane, 2-15 selecting a detection mode, 11-9
perfusion indicator, 4-6 selecting an apnea time, 11-5
physiological alarms, list, B-1 setting the threshold, 11-10
powering up, 2-6 respiration waveform
primary ECG lead, 9-8 changing the size, 11-8
profile default settings, A-2 changing the speed, 11-7
profile, current, 2-45 configuring, 11-7
profiles rhythm status messages, 9-25
alarm limit settings, A-11
default profiles, A-1 S
viewing the current profile, A-1 safety standards, 18-3
pulse rate
secondary ECG lead, 9-8
changing alarm limits, 10-2
Select Waveform option, 2-22
changing the pulse rate source, 10-2
serial number, 2-45
changing the pulse rate volume, 10-3
Shut Down button, 2-44
settings, 10-1
Sidestream CO2
Pulse Rate Menu, 10-1 changing the awRR apnea time, 7-13
pulse rate source, 10-2
changing the measurement time, 7-8
changing units of measurement, 7-10
R connecting the sampling line, 7-4
radio regulatory compliance, 18-39 Humidity Correction option, 7-10
rear panel, connectors, 2-4 safety information, 7-14
reccorder settings, 7-6
loading paper, 14-3 Standby setting, 7-8
Index-5
Sidestream CO2 accessories SpO2 Waveform Menu, 4-7
for intubated patients, 7-3 ST analysis
for non-intubated patients, 7-3 about, 9-30
selecting, 7-2 changing alarm limits, 9-32
Sidestream CO2 waveform configuring, 9-31
changing the size, 7-12 enabling or disabling, 9-32
changing the speed, 7-12 Indications for Use, 9-17
configuring, 7-11 Intended Use, 9-17
silencing alarms, 3-17 ST baseline, updating, 9-34
Software Version, 2-45 ST Map window, 9-35
speaker malfunction, 3-5 ST measurement points, adjusting, 9-33
specifications ST View window, 9-34
cardiac output, 18-36 Standby mode, 2-11
CO2, 18-21, 18-26 Standby setting
ECG, 18-30 Mainstream CO2, 8-7
electrical, 18-3 Sidestream CO2, 7-8
environmental, 18-4 STAT measurements, 5-10
general, 18-1 SureSigns Dashboard requests
IBP, 18-34 considerations, 2-40
impedance respiration, 18-33 responding to, 2-40
interface, 18-37 sweep speed, changing, 2-25
Mainstream CO2, 18-26 System button, 2-17
NBP, 18-17 system settings
Sidestream CO2, 18-21 changing, 2-43
SpO2, 18-7 viewing, 2-45
SpO2, 18-7 system toolbar, 2-15
temperature, 18-20
SpO2 T
alarm limits, 4-6, 13-5
Desaturation alarm, 4-8 tabular trends, 15-3
changing the display interval, 15-4
perfusion indicator, 4-6
changing the displayed parameters, 15-4
settings, 4-4, 13-5 finding trend records, 15-5
recording, 15-19
SpO2 alarm delay, 4-9
Tblood alarm limits, changing, 13-5
SpO2 cables, connecting, 4-2
SpO2 Menu, 4-4, 13-5 technical alarms
acknowledging, 3-19
SpO2 Response Mode, 4-5
technical alarms, list, B-11
SpO2 sensors
selecting, 4-1 technical alarms, visual only, B-20
temperature
types of, 4-1
alarm limits, 6-3
SpO2 waveform, 4-7
changing the speed, 4-7 changing units of measurement, 6-4
configuring, 4-7
settings, 6-3
Index-6
temperature probes Weight Units, changing, 2-44
connecting, 6-2 WLAN IP Address, 2-45
testing alarms, 3-19 WLAN MAC Address, 2-45
timeout periods
arrhythmia analysis, 9-27 Z
tool tips, 2-18
zeroing IBP
touch screen, locking, 2-44
error messages, 12-10
trend data
recording, 15-18 overview, 12-8
troubleshooting, 12-10
trend display
zeroing Mainstream CO2, 8-3
viewing, 15-2
trends
graphical trends, 15-8
NBP trends, 15-6
overview, 15-1
tabular trends, 15-3
Trends button, 2-16
U
USB ports, 2-5
V
VGA port, 2-5
viewing all alarms, 3-3
visual alarms, 3-1
volume, alarm, 3-14
volume, changing pulse rate, 10-3
W
waveform speed, changing, 2-25
waveforms
changing, 2-22
ECG, 2-24
freezing, 2-25
Select Waveform option, 2-22
Index-7
Index-8

IFU - Efficia CM Series Rel A.01 - English

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Efficia CM Series

INSTRUCTIONS FOR USE

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ii Efficia CM Series Instructions for Use

First Edition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .January 2015

Efficia CM Series Instructions for Use iii

This section describes the conventions used in this guide.

Typeface Usage Example

Bold System keys Press the Main Screen key.

Italic Variables, document • <product name>-

iv Efficia CM Series Instructions for Use

Note — A Note calls attention to an important point in the text.

Caution A Caution calls attention to a condition or possible situation that could

Warning A Warning calls attention to a condition or possible situation that could

Efficia CM Series Instructions for Use v

Symbol Description Symbol Description

Keep upright Keep dry

Fragile, handle with 40°C

Stacking limit by CE mark

708 hPA 15%

vi Efficia CM Series Instructions for Use

Symbol Description Symbol Description

On/Standby key Charging LED

AC power LED Alarm silence key

NBP key Freeze Waveform key

Record key Trend key

Efficia CM Series Instructions for Use vii

Symbol Description Symbol Description

Sidestream CO2 input Sidestream CO2 output

Mainstream CO2 Caution, consult

Defibrillator Proof IBP connectors

ECG ECG connector

SpO2 connector Masimo SET® and

NBP connector Cardiac Output

viii Efficia CM Series Instructions for Use

Follow Instructions for

Input/Output Connector Port Symbols

Symbol Description Symbol Description

Nurse call connector USB port

VGA Output Ethernet port

ECG Out port

Efficia CM Series Instructions for Use ix

Symbol Description Symbol Description

Catalog number Date of manufacture

Serial number Unique Device

Monitor key code Option number

Manufacturer’s name Rx Only Prescription Use Only

ICES-001 Canadian ISM Ingress protection

RF interference Caution, consult

Compliance with CSA mark

x Efficia CM Series Instructions for Use

CE mark for radio CE mark

100V-240V ~ 50Hz/60Hz 120VA Input power and fuse Equipotential

Authorized EU Part number for label

Symbol Description Symbol Description

Protective earth Dangerous Voltage

Efficia CM Series Instructions for Use xi

xii Efficia CM Series Instructions for Use

Efficia CM Series Instructions for Use xiii

7. Monitoring Carbon Dioxide - Sidestream

8. Monitoring Carbon Dioxide - Mainstream

9. ECG, Arrhythmia and ST Monitoring

10. Monitoring Pulse Rate