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Dokumen - Tips Vista 120120 Cms 22 Draeger 10 Instructions For Use Vista 120vista
Dokumen - Tips Vista 120120 Cms 22 Draeger 10 Instructions For Use Vista 120vista
WARNING
A WARNING statement provides important
information about a potentially hazardous
situation which, if not avoided, could result in
death or serious injury.
CAUTION
A CAUTION statement provides important
information about a potentially hazardous
situation which, if not avoided, may result in minor
or moderate injury to the user or patient or in
damage to the medical device or other property.
NOTE
A NOTE provides additional information intended
to avoid inconvenience during operation.
Contents
Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
WARNING
Portable RF communications equipment
(including peripherals such as antenna cables
and external antennas) should be used no
closer than 30 cm (12 inches) to any part of
Vista 120/Vista 120S, including cables
specified by the manufacturer. Otherwise,
degradation of the performance of this
equipment could occur.
Sterile accessories
CAUTION
Risk of medical device failure and of patient injury
Do not use sterile-packaged accessories if the
packaging has been opened, is damaged, or if
there are other signs of non-sterility.
Single-use accessories must not be reused,
reprocessed, or resterilized.
Installing accessories
CAUTION
Risk of device failure
Install accessories to the basic device in
accordance with the instructions for use of the
basic device. Make sure that there is a safe
connection to the basic device.
WARNING WARNING
Before using Vista 120/Vista 120S, patient When interfacing with other equipment, a test
cables, electrodes etc. should be checked. for leakage current must be performed by
Replacement should be taken if there is any qualified hospital technical personnel before
evident defect or signs of aging which may using with patients.
impair the safety or performance.
WARNING
WARNING During monitoring, if the power supply is off
The power receptacle must be a three-wire and there is no battery for standby, the
grounded outlet. A hospital grade outlet is monitor will be off. The settings configured by
required. Never adapt the three-prong plug the user can be stored, and settings not
from the monitor to fit a two-slot outlet. configured by user keep no change. That is,
the last settings used will be recovered when
WARNING the power is restored.
Route all cables carefully to avoid possible
entanglement, apnea, or electrical WARNING
interference. For the device mounted over the Keep away from fire immediately when
patient, sufficient precautionary measures leakage or foul odor is detected.
should be taken to prevent it from falling on
the patient. WARNING
The device and accessories are to be
WARNING disposed of according to local regulations
Do not rely exclusively on the audible alarm after their useful lives. Alternatively, they can
system for patient monitoring. Adjustment of be returned to the dealer or the manufacturer
alarm volume to a low level or off during for recycling or proper disposal. Batteries are
patient monitoring may result in a hazard to hazardous waste. Do NOT dispose them
the patient. Remember that the most reliable together with house-hold garbage. At the end
method of patient monitoring combines close of their life hand the batteries over to the
personal surveillance with correct operation applicable collection points for the recycling
of monitoring equipment. of waste batteries. For more detailed
information about recycling of this product or
WARNING battery, contact the local Dräger sales
Ensure that the volume is properly set up. representative.
When the sound pressure of audible alarm is
below or equivalent to the ambient noise, it WARNING
may be difficult for the operator to distinguish
This equipment is not intended for home
the audio alarm.
usage.
WARNING WARNING
Devices connected to the equipment must The appliance coupler or mains plug is used
meet the requirements of the applicable IEC as isolation means from supply mains.
standards (e.g., IEC 60950 “Safety standards Position the monitor in a location where the
for information technology equipment” and operator can easily access the disconnection
IEC 60601-1 “Safety standards for medical device.
electrical equipment”) The system
configuration must meet the requirements of WARNING
the IEC 60601-1 “Medical electrical systems” Assembly of the monitor and modifications
standard. Any personnel who connect devices during actual service life shall be evaluated
to the equipment’s signal input/output port is based on the requirements of IEC60601-1.
responsible for providing evidence that the
safety certification of the devices has been WARNING
performed in accordance to the IEC 60601-1.
Additional multiple socket-outlets or
extension cords can not be connected to the
WARNING
system.
The operator can not touch the patients or
signal port simultaneously. WARNING
Only items that have been specified as part of
WARNING the system or specified as being compatible
Do not service or maintain the monitor or any with the system can be connected to the
accessory which is in use with the patient. system.
WARNING WARNING
After defibrillation, the ECG display recovers If several items of medical equipment are
within 10 s if the correct electrodes are used interconnected, pay attention to the sum of
and applied based on the manufacturers' the leakage currents, otherwise it may cause
instructions. shock hazard. Consult your service
personnel.
WARNING
The monitor is not intended for use in a WARNING
hyperbaric chamber or an MRI (Magnetic Only recommended batteries can be used for
Resonance Imaging) environment. the monitor.
WARNING WARNING
The alarm log is cleared either when the Without use of data store function, all data
monitor is turned off, or when the monitor is measured (including trend data, review data,
powered down in a finite duration. alarm events and so on) will be cleared either
when the monitor is turned off or when the
WARNING monitor is powered down in the process of
Ensure the current alarm preset is appropriate monitoring.
prior to use on each patient.
WARNING WARNING
Connecting any accessory (such as external The monitor should not be used adjacent to or
printer) or other device (such as the stacked with other equipment. If adjacent or
computer) to this monitor makes a medical stacked use is necessary, the user must check
system. In that case, additional safety that normal operation is possible in the
measures should be taken during installation necessary configuration before starting
of the system, and the system shall provide: monitoring patients.
a) Within the patient environment, a level of
WARNING
safety comparable to that provided by
medical electrical equipment complying Do not touch accessible parts of medical or
with IEC/EN 60601-1, and non-medical electrical equipment in the
patient environment and the patient
b) Outside the patient environment, the simultaneously, such as USB connector, VGA
level of safety appropriate for non- connector or other signal input/output
medical electrical equipment complying connectors.
with other IEC or ISO safety standards.
WARNING
WARNING
SHOCK HAZARD - Do not connect electrical
All the accessories connected to system must equipment, which has not been supplied as a
be installed outside the patient vicinity, if they part of the system, to the multiple portable
do not meet the requirement of IEC/EN 60601-1. socket-outlet supplying the system.
WARNING WARNING
The medical electrical equipment needs to be SHOCK HAZARD - Do not connect electrical
installed and put into service according to the equipment, which has been supplied as a part
EMC Information provided in this user of the system, directly to the wall outlet when
manual. the non-medical equipment is intended to be
supplied by a multiple portable socket-outlet
WARNING with an isolation transformer.
Portable and mobile RF communications
equipment can affect medical electrical WARNING
equipment, refer to the recommended Operation of the equipment exceeding
separation distances provided in this user specified physiological signal or the
manual. operational specification may cause
inaccurate results.
WARNING
Using accessories other than those specified WARNING
may result in increased electromagnetic The equipment can provide protective means
emission or decreased electromagnetic to prevent the patient from being burned when
immunity of the monitoring equipment. used with HF surgical equipment. The
equipment can protect against the effects of
the discharge of a defibrillator. Use only
Dräger-approved accessories.
WARNING WARNING
To protect the monitor from damage during Devices connecting with monitor should be
defibrillation, for accurate measurement equipotential.
information and to protect against noise and
other interference, use only accessories WARNING
specified by Dräger. If the protective grounding (protective earth)
system is doubtful, the monitor must be
WARNING supplied by internal power only.
When the monitor is used with HF surgical
equipment, avoid conductive connections of WARNING
the transducer and the cables to the HF The monitor is equipped with wireless AP/Wi-Fi
surgical equipment. This is to protect against to receive RF electromagnetic energy.
burns to the patient. Therefore, any other equipment complying
with CISPR radiation requirements may also
WARNING interfere with the wireless communication and
No modification of this equipment is allowed make it interrupted.
without authorization of the manufacturer. If
this equipment is modified, appropriate WARNING
inspection and testing must be conducted to Wireless LAN equipment contains an
ensure continued safe operation. intentional RF radiator that has the potential
of interfering with other medical equipment,
WARNING including patient implanted devices. Be sure
Extreme care must be exercised when to perform the electromagnetic compatibility
applying medical electrical equipment. Many test, as described in the Wireless LAN System
parts of the human/machine circuit are Installation, before installation and any time
conductive, such as the patient, connectors, new medical equipment is added to the
transducers. It is very important that these Wireless LAN coverage area.
conductive parts do not come into contact
with other grounded, conductive parts when WARNING
connected to the isolated patient input of the The packaging is to be disposed of according
device. Such contact would bridge the to local or hospital’s regulations; otherwise, it
patient's isolation and cancel the protection may cause environmental contamination.
provided by the isolated input. In particular, Place the packaging at the place which is
there must be no contact of the neutral inaccessible to children.
electrode and ground.
WARNING
WARNING
Clinical decision making based on the output
Magnetic and electrical fields are capable of of the device is left to the discretion of the
interfering with the proper performance of the provider.
device. For this reason make sure that all
external devices operated in the vicinity of the WARNING
monitor comply with the relevant EMC
The monitor is suitable for use in the presence
requirements. X-ray equipment or MRI devices
of electrosurgery. When the monitor is used
are a possible source of interference as they
with HF surgical equipment, user (doctor or
may emit higher levels of electromagnetic
nurse) should be cautious about patient
radiation.
safety.
WARNING CAUTION
Do not touch the patient, table, or the monitor Electromagnetic Interference - Ensure that the
during defibrillation. environment in which the patient monitor is
installed is not subject to any sources of strong
WARNING electromagnetic interference, such as radio
Make sure networking function is used in a transmitters, mobile telephones, microwaves, etc.
secure network environment.
CAUTION
WARNING Protect the device against mechanical damage
Only patient cable and other accessories resulting from falls, impacts, and vibration.
supplied by Dräger shall be used. The
performance and electric shock protection CAUTION
cannot be guaranteed, and the patient may be A ventilated environment is required for monitor
injured otherwise. Prior to use, check the installation. Do not block up the ventilation grille at
disposable or sterilized accessories for any the back of the device.
sign of damage. Do not use them if any
damage is detected. CAUTION
The device must be connected to the ground to
CAUTION avoid the signal interference.
Do not immerse transducers in liquid. When using
solutions, use sterile wipes to avoid pouring fluids CAUTION
directly on the transducer. Keep the environment clean. Avoid vibration.
Keep it far away from corrosive medicine, dust
CAUTION area, high temperature and humid environment.
Do not use autoclave or gas to sterilize the
monitor, recorder or any accessories. CAUTION
Before connecting the monitor to the AC power,
CAUTION make sure the voltage and the power frequency
Disposable devices are intended for single use are consistent with the requirements indicated on
only. They should not be reused as performance the device label or in this user manual.
could degrade or contamination could occur.
CAUTION
CAUTION Poor connection might be caused by frequently
plugging and unplugging the power cord. Check
Remove a battery whose life cycle has expired
the power cord regularly and replace it in time.
from the monitor immediately.
CAUTION
CAUTION
To protect eyes from damage, don't look directly
Avoid liquid splashing on the device.
into barcode scanner’s light.
CAUTION NOTE
Touchscreen is fragile, be gentle when using it Position the device in a location where the
and avoid using force that may cause damage operator can easily see the screen and access the
to it. operating controls.
NOTE
The monitor can only be used on one patient at a
time.
NOTE
If the monitor gets damp, put it in dry circumstance
to dry it until it can work normally. If liquid pours on
the monitor, contact DrägerService.
NOTE
Do not use this monitor for diagnostic purposes.
NOTE
The pictures and dialog boxes in these Instructions
for Use are for reference only.
NOTE
Regular preventive maintenance should be carried
every two years. The user is responsible for any
requirements specific to their country.
NOTE
When the monitor is connected to CMS, the period
for alarm signal sent to network port is less than
0.5 s.
NOTE
The monitor may not be compatible with all models
of USB flash drives. Use the USB flash drives that
are recommended by Dräger.
NOTE
When there's measurement beyond range, invalid
measurement or no measurement value, it will
display -?-.
NOTE
Where applicable, materials, with which the patient
or third person can come into contact, must be
conforming to standard ISO 10993-1.
NOTE
In normal use, the operator shall stand in front of
the monitor.
CAUTION
When building the networking environment: 1) If a
wireless router is used, please turn on the MAC
address filtering function of the wireless router
and add the MAC address of the monitor to the
rule list. The wireless router only allows devices in
the rule list to access the wireless network. 2) It is
suggested to build a VLAN, assign the LAN ports
where the approved switch port, monitor and Vista
120 CMS are into the same VLAN, and isolate it
from other VLANs.
CAUTION
When the monitor is returned for maintenance,
disposed of, or removed from the medical
institution for other reasons, it is necessary to
ensure that all patient data are removed from the
monitor (Refer to Section Deleting data stored in
the storage device).
CAUTION
Please protect the privacy for the information and
the data displayed on the screen, and for the
information and the data stored in the monitor.
CAUTION
For security, disable all unused USB and network
ports.
NOTE
Log files generated by the monitor are used for
system troubleshooting and do not contain
protected medical data.
Security
NOTE
When the monitor is turned on for the first time,
modify the User Maintain password according to
the prompts. The default initial User Maintain
password can be found in Section Passwords.
Application
Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Intended user . . . . . . . . . . . . . . . . . . . . . . . . . 26
Intended use
The Vista 120 series patient monitors (Vista 120, The monitor is intended to be used only under
Vista 120S), hereafter called the monitor, are regular supervision of clinical personnel. It is
intended to monitor multiple parameters including applicable to adult, pediatric, and neonatal usage in
ECG (3-lead or 5-lead selectable), respiration a hospital environment and during patient transport
(RESP), functional arterial oxygen saturation inside a healthcare facility.
(SpO2), invasive or non-invasive blood pressure
The arrhythmia detection, ST Segment analysis
(IBP, NIBP), temperature (dual-TEMP), end-tidal
and BIS are intended for adult and pediatric
CO2, Cardiac Output (C.O.), AG and bispectral
patients.
index (BIS). BIS is only applicable to Vista 120.
The monitor and AG module are suitable for use
within the patient environment.
CAUTION
Device is for use in health care facilities only and
exclusively by persons with specific training and
experience in its use.
Intended user
Overview
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Front view . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Side view . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Back view . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . 34
Symbols. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Overview
The monitor is optimized for surgical, cardiac, Vista 120 has a 15-inch TFT color flat panel display,
medical and neonatal care environments, and can and Vista 120S has a 12.1-inch TFT color flat panel
store data for both trends and events. The user can display. Up to 13 waveforms for Vista 120 and 11
also view and record graphical and tabular trends waveforms for Vista 120S can be displayed on the
(vital signs). screen.
Front view
B
C
D
E
F
G
A Alarm indicator When an alarm occurs, the alarm indicator will light or flash. The alarm level is
color coded.
B Audio Pause/ Upon the configuration, pressing this button to pause or turn off the audio alarm.
Audio Off Further information can be found in the chapter "Audio Alarm Paused"and
chapter "Audio Alarm Off".
C NIBP Press to inflate the cuff and perform NIBP measurement. Press again to stop the
measurement measurement and deflate the cuff.
D Trend Press this button to enter trend table review dialog box.
E Freeze In normal mode, press this button to freeze all the waveforms on the screen. In
Freeze mode, press this button to restore the waveform refreshing.
F Recording Press this button to start a real-time recording. Press again to stop recording.
G Menu Press this button to open the main menu when there is no menu open. Press it
again to exit.
H Rotary knob The user can turn the rotary knob clockwise or counter-clockwise to highlight the
desired item. Press the rotary knob to select the item.
I Mains/Battery Refer to chapter “Battery power indicator” for details.
indicator
J On/Off When connected to the AC power supply, press the key to turn the monitor on.
Press the key again to turn the monitor off.
Side view
Vista 120
A ECG port
B BIS port (Optional)
C Dräger SpO2 port
D T1 and T2 port
E IBP1, IBP2 and IBP3 ports (Optional)
F NIBP port
G Nellcor SpO2 port (Optional)
H etCO2 port (Optional)
I C.O. port (Optional)
J Recorder (Optional)
K Battery compartment door
L Dräger G2 module holder (Optional)
Vista 120S
A NIBP port
B ECG port
C T1 and T2 ports
D SpO2 port
E IBP1, IBP2 and IBP3 ports (Optional)
F etCO2 port (Optional)
G C.O. port (Optional)
H Recorder (Optional)
I Battery compartment door
J Dräger G2 module holder (Optional)
NOTE
The side view above is for demonstration. The port distribution on the monitor depends on the monitor
configuration and on the options purchased and may deviate from the side view.
NOTE
To avoid blocking and affecting NIBP measurement, the user can open the battery compartment door to
clean the dustproof vent periodically. Do not use wet cotton swab to clean the vent. If NIBP measurement
is still affected after cleaning, contact DrägerService.
Back view
Vista 120
Vista 120S
A Speaker
B Equipotential grounding terminal. If the monitor is used with other devices, connect this terminal to
eliminate potential ground differences between devices.
C Power cord safety latch. Used to prevent the power cord from detaching. Place the latch on the
power cord and press it down firmly to ensure that it secures the power cord.
D Ventilation grid
E Anti-theft lock
F Medibus/X interface
G RJ45 network interface
H Nurse call port/ analog output/ defibrillator synchronization.
Nurse call port: it connects the monitor to the hospital’s nurse call system. Alarms indications are
alerted through the nurse call system if configured to do so.
Analog output: the monitor outputs the waveform through the port.
Defibrillator synchronization: the monitor outputs the defibrillator synchronization signal through
the port.
I USB interfaces. They are used to connect the USB device.
J VGA output
K AG Scio module interface
Abbreviations
Abbreviation Explanation
R Right
RA Right arm
RAP Right atrial pressure
RESP Respiration
RHb Reduced hemoglobin
RL Right leg
RR Respiration rate
SYS Systolic pressure
TB Blood Temperature
TD Temperature difference
TEMP Temperature
USB Universal serial bus
Symbols
Defibrillation-proof type BF
Battery indicator
applied part
Caution Recycle
Getting started
Initial inspection . . . . . . . . . . . . . . . . . . . . . . . 40
Initial inspection
Before unpacking, check the packaging and check Open the package carefully and remove the
that there are no signs of mishandling or damage. monitor and accessories. Check that all correct
If the shipping cartons are damaged, contact the options and accessories are included.
local supplier for assistance.
If the user has any question, contact the local
supplier.
NOTE
If the system is not used for a long period of time,
its system time may be inaccurate. In this case,
readjust the system time after powering on.
System configuration
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Overview
1 Select the Menu item on the main interface. 3 Type the password into the displayed dialog box
and press OK to enter the User Maintain
2 Select Maintenance > User Maintain.
menu.
Only if the monitor is connected and admitted by 1 The screen displays message: Privacy mode
Vista 120 CMS, the privacy mode can be activated. and Patient monitored without audio and
To enter into privacy mode, you can select Menu > visual alarms. Please click on screen or hard
Maintenance > User Maintain > Shortcut Setup key to exit.
> Privacy Mode (off by default). Press the shortcut
2 Monitoring data, alarm information, stored data
key on the screen, the monitor enters into
and monitor status are transmitted to Vista 120
privacy mode after user’s confirmation.
CMS.
In privacy mode:
3 Audio alarm paused status discontinues. Audio
alarm off, alarm off, alarm reset and alarm latch
status are not influenced.
The monitor exits privacy mode under any of the 3 The monitor is disconnected with Vista 120
conditions: CMS.
1 The user clicks anywhere on the screen or NOTE
presses any key (except Power ON/OFF key).
The monitor is unable to enter into privacy mode
2 Battery Low alarm occurs. when exporting data.
* This is for French users only and NFC has nothing 5 Symbol is displayed in the HR parameter
to do with "Near Field Communication". area.
NFC mode means HR physiological alarms can't be 6 Monitoring data, alarm information, stored data
turned off. To configure NFC mode, select Menu > and monitor status are transmitted to Vista 120
Maintenance > User Maintain > Alarm Setup and CMS.
choose NFC Mode which can be set to On or Off.
NFC mode is off by default. NOTE
In NFC mode: NFC mode and standby mode can't coexist. When
1 The HR physiological alarms are always on and the monitor enters the standby mode, the NFC
mode will automatically pause. After exiting the
can't be set to off by the user.
standby mode, the monitor will automatically
2 The user can't turn off the audio alarm resume the NFC mode.
permanently.
After exiting NFC mode:
3 The audio alarm off status will be finished and
the monitor enters normal alarm response 1 The HR physiological alarms are still on and
status. Pause Time will automatically switch to can be set to off by the user.
120 s, which can be set to 60 s, 120 s, or 180 s
2 Pause Time keeps no change and the user can
manually.
set it to Permanent.
4 The audio alarm paused status before entering
3 Symbol gets disappeared.
NFC mode is not affected.
Operation
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Using keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Permanent keys . . . . . . . . . . . . . . . . . . . . . . . . 49
Shortcut keys . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Hardkeys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Pop-up keys . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Adjusting volume . . . . . . . . . . . . . . . . . . . . . . 51
Adjusting key volume . . . . . . . . . . . . . . . . . . . . 51
Adjusting alarm volume . . . . . . . . . . . . . . . . . . 51
Adjusting beat volume . . . . . . . . . . . . . . . . . . . 51
Networked monitoring . . . . . . . . . . . . . . . . . . 52
Setting languages. . . . . . . . . . . . . . . . . . . . . . 52
Understanding screens . . . . . . . . . . . . . . . . . 53
Calibrating screens . . . . . . . . . . . . . . . . . . . . 53
Overview
The user may frequently use the follow functions: Everything the user needs to operate the monitor is
displayed on its screen. Nearly every element on
• ECG monitoring (Refer to chapter “Monitoring
the screen is interactive. Screen elements include
ECG” for more information.)
measurement numerics, waveforms, screen keys,
• SpO2 monitoring (Refer to chapter “Monitoring information fields, alarms fields and menus. The
SpO2” for more information) monitor can be configured in a number of different
ways. For example, the user can access an item
• PR monitoring (Refer to chapter “Monitoring PR”
through the on-screen setup menu, via a hard key,
for more information.)
or via a shortcut key. This Instructions for Use
• NIBP monitoring (Refer to chapter “Monitoring describes how to access items via an on-screen
NIBP” for more information.) menu.
• Alarm (Refer to chapter “Alarms” for more
information.)
Using keys
Permanent keys
Review the trend table
A permanent key is a graphical key that is
permanently located at the bottom of the main
screen allowing fast, direct access to functions.
Access the NIBP review
Hardkeys
Change the beat volume
Hardkeys are the physical keys on the front panel
of the monitor. The monitor has the following
View Medibus/X window hardkeys: Mute, NIBP, Trend, Freeze, Recording,
and Menu. Refer also to the chapter “Front view”.
Alarm setup
Bed View
Adjusting volume
Networked monitoring
Setting languages
To change the language: 3 Select the desired language from the list.
To make the change permanent, restart the
1 Select Menu > Maintenance > User Maintain,
monitor.
then type the maintenance password into the
displayed dialog box.
2 Select the Language option on the pop-up
dialog box to display the language list.
Understanding screens
The monitor has a set of preconfigured screens, monitoring. Screens do not affect alarm settings,
which are optimized for common monitoring patient category etc. If the user changes from a
scenarios such as OR adult or ICU neonatal. A complex to a less complex screen layout, some
screen defines the overall selection, size and measurements may not be visible but are still
position of waveforms, numerics and shortcut keys monitored in the background. For detailed
displayed when the user starts the monitor. The information, refer to chapter “User Interface”.
user can switch between different screens during
Calibrating screens
To enter the barcode setup menu, please select User can also check relevant scanner device
Menu > Maintenance > User Maintain. After information in User Maintain > Scanner
entering the required password, select Other Management.
Setups > BarCode Setup. Then the user can set
MRN, last name, first name and so on.
NOTE
The start and end code should be set before using
scanner to update patient, otherwise the barcode
can’t be recognized correctly. After setting start
and end code, user should also set male code and
female code to distinguish the gender.
Alarms
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Alarm categories . . . . . . . . . . . . . . . . . . . . . . 56
Physiological alarms. . . . . . . . . . . . . . . . . . . . . 56
Technical alarms. . . . . . . . . . . . . . . . . . . . . . . . 56
Prompts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Alarm levels . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Controlling alarm . . . . . . . . . . . . . . . . . . . . . . 58
Switching the individual alarm off . . . . . . . . . . . 58
Audio alarm paused . . . . . . . . . . . . . . . . . . . . . 58
Audio alarm off . . . . . . . . . . . . . . . . . . . . . . . . . 59
Alarm reset . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Setting alarm limits . . . . . . . . . . . . . . . . . . . . . . 59
Latching alarms . . . . . . . . . . . . . . . . . . . . . . . . 60
Disabling Sensor Off Alarms . . . . . . . . . . . . . . 60
Network Disconnected Alarms . . . . . . . . . . . . . 61
Testing alarms . . . . . . . . . . . . . . . . . . . . . . . . . 61
Overview
WARNING
A potential hazard can exist if different alarm
presets are used for the same or similar
equipment in different areas, e.g., an intensive
care unit or a cardiac operating room.
Alarm categories
Alarm levels
There are three alarm levels consisting of high, 3 Low level alarms
medium, and low. A low level alarm reminds the operator of a low
priority alarm condition which requires
1 High level alarms
response. And the response time for a low
A high level alarm intensively warns the
priority alarm condition can be greater than that
operator of a high priority alarm condition which
for a medium priority alarm condition. Failure to
requires immediate operator response. Failure
respond to the cause of the alarm condition is
to respond to the cause of the alarm condition is
likely to result in discomfort or reversible minor
likely to result in death or irreversible injury of
injury of the patient.
the patient.
The high/medium/low-level alarms have the
2 Medium level alarms
following audible characteristics:
A medium level alarm warns the operator of a
medium priority alarm condition which requires
prompt operator response. Failure to respond to
the cause of the alarm condition is likely to
result in reversible injury of the patient.
Standard
Mode 1
Alarm level Prompt
High Mode is “Di-Di-Di------Di-Di”, which is triggered once every 10 s. The alarm indicator
flashes in red, with frequency of 1.4 Hz ~ 2.8 Hz. The alarm message flashes with
red background, and the symbol *** is displayed at the alarm area.
Medium Mode is “Di-Di-Di”, which is triggered once every 25 s. The alarm indicator flashes
in yellow, with frequency of 0.4 Hz ~ 0.8 Hz. The alarm message flashes with yellow
background, and the symbol ** is displayed at the alarm area.
Low Mode is “Di-”, which is triggered once every 30 s. When physiological alarm is
triggered, the alarm indicator is constantly yellow. While for technical alarm, the
alarm indicator is constantly blue. The alarm message flashes with yellow
background, and the symbol * is displayed at the alarm area.
The sound pressure range for standard audible The parameter area has two flash methods to
alarm signals is from 45 dB to 85 dB, and for Mode prompt alarms: background flash and text flash.
1 is from 30 dB to 85 dB. User can select one method from Menu > Alarm
Setup > Visual Effect:
When different level alarms occur at the same time,
alarm sound and alarm indicator prompt the highest 1 Text Flash: text flashes with frequency of 1 Hz.
level alarm, alarm messages display in turn.
2 Background Flash: background flashes with
frequency of 1 Hz.
Controlling alarm
To switch the alarm off, If the monitor is in audio alarm paused status, the
monitor will:
1 Select the parameter area, open the XX Setup
menu (XX stands for parameter name). Select Not generate an auditory alarm signal.
Alarm Setup > Switch to toggle between On or
Visually display alarm information.
Off, or
2 Use the shortcut key or select Menu >
The audio alarm paused symbol is displayed
Alarm Setup, and then click Alarm Options >
and the remaining pause time is displayed on a red
Switch to toggle between On or Off.
colored background.
When alarm switch is off, the parameter alarm off
The user can set the pause time as desired. The
icon will be displayed in the corresponding default pause time is 120 s.
parameter area.
Setting value
of high alarm
limit
Low
Alarm Limit
Setting value
of low alarm
limit
Latching alarms
pressing the hardkey or permanent key
To configure the alarm latching setting, select
Menu > Maintenance > User Maintain > Alarm
the user can disable the audio alarm
Setup and choose Alarm Latch which can be set
to On or Off. When it is set to Off, alarm indications signal, however, the visual alarm indications are
end when the alarm condition ends. When it is set still displayed. If it is set to Off, and a sensor off
to On, the visual and audio alarm indications are
alarm occurs, after pressing the hardkey or
still displayed after the alarm condition ends;
meanwhile, the alarm time is also displayed for the
latched alarm for reference. The indication lasts permanent key , sensor-off status will be
until the alarm is acknowledged. announced with a prompt message. It means
there’s no audio alarm signal and alarm indicator,
but prompt information displayed.
The user can use the permanent key on
the screen to acknowledge the lated alarm. In Menu > Maintenance > User Maintain > Alarm
Setup, SpO2 Sensor Off and ECG Lead Off alarm
level can be adjusted as High, Med. or Low. These
Disabling Sensor Off Alarms alarm levels are set to Low by default.
NOTE
When the monitor is connected with the central
monitoring system, the user must set Disconnect
Alarm to On.
NOTE
If Disconnect Alarm occurs during audio alarm
paused or audio alarm off status, the monitor will
prompt a sounding alarm with information of
NetWork Disconnect. During the network
disconnected status, activating audio alarm
paused or audio alarm off function can disable the
audio alarm signal of Disconnect Alarm.
Testing alarms
NOTE
The patient monitor will reboot in 3 s due to self-
test failure.
Alarm information
Prompts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
WARNING
The physiological alarms including Asystole,
RESP APNEA, SpO2 No Pulse, CO2 APNEA,
AG FiO2 Low, and AG APNEA cannot be
turned off.
R on T A type of single PVC under the condition that HR<100, R-R User-selectable
interval is less than 1/3 the average interval, followed by a
compensating pause of 1.25X the average R-R interval (the
next R wave advances onto the previous T wave).
PVC Single PVC detected in normal heartbeats, and the number of User-selectable
single PVC ≥ 4 within 30 s.
Missed Beat If HR < 120 bpm, no beats are detected for 1.75 times average User-selectable
RR interval; or if HR ≥ 120 bpm, no beats are detected for one
second; or no valid QRS wave is detected within 3 s or longer.
Pacer not No QRS complex detected in 300ms after a pace pulse. User-selectable
Capture
Pacer not No pace pulse detected in 1.75 times RR interval after a QRS User-selectable
Pacing complex.
Vent Brady 5 consecutive ventricular beats, and ventricular HR < 40 bpm. High
RESP
RESP APNEA RESP waveform can not be detected within the set apnea High
alarm delay time.
RR High RR value is above upper alarm limit. User-selectable
RR Low RR value is below lower alarm limit. User-selectable
SpO2
SpO2 High SpO2 value is above upper alarm limit. User-selectable
SpO2 Low SpO2 value is below lower alarm limit. User-selectable
SpO2 No Pulse The signal of the measurement site is too weak due to High
insufficient blood supply and environmental factors, so the
monitor can not detect the pulse signal.
SpO2 Desat SpO2 measuring value is below the SpO2 Desat Limit. High
PR
PR High PR value is above upper alarm limit. User-selectable
PR Low PR value is below lower alarm limit. User-selectable
TEMP
T1 High Value of T1 channel is above upper alarm limit. User-selectable
T1 low Value of T1 channel is below lower alarm limit. User-selectable
T2 High Value of T2 channel is above upper alarm limit. User-selectable
Art SYS High Art SYS value is above upper alarm limit. User-selectable
Art SYS Low Art SYS value is below lower alarm limit. User-selectable
Art DIA High Art DIA value is above upper alarm limit. User-selectable
Art DIA Low Art DIA value is below lower alarm limit. User-selectable
Art MAP High Art MAP value is above upper alarm limit. User-selectable
Art MAP Low Art MAP value is below lower alarm limit. User-selectable
CVP MAP High CVP MAP value is above upper alarm limit. User-selectable
CVP MAP Low CVP MAP value is below lower alarm limit. User-selectable
ICP MAP High ICP MAP value is above upper alarm limit. User-selectable
ICP MAP Low ICP MAP value is below lower alarm limit. User-selectable
LAP MAP High LAP MAP value is above upper alarm limit. User-selectable
LAP MAP Low LAP MAP value is below lower alarm limit. User-selectable
RAP MAP High RAP MAP value is above upper alarm limit. User-selectable
RAP MAP Low RAP MAP value is below lower alarm limit. User-selectable
CO2
etCO2 High etCO2 value is above upper alarm limit. User-selectable
etCO2 Low etCO2 value is below lower alarm limit. User-selectable
FiCO2 High FiCO2 value is above alarm limits. User-selectable
AWRR High AwRR value is above upper alarm limit. User-selectable
AWRR Low AwRR value is below lower alarm limit. User-selectable
CO2 APNEA In a specific time interval, no RESP were detected by the CO2 High
module.
NOTE
The lead names in the table below use the AHA
(American Heart Association) denomination. For
the corresponding IEC lead names, refer to
chapter “Installing Electrodes”.
ECG
RESP
If patients’ breath is
normal, adjust the
electrode measurement
No RESP waveform can be
site.
RESP Cardiac detected due to apnea or
High
Artifact shallow breathing of the If patients’ breath is
patient. abnormal, take some
measures to make
patients breath normal.
SpO2
NIBP
TEMP
Check sensor
Excessive T1 TEMP1 measuring value is
High connection and patient
beyond measuring range.
condition.
Check sensor
Excessive T2 TEMP2 measuring value is
High connection and patient
beyond measuring range.
condition.
IBP
YY Sensor Off
Make sure that cable is
(YY stands for the IBP sensor falls off monitor. Medium
properly connected.
IBP label name)
Stop monitoring IBP and
YY Comm Fail
IBP module failure or notify hospital technical
(YY stands for the High
communication failure. personnel or customer
label name)
support.
C.O.
Insert injective
C.O. TI No Sensor C.O. TI sensor not connected. Low
temperature sensor.
CO2
AG
AG Change
Malfunction in watertap. Medium Replace the watertrap.
Watertrap
Watertrap will be
Watertrap will be full. Medium Replace the watertrap.
full
1 Unplug and plug the
communication cable.
AG Software Error AG module software failure. High 2 Restart AG module.
3 Call manufacturer.
1 Check connection.
BIS
Others
Prompts
Message Cause
ECG ARR Learning The QRS template building required for Arr. Analysis is in process.
V-Fib/V-Tach Off V-Fib/V-Tach alarm is set to Off.
Vent Brady Off Vent Brady alarm is set to Off.
Key ARR Alarm Off One of Key ARR alarms is set to Off.
SpO2 Search Pulse When the sensor is connected to the patient, the SpO2 is analyzing
the patient signal and searching for the pulse to compute the
saturation.
SpO2 Noisy Signal There is interference with SpO2 measurement signals due to patient
movement, ambient light, electrical interference or else.
(Nellcor SpO2)
Manual Measuring In manual measuring mode.
Venipuncture Starting Start the assisting venipuncture and the cuff begins to inflate.
Venipuncture Ending Finish the assisting venipuncture and the cuff begins to deflate.
CO2 Standby Changing from measuring to standby mode places the module in
energy-saving status.
Message Cause
CO2 Calibration Reset The entered test gas is out of range. Reset the calibration.
Please Press 'Zero'. Enter the IBP zeroing menu, and zeroing is not performed yet.
Pulsatile Pressure Zero Fail. During the zeroing process, pressure fluctuation is excessive.
Pressure out of normal During the zeroing process, pressure value is beyond the zeroing
range,Fail. range.
Please Press 'Calibrate'. Enter the Calibration menu, and Calibration is not performed yet.
Message Cause
Reconnect BIS Device The module has stopped or the BISx device is not connected.
Recorder Setup Needed The user presses the RECORD button or shortcut key Record
when Recorder is not configured.
NIBP Simul NIBP Simul function is turned on.
ECG alarm limits are listed as follows (unit bpm): NIBP alarm limits are listed as follows (unit mmHg):
Adjustable
Range
High limit:
FiCO2
0% to 10.0%
etCO2 0% to 10.0%
FiO2 18.0% to 100.0%
EtO2/FiN2O/EtN2O 0% to 100.0%
EtDES/FiDES 0% to 20.0%
EtISO/FiISO/EtHAL/FiHAL 0% to 8.5%
EtSEV/FiSEV/EtENF/FiENF 0% to 10.0%
AwRR 0 rpm to 100 rpm
Apnea Time 20 s to 40 s
Managing patients
Confirming a patient. . . . . . . . . . . . . . . . . . . . 86
Admitting a patient . . . . . . . . . . . . . . . . . . . . . 86
Patient category and paced status . . . . . . . . . . 87
Quick admit . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Barcode admit. . . . . . . . . . . . . . . . . . . . . . . . . 87
Confirming a patient
The pre-selected configuration may not be After the user switches the monitor on, the monitor
appropriate for the newly admitted patient. will prompt “Continue current patient or admit
Therefore, the monitor allows the user to load a new patient?”. Select Current Patient to use the
desired configuration to ensure that all the settings current configuration; Select New Patient to admit
are appropriate for the patient. new patient.
NOTE
If the user does not make a selection within 3
minutes, Current Patient is selected by default.
Admitting a patient
The monitor displays patient physiological data and First name: Enter the patient’s first name,
records the information in trends. This allows the for example Joseph.
user to monitor unadmitted patients. It is
Bed No.: supports up to 8 characters.
recommended, however, that the user admit
Chinese, English, Russian, number and
patients to record their information in reports.
special characters can be input.
During admission, the patient category setting
Doctor: Enter the attending doctor for the
determines the algorithm that the monitor uses to
patient.
process and calculate measurements. These
include safety limits that are applied for specific Gender: Choose Male or Female.
measurements and alarm limit ranges.
Type: Choose the patient type, Adult,
To admit a patient: Pediat, or Neonat.
1 Select the Admission shortcut key on the BloodType: Choose the patient type N/A,
screen or A, B, AB, or O.
2 Select Menu > Patient Setup > New Patient, Pace: Choose On or Off (The user must use
then a message is displayed to ask the user to On if the patient has a pacemaker).
confirm to update patient.
Date of Birth: Enter the patient’s date of
3 Click No to cancel this operation; click Yes, the birth.
Patient Info window is displayed.
Date of Admission: Enter the patient’s date
4 Enter the patient information: of admission.
MRN: Enter the patient's medical record Height: Enter the patient’s height.
number (MRN), for example 12345678.
Weight: Enter the patient’s weight.
Last name: Enter the patient’s last name
Height unit: cm or inch.
(family name), for example Smith.
Weight unit: kg or lb.
Quick admit
If the user does not have the time or information to 1 Select the shortcut key on the screen
fully admit a patient, fill in the rest of the patient directly, or
information later.
2 Select Menu > Patient Setup > Quick Admit,
The user can quickly admit a patient as follows: a message is displayed requesting that the user
confirm the patient update.
3 Click No to cancel this operation; click Yes to
continue and the Quick Admit window is
displayed, choose Type and Pace and set them
to the correct mode.
Barcode admit
NOTE
The user can load patient information from the
network server only when ADT Query is enabled.
Default setting is off. Setting path: Maintenance >
User Maintain > Network Maintain > ADT Query.
NOTE
Use wired instead of wireless networking when
connecting the monitor to central monitoring
system in the operating room because the ESU
will interfere with a wireless network, which may
cause networking failure.
NOTE
Make sure the network connection between the
monitor and the central monitoring system is in
good condition when the time synchronization
function on the monitor is active (Default setting is
off. Route: Maintenance > User Maintain >
Date/Time Setup > Sync Time). If the setting is
on, the monitor will accept time synchronization
from Vista 120 CMS.
User interface
The user can set the interface style. The following Only authorized personnel should set the interface
options are available: style.
Waveform sweep
Monitored parameters
The user can select the display parameters based 3 Select the required parameters from the popup
on specific monitoring and measurement interface.
requirements. To select the parameter:
4 Exit the menu and the screen will adjust the
1 Select the shortcut key on the screen parameters automatically.
directly, or
2 Select Menu > System Setup > Module
Switch.
Select Menu > Display Setup to open the Display Decide whether the control bar is displayed or
Setup menu on which the user can not displayed on the screen by setting Control
Bar to On or Off.
Select a function screen based on the clinical
requirements by configuring View Selection.
Select the maximum number of waveforms
displayed on the screen by configuring Wave.
Num.
To view the trend screen, the user can press the Select short trend to open Short Trend Setup
menu, the user can set:
shortcut key on the screen directly or select
Menu > Display Setup > View Selection > 1 Parameter.
TrendScreen.
2 Interval: set the interval to 30 min, 1 h and 2 h.
NOTE
In order to use the bed view function without
impediment, the monitor needs to be restarted
after changing its IP address.
NOTE
To use the bed view function smoothly, make sure
the network connection is in good condition.
Before opening the Bed View window, make sure Display Setup and choose Bed View in the View
the bed view function is configured on the monitor.
Selection list, or select the shortcut key on
To open the Bed View window, select Menu >
the screen directly.
Click on the Bed View window to open the Select the waveform to be displayed on the
ViewBed Setup menu on which the user can window in the Wave Type list.
Assign a bed to be viewed by selecting the bed Use the buttons and to view more
No. in the Bed No. list. numeric information of parameters in the
window.
The user can set the display colors of parameter Maintain, enter the required password. Then select
and waveform as desire. To change the display Color Setup to make color changes on parameter
color, select Menu > Maintenance > User and waveform.
The monitor has the timer function to notify you In the timer displaying area, the user can set the
when a preset time period is expired. To display the timer counting direction. Select Timer Setup >
timer on the main interface, Timing Direction.
1 Select the shortcut key on the screen
directly, or
2 Select Menu > System Setup > Module
Switch.
3 Select Timer from the popup interface. Exit the
menu and the screen will adjust the parameters
automatically.
NOTE
The user cannot change timer settings when a
timer is running.
NOTE
Do not use the timer to schedule critical patient-
related tasks.
NOTE
The timer function is not available in privacy mode
and standby mode.
Monitoring ECG
Overview
WARNING WARNING
Use only compatible ECG cables for Check if the lead connection is correct before
monitoring. monitoring. If the ECG cable is unplugged
from the socket, the screen will display the
WARNING error message “ECG LEAD OFF” and an
audible alarm sounds.
When connecting the cables and electrodes,
make sure no conductive part is in contact
with the ground. Verify that all ECG WARNING
electrodes, including the neutral electrode, If the ECG signal exceeds the measuring
are securely attached to the patient but not a range, the monitor will indicates it by a
conductive part or ground. message “ECG Signal Exceed”.
WARNING WARNING
Place the electrode carefully and ensure a In order to avoid being burnt, please keep the
good contact. Check every day whether there electrodes far away from the radio knife while
is skin irritation resulted from the ECG using electrosurgical equipment.
electrodes. If yes, replace electrodes every 24
hours or change their sites. WARNING
ECG cables can be damaged when connected
WARNING to a patient during defibrillation or using other
Store the electrodes in room temperature. high frequency equipment. Check cables for
Open the electrode package immediately prior functionality before using them again. It is
to use. Never mix electrode types or brands. recommended to use defibrillator-proof ECG
This may lead to problem due to impedance lead to avoid burn.
difference. When applying the electrodes,
avoid bones close to skin, obvious layers of WARNING
fat, and major muscles. Muscle movement can When using electrosurgery (ES) equipment,
result in electrical interference. Applying do not place an electrode near the grounding
electrodes on major muscles, for example on plate of the electrosurgery device: otherwise,
muscles of thorax, may lead to erroneous more interference will be evident on the ECG
arrhythmia alarm due to excessive muscle waveform.
movement.
WARNING WARNING
The electrodes should be made of the same The monitor can only be used on one patient
metal materials. at a time. Monitoring more than one patient
simultaneously may result in hazards to the
WARNING patient.
According to AAMI specifications the peak of
the synchronized defibrillator discharge WARNING
should be delivered within 60 ms of the peak Pacemaker Failure: During a complete cardiac
of the R wave. The synchronization pulse block or when pacemaker is unable to
output on the patient monitors is delayed by a pacing/capture, high P-wave (greater than 1/5
maximum of 35 ms from the R wave peak. The of the average height of the R-wave) may be
biomedical engineer should verify that the incorrectly counted by the monitor, which
ECG/Defibrillator combination does not leads to a missing asystole.
exceed the recommended maximum delay of
60 ms. NOTE
Interference from a non-grounded instrument near
WARNING the patient and ESU interference can cause
Before outputting signals with defibrillator inaccuracy of the waveform.
synchronization or ECG, check if the output is
functioning normally. NOTE
IEC/EN60601-1-2 (protection against radiation is
WARNING 3 V/m) specifies that the electrical field density
ECG accessories are not suitable for DIRECT exceeding 3 V/m may cause measurement error in
CARDIAC APPLICATION. (Refer to IEC60601-1 various frequencies. It is accordingly suggested to
for more information about the definition of not use equipment generating electrical radiation
DIRECT CARDIAC APPLICATION.) near ECG/RESP monitoring devices.
WARNING
Line isolation monitor transients may NOTE
resemble actual cardiac waveforms and thus The simultaneous use of cardiac pacemaker and
inhibit heart rate alarms. When the electrode other patient-connected equipment may cause a
or lead is loose or fallen, the monitor is easily safety hazard.
affected by the transient response of certain
types of insulation monitors. The transient NOTE
monitor signal produced by poor insulation of If the pacemaker signals are beyond the claimed
the line may be very similar to the actual heart range, the heart rate may be calculated incorrectly.
waveform, which will prevent the monitor from
prompting a heart rate alarm. In order to avoid
NOTE
this, user should check lead wires for damage
and ensure good skin contact prior to and In the default settings of the monitor, the ECG
during use. Always use fresh electrodes and waveforms are the first two waveforms from the
follow proper skin preparation techniques. top in the waveform area.
NOTE
For measurements in or near the heart connect the
monitor to the potential equalization system.
NOTE
For protecting the environment, the used
electrodes must be recycled or disposed of
properly.
ECG display
The symbol 1 indicates the lead name of the X1 to make the size of 1 mV ECG waveform signal
displayed waveform; refer to chapter “Selecting become 10 mm;
calculation lead”.
X2 to make the size of 1 mV ECG waveform signal
The symbol 2 indicates waveform gain; refer to become 20 mm;
chapter “Changing the size of the ECG waveform”.
X4 to make the size of 1 mV ECG waveform signal
The symbol 3 indicates Filter setting; refer to become 40 mm;
chapter “Changing the ECG filter settings”.
AUTO let the monitor choose the optimal
adjustment factor for all the ECG waveforms.
Changing the size of the ECG waveform NOTE
The effect of ECG wave gain is subject to the size
If any of the displayed ECG waveforms are too of the wave area. Whichever wave gain is chosen,
small or clipped, the size can be changed. Select the ECG wave has to be displayed within the wave
ECG Waveform Setup > ECG Gain, then select an area, the exceeded part is clipped.
appropriate factor from the pop-up box to adjust the
ECG waveform.
X0.125 to make the size of 1 mV ECG waveform Changing the ECG filter settings
signal become 1.25 mm;
The ECG filter setting defines how ECG waveforms
X0.25 to make the size of 1 mV ECG waveform
are smoothed. An abbreviation indicating the filter
signal become 2.5 mm;
type is shown under the lead label on the monitor
X0.5 to make the size of 1 mV ECG waveform display. Filter settings do not affect ST
signal become 5 mm; measurement.
To change the filter setting, in the ECG Setup Diagnos: Use when undistorted quality is
menu, select Filter and then select the appropriate required and its own characteristics can be
setting. maintained. The waveform filtered by the
bandwidth of 0.05 Hz~150 Hz is displayed so
Monitor: Use this mode under normal
that the actual changes such as R-wave
measurement conditions.
notching or discrete elevation or depression of
Surgery: The filter reduces interference to the the ST segments are visible.
signal. It should be used if the signal is distorted
by high- 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 HF surgical equipment. Under
normal measurement conditions, selecting
Surgery may distort the QRS complexes too
much and thus interfere with the clinical
evaluation of the ECG displayed on the monitor.
To set the calculation lead, select ECG Setup > The P-waves and the T-waves should be less
Calc. Lead, or on the Normal display interface, than 0.2 mV.
click on the calculation lead waveform area, select
Calc. Lead from the popup interface to make the NOTE
appropriate setting. For 3 Leads, II, I, and III are Make sure you have selected the best lead with
selectable; For 5 Leads, II, I, III, aVR, aVL, aVF, the best waveform amplitude and highest signal-
and V are selectable. Normal QRS complex is to-noise ratio. Choosing the best lead is important
defined as: for heart beat test, heart beat classification and
ventricular fibrillation detection.
The normal QRS should be either completely
above or below the baseline and it should not
be biphasic. For paced patients, the QRS
complexes should be at least twice the height of
pace pulses.
The QRS should be tall and narrow.
Monitoring procedure
Skin is a poor conductor of electricity. Prepare the 1 Attach a clip or snap to the electrodes prior to
patient's skin to facilitate good electrode placement.
conductivity.
2 Place the electrodes on the patient. Before
Select sites with intact skin, without impairment attaching, apply some conductive jelly on the
of any kind. electrodes if the electrodes are not electrolyte
self-supplied.
Shave hair from sites, if necessary.
3 Connect the electrode lead to the patient's
Wash sites thoroughly with soap and water.
cable.
(Never use ether or pure alcohol, because this
increases skin impedance). 4 Plug the patient cable into the ECG connector
on the monitor.
Rub the skin briskly to increase capillary blood
flow in the tissues and remove skin scurf and CAUTION
grease. 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
Dräger.
Installing electrodes
NOTE
The following table gives the corresponding lead
names according to IEC (used in Europe) and the
AHA (USA) respectively.
RE
LL: On the left hypogastrium.
SP
Lewis
LA
RA RL LL
NOTE
To ensure safety, all leads must be attached to the
patient.
RE
SP
V5: On the left anterior axillary line, horizontal ECG leads are used mainly for monitoring patient
with V4 electrode. vital signs. When using the patient monitor with
other HF surgical equipment, use defibrillator-proof
V6: On the left middle axillary line, horizontal
ECG leads.
with V4 electrode.
The placement of the ECG leads depends on the
V3R-V6R: On the right side of the chest in
type of surgery. For example, during open heart
positions corresponding to those on the left.
surgery the electrodes can be placed laterally on
VE: Over the xiphoid position. the chest or back. In the operating room, artifacts
may affect the ECG waveform due to the use of ES
V7: On the 5th intercostal space at the left
(electrosurgery) equipment. To help reduce this
posterior axillary line of back.
interference, the electrodes can be placed on the
V7R: On the 5th intercostal space at the right right and left shoulders, the right and left sides near
posterior axillary line of back. the abdomen and the chest lead on the left side at
mid-chest. Avoid placing the electrodes on the
upper arms, which might result in a small
waveform.
WARNING
ECG cables can be damaged when connected
to a patient during defibrillation or using other
high frequency equipment. Check cables for
functionality before using them again. It is
recommended to use defibrillator-proof ECG
lead to avoid burn.
NOTE
If an ECG waveform is not accurate (with
electrodes are tightly attached), change the leads
displayed on the screen.
NOTE
Interference from a non-grounded instrument near
the patient and ESU interference can cause
Recommended ECG lead placement for inaccurate waveforms.
surgical patients
WARNING
When using HF surgical equipment, leads
should be placed in a position in equal
distance from the Electrosurgery electrotome
and the electrosurgery grounding plate to
avoid cautery. HF surgical equipment wires
and ECG cable must not be tangled up.
ST segment monitoring
NOTE
ST values may be affected by such factors as
some drugs or metabolic and conduction
disturbances.
NOTE
ST is calculated with a fixed delay from the R
position. Changes in heart rate or the width of QRS
may affect ST.
NOTE
If the algorithm triggers self-learning (either
manually or automatically), the calculation of ST
segment will be reinitialized.
Setting ST analysis
Arrhythmia monitoring
analysis to evaluate patient’s condition (such as change of ECG, arrhythmia algorithm can also
heart rate, PVCs frequency, rhythm and ectopic monitor patients and give proper alarm for
beat) and decide the treatment. Besides detecting arrhythmia.
The monitor can support up to 16 different
arrhythmia analyses.
R on T A type of single PVC under the condition that HR<100, R-R interval is less than 1/3
the average interval, followed by a compensating pause of 1.25X the average R-R
interval (the next R wave advances onto the previous T wave).
PVC Single PVC detected in normal heartbeats, and the number of single PVC ≥4 within
30 s.
Tachy Adult: RR interval for 5 consecutive QRS complex ≤ 0.5 s.
Pediatric/neonatal: RR interval for 5 consecutive QRS complex ≤ 0.375 s.
Brady Adult: RR interval for 5 consecutive QRS complex ≥ 1.5 s.
Pediatric/neonatal: RR interval for 5 consecutive QRS complex ≥ 1 s.
Missed Beat If HR < 120 bpm, no beats are detected for 1.75 times average RR interval; or if
HR ≥ 120 bpm, no beats are detected for one second; or no valid QRS wave is
detected within 3 s or longer.
Irr Rhythm Consistently irregular heart rhythm.
Pacer not Capture No QRS complex detected in 300 ms after a pace pulse.
Pacer not Pacing No pace pulse detected in 1.75 times RR interval after a QRS complex.
Vent Brady 5 consecutive ventricular beats, and ventricular HR < 40 bpm.
Vent Rhythm 5 consecutive ventricular beats, and 40 bpm ≤ ventricular HR < 100 bpm.
PVCs High The measurement value of PVCs is greater than high alarm limit that has been set.
Selecting an ECG lead for Arrhythmia: For non-paced patients, the guidelines are:
In arrhythmia monitoring, it is important to select the – QRS should be tall and narrow (recommended
appropriate lead. amplitude > 0.5 mV)
– R wave should be above or below the baseline classification. Ventricular heartbeat should have a
(but not biphasic) different appearance from “normal heartbeat”.
Physicians should be more alert to these patients.
– T wave should be smaller than 1/3 of the R
wave height. NOTE
– P wave should be smaller than 1/5 of the R Heart rate reading may be affected by cardiac
wave height. arrhythmias. Do not rely entirely on heart rate
alarms when monitoring patients with arrhythmia.
For paced patients, in addition to above guidelines, Always keep these patients under close
the pacemaker signal should also: surveillance.
– not wider than normal QRS
NOTE
– The QRS complexes should be at least twice
Since the arrhythmia detection algorithm
the height of the pacing pulse
sensitivity and specificity is less than 100%,
– large enough to be detected, without sometimes there may be some false arrhythmias
repolarization signal. detected and also some true arrhythmia events
may not be detected. This is especially true when
According to Standard ISO60601-2-27, the
the signal is noisy.
minimum detection level of the QRS complex is set
to 0.15 mV, to prevent the detection of P-wave or
NOTE
baseline noise as QRS complexes. Adjusting ECG
displayed waveform size (gain adjustment) won’t The ventricular HR mentioned above refers to:
influence ECG signals which are used for when the consecutive PVCs number ≥ 5, the
arrhythmia analysis. If the ECG signal is too small, algorithm calculates ventricular HR with the
a false asystole alarm may occur. average of 4-8 RR intervals.
NOTE
If ARR selflearning is performed during ventricular
rhythm, ventricular heartbeats may be erroneously
identified as normal QRS complexes. This may
lead to missed ventricular tachycardia and
ventricular fibrillation events.
Due to this reason, you should:
1 Take care that ARR selflearning may start
automatically;
2 Response to lead off information;
3 Always check the correctness of arrhythmia
alarm.
Order list
For the ECG leadwires and trunk cables, users are For installation of the ECG leadwires and
defined as target group. trunkcables, refer to the chapter Monitoring
procedure in this instruction for use. Pay special
This target group must have received instruction in
attention to all WARNING and -CAUTION
the use of the product and must have the necessary
statements relating to the use of ECG equipment.
training and knowledge to use the product.
The product must be used exclusively by the WARNING
defined target group. Risk of patient injury
Do not operate the medical device in magnetic
Users resonance imaging environments.
ECG leadwires and Trunkcables are not to be
See chapter “Intended user” on page 26. used in X-Ray environment.
During electro surgery the applicable
precautions stated in the instructions for use
For your safety and that of your patients
of the basic device must be observed.
To minimize the risk of patient strangulation,
WARNING carefully position and secure ECG cables.
The medical device must not be modified.
Modifications to the medical device may lead CAUTION
to malfunction. ECG leadwires and trunkcables are intended to
be used with Vista 120 series models only.
WARNING
Before first use inspect the primary packaging. Do
Risk of patient injury
not use the ECG leadwire in case the primary
Do not use damaged or broken items. packaging is damaged.
Otherwise, the correct functioning of the
medical device may be impaired. WARNING
Impedance respiration monitoring and
CAUTION pacemaker spike detection are inoperative
Strictly observe the instructions for use of the when using the blue ESU trunk cables.
basic device on which this medical device is used.
Do not use the blue ESU trunk cables except
during electrosurgery.
Intended use
Cleaning and disinfection of ECG lead wires and 2 Perform surface disinfection (scrub-and-wipe
trunk cables have been tested with the following disinfection).
procedures and agents. At the time of testing, the 3 After the contact time has elapsed, remove
following procedures and agents showed good disinfectant residues.
material compatibility and effectiveness:
Manual disinfection and simultaneous cleaning: WARNING
Risk of electric shock or device malfunction
– Incidin® Extra N by Ecolab
Penetrating liquid may cause malfunction of
– Incidin® Plus by Ecolab
or damage to the reusable ECG cables, which
– Sani-Cloth Active® by Ecolab may endanger the patient.
– Optim 33 TB® by Virox Only scrub-and-wipe-disinfect ECG cables
and make sure no -liquids penetrate into the
– mikrozid® PAA wipes by Schülke
ECG cables.
– Klorsept 17 by Medentech
– Green soap, green soap tincture
(U.S.Pharmacopoeia), or alcohol-free hand Visual inspection
soap;
Check all items for damage and external signs of
– 2% glutaraldehyde solution; wear, such as cracking, embrittlement, or
– Sodium hypochlorite (bleach) solution 10% in pronounced hardening, and residual dirt.
water
WARNING
Risk due to faulty accessories
Even reusable accessories have a limited
service life. If there are external signs of wear,
e.g., cracks, deformations, or peeling,
exchange affected accessories.
Disposal
Ambient conditions
During operation
Temperature 0 °C to 40 °C
Atmospheric pressure 860 to 1060 hPa
Relative humidity 5 % to 95 %, non-
condensing
During storage/transport
Temperature –20 °C to 55 °C
Atmospheric pressure 500 to 1100 hPa
Relative humidity 5 % to 95 %, non-
condensing
The ECG equipment in this chapter meets the
requirements of the standard, ECG TRUNK
CABLES and PATIENT LEADWIRES
ANSI/AAMIEC53.
Monitoring RESP
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Overview
WARNING WARNING
If the user does not set the Hold High and Hold Cardiogenic artifact in impedance respiration
Low for the respiration correctly in manual monitoring may make it difficult to detect
detection mode, it may not be possible for the breaths or may otherwise be counted as
monitor to detect apnea. If the user sets the breaths. In some instances, the breath rate
Hold High and Hold Low too low, the monitor may also correspond to the heart rate making
is more likely to detect cardiac overlay, and to it difficult to determine if the signal is due to
falsely interpret cardiac overlay as respiratory breathing or the cardiac cycle. Do not rely on
activity in the case of apnea. RESP monitoring as the sole method for
detecting cessation of breathing. Follow
WARNING hospital guidelines and best clinical practices
for apnea detection including monitoring
Respiration measurements can not detect all
additional parameters that indicate the
underexposure sudden events, nor can they
patient’s oxygenation status, such as etCO2
distinguish between central, obstructive and
and SpO2.
mixed respiratory asphyxial events. It only
prompts alarm in a predetermined time if the
last breath is detected and the next breath is WARNING
not detected, so it can not be used for For the diagnosis of apnea, especially in
diagnostic purposes. premature infants and infants, the safety and
effectiveness of respiration measurements
WARNING have not been validated.
If operating under conditions according to the
EMC Standard EN 60601-1-2 (Radiated WARNING
Immunity 3 V/m), field strengths above 3 V/m To monitor the respiration, only non-ESU-
may cause erroneous measurements at proof accessories can be used. This is
various frequencies. Therefore it is because the internal impedance of the ESU-
recommended to avoid the use of electrically proof accessories required to be used for
radiating equipment in close proximity to the electrosurgical operation is too large.
respiration measurement unit.
WARNING WARNING
Some implantable pacemakers can adjust Respiration measurement cannot be
their triggering frequency according to the performed when ESU is used.
"minute ventilation rate." Impedance
respiration measurements may cause these WARNING
pacemakers to react incorrectly. To prevent Impedance respiration monitoring is
this, turn off the respiration measurement. inoperative when using the blue ESU trunk
cables.
WARNING
In manual detection mode, after changing the NOTE
gain of the respiration wave, be sure to check The RESP monitoring is not recommended to be
the setting of Hold High and Hold Low. used on patients who are very active, as this can
cause false alarms.
WARNING
When ECG electrode is placed on patient’s
limb, the impedance respiration may be
unreliable.
LA
RA
RE
SP
RL LL
Cardiac overlay
Cardiac activity that affects the RESP waveform is can reduce cardiac overlay: avoid the liver area and
called cardiac overlay. This occurs when RESP the ventricles of the heart in the line between the
electrodes detect impedance changes caused by respiratory electrodes. This is particularly important
rhythmic blood flow. Correct electrode placement for neonates.
Chest expansion
Some patients, especially neonates, expand their left lateral chest areas at the maximum expansion
chests laterally. In this case, place the two point. This placement optimizes respiratory
respiratory electrodes in the right midaxillary and waveform results.
Abdominal breathing
Select the RESP waveform area to display the Select Sweep: Select an appropriate setting
Resp waveform menu: from the pop-up list.
Select AMP and select the desired value.
Larger values increase the waveform
amplitude.
Monitoring SpO2
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Overview
WARNING WARNING
Do not use the SpO2 sensors if the packaging Neonate SpO2 sensor can only be used when
or the sensor is damaged and return them to required, no more than 20 min at a time.
the vendor.
WARNING
WARNING Use only Dräger permitted sensors and
If the SpO2 sensor does not work properly, extension cables with the oximeter. Other
reconnect the sensor or use a new one. sensors or extension cables may cause
improper monitor performance and/or minor
WARNING personal injury.
Correct and proper sensor application: if the
sensor is too loose, it might compromise the WARNING
optical alignment, and even cause the sensor High oxygen levels may predispose a
to fall off. If the sensor is too tight, (such as premature infant to retrolental fibroplasia. If
the application site is too large or becomes this is a consideration do NOT set the high
too large due to edema), excessive pressure alarm limit to 100%, which is equivalent to
and local tissue ischemia, hypoxia and lack of switching the high limit alarm off.
nutrition may occur on the application site.
Prolonged and continuous monitoring may WARNING
increase the risk of skin irritations or When serious arrhythmia is present, the SpO2
lacerations. To avoid these damages, users pulse rate may differ from ECG heart rate but
should periodically check surrounding skin of this does not indicate an inaccurate PR (SpO2)
application site according to the patient's value.
condition and pressure sensor, inspect the if
there is sign of stress-related damage in WARNING
surrounding tissue, and regularly change the
Misapplied sensor or sensor that becomes
application site. For the patients whose fluid is
partially dislodged may cause either over or
easy to transfer and/or the patients with
under reading of actual arterial oxygen
systemic or localized edema, users should
saturation.
inspect the skin and change application site
more frequently.
NOTE NOTE
Avoid placing the sensor on extremities with an SpO2 waveform is not directly proportional to the
arterial catheter, or intravascular venous infusion pulse volume.
line, or inflated NIBP cuff. When measuring SpO2
on the limb with inflated NIBP cuff, please turn on NOTE
the NIBP Simul function. The device is calibrated to display functional
oxygen saturation.
NOTE
When a trend toward patient deoxygenation is NOTE
indicated, analyze the blood samples with a Functional tester or simulator can not be used to
laboratory co-oximeter to completely understand assess the SpO2 accuracy. However, it can be
the patient’s condition. used to demonstrate that a particular monitor
reproduces a calibration curve that has been
NOTE independently demonstrated to meet a particular
If the surrounding temperature increases, the accuracy.
operator should pay attention to the site of poor
perfusion, and increase the frequency of checking NOTE
the skin and changing the measurement site to The cumulative use time for the SpO2 sensor in a
prevent burns. If the initial skin temperature is less single patient should be less than 30 days.
than 35 °C (95 °F), the temperature of all the listed
sensors on the skin will not exceed 41 °C
(105.8 °F) during working.
Measuring SpO2
1 Select the correct patient category setting Before Applying the Sensor
(adult/pediatric and neonatal). This is used to
Be sure to understand all warnings listed in the
optimize the calculation of the SpO2 and pulse
previous section before applying any sensor to a
numerics.
patient. Also,check the sensor as follows:
2 During measurement, ensure that the
Check the sensor outside and inside. To inspect
application site:
the inside, gently open the sensor cavity and
– has a pulsatile flow, ideally with a good check splits on or next to the transparent
circulation perfusion. silicone that covers the optical elements.
– has not changed in its thickness, causing an Any sensor showing signs of damage or
improper fit of the sensor. alteration must not be used for further patient
monitoring; instead, dispose of it using proper
disposal procedures.
Measurement procedure
NOTE NOTE
The SpO2 accuracy has been validated in Clean and remove any substances such as nail
controlled human studies against arterial blood polish from the application site. Periodically check
sample reference measured with a CO-oximeter. to ensure that the sensor remains properly
SpO2 measurements are statistically distributed, positioned on the patient.
only about two-thirds of the measurements can be
expected to fall within the specified accuracy
compared to CO-oximeter measurements. The
volunteer population in the studies are composed
of healthy men and women from age 19 to 37 (for
Dräger SpO2 module), from 18 to 50 (for Nellcor
SpO2 module), with variations of skin
pigmentations. Note that the study population was
healthy adults and not in the actual intended use
population.
NOTE
The pulse rate accuracy is obtained by comparison
to the pulse rate generated with an arterial oxygen
simulator (also an electronic pulse simulator).
NOTE
During monitoring, if the monitor's reading differs
significantly from the patient's physiological
condition, it indicates that the signal may be
disturbed, resulting in an inaccurate reading. In
this case, the artifact can disguise as a similar
reading, causing the monitor to fail to send an
alarm. In order to ensure reliable monitoring, it is
necessary to regularly check whether the sensor is
wearing properly and the signal quality is good.
NOTE
Injected dyes such as methylene blue or
intravascular dyshemoglobins such as
methemoglobin and carboxyhemoglobin may lead
to inaccurate measurements.
NOTE
Inspect the sensor to ensure that the light emitter
and receiver are aligned with each other and there
is no gap between the sensor and the finger. All the
light emitted by the light emitter must pass through
the patient's tissue. The sensor cable should be
placed on the back of the hand.
Measurement limitations
* Only applicable to the Dräger SpO2 module. PI is indicated by a value ranging from 0 to 10. The
bigger the value is, the better the perfusion and the
PI is a numeric value indicating perfusion level. It
signal quality will be. The perfusion level and the
reflects the perfusion level at the monitoring site.
signal quality are at their maximum when the value
As the measurement of SpO2 is based on the reaches 10. When PI is below 2, it indicates the low
pulsation caused by the blood flow through the perfusion and the poor signal quality at the
vessel, PI is in relation to the strength of the pulse. monitoring site; the user needs to reposition the
Also, the user can use PI as a signal quality sensor or find a better site.
indicator for the measurement of SpO2.
The PI value is displayed in the SpO2 parameter area.
There is a delay between a physiological event at 2 The time between the displayed numerical
the measurement site and the corresponding alarm values exceeding an alarm limit and the alarm
at the monitor. This delay has two components: indication on the monitor. This delay is the
combination of the configured alarm delay time
1 The time between the occurrence of the
plus the general system delay time.
physiological event and when this event is
represented by the displayed numerical values.
This delay depends on the algorithmic
processing time and the sensitivity. The lower
the sensitivity configured, the longer the time
needed until the numerical values reflect the
physiological event.
* Only applicable to the Nellcor SpO2 module. level fluctuates near an alarm limit, the alarm is
triggered each time the limit is violated. Such
* Not applicable to Vista 120 CMS.
frequent alarms can be distracting.
With the SatSeconds technique, upper and lower
Describing SatSeconds SpO2 alarm limits are set in the same way as
traditional alarm management. However, the user
With traditional alarm management, upper and can also set a SatSeconds limit that allows
lower alarm limits are set for monitoring oxygen monitoring of SpO2 below the selected lower alarm
saturation. During monitoring, as soon as an alarm limit and above the selected upper alarm limit for a
limit is violated by as little as one percentage point, period of time before an alarm is triggered.
an alarm is immediately triggered. When the SpO2
While measuring SpO2 and NIBP on the same limb set to Off, low perfusion caused by NIBP
simultaneously, the user can set NIBP Simul to On measurement may lead to inaccurate SpO2
in SpO2 Setup menu to lock the SpO2 alarm status readings and therefore cause false physiological
until the NIBP measurement ends. If NIBP Simul is alarms.
Setting sensitivity
Monitoring PR
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Overview
Setting PR Source
Setting PR volume
Select PR Setup > PR Volume, then select the selected, the PR volume will be off. Beat frequency
appropriate setting for the PR volume: five bars of pulse has positive correlation with measurement
represent the maximum volume and one bar value.
represents the minimum volume. If none of bars are
In most cases, the HR and PR numerics are AUTO: If the alarm source is set to AUTO, the
identical. To avoid simultaneous alarms on HR and monitor will use the heart rate from the ECG
PR, the monitor uses either ECG or PR as its active measurement as the alarm source whenever the
alarm source. To change the alarm source, select ECG measurement is switched on and at least one
either ECG Setup > Alarm Source or PR Setup > ECG lead can be measured without a technical
Alarm Source, then select: alarm condition. The monitor will automatically
switch to PR for the alarm source if:
HR: HR is HR/PR alarm source;
a valid ECG lead can no longer be measured
PR: PR is HR/PR alarm source. Be aware that if
and
you select PR as the alarm source, ECG HR alarms
are switched off; a PR source is switched on and available.
NOTE
Pulse alarms are generated only when the active
alarm source is set to PR, a pulse source is set as
system pulse and pulse alarms are switched on.
Monitoring NIBP
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Overview
This monitor uses the oscillometric method for The blood pressure measurements determined
measuring NIBP. It can be used for adult, pediatric with this device comply with the American National
and neonatal patients. It is also intended for use Standard for Electronic or Automated
with pregnant, including pre-eclamptic patients. Sphygmomanometers (ISO 81060-2:2013) in
relation to mean error and standard deviation. In
Oscillometric devices measure the amplitude of
clinical investigation method with a reference
pressure changes in the occluding cuff as the cuff
sphygmomanometer, the fifth Korotkoff sound was
deflates from above systolic pressure. The
used to determine adult diastolic pressure, and the
amplitude suddenly increases as the pulse breaks
fourth Korotkoff sound was used to determine
through the occlusion in the artery. As the cuff
pediatric diastolic pressure. The invasive blood
pressure decreases further, the pulsations increase
pressure is used to determine the neonate
in amplitude, reach a maximum (which
pressure in clinical investigation, and the arterial
approximates to the mean pressure), and then
reference sites include umbilical artery, arteria
diminish.
cruralis, axillary artery, brachial artery, dorsalis
pedis, and radial artery.
WARNING NOTE
Ensure that the correct patient type is selected If the user spills liquid onto the equipment or
before performing measurements. Do not accessories, particularly if there is a chance that it
apply the higher adult inflation, overpressure can get inside the tubing or the measurement
limits and measurement duration for neonatal device, contact service personnel.
patients. Not using the neonate mode on a
neonatal patient can block the blood flow, NOTE
potentially causing harm to the patient. Continuous use of the automatic measuring mode
for short intervals may lead to the discomfort of the
WARNING patient. Continuous measuring and automatic
Make sure that the air tubing connecting the measuring in neonatal or pediatric mode may
blood pressure cuff and the monitor is neither result in tissue damage or ischemia to the patient.
blocked nor tangled.
NOTE
WARNING NIBP measurement can be affected by extremes
Measuring of blood pressure can temporarily of temperature, humidity and altitude.
cause malfunctioning of other medical
monitoring devices on the same limb. NOTE
NIBP measurement value should be explained by
WARNING qualified professionals.
NIBP readings can be affected by the
measurement site, the position of the patient, NOTE
exercise, or the patient's physiologic The pulse rate based on the NIBP measurement
conditions. may differ from the heart rate based on the ECG
waveform. NIBP measures the number of
WARNING peripheral pulse pulsations, and the heart rate is
Continuous cuff pressure due to connection measured by the electrical signal of the heart.
tubing kinking can block the blood flow, and When the electrical signals of the heart
may result in injury to the patient. occasionally fail to cause the peripheral blood
vessels to pulse or the patient's peripheral
WARNING perfusion is poor, the difference happens.
Verifying the calibration is only applicable for
adults, and it cannot be operated in automatic NOTE
measuring interval. Continuous measuring The cumulative use time for the NIBP cuff in a
cannot be operated in automatic measuring single patient should be less than 30 days.
interval either.
NOTE
Do not start NIBP measurements during low
battery conditions (the monitor may turn off
automatically).
NOTE
If an alarm occurs or measurement fails,
discontinue the measurement.
Measurement limitations
Measurement procedures
To obtain accurate measurements, the following 5 Check if the patient type is appropriate. Access
operating steps need to be observed: the Patient Setup menu from Menu. Turn the
knob to select the desired patient Type in the
1 Ensure the patient position in normal use,
Patient Info. menu.
including:
6 Select a measurement mode and NIBP Unit
Comfortably seated (or lie flat on back)
(mmHg, kPa or cmH2O, 1 mmHg=0.133 kPa,
Legs uncrossed 1 mmHg=1.36 cmH2O) in the NIBP Setup
menu. Refer to chapter “Operation prompts” for
Feet flat on the floor
information.
Back and arm supported
7 Press the button on the front panel or
2 Make sure the patient relaxes as much as
possible and neither talking nor applying shortcut key on the main screen to start a
external pressure against the cuff. Rest for five measurement.
minutes in a quiet environment. 8 Wait until the first reading is taken.
3 Connect the air hose and switch on the monitor.
NOTE
4 Attach the blood pressure cuff to the patient's The width of the cuff is either approximately 40%
arm or leg and follow the following instructions. of the limb circumference or 2/3 of the upper arm
length. The inflatable part of the cuff should be
long enough to encircle 80-100% of the limb. The
wrong size of cuff can cause erroneous readings.
If the cuff size is in question, use another cuff with
suitable size to avoid errors.
NOTE
If an NIBP measurement is suspect, repeat the
measurement. If you are still uncertain about the
reading, use another method to measure the blood
pressure.
– Ensure that the cuff is completely deflated.
– Attach the appropriate size cuff to the NOTE
patient (For information about cuff size Please make sure the cuff is well connected. A
selection, refer to the chapter "NIBP leak of air may cause measurement error.
accessories"), and ensure the symbol "Φ" is
over the artery. Ensure that middle of the
NOTE
cuff is at the level of the right atrium of the
heart and the cuff is not wrapped too tightly Please select the cuff with the suitable size. An
around the limb. Excessive tightness can unsuitable cuff may cause incorrect
cause discoloration and ischemia of the measurements.
extremity.
NOTE
Avoid incursion of liquid into the cuff. If this
happens, please desiccate the cuff completely.
Operation prompts
Resetting NIBP
Calibrating NIBP
Leak test
1 Connect the cuff securely with the socket for If the prompt of Leakage Test Ok appears, it
NIBP air hole. indicates that the airway is in good condition and no
air leaks exist. However if the alarm information of
2 Wrap the cuff around the cylinder of an NIBP Leak appears, it indicates that the airway
appropriate size, don’t wrap the cuff around might have air leaks. In this case, the user should
limbs. check for loose connections. After confirming
3 Make sure the patient type has been set to secure connections, the user should re-perform the
Adult. pneumatic test. If the failure prompt still appears,
contact DrägerService.
4 Access User Maintain > NIBP Maintain.
5 Turn the knob to the Leakage Test item and Monitor Cylinder
press the item. Then the prompt of Leak. Test
Running will appear indicating that the system Cuff
has started performing the leak test. NIBP
Assisting Venipuncture
NOTE
When the monitor is in DEMO mode, continuous
measurement process, or auto measurement
process, Assisting Venipuncture function is not
available.
Monitoring TEMP
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Overview
Body temperature is measured using a thermistor Two TEMP probes can be used simultaneously
probe (a semiconductor whose resistance changes to measure two TEMP values. The monitor
with temperature) placed appropriately on the automatically calculates the temperature
patient. difference. The default configuration is skin sensor
for adult.
CAUTION WARNING
Place a protective rubber sheath over the probe to Prior to use, make sure that the temperature
prevent the possibility of burns during probe is not damaged and that it is correctly
electrosurgery or defibrillation. Do not use surface applied to the patient. Otherwise, the correct
probes during electrosurgery. functioning of the medical device may be
impaired.
WARNING
Verify probe cables fault detection before NOTE
using the probe to monitor the patient. If the Disposable TEMP probe can only be used once
temperature probe cable of channel 1 is per patient.
unplugged from the socket, the screen will
display the error message TEMP1 SENSOR NOTE
OFF and the audible alarm is activated. It is the The reference body site temperature is the same
same for the other channel. as the temperature of the measuring site.
WARNING NOTE
Handle the TEMP probe and cable carefully. The cumulative use time for the oral or rectal
When they are not in use, the probe and cable temperature probe in a single patient should be
should be coiled into a loose circle. Pulling less than 24 hours.
the wire inside the cable may mechanically
damage the probe and the cable. NOTE
Cover internally placed reusable temperature
WARNING sensors with temperature probe sheaths.
Remember to disinfect the reusable TEMP
probe after each use on a patient.
WARNING
Risk of patient injury. Do not operate the
device in magnetic resonance imaging
environments.
The user can choose the TEMP sensor type as the To configure the TEMP sensor type, select Menu >
temperature signal source. Maintenance > User Maintain > Other Setups,
and set TEMP Sensor to YSI-10K or YSI-2.252K.
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Overview
IBP is measured by means of a catheter inserted The monitor measures direct blood pressure of one
into the circulatory system. A pressure transducer selected blood vessel and displays waveforms and
connected to the catheter converts the mechanical numerics for the measured direct blood pressure
force exerted by the blood into an electrical signal. (SYS, DIA and MAP).
This is displayed graphically as pressure versus
For further information on the IBP Kit, refer to the
time and as numerics on the monitor screen.
accompanying Instructions for Use of the
manufacturer.
WARNING WARNING
The operator should avoid contact with the All invasive procedures have risks to the
conductive parts of the device when it is patient. Use aseptic technique and follow
connected to the patient. catheter manufacturer's instructions.
WARNING WARNING
When the monitor is used with HF surgical Mechanical shock to the invasive blood
equipment, the transducer and the cables pressure transducer may cause severe shifts
must be avoided from conductive connection in zero and calibration, and then cause
to the HF equipment. This is to protect against erroneous readings.
burns to the patient.
NOTE
WARNING Use only the pressure transducer listed in the IBP
Disposable IBP transducer or domes should accessories.
not be reused.
NOTE
WARNING If measuring intracranial pressure (ICP) on a
sitting patient, adjust the transducer on the same
If any kind of liquid, other than solution to be
level with the top of the patient’s ear. Incorrect
infused in pressure line or transducer, is
leveling may lead incorrect values.
splashed on the equipment or its accessories,
or enters the transducer or the monitor,
NOTE
contact service personnel immediately.
Confirm you set correct alarm limit for labels, the
alarm limit you set are stored for its label only.
WARNING
Changing label may change the alarm limit.
The longest duration of IBP arterial
catheterization is 7 days. NOTE
Don’t perform IBP calibration when a patient is
being monitored.
NOTE
When using high frequency ventilation, make sure
that the ventilator catheter is not connected to or
indirectly connected to the arterial catheter at zero
pressure. This can lead to less pressure
variations, thus interfere the zeroing process.
Monitoring procedures
Preparatory steps for IBP measurement: 5 Position the transducer so that it is at the same
level as the patient’s heart, approximately mid-
1 Connect the pressure cable to the
axillary line.
corresponding socket and switch on the
monitor. 6 For the label name selection, refer to chapter
“Selecting a pressure for monitoring”.
2 Prepare the flush solution.
7 To zero the transducer, refer to chapter “Zeroing
3 Flush through the system, exhaust all air from
the pressure transducer”.
the tube, ensure that the transducer and
stopcocks are free of air bubbles.
WARNING
4 Connect the patient catheter to the pressure If there are air bubbles in the tube system, you
line, making sure that there is no air present in should flush the system with the solution
the catheter or pressure line. again. The bubbles may cause erroneous
pressure readings.
IBP calibration
The top, middle and bottom rulers are available for 1 Open the menu Wave Setup of IBP by clicking
each channel of IBP waveform. Users can adjust on the IBP waveform area.
the top, middle or bottom rulers manually:
2 Select a suitable ruler from the options
TopRuler, MidRuler and BotRuler.
The monitor can display IBP overlapped 4 After exiting the interface, the main screen will
waveforms. To set IBP waveform overlapping: display the overlapped IBP waves. The flashing
label is the main label of the waveform area.
1 Select Menu > Maintenance > User Maintain
> Other Setups, and set IBP Wave Click the IBP overlapping waveform area on the
Overlapping to On or Off. main screen, and then select Setup Rulers. The
user can select a suitable ruler for the overlapped
2 Click the IBP waveform area to show the IBP
waveforms from the options TopRuler and
Wave Setup menu.
BotRuler.
3 Select Add IBP Waves and then select the IBP
waves for overlapping from the pop-up list. A
maximum of four overlapping waveforms can
be displayed.
Measuring PAWP
WARNING
If the PAWP (mean) is greater than the PA
(systolic), deflate the balloon and report the
incident in accordance with hospital policy,
because the pulmonary artery could be
accidently ruptured, and the PAWP value
derived will not reflect the patient’s
hemodynamic state, but will merely reflect the
pressure in the catheter or balloon.
Calculating PPV
Pulse Pressure Variation (PPV) is calculated from 1 Click the PPV parameter area to enter PPV
the specific arterial pressure values, which reflects Setup menu.
the variation between the maximal pulse pressure
2 Select Art, P1, P2, or AUTO as PPV Source.
and the minimum pulse pressure in 30 s. Pulse
pressure is affected by left ventricular-stroke Only when P1 and P2 are arterial pressure can they
volume, arterial resistance and arterial compliance. be selected as PPV source. When it is set to AUTO
and if there is more than one arterial pressure at the
WARNING same time, the priority level should be: Art > P1 >
The clinical value of the derived PPV P2.
information must be determined by a
physician. According to recent scientific
literature, the PPV information is restricted to
sedated patients who receive controlled
mechanical ventilation and without
arrhythmia. Whether the calculation results in
other situations are clinically significant,
applicable and reliable must be determined by
a physician.
WARNING
In below situations, the calculated PPV value
may be inaccurate:
– the respiration rate is lower than 8 rpm
– the tidal volume during ventilation is lower
than 8 ml/kg
– patients have acute right ventricular
functional disorder (pulmonary heart
disease)
WARNING
PPV measurement has been validated only for
adult patients.
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Overview
The monitor provides the sidestream and concentration will compute according to the
mainstream methods for CO2 monitoring. Dräger detecting CO2 absorption intensity of patient
G2 module and Respironics Sidestream CO2 sample.
module are used for sidestream measuring, and
Sidestream measurement takes a sample of the
Respironics Mainstream CO2 module and Dräger
respiratory gas with a constant sample flow
Mainstream CO2 module M11.1 are used for
from the patient’s airway and analyzes it with a
mainstream measuring. Respironics CO2 module
remote CO2 sensor. The user can measure
is plug-and-play and the monitor can automatically
Sidestream CO2 using the monitor’s built-in
identify sidestream and mainstream modules.
CO2 measurement. Respiration rate is
The principle of CO2 measurement is primarily calculated by measuring the time interval
based on the fact that CO2 molecule can absorb 4.3 between detected breaths.
μm infrared ray. Absorption intensity is proportional
Mainstream measurement uses a CO2 sensor
to CO2 concentration of patient sample, the CO2
attached to an airway adapter directly inserted
into the patient’s breathing system.
WARNING WARNING
Do not use the device in the environment with The accuracy of the CO2 measurement will be
flammable anesthetic gas. affected by the following reasons: the airway
was highly obstructed; a leaky airway
WARNING connection or quick variation of environment
temperature.
The device should be used by trained and
qualified medical personnel.
WARNING
WARNING Follow precautions for electrostatic discharge
Nitrous oxide, elevated levels of oxygen, (ESD) and electromagnetic interference (EMI)
helium, xenon, halogenated hydrocarbons, to and from other equipment.
and barometric pressure can influence the
CO2 measurement. WARNING
Do not place the sensor cables or tubing in a
WARNING way that may cause tangling or strangulation.
The monitor will be damaged if any pipeline
from the CO2 module’s air tube/the air inlet/the WARNING
air outlet are plugged by water or other When using mechanical ventilation, gas
materials. compensation should be well set.
Inappropriate setting may cause incorrect
measurement result.
WARNING WARNING
Respironics module is not equipped with The CO2 module temporally stops measuring
automatic air pressure compensation, before during zeroing.
you start the CO2 measurement for the first
time, you must set the correct altitude. NOTE
Incorrect altitude settings can cause incorrect After the low battery alarm appears, do not start
CO2 readings. Dräger G2 module is equipped the CO2 measurement. The monitor may turn off
with automatic air pressure compensation, from lack of battery power.
and manual setting is not required.
NOTE
WARNING
For disposal of hospital waste such as
Leakage in the respiratory system or sampling accumulated fluids, calibration gases, sampled
system may result in a significant low display gases, where not otherwise specified, follow local
of the etCO2 value. Always keep all regulations regarding disposal of hospital waste.
components connected firmly and check for
leaks according to standard clinical NOTE
procedures.
If the measurement or sensor fails, stop
measurement before the qualified service
WARNING personnel solves the problem.
The etCO2 reading is not always closely
related to the paCO2 value, especially in NOTE
neonatal patients, and patients with The cumulative use time for the sampling line in a
pulmonary disease, with pulmonary embolism single patient should be less than 30 days.
or inappropriate ventilation.
NOTE
WARNING Disconnect the water trap from the holder or set
Don’t measure CO2 while nebulized Work Mode to Standby when the module is not in
medications are being delivered. use. Setting path: CO2 Setup > Work Mode >
Standby.
Monitoring procedures
2 In the CO2 Setup menu, set Work Mode to 2 Connect the sampling cannula or the sampling
Measure. line to the water trap.
3 Select Zero Calibration in CO2 Setup menu. 3 Set Work Mode to Measure.
4 After the zeroing calibration is completed, the 4 For intubated patients, an airway adapter is
zeroing message disappears, and the CO2 required. For non-intubated patients, place the
monitoring can be performed. If the monitor nasal cannula or the sampling mask onto the
displays Breath Detected or Zero Required, patient.
zeroing has failed. Zero calibration must be CAUTION
performed again.
The water trap collects water drops condensed in
For the Respironics Mainstream CO2 Module: the sampling line and therefore prevents them
from entering the module. If the water trap is
1 Wait until the monitor’s warm-up message
nearly filled, the user should replace it to avoid
disappears; correctly install the mainstream
blocking the airway.
CO2 sensor to airway adaptor and remove it
from breathing circuit, keep the monitor away
CAUTION
from CO2 source.
Based on a sample gas temperature of +37 °C
2 In the CO2 Setup menu, set Work Mode to (+98.6 °F), a room temperature of +23 °C
Measure. (+73.4 °F) and sample relative humidity of 100%,
3 Select Zero Calibration in CO2 Setup menu. the water trap will be filled after approximately
90 hours with the flowrate of 100 ml/min and
4 After the zeroing calibration is completed, the approximately 130 hours with the flowrate of
zeroing message disappears, and the CO2 70 ml/min. In clinical practice, the water trap can
monitoring can be performed. If the monitor be used for a longer time before it is filled. It is
displays Breath Detected or Zero Required, recommended to replace the water trap once
zeroing has failed. Zero calibration must be every month.
performed again.
CAUTION
NOTE When replacing the water trap or suspecting the
CO2 source includes ventilator, patient’s and measurement value, check if the O-rings of the
operator’s breath. water trap holder are normal and well installed.
If the O-rings get damaged or loose, contact
DrägerService.
CAUTION
To prevent the module from abnormal work,
please ensure the water trap detection button is
not mistakenly touched.
CAUTION
Replace and discard the water trap when
blocking. Don’t reuse it, otherwise the reading is
not accurate and even the device may be
damaged.
NOTE
To avoid patient cross infection, do not connect the NOTE
exhaust tube to the ventilator circuit. If the sampled The user must perform a zero calibration as
gas is returned to the breathing system, always described in this procedure each time the ambient
use the bacterial filter of the sample gas return kit. temperature changes more than 10 °C (50 °F) (for
example during transport).
Respironics Sidestream Module
NOTE
1 Plug the sensor cable into the monitor’s CO2
input connector. Allow the sensor two minutes Always connect the airway adapter to the sensor
for warm-up. before inserting the airway adapter into the
breathing circuit. In reverse, always remove the
2 Appropriately connect the cannula, airway airway adapter from the breathing circuit before
adapter or sample line to the sensor. It will click removing the sensor.
into place when seated correctly.
3 To zero the sensor, refer to zeroing the sensor. NOTE
Always disconnect the cannula, airway adapter or
4 For intubated patients, an airway adapter is
sample line from the sensor when the sensor is not
required;
in use.
NOTE
To extend the lifetime of the module, set Work
Mode to Standby when the module is not in use.
NOTE
The sidestream CO2 module continuously extracts
a quantity of gas from the patient's airway per
minute. Please do not use this module in any
patient who will be affected by this sampling rate.
NOTE
If the catheter falls off during the measurement, it
For non-intubated patients: Place the nasal is necessary to re-zero after the catheter is well
cannula onto the patient. connected, and then measurement can be
performed.
WARNING
Do not connect the exhaust tube to the
ventilator circuit, connect the outlet to a
scavenging system, cross infection can occur
if sampling gas is returned to the breathing
system. When using the sidestream CO2
measurement on patients who are receiving or
have recently received anesthetics, avoid
exposing medical staff to anesthetics.
WARNING
No routine user calibration is required.
4 To zero the sensor, refer to zeroing the sensor. 5 Insert the airway adapter with vertically
Zeroing must be done without any airway positioned windows between endotracheal tube
adapter in room air. and ventilator circuit (Y-piece).
Checking the calibration of the CO2 sensor with
a test filter
Perform the calibration check of the CO2 sensor
with a test filter at intervals of one month.
Open the menu CO2 Waveform Setup by clicking 1 Set Mode to Curve or Filled as desired.
on the CO2 waveform area:
2 Set Sweep to an appropriate value from the
pop-up list. The larger the value, the faster the
speed.
Temperature, water vapor in the patient’s breath, For the Respironics CO2 modules, there are Baro
barometric pressure, and the proportions of O2, Press, O2 Compens, Anes Agent and Balance
N2O and Helium in the mixture all influence CO2 Gas in the CO2 Other Setup menu. For Dräger
absorption. If values seem inaccurately high or low, MCable Mainstream CO2 module, there are Baro
check that the monitor is using the appropriate Press, O2 Compens., N2O Compen., He
corrections. Compens. and Xe Compens. in the CO2 Other
Setup menu.The concentration of compensated
For Dräger G2 module, the following items are
gas (including O2 and AG) should be set based on
available in the CO2 Other Setup menu: N2O
the current gas concentration which is supplied for
Compen., O2 Compens., Anest. Agent, Vapor
patient. The selection of balance gas depends on
Compen. and Pump Rate. The concentration of
actual situation. For instance, N2O should be
compensated gas should be set based on the
selected as balance gas if the real balance gas is
current gas concentration which is supplied for
N2O.
patient. As for O2 and N2O, Make the supplied gas
concentration multiply to its volume to get the After settings, the interface will display a dialog box:
concentration. For instance, supply 100% O2, and Confirm to change the settings? And the detailed
its volume is 60%, then O2 compensation is: settings are displayed under the warning. Click Yes
100%*60%=60%. AG concentration is decided by to confirm, and click No to cancel the settings.
anaesthesia apparatus.
NOTE
Make sure compensation value is correctly set,
otherwise the measurement accuracy may be
affected.
WARNING
Safety and effectiveness of the respiration
measurement method in the detection of
apnea, particularly the apnea of prematurity
and apnea of infancy, has not been
established.
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Overview
The cardiac output (C.O.) measurement invasively pulmonary artery floating catheter, and the C.O.
measures cardiac output and other hemodynamic value is calculated by using the temperature
parameters by using the Thermodilution method. dilution curve.
The Thermodilution method is to inject a cold
As C.O. is a variable value, a series of
solution into the blood circulation system and
measurements must be carried out to obtain a
measure the temperature changes caused by the
reliable and average C.O. value. Always use the
cold solution through the thermistor of the
average of multiple measurements for thereapy
decisions. The monitor can save a maximum of 6
measurement results.
WARNING NOTE
Make sure that the C.O. accessories conform To replace the catheter thermistor, enter the
with the applicable medical device safety catheter computation coefficient into the Constant
requirements and regulations and are applied item according to the instruction.
in correspondence with the C.O. accessories'
instructions for use. NOTE
Please set injection switch well. The calculation of
WARNING the cardiac output is based on the state of the
C.O. accessories should be avoided from injection switch at the end of the measurement.
contact with conductive metal body when Therefore, after the selection of the injection
being connected or applied. switch is completed, don’t change until the
measurement is completed.
WARNING
NOTE
All invasive procedures involve risks to the
patient. Use aseptic technique and follow Start C.O. measurement after blood temperature is
catheter manufacturer's instructions. stable, otherwise the measurement may fail.
WARNING
The C.O. measurement results may be
incorrect during electrosurgery.
WARNING
C.O. floating catheter shall be removed or
reinserted after 3 days.
C.O. Monitoring
1 Monitor 5 Injectate
2 Thermodilution Catheter 6 Delivery System
3 Cardiac Output Cable 7 In-line injectate Temperature probe
4 Injectate Sensor Housing
3 Open the patient information window to confirm INJ. TEMP Source: Select Auto or Manual
the patients’ height and weight. from the list, when set as Manual, the system
directly displays the injectate temperature from
4 In C.O. Setup menu, set:
INJ. TEMP. Ensure INJ. TEMP is correct,
C.O. Constant: The computation constant is otherwise the C.O. measurement may be
associated with catheter and injectate volume. affected. When set as Auto, the system obtains
When the catheter is changed, adjust Constant the injectate temperature through sampling.
in the C.O. Setup menu based on product
description provided by the manufacturer. After
user’s confirmation, the setup takes effect.
1 Pick the C.O. Measure item in the C.O. Option 10 X axis: Change the Scale X (time) value.
menu. The C.O. Measure menu displays as Two modes are available: 0 s to 30 s, 0 s
below: to 60 s. If you start measurement in the 0
s to 30 s mode, it will be switched to 0 s to
60 s mode automatically if the
3 measurement can not finish within 30 s.
4 After the switch, no further adjustment can
5 be made to the Scale X.
6
1 7 11 Y axis: Change the scale Y (temperature)
8 value. Three modes are available: 0 °C
(+32 °F) to +0.5 °C (+32.9 °F), 0 °C
(+32 °F) to +1 °C (+33.8 °F), 0 °C (+32 °F)
2 to +2.0 °C (+35.6 °F). Adjust the scale by
10 11 the temperature differences. A smaller
9 scale results in a larger curve.
The functional keys on the C.O. measure window
1 Measurement curve
are explained in the following table:
2 Prompt message area
3 Cardiac Output Start Start a measurement.
4 Cardiac Index Stop If the blood temperature cannot
resume in a considerably long time,
5 Body Surface Area the measurement could not stop
6 Blood Temperature automatically. Use this button to stop
7 Injectate Temperature the measurement and display the
C.O., CI calculation result.
8 Start time of the measurement
Cancel Cancel the processing measurement or
9 Function keys cancel the result after measurement.
Record Print out the curve.
Review Enter the Review window.
2 3
Flotation catheter
Pulmonary artery
Air cell
Thermal resistance
Right atrium
Right ventricle
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Operation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Safety information. . . . . . . . . . . . . . . . . . . . . . . 177
Multigas monitoring setup. . . . . . . . . . . . . . . . . 178
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . 186
Overview
Intended use
NOTE
The Scio Four modules are hereafter referred to as
“gas analyzer”.
Getting started
Switch on the gas analyzer 1 Connect the mains plug if necessary and set the
device switch on the back to the ON position.
To prevent condensation and resulting failure of
electrical components, do not switch on the device
after abrupt temperature changes for 1 to 2 hours
(e.g., after storage in unheated rooms).
WARNING WARNING
Risk of inaccurate gas measurement values. Risk of inaccurate gas measurement values.
During warm-up, reported values may not be When the monitor is used with a gas analyzer,
accurate. Refer to the Technical Data appendix it meets the Class A limits of CISPR11. The
in the gas analyzer supplement for further system is not intended for connection to
information regarding gas analyzer accuracy. public mains due to possible line-conducted
disturbances.
Operation
NOTE
Disconnect the water trap from the holder or set
Work Mode to Standby when the module is not in
use. Setting path: AG Setup > Work Mode > NOTE
Standby. If alarms are disabled, crossed-out bell icons
appear next to the corresponding parameter
values.
Multigas monitoring setup The monitor does not alarm for CO2 (AG) limit
violations until it has established a valid respiratory
The gas analyzer parameters are displayed in the rate.
CO2 (AG), O2 (in some models only), N2O and
anesthetic agent parameter boxes. Each has its To access the CO2 (AG) setup menu, click on the
own setup menu, described on the following pages. CO2 (AG) parameter box.
To execute CO2 (AG) setup functions, click on the
following items:
NOTE
The monitor does not alarm for inspiratory and
expiratory oxygen limit violations until it has
established a valid respiratory rate.
O2 Setup menu
Menu item Description Settings
Work Mode Sets the Scio status to Measure or Standby Measure, Standby
Unit Sets the units for the concentration %, mmHg, kPa
Zero Calibration Manually zeroes the Scio module Not applicable
EtO2 Alarm setup Sets the Alarm switch, Record switch, Level, and Alarm switch: ON, OFF
Alarm limits
FiO2 Alarm Setup Record switch: ON, OFF
Level: High, Med., Low
Alarm limits: digitals
Default Restores all menu setup to factory default Not applicable
Monitoring of N2O
The N2O waveform indicates the instantaneous
N2O concentrations. The N2O parameter box
displays the following parameters:
Inspired N2O (FiN2O) - The level of N2O in the NOTE
airway during the inspiration phase.
The monitor does not alarm for inspiratory and
Expired N2O (etN2O) - The level of N2O in the expiratory N2O limit violations until it has
airway during the expiration phase. established a valid respiratory rate.
Typical N2O parameter box displays are shown
To access the N2O setup menu, click on the N2O
below
parameter box.
To access the N2O waveform setup menu, click on the N2O waveform area.
To execute N2O waveform setup functions, click on the following items:
NOTE
If two agents are detected, the one with the higher
expired MAC value is regarded as the primary
agent.
The monitor does not alarm for Inspiratory and
expiratory agent limit violations until it has
established a valid respiratory rate.
Manual agent ID If the gas analyzer has not yet identified or cannot
identify an agent (e.g. due to too low agent
NOTE
concentrations, a leaking vaporizer, or traces of
The manual agent ID setup is only relevant for gas disinfectants), the agent parameter box displays
analyzers without automatic agent recognition - the message AA or AA1.
Scio Four and Scio Four Oxi.
2 Click on the drop-down list of Agent When the gas analyzer detects a mix of two or more
anesthetic agents, the displayed agent waveform
3 Click and select the desired agent ID.
reflects the agent with the highest level of
WARNING concentration.
Risk due to inaccurate gas measurement The color of the waveform represents the agent
values with the highest level of concentration. If there is a
Use care when setting agent ID manually. change of the anesthetic agent during monitoring,
Measurements will be inaccurate if the wrong the parameter box displays the message
agent ID is selected. AG Agent Mixture and replaces the concentration
values with -?-. The mixed label in waveform area
WARNING indicates only the agent that has the highest level
of concentration. This label will switch to that of the
Risk due to inaccurate gas measurement
second administered agent when its concentration
values
exceeds that of the first agent.
Measurements using a gas analyzer without
automatic agent recognition will be inaccurate
Standard MAC values
if anesthetic gases are mixed.
NOTE
NOTE When the gas analyzer is connected to the
The agent ID resets to blank upon a power cycle or monitor, users need to access the MAC Setup
patient discharge. menu to determine if Standard MAC, Age-based
MAC or no MAC is displayed.
Automatic agent ID The minimum alveolar concentration (MAC) value
NOTE of the agent is a simple navigation aid for anesthetic
The automatic agent ID setup is only relevant for agent delivery.
gas analyzers with automatic agent recognition - 1 standard MAC is equal to the alveolar anesthetic
Scio Four plus and Scio Four Oxi plus. concentration at one atmosphere (760 mmHg) at
which 50 % of all patients no longer respond to
These gas analyzers are able to automatically noxious stimuli. The integrated MAC algorithm is
identify up to two anesthetic agents, even in based on the MAC values shown in the following
mixtures. Then the specific agent (e.g. HAL) will be table. The values specified in the table apply to a
show in the parameter box.
patient age of 40 years and are guiding values only. For gas mixtures, the respective multiples for N2O
The binding values are specified on the package and anesthetic agents are added according to the
information leaflet of the anesthetic agent. following equation.
Zeroing
The gas analyzer purges and zeroes itself and does
not need any interaction by the user. Waveforms
flatline and parameter box values blank from the
screen during this cycle. Status messages are as
follows:
Troubleshooting
If gas measurement fails, the patient can no The following table lists the alarm messages in
longer be adequately monitored. alphabetical order. If an alarm occurs, the table
– Ensure corresponding substitute monitoring. helps to quickly identify causes and remedies. The
– Check sample line and water trap for damage possible causes and remedial measures should be
or blockage and resolve these as needed. looked through in the order they are listed until the
– Observe the prescribed exchange intervals. alarm is resolved.
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Overview
Bispectral Index monitoring helps to monitor the Note: This chart reflects a general association
hypnotic state of the brain based on acquisition and between clinical state and BIS values. Ranges are
processing of EEG signals. The monitor processes based on results from a multi-center study of the BIS
raw EEG signals to produce a single number, involving the administration of specific anesthetic
namely BIS, which correlates with the patient's agents. BIS values and ranges assume that the EEG
level of hypnosis. The user can view the BIS is free of artifacts that can affect its performance.
measurement result via connected CMS. Titration of anesthetics to BIS range should be
dependent upon the individual goals established for
The BISx device provides the monitor with the each patient. These goals and associated BIS ranges
display consisting of: may vary over time and in the context of patient status
and treatment plan.
BIS EEG waveform
– SQI: The SQI numeric reflects the signal quality
BIS trend
for the EEG channel source and provides
Measure values of BIS, SQI, SR, SEF, TP and information about the reliability of the BIS, SR,
BC SEF, TP and BC numerics during the last
– BIS: The BIS numeric reflects the patient’s level minute. It ranges from 0% to 100%:
of consciousness. It ranges from 100 (fully 0% to15%: the numerics cannot be derived.
awake) to 0 (absence of electrical brain
activity). The BIS range guidelines are 15% to 50%: the numerics cannot be reliably
derived.
illustrated in the following chart.
50% to 100%: the numerics are reliable.
– SR: The SR is the percentage of time over the
BIS Range and Clinical State
last 63-second period that the signal is
100 Awake considered to be in the suppressed state.
Responds to normal voice – SEF: The SEF is a frequency below which 95%
80 Light/ Moderate Sedation of the total power is measured.
May respond to loud commands or – TP: The TP numeric indicates the power in the
BIS Index Range
EMG bar graph: The EMG bar graph displays No bar represents power less than 30.
the power (in decibels) in the frequency range
1 bar represents power in the 30-38 range.
70 Hz -110 Hz. This frequency range contains
power from muscle activity (i.e., 2 bars represent power in the 39-47 range.
electromyography or “EMG”) as well as power
3 bars represent power in the 48-55 range.
from other high-frequency artifacts. When the
indicator is low, it indicates that EMG activity is 4 bars represent power greater than 55.
low. BIS monitoring conditions are optimal when
the bar is empty.
WARNING WARNING
Explosion hazard: Do not use the BISx device To reduce the hazard of burns during use of
in a flammable atmosphere or where high- frequency surgical equipment, the
concentrations of flammable anesthetics may sensor or electrodes should not be located
occur. between the surgical site and the electro-
surgical unit return electrode.
WARNING
The BISx device is not designed for use in MRI WARNING
environment. The conductive parts of electrodes or sensor
and connectors should not contact other
WARNING conductive parts, including earth.
The use of accessory equipment not
complying with the equivalent safety WARNING
requirements of this equipment may lead to a To reduce the hazard of burns during use of
reduced level of safety of the resulting brain-stimulating devices (e.g., transcranial
system. Consideration relating to the choice electrical motor evoked potential), place
shall include: use of the accessory in the stimulating electrodes as far as possible from
patient vicinity; evidence that the safety the BIS sensor and make certain that sensor is
certification of the accessory has been placed according to package instructions.
performed in accordance to the appropriate
IEC 60601-1 harmonized national standard. WARNING
The sensor must not be located between
WARNING defibrillator pads when a defibrillator is used
Due to elevated surface temperature, do not on a patient connected to the BISx device.
place the BISx device in prolonged direct
contact with patient’s skin, as it may cause WARNING
discomfort.
To minimize the risk of patient strangulation,
the patient interface cable (PIC) must be
carefully placed and secured.
WARNING CAUTION
Universal precautions shall be observed to When connecting or disconnecting the BISx
prevent contact with blood or other potentially device, take care not to touch the exposed
infectious materials. Place contaminated contacts of either connector. Damage due to
materials in regulated waste container. electrostatic discharge may result.
WARNING CAUTION
Whenever an event such as spillage of blood Using accessories other than those specified may
or solutions occurs, re-test ground leakage result in increased electromagnetic emissions or
current before further use. decreased electromagnetic immunity of the BISx
device.
WARNING
Do not reuse the BIS sensor. CAUTION
The BISx device should not be used adjacent to
CAUTION or stacked with other equipment. If adjacent or
stacked use is necessary, the BISx device should
Do not autoclave the BISx device. Autoclaving will
be observed to verify normal operation in the
seriously damage the components.
configuration in which it will be used.
CAUTION
NOTE
Do not open the BISx device for any reason.
The BIS measurements are very sensitive
measurements that measure very small signals.
CAUTION Technological limitations don't allow higher
The BISx device has been designed to operate immunity levels than 1 V/m for radiated RF
with a BIS sensor. The sensor is a silver/silver electromagnetic fields and 1 Vrms for conducted
chloride electrode array that utilizes Aspect's disturbances induced by RF fields.
patented Zipprep™ technology and uses a Electromagnetic fields with field strengths above
proprietary connector. Use of other electrodes is 1 V/m and conducted disturbances above 1 Vrms
not recommended. may cause erroneous measurements. Therefore
Dräger recommends that you avoid using
CAUTION electrically radiating equipment in the close
proximity of these measurements.
Considerations when using Electro-Convulsive
Therapy (ECT) equipment during BIS monitoring:
Place ECT electrodes as far as possible from the
BIS sensor to minimize the effect of interference.
Certain ECT equipment may interfere with the
proper function of the BISx device. Check for
compatibility of equipment during patient setup.
CAUTION
Avoid liquid ingress to the Patient Interface Cable.
Contact of fluids with the PIC sensor connector
can interfere with PIC performance.
BISx device
Patient interface
cable (PIC)
Adapter cable
The continuous impedance check is always active This is done continuously and does not affect the
to enable you to understand the sensor condition in EEG wave. As long as the impedances are within
real time. It checks: the valid range, no prompt message of this check or
its results will be announced
The combined impedance of the signal
electrodes and the reference electrode The impedance of the ground electrode
This is done every ten minutes and takes the ground electrode does not pass the check,
approximately four seconds. It causes an artifact in another check will be performed. This continues
the EEG wave, and the monitor will announce BIS until the ground electrode passes the check.
Ground Check on the screen during the check. If
The smoothing rate defines how the monitor Contrarily, the monitor provides a smoother BIS
averages the BIS value. With the decline in trend with decreased variability and sensitivity to
smoothing rate, the monitor provides increased artifacts.
responsiveness to changes in the patient’s state.
To change the smoothing rate, open the BIS Setup
menu and set Smoothing Rate to 10 sec, 15 sec
or 30 sec.
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Ventilator/Anesthesia Machine
Monitoring Interface . . . . . . . . . . . . . . . . . . . . 201
Overview
Ensure the ventilator/anesthesia machine and the can select Menu > Maintenance > User Maintain
monitor share the same baud rate, thus they can be > Medibus Maintain > Baud Rate and choose
well communicated. To set the baud rate, the user 9600 or 19200 from the drop-down list.
To open the Medibus/X window, the user can press Depending on the device connected, the
Medibus/X window varies. There’re three kinds of
the shortcut key on the screen directly or user interfaces: ventilator monitoring interface,
select Menu > Display Setup > View Selection > anesthesia machine monitoring interface, and
Medibus/X. respiratory loop interface. When the device is
Respiratory loops can indicate a fault in the airway F-V (flow-volume) loops: it illustrates the
tubing and help physicians to detect respiratory dynamic relation between flow and volume
problems of patients. during respiration and provides information
about condition of the airway tubing.
The two types of loops are available in real time:
P-V (pressure-volume) loops: it reflects the
dynamic relation between pressure and volume
as well as compliance of the respiratory system.
Viewing Loops
1 Respiratory loop
2 Timestamp of the saved respiratory loop
3 Measurement value
Up to four loops of each kind can be stored for Selecting the timestamp of a currently hidden loop
reference. When the number of stored loops is over can review the loop. The color-coded loops tell
four, the latest stored loops will replace the whether the loop is currently displayed or not. If
previously stored loops. there is no whole respiratory loop detected within
15 s, the loop cannot be saved.
To save the current loop, click on Save in the
respiratory loop interface. When it is successfully
stored, a timestamp will be displayed in the
rectangle box.
Physiological alarm limits and alarms from the When it is set to On and the user selects the the
ventilator/anesthesia machine are transmitted to
the monitor. If external device generates
physiological alarms about exceeding the alarm permanent key , the XX Comm. Failed
limits, the monitor prompts visual alarms to notify alarm (including visual and audio alarm indications)
users. The alarms are always non-latching on the will be cleared, even if the alarm condition still
monitor, and announced as a flashing numeric with exists, the monitor won’t generate this technical
alarm. If a new alarm occurs after the alarm is reset,
parameter alarm off icon while the alarm the new alarm will be sounding.
condition persists.
NOTE
When the external device has communication The physiological alarm limits are non-adjustable
failure, the monitor will trigger XX Comm. Failed on the monitor; the users can adjust them on
alarm (XX represents one of the external devices ventilator/anesthesia machine if necessary.
connected.). To configure Clear Comm Fail Alarm
(V/A) function, select Menu > Maintenance > User
Maintain > Alarm Setup and choose Clear Comm
Fail Alarm (V/A) which can be set to On or Off.
Freeze
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206
Overview
When monitoring a patient, the user can freeze Upon freezing, the system exits all other
waveforms and examine them. The Freeze function operating menus. The system freezes all
has the following features: waveforms in the Waveform area of the Basic
Screen, the Full Lead ECG waveforms and
Freeze status can be activated on any
extra waveforms on the Full Lead ECG
operating screen.
interface (if any). The Parameter area refreshes
normally.
The frozen waveforms can be reviewed and
recorded.
Entering freeze status After exiting Freeze status, the system will clear
screen waveforms and resume displaying real-time
waveforms. In the Screen Refresh mode, the
In the non-Freeze status, press the hardkey on
system will sweep the waveforms from left to right
the monitor control panel to exit the current menu. in the Waveform Area.
Press the button again, freeze status is entered
and the popup Freeze menu is displayed. In Freeze Press the hardkey on the control panel, and the
status, all waveforms are frozen and will not be Freeze menu will appear on the bottom part of the
refreshed. screen. At the same time, the system freezes the
waveforms.
NOTE
Exiting freeze status
Pressing the hardkey repeatedly over a short
Executing any of the following operations will exit period of time may result in discontinuous
Freeze status: waveforms on the screen.
1 Exit the Freeze menu;
2 Press hardkey on the control panel again;
3 When the freeze time expires;
4 Execute any operation that triggers the
adjustment of the screen or displays a new
menu.
By setting the freeze duration, the monitor can exit 1 On the Freeze menu, select Freeze Duration.
freeze status automatically after certain period. To
2 Select the desired setting from the pop-up list.
set the freeze duration:
None/1/2/3/4/5/10/15/20/30/60 min are
optional. When None is selected, the user can
exit freeze status manually based on the actual
situation.
Review
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Overview
To review the trend Graph, press the shortcut key Select Parameter and you can choose the
required parameters to be displayed in the trend
on the screen or select Menu > Review >
graph.
Trend Graph.
To display a different parameter’s trend, you
In the trend graph, the y-axis is the measurement
can either:
value and x-axis represents time. With the
exception of NIBP, other trends are displayed as
continuous curves. Select beside the parameter name and
choose the desired parameter from the pop-
up list (as shown in red circle above).
In the trend graph review window: Select and to scroll the screen left and
right manually to browse the trend graph.
Select Trend Table to switch to the trend table
interface.
NIBP review
Alarm review
To review the alarm event, press the shortcut key Select Event Type to choose the required
parameter from the popup list and the user can
on the screen or select Menu > Review >
review alarm event of the specific parameters.
Alarm Review.
Select Time Index to set end time of alarm
In the alarm review window: review.
Current Time: the alarm events occurring Select Record to print out the alarm events by
before the current time are displayed on the the recorder.
alarm event review interface.
When an alarm event occurs, all the measurement
User Define: the user can define the review numerics and related waveform 4 (8 or 16) s before
time by setting time box displayed on the and after the event are stored. To set the waveform
interface. The alarm events occurring length, select Menu > Alarm Setup > Alarm Rec.
before the User Define option are displayed Time. 8 s, 16 s and 32 s are optional.
on the alarm event review interface.
NOTE
Select and to browse more alarm The monitor can store a maximum of 200 alarm
events. events. As soon as the alarm event storage is full,
the earliest alarm event will be replaced by the
latest one.
ARR review
Selecting waveform
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Overview
Drug Calculation
Drug Unit
Drug A, Drug B, Drug C, Aminophylline, Dobutamine, DopaminE, g, mg, mcg
Epinephrine, IsupreL, Lidocaine, Nipride, Nitroglycerin
Drug D, Pitocin, Heparin Ku, mu, Unit
Drug E mEq
Titration Table
Hemodynamic Calculation
Output Parameters
LVSW g·m Left ventricular stroke work 0.136 × (AP MAP – PAWP) × SV
EF % Ejection fraction SV / EDV × 100%
SVI ml/m2 Stroke volume index SV / BSA
SVRI DS·m2/cm5 Systemic vascular resistance index SVR × BSA
PVRI DS·m2/cm5 Pulmonary vascular resistance index PVR × BSA
LCWI kg·m/m2 Left cardiac work index LCW / BSA
LVSWI 2 Left ventricular stroke work index LVSW / BSA
g·m/m
RCW kg·m Right cardiac work 0.0136 × PA MAP × C.O.
RVSW g·m Right ventricular stroke work 0.0136 × (PAP-PAWP) × SV
BSA m2 Body surface area Weight0.425 × Height0.725 × 0.007184
RCWI kg·m/m2 Right cardiac work index RCW / BSA
RVSWI 2 Right ventricular stroke work index RVSW / BSA
g·m/m
Oxygenation Calculation
Calculation Procedure
1 Select Menu > Common Function >
Calculation > Oxygenation.
2 Manually enter the values required on this
interface. The user can also directly obtain the
values of patient height, patient weight, C.O.
and FiO2 if they are available from the monitor
by selecting Get Info.
3 Select Calculate to output parameter value.
Input Parameters
Output Parameters
English Full
Items Unit Formula
Name/Description
BSA m2 Body surface area Weight0.425 × Height0.725 × 0.007184
VO2 ml/(min.m2) Oxygen consumption Ca-v O2 × CI
CaO2 ml/L Arterial oxygen content Hb × 1.34 × SaO2/100% + (0.0031 × PaO2)
CvO2 ml/L Venous oxygen content Hb × 1.34 × SvO2/100% + (0.0031 × PvO2)
Arterial venous oxygen
Ca-v O2 ml/L CaO2 – CvO2
content difference
O2ER / Oxygen extraction ratio (VO2 / DO2) × 100%
DO2 ml/(min.m2) Oxygen transport CaO2 × CI
Partial pressure of PiO2-PACO2 × [FiO2/100% + (1-
PAO2 mmHg
oxygen in the alveoli FiO2/100%) / RQ]
Alveolar-arterial oxygen
AaDO2 mmHg PAO2 – PaO2
difference
CC’O2 ml/L Capillary oxygen content PAO2 × 0.003 + 1.34 × SaO2/100% × Hb
Qs/Qt / Venous admixture (CC’O2 – CaO2) / (CC’O2 – CvO2) × 100%
C.O. L/min Cardiac output VO2 /( Ca-v O2 × BSA)
AaDO2/PaO2 / Spiro-index (PAO2 – PaO2) / PaO2× 100%
DO2I ml/(min.m2) Oxygen delivery index DO2/BSA
Oxygen consumption
VO2I ml/(min.m2) index
VO2/BSA
Ventilation Calculation
Output Parameters
Calculation Procedure
1 Select Menu > Common Function >
Calculation > Renal Function.
2 Manually enter the values required on this
interface.
3 Select Calculate to output parameter value.
Input Parameters
Output Parameters
Strip recording
General information
NOTE
Do not use the strip recorder with a low battery as
recorder usage will more quickly deplete the
battery.
Proper operation
NOTE
2 Insert a new roll of paper into the paper Be careful when inserting paper. Avoid damaging
cassette, printing side facing upwards. the thermo-sensitive print head. Do not leave the
strip recorder door open except to insert paper or
troubleshoot printing problems.
NOTE
If the monitor is not installed with a strip recorder,
it will indicate Recorder Setup Needed after
pressing the Record button in the dialog box.
NOTE
Do not touch the thermo-sensitive print head when
performing continuous recording.
Other Functions
Nurse call
The monitor provides a dedicated nurse call port 3 Choose On in the Nurse Call list.
which can be connected to the hospital’s nurse call
system. The user should activate the function
NOTE
following the steps below:
Before using nurse call function, check whether it
1 Select Menu > Maintenance > User Maintain, is working normally.
and input the password;
2 Select Other Setups > Aux Output;
The monitor provides analog output signals to 1 Select Menu > Maintenance > User Maintain,
accessory equipment. Also, if a defibrillator is and input the password;
connected to the monitor, a defibrillator
2 Select Other Setups > Aux Output;
synchronization pulse can be output. The user
should activate the function following the steps 3 Choose Analog Output or Defibrillation in the
below: Aux Output list.
Wi-Fi (optional)
Wi-Fi modules are optional to be configured in the 4 Choose a network from the window, in which
monitors. And The user should configure the the user can check the network’s encryption
settings on the monitor following the steps below information (Security). The user will be
before connecting the monitor to a wireless prompted to enter the password of that network
network: if a password is required. After entering the
password and setting the IPv4 address, the
1 Select Menu > Maintenance > User Maintain,
and input the password. user can click to connect the network.
2 In the User Maintain menu, select Network
Maintain. 5 Or select to connect the hidden networks.
After entering Network Name, Security,
3 In the Network Maintain menu, select Wi-Fi password and setting the IPv4 address, the
from the Network Type list. And click Config to
open the Wi-Fi Setup window. The available user can click to connect the hidden
networks will be listed in this window. network.
The monitor can detect the storage space The monitor is switched off.
threshold. Select Menu > Common Function > The power supply is off.
Data Store and set Threshold Detection to On.
When the removable device is newly inserted and
its remaining storage space is less than 300 M, the Selecting a Storage Device
monitor will stop storing data, prompting The space
in U disk is less than 300 M. Please clean it up.. To configure the storage device, select Menu >
The user needs to clean up the space manually till Common Function > Data Store > Storage
the remaining space is more than 300 M, thus the Medium, and choose the storage medium from the
monitor will keep storing data. pop-up list as desired. Internal Storage Device
and Removable Device can be selected.
When Internal Storage Device is selected as the
storage medium, if configured, the storage device
name will automatically become Internal Storage
Device. When Removable Device is selected as
the storage medium, the user may plug several Deleting Data Stored in the Storage
removable devices into the monitor at the same Device
time, but only one is operative. The user can select
a removable device as a working one among the To delete data of one patient, choose the patient
plugging devices by selecting Menu > Common from the list after selecting Menu > Review >
Function > Data Store > Storage Device and History Patient, and then click Delete Data on the
choosing the device name from the list. By default, Review menu. Further confirmation of deletion is
the first plugged removable device is the working required.
one.
To delete data of all patients, select Menu >
After configuring the appropriate storage device, Review > History Patient and click Delete all data
click exit. If the storage device is successfully on the History Patient Review menu. Further
starting data storing, the monitor will be indicated confirmation is required.
by the symbol . If there is no enough space in
storage device, or the storage device is read-
Exporting data stored in the internal
only/damaged, the symbol will be displayed. storage device
CAUTION
Formatting the internal storage device
It is recommended to format the USB flash drive To format the internal storage device, select Menu
to the FAT file type via PC prior to use. > Maintenance > User Maintain > Other Setups
> Format internal storage device. Further
confirmation is required.
Reviewing Data Stored in the Storage
Device NOTE
As soon as the internal storage device is
To review data stored in the storage device, select formatted, all the data will be cleared.
Menu > Review > History Patient. The user can
choose to review the storage device as desired NOTE
from the pop-up list. Choose a patient from the list
You have no need to restart the monitor after
to review the data including patient information,
formatting is successful. The internal storage
trend graph, trend table, NIBP measurements,
device can be identified and loaded automatically.
arrhythmia event, alarm event, and full disclosure
waveform. The user can choose to record trend
graph, trend table, NIBP measurements, and full
disclosure waveform via recorder.
NOTE
If formatting is failed, try again. Restart the monitor
and retry the formatting, or contact the service
personnel of the manufacturer if formatting is failed
repeatedly.
Using battery
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Overview
This monitor can run on battery, which ensures the interrupted, the monitor will take power from the
uninterrupted operation even when AC power internal battery. If the monitor is powered by battery,
supply is interrupted. The battery recharges the monitor will switch off automatically before the
whenever the monitor is connected to the AC battery is completely depleted.
power source. During monitoring, if the AC power is
NOTE WARNING
Remove the battery from the monitor when the Do not connect the positive (+) and negative
monitor is not used for a long period of time. (-) terminals with metal objects, and do not put
the battery together with metal objects, which
The performance of rechargeable batteries may can result in short circuits.
deteriorate over time. The battery should be
conditioned regularly as follows: WARNING
1 Disconnect the patient from the monitor and Do not destroy, disassemble or modify the
stop all monitoring and measurement. battery in any way. Do not short circuit the
battery, or its terminals, to a metal object.
2 Switch the monitor power on and charge the
battery for more than 6 hours continuously.
WARNING
3 Disconnect the monitor and let it run until there
Do not unplug the battery while the monitor is
is no battery power remaining and the monitor
working.
shuts off.
4 Reconnect the monitor to mains. WARNING
This should improve the battery running time. If the Do not heat or throw battery into a fire.
running time is less than listed in the specification,
change the battery or contact the customer service. WARNING
Do not use, leave the battery close to fire or
WARNING other places where temperature may be above
Before using the rechargeable lithium-ion +60 °C.
battery (hereinafter called battery), be sure to
read these Instructions for Use and follow all
WARNING
safety precautions.
Do not immerse, throw, or wet battery in
water/seawater.
WARNING
The service life of the battery depends on the
WARNING
service interval. The service life of the battery
is about three years if the battery is well Do not destroy the battery: do not pierce the
maintained and stored. The service life of the battery with a sharp object such as a needle;
battery may shorten if it is used do not hit with a hammer, step on or throw or
inappropriately. If the battery life is exhausted drop to cause strong shock; do not
and not replaced in time, it may cause damage disassemble or modify the battery.
or heat to the device.
WARNING
WARNING The recommended battery can only be used
Periodic checks on the battery performance for this monitor. Do not connect battery
are required. Change the battery if necessary. directly to an electric outlet or cigarette lighter
charger.
WARNING WARNING
Do not solder the leading wire and the battery Stop using the battery if abnormal heat, odor,
terminal directly. discoloration, damage, deformation, or
abnormal condition is detected during use,
WARNING charge, or storage. Keep it away from the
If liquid leaking from the battery gets into monitor.
eyes, do not rub eyes. Wash them well with
clean water and go to see a doctor WARNING
immediately. If liquid leaks of the battery Do not use a battery with serious scratch or
splash onto skin or clothes, wash well with deformation.
fresh water immediately.
WARNING
WARNING When the monitor is running on battery power,
If leakage or foul odor is detected, ensure that do not replace the battery during monitoring
there’s no fire around. patients; or the monitor will be powered off,
which may result in patient injury.
WARNING
Do not place battery in the monitor with the (+)
and (-) in the wrong way.
WARNING
Replacement of lithium batteries or fuel cells
by inadequately trained personnel would
result in an unacceptable risk (e.g., excessive
temperatures, fire or explosion).
To install or replace the battery: 1 Pull the battery door downwards to open it.
2 Pull the metal retainer until the battery can be
removed.
3 Insert the new battery into the battery
compartment.
4 Pull the metal retainer downward to fix the
battery and close the battery door.
Battery door
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
Cleaning the monitor . . . . . . . . . . . . . . . . . . . . 245
Cleaning the Reusable Accessories. . . . . . . . . 245
Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
Disinfecting the Monitor . . . . . . . . . . . . . . . . . . 246
Disinfecting the Reusable Accessories . . . . . . 247
Overview
Use only the Dräger-approved substances and Dräger has validated the cleaning and disinfection
methods listed in this chapter to clean or disinfect instructions included in this User Manual. It is the
the equipment. The warranty does not cover responsibility of the healthcare professional to
damage caused by using unapproved substances ensure that the instructions are followed so as to
or methods. ensure adequate cleaning and disinfection.
Dräger makes no claims regarding the efficacy of
the listed chemicals or methods as a means for
controlling infection. Contact infectious disease
experts in the hospital for details.
General points
Keep the monitor, cables and accessories free of Do not pour liquid onto the system.
dust and dirt. To prevent the device from damage,
Do not allow liquid to enter the case.
follow the procedure:
Never use abrasive material (such as steel wool
Use only recommended cleaning substances
or silver polish).
and disinfectants listed in this manual. Others
may cause damage (not covered by warranty), Inspect the monitor and reusable accessories
reduce product lifetime or cause safety after they are cleaned and disinfected.
hazards.
CAUTION
Always dilute according to the manufacturer’s
If the user spills liquid on the equipment, battery,
instructions.
or accessories, or they are accidentally immersed
Unless otherwise specified, do not immerse any in liquid, contact service personnel or Dräger
part of the equipment or any accessories in service engineer.
liquid.
Cleaning
If the device or accessory has been in contact with Mild near neutral detergent
the patient, then cleaning and disinfection is
Ethanol (75%)
required after every use. If there has been no
patient contact and there is no visible Isopropanol (70%)
contamination then daily cleaning and disinfection
Cleaning agents should be applied and removed
is appropriate.
using a clean, soft, non-abrasive cloth or paper
The validated cleaning agents for cleaning the towel.
monitor and reusable accessories are:
Cleaning the monitor 3 Rinse the cuff and after cleaning, wipe off the
cleaning solution with a fresh cloth or towel
dampened with tap water until no visible
CAUTION cleaning agent remains.
Before cleaning the monitor, make sure that the
monitor is switched off and disconnected from the 4 Wipe off residual moisture with a dry cloth.
power line. 5 Air dry the cuff thoroughly after cleaning.
To surface-clean the monitor, follow these steps: Replacing the Air Bladder:
1 Switch off the monitor and disconnect it from the After cleaning, replace the air bladder into the cuff
power line. following the steps below:
2 Wipe the entire exterior surface, including the 1 Roll the bladder lengthwise and insert it into the
screen, of the equipment using a soft cloth cuff from the large opening at one end of the
dampened with the cleaning solution thoroughly cuff.
until no visible contaminants remain. 2 Thread the hose from within the cuff and out
3 After cleaning, wipe off the cleaning solution through the small hole at the top of the cuff.
with a fresh cloth or towel dampened with tap 3 Adjust the bladder until it is in position.
water until no visible cleaning agent remains.
4 Dry the monitor in a ventilated and cool place. Cleaning the SpO2 Sensor
1 Wipe the surfaces of the sensor and cable using
Cleaning the Reusable Accessories a soft cloth dampened with the cleaning solution
until no visible contaminants remain.
Cleaning the ECG Cable Assembly 2 Wipe the patient contact area of the sensor with
the cotton swab dampened with the cleaning
1 Wipe the cable assembly with a soft cloth solution. until no visible contaminants remain.
dampened with the cleaning solution until no
visible contaminants remain. 3 After cleaning, wipe off the cleaning solution
with a fresh cloth or towel dampened with tap
2 After cleaning, wipe off the cleaning solution water until no visible cleaning agent remains.
with a fresh cloth or towel dampened with tap
water until no visible cleaning agent remains. 4 Wipe off residual moisture with a dry cloth.
3 Wipe off residual moisture with a dry cloth. 5 Leave the sensor to air dry.
2 Hand wash the cuff with the cleaning solution; 2 After cleaning, wipe off the cleaning solution
clean the air bladder with a soft cloth dampened with a fresh cloth or towel dampened with tap
with the cleaning solution until no visible water until no visible cleaning agent remains.
contaminants remain. 3 Wipe off residual moisture with a dry cloth.
4 Leave the cables to air dry.
Cleaning the TEMP Sensor 3 Wipe off residual moisture with a dry cloth.
1 Wipe the patient contact area with a soft cloth 4 Leave the sensor/probe to air dry.
dampened with the cleaning solution until no
visible contaminants remain.
2 After cleaning, wipe off the cleaning solution
with a fresh cloth or towel dampened with tap
water until no visible cleaning agent remains.
Disinfection
Ethanol (75%)
WARNING
Isopropanol (70%) Before disinfecting the monitor, make sure
Cidex OPA (High level disinfection of that the monitor is switched off and
intracavitary temperature probe only) disconnected from the power line.
If Ethanol or Isopropanol is used for both cleaning To disinfect the monitor, follow these steps:
and disinfecting, then a new cloth is required to be
used for the disinfection step. 1 Switch off the monitor and disconnect it from the
power line.
CAUTION
2 Wipe the display screen using a soft, clean cloth
Do not use any disinfectant containing additional dampened with the disinfectant solution.
active ingredients other than those listed, such as
disinfectant didecyl dimethyl ammonium bromide 3 Wipe the exterior surface of the equipment
which contains quanternary ammonium salt. using a soft cloth dampened with the
disinfectant solution.
CAUTION 4 Wipe off the disinfectant solution with a dry cloth
Although the monitor is chemically resistant to after disinfection if necessary.
most common hospital cleaners, disinfectants
5 Dry the monitor for at least 30 minutes in a
and non-caustic detergents, unvalidated cleaners
ventilated and cool place.
or disinfectants are not recommended and may
stain the monitor, such as disinfectant didecyl
dimethyl ammonium bromide which contains
quanternary ammonium salt.
Disinfecting the Blood Pressure Cuff The intracavitary TEMP sensors should be
reprocessed by high-level disinfection before and
Disinfecting the Cuff: after use on each new patient. Cidex OPA is the
1 Take out the air bladder before disinfection. validated agent for high level disinfection. Refer to
the instructions of the disinfectant for the methods
2 Wipe the cuff and the air bladder with a soft of disinfection. High level disinfection has been
cloth dampened with the disinfectant solution. validated with a 12 minute soak. Rinse and dry
3 Leave the cuff and air bladder to air dry for at according to the labeled instructions of Cidex OPA.
least 30 minutes. Do not dampen the sensor connector.
Replacing the Air Bladder: For the skin TEMP sensors, disinfect them as
follows using ethanol or isopropanol only:
After disinfection, replace the air bladder into the
cuff. Refer to Section Cleaning the blood pressure 1 Wipe the patient contact area with a soft cloth
cuff for more information. dampened with the disinfectant solution
(ethanol or isopropanol).
NOTE
Prolonged use of disinfectant may cause 2 Wipe off the disinfectant solution with a dry cloth
discoloration of the cuff. after disinfection.
3 Leave the sensor to air dry.
Disinfecting the SpO2 Sensor
1 Wipe the surfaces of the sensor and cable using NOTE
a soft cloth dampened with the disinfection Do not use phenol disinfectants because vinyl
solution. absorbs them. Do not use strong aromatic,
chlorinated, ketone, ether or ester solvents. Do not
2 Wipe the patient contact area of the sensor with
immerse the cables for any prolonged period in
the cotton swab dampened with the disinfection
alcohol, mild organic solvents, or highly alkaline
solution.
solutions. Never boil or autoclave the cable. Vinyl
3 Wipe off the disinfection solution with a dry cloth withstands temperatures up to 100 °C but begins
after disinfection. to soften at around 90 °C. Handle gently when hot
and wipe away from the tip toward the cable.
4 Leave the sensor to air dry for at least 30
minutes.
Maintenance
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Overview
WARNING WARNING
Failure on the part of the responsible If the user finds any problems with the
institution to implement a satisfactory equipment, contact service personnel or
maintenance schedule may cause undue authorized supplier.
equipment failure and possible health
hazards. WARNING
The maintenance operations such as software
WARNING upgrade of the device shall only be conducted
If the monitor is mechanically damaged, or if it by Dräger-qualified service professionals.
is not working properly, do not use it. Contact
technical personnel. WARNING
Any serious incident that has occurred in
relation to the device should be reported to
the manufacturer and the competent authority
of the Member State in which the user and/or
patient is established.
Inspection
The overall check of the monitor, including the If grounding resistance and leakage function
safety check, should be performed by trained properly.
service personnel every 24 months, and following
If any damage or abnormality is found, do not use
repair.
the monitor and contact customer support.
The following items should be checked:
Maintenance shall be carried out at least once
If the environmental condition and power supply every two years, or as specified by local
meet requirements. regulations. The following tasks are for Dräger-
qualified service professionals only. Contact an
If the power supply cord is damaged and the
Dräger-qualified service provider if the monitor
insulation is not cut.
needs a safety or performance test. Clean and
If the device and accessories are damaged. disinfect equipment to decontaminate it before
testing or maintaining it.
Specified accessories.
If the alarm system works properly.
If the recorder works properly and there is
sufficient paper.
Battery performance
If all monitoring functions are in good condition.
Repair
Replacing fuse
Disposal
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Overview
CAUTION
The device and its components must be
disinfected and cleaned before disposal!
Accessories
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Overview
ECG accessories
* Note: For use with the following part numbers: 2612020, 2612021, 2612024, 2612025.
SpO2 accessories
NIBP accessories
Temp accessories
IBP accessories
CO2 accessories
C.O. Accessories
NOTE
The Thermodilution Catheter is required when
measuring C.O.. Swan-Ganz catheter (Type
131HF7 and 741HF7), manufactured by Edwards
Lifesciences Corporation, has been validated to be
compatible with the monitor. Refer to Edwards for
more details.
BIS Accessories
Device accessories
NOTE
The part description may vary depending on
context, but the part number is constant.
Technical data
Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Wi-Fi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
3-, 5-lead monitoring . . . . . . . . . . . . . . . . . . . . 272
RESP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
NIBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
SpO2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
PR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
TEMP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
IBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
CO2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
C.O. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
AG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
BIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Interfaces. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Overview
NOTE
The performance of the equipment with ☆ mark is
determined to be essential performance.
Classification
Device specifications
Function configuration
Vista 120S ECG, RESP, TEMP, SpO2 (Dräger), NIBP, AG, IBP, C.O., CO2
C (Dräger G2), CO2(Respironics C5, LoFlo), CO2 (Dräger MCable)
Wired network, Wi-Fi, recorder
Ambient conditions
WARNING
The monitor may not meet the performance
specifications given here if stored or used
outside the specified temperature, humidity
and altitude ranges.
Temperature
Operating +0 °C to +40 °C (+32 °F to +104 °F)
Transport and storage -20 °C to +55 °C (-4 °F to +131 °F)
Relative humidity
Operating 15%RH to 95%RH (non-condensing)
Transport and storage 15%RH to 95%RH (non-condensing)
Ambient pressure
Operating 86 kPa to 106 kPa
Transport and storage 70 kPa to 106 kPa
Leakage current
Power supply
Display
Recorder
Record width 48 mm
Paper speed 12.5 mm/s, 25 mm/s, 50 mm/s
Trace Up to 3
Recording types Continual real-time recording
8-second/20-second real-time recording
Trend graph recording
Trend table recording
NIBP review recording
Arrhythmia review recording
Alarm review recording
C.O. measurement recording
Frozen waveform recording
Drug calculation titration recording
Hemodynamic Calculation result recording
Oxygenation Calculation result recording
Ventilation Calculation result recording
Renal Function Calculation result recording
Data management
Data review
Data storage
Wi-Fi
IEEE 802.11b/g/n
ECG
Pace Pulse
Pace Pulse Detecting Lead: one among I, II, III, AVR, AVL, AVF, V
Heart Rate
HR Calculation
Resolution 1 bpm
☆ QRS Detection Range The detection range has exceeded the requirement described in
the standard:
Width: 70 ms~120 ms for adult, 40 ms~120 ms for
Pediatric/neonate.
Amplitude: 0.5 mv~5 mv
In adult mode, these two signals are not responded:
1 when QRS amplitude of 0.15 mV or less is applied;
2 when QRS duration of 10 ms and QRS amplitude of 1 mV or
less is applied.
Complied with IEC 60601-2-27: 2011, Sect. 201.12.1.101.15.
PVC
Resolution 1 PVCs/min
ST value
Resolution 0.01 mV
HR Averaging Method
Normal Adult: 0.5 s < RR interval for 5 consecutive QRS complex < 1.5 s.
Pediatric/neonatal: 0.375 s < RR interval for 5 consecutive QRS
complex < 1 s.
Ventricular Tachycardia The interval of 5 consecutive ventricular beats is less than 600 ms
Ventricular Rhythm The interval of 5 consecutive ventricular beats ranges from 600 ms to
1000 ms
Ventricular Bradycardia The interval of 5 consecutive ventricular beats is more than 1000 ms
☆ Tall T-wave Rejection Complied with IEC 60601-2-27: 2011, Sect. 201.12.1.101.17
minimum recommended 1.2 mV T-Wave amplitude
Accuracy of Heart Rate Meter Complied with IEC 60601-2-27: 2011, Sect. 201.7.9.2.9.101 b) 4),
and Response to Irregular the HR value after 20 s of stabilization is displayed as follows:
Rhythm Ventricular bigeminy: 80 bpm±1 bpm
Slow alternating ventricular bigeminy: 60 bpm±1 bpm
Rapid alternating ventricular bigeminy: 120 bpm±1 bpm
Bidirectional systoles: 91 bpm±1 bpm
RESP
NIBP
Method Oscillometric
☆ Measuring range
Adult/Pediatric 120 s
Neonate 90 s
Pre-inflation pressure
Venipuncture pressure
SpO2
Resolution 1%
☆ Accuracy
Sensor
PI (Perfusion Index)
Resolution 1
Nellcor Module
Resolution 1%
DS-100A, OXI-A/N(Adult): ± 3%
OXI-A/N(Neonate): ± 4%
☆ Accuracy D-YS (Infant to Adult): ± 3%
(70% to 100% SpO2) D-YS (Neonate): ± 4%
D-YS with D-YSE Ear Clip: ± 3.5%
MAX-FAST: ± 2%
NOTE
Information about the wave length range can be
especially useful to clinicians (for instance, when
photodynamic therapy is performed).
PR
TEMP
Channel 2
Unit °C, °F
NOTE NOTE
The accuracy consists of two parts, as following: The claimed response time is valid without probe
covers.
Accuracy (not including sensor): ± 0.1 °C
(± 32.18 ºF)
Sensor accuracy: ≤ ±0.2 °C (± 32.36 ºF)
IBP
Channel 3 channels
Resolution 1 mmHg
Pressure sensor
Sensitivity 5 μV/V/mmHg
CO2
G2 Module.
Measure
etCO2, FiCO2, AwRR
Parameters
etCO2 1 mmHg
AwRR 1 rpm
AwRR ± 1 rpm
Drift of Measure
Meets the requirements of the measure accuracy
Accuracy
Sample Gas
70 ml/min or 100 ml/min(default), accuracy: ±15 ml/min
Flowrate
Warm-upTime Display reading within 20 s; reach to the designed accuracy within 2 minutes.
< 400 ms (with 2 m gas sampling tube, sample gas flowrate: 100 ml/min)
Rise Time
<500 ms (with 2 m gas sampling tube, sample gas flowrate: 70 ml/min)
< 4 s (water trap with 2 m gas sampling tube, sample gas flowrate: 100 ml/min)
Response Time
<4 s (with 2 m gas sampling tube, sample gas flowrate: 70 ml/min)
Range: 0% to 100%
O2 Compensation Resolution: 1%
Default: 16%
Range: 0% to 100%
N2O
Resolution: 1%
Compensation
Default: 0%
Range: 0% to 20%
AG
Resolution: 0.1%
Compensation
Default: 0%
Humidity
Compensation ATPD(default), BTPS
Method
Barometric
Automatic (The change of barometric pressure will not add additional errors to
Pressure
the measurement values.)
Compensation
etCO2 Change1 AwRR ≤ 80 rpm, meet the with 2 m gas sampling tube, sample gas
accuracy mentioned above; flowrate: 100 ml/min)
AwRR >80 rpm, etCO2
descending 8%
AwRR >120 rpm, etCO2
descending 10%
AwRR ≤ 60 rpm, meet the with 2 m gas sampling tube, sample gas
accuracy mentioned above; flowrate: 70 ml/min)
AwRR > 60 rpm, EtCO2
descends 8%;
AwRR > 90 rpm, EtCO2
descends 10%;
AwRR > 120 rpm, EtCO2
descends 15%;
NOTE
Use a test device equivalent to EN ISO 80601-2-55
fig 201.101 to measure at 1:2 I/E ratio. Respiration
rate accuracy is determined by frequency of
device, and end-tidal gas reading change refers to
the nominal value.
☆ Measuring Range
FiCO2 1 mmHg
AwRR 1 rpm
O2 Compensation
Range 0% to 100%
Resolution 1%
Default 16%
Range 0% to 20%
Resolution 0.1%
Default 0.0%
Stability
Sensor Response Time < 3 s, including transport time and rise time
(sidestream)
Quantitative Effect
NOTE
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. 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.
☆ Measuring Range
FiCO2 1 mmHg
AwRR 1 rpm
O2 Compensation
Range 0% to 100%
Resolution 1%
Default 16%
N2O Compensation
Range 0% to 100%
Resolution 1%
Default 0%
He Compensation
Range 0% to 100%
Resolution 1%
Default 0%
Xe Compensation
Range 0% to 100%
Resolution 1%
Default 0%
*blood concentration equivalent spilled onto the airway adapter windows and of
contamination, as long as still some measurement
NOTE
light passes the airway adapter windows, is largely
The numbers given at the end of each line are compensated for, water droplets and other window
typical CO2 readings of the sensor for the pure contamination may slightly influence measurement
interfering gas or vapour, balance N2 (if bias, up to 0.3 Vol.% approximately at 5 Vol.% CO2
applicable), without CO2 content. CO2 reading of (normally much less). Precision, of course,
common mixtures like CO2, O2, N2O, anaesthetic worsens if less light passes (i.e., noise of reading
agent (in physiological concentration) or CO2, O2, gets higher). After some time, water droplets are
N2, water vapour is within specified bias, provided heated away.
that the major foreign gases (see above: O2, N2O,
He, Xe) are entered to the sensor. If measurement light is blocked such that noise of
reading gets unacceptably high, an error message
Effects of Humidity or Condensate: is sent from the CO2 sensor indicating that the
airway adapter has to be checked (cleaned or
The airway adapter windows are indirectly heated
replaced).
via the sensor to prevent moisture condensation.
While by sensor design the effect of water droplets
C.O.
Measuring Range
Resolution
Accuracy
NOTE
At least 90% of the C.O. data should reside inside
the bounded region, and the lower 95%
confidence interval should not exceed 85%.
AG
NOTE
Regarding the AG specifications, refer to the
Supplement Scio Four modules.
BIS
EMG 30 dB to 80 dB
TP 40 dB to 100 dB
BC (only applicable to 0 to 30
BIS™ Extend Sensor)
Smoothing Rate 10 s, 15 s, 30 s
Interfaces
Analog Output
Compliant with Standard and Complies with the requirements in terms of short circuit
Directive protection and leakage current in EN60601-1.
NOTE
While using analog output, set the calculation lead
as following:
1 In 3-lead mode, set to Lead I, Lead II, or Lead
III.
2 In 5-lead mode, set to Lead I, Lead II, Lead III
or Lead V.
Defibrillator Synchronization
Nurse Call
USB Interfaces
VGA Interface
Level RS232
Network Interface
Bandwidth 10M
EMC Declaration
General information
The EMC compliance of the Vista 120 series The Vista 120 series patient monitors (Vista 120,
patient monitors (Vista 120, Vista 120S) is also Vista 120S) may only be used adjacent to or
applicable to the external cables, transducers, and stacked with other devices when the configuration
accessories specified in the list of accessories. In is approved by Dräger. If adjacent or stacked use of
addition, accessories which do not affect EMC non-approved configurations is inevitable, the Vista
compliance may be used if no other reasons forbid 120 series patient monitors (Vista 120, Vista 120S)
their use (see other sections of the Instructions for must be observed to verify normal operation in the
Use). The use of non-compliant accessories may said configuration. In any case, strictly observe the
result in increased emissions or decreased Instructions for Use of the other devices.
immunity of the Vista 120 series patient monitors
(Vista 120, Vista 120S).
Electromagnetic emissions
Electromagnetic environment
NOTE
The EMISSIONS characteristics of the Vista 120
series patient monitors (Vista 120, Vista 120S)
make it suitable for use in industrial areas and
hospitals (CISPR 11 class A). If it is used in a
residential environment (for which CISPR 11 class
B is normally required) the Vista 120 series patient
monitors (Vista 120, Vista 120S) might not offer
adequate protection to radio-frequency
communication services. The user might need
to take mitigation measures, such as relocating or
re-orienting the equipment.
Electromagnetic immunity
NOTE
At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE
These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption
and reflection from structures, objects and people.
Test Immunity
Band a) Maximum Distance
frequency Service a) Modulation b) test level
(MHz) power (W) (m)
(MHz) (V/m)
Pulse
385 380-390 TETRA 400 modulation b) 1.8 0.3 27
18 Hz
FM c)
GMRS 460, ± 5 kHz
450 430-470 deviation 2 0.3 28
FRS 460
1 kHz sine
710
Pulse
LTE Band
745 704-787 modulation b) 0.2 0.3 9
13, 17
217 Hz
780
Test Immunity
Band a) Maximum Distance
frequency Service a) Modulation b) test level
(MHz) power (W) (m)
(MHz) (V/m)
810 GSM
800/900,
870 TETRA Pulse
800-960 800, iDEN modulation b) 2 0.3 28
820, CDMA 18 Hz
930 850, LTE
Band 5
Bluetooth,
WLAN,
Pulse
802.11
2450 2400-2570 modulation b) 2 0.3 28
b/g/n, RFID
217 Hz
2450, LTE
Band 7
5240
Pulse
WLAN
5500 5100-5800 modulation b) 0.2 0.3 9
802.11 a/n
217 Hz
5785
NOTE If necessary to achieve the IMMUNITY TEST LEVEL, the distance between the transmitting
antenna and the ME EQUIPMENT or ME SYSTEM may be reduced to 1 m. The 1 m test distance is
permitted by IEC 61000-4-3.
(W)
( ) ( ) ( 800 kHz to
2.5 GHz)
The separation distance values in the brackets are specific to the occasion
when the BIS module is used.
For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in meters (m) can be estimated using the equation applicable to the frequency of the
transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the
transmitter manufacturer.
NOTE
At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE
These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption
and reflection from structures, objects and people.
Default settings
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308
Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308
Ventilator/Anesthesia Machine
Monitoring default settings . . . . . . . . . . . . . . 315
Overview
NOTE
If the monitor has been preconfigured according to
the requirements, the settings at delivery will be
different from the default settings listed below.
Profile
To set default configuration, select Menu > Profile. To check the configuration currently used, select
On the Profile menu, users can choose a factory Menu > Profile. The one labeled with (√) is current
configuration (adult, pediatric or neonate) based on configuration. If there's no labeled configuration, it
the patient category. Also, users can choose a user means the currently used configuration is not one
configuration saved in the monitor if it is available. of them.
For more information about user configuration,
refer to User configuration.
User Configuration
Select Menu > Maintenance > User Maintain, enter configuration can be saved in the monitor. User can
the required password, users can save the current select as desire. The one labeled with (√) is current
monitor's configuration, delete the saved user configuration.
configuration and rename it. Three pieces of user
Alarm settings
Pause time 120 s
Sensor off alarm On
Alarm latch Off
Alarm switch On
Pace Off
Display Normal
Filter Monitor
Heart volume 3
ST analysis Off
ARR analysis
ARR analysis On
R on T On Medium Off
PR default settings
Alarm Switch On
Unit /
Ventilator/Anesthesia
ADU PED NEO
Machine Monitoring Settings
Top Ruler: 40 Top Ruler: 40 Top Ruler: 40
Paw Ruler
Bottom Ruler: 0 Bottom Ruler: 0 Bottom Ruler: 0
Mode Filled
Reference Loop On
Paw: 40
P-V
Vol: 800
Vol: 800
F-V
Flow: 150
Passwords
WARNING
To properly use this medical device,
read and comply with these
instructionsfor use.
Screen images
WARNING
A WARNING statement provides important
information about a potentially hazardous
situation which, if not avoided, could result in
death or serious injury.
CAUTION
A CAUTION statement provides important
information about a potentially hazardous
situation which, if not avoided, may result in minor
or moderate injury to the user or patient or in
damage to the medical device or other property.
NOTE
A NOTE provides additional information intended
to avoid inconvenience during operation.
Contents
Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Printing Report with a Printer . . . . . . . . . . . . . . 72 Control and safety index . . . . . . . . . . . . . . . . . 94
Printing Preview/ Printing Settings . . . . . . . . . . 72 Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . 94
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Cleaning the filter mat. . . . . . . . . . . . . . . . . . . . 96
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . 101
Recommended Hardware Configuration . . . . . 102
Software Performance . . . . . . . . . . . . . . . . . . . 104
Components . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Application scope. . . . . . . . . . . . . . . . . . . . . . 8
Safety guidance . . . . . . . . . . . . . . . . . . . . . . . 9
Vista 120 CMS Central Station provides centralized Vista120 CMS is just the secondary monitor for all
monitoring and critical care management for bedside monitors displayed on the Main screen, so
bedside Vista 120 monitored patients. From the it is not intended to be the only one approach relied
Vista 120 CMS Central Station, clinicians can gain on by users to make therapeutic and diagnostic
access to patient information for patients on the decisions for monitoring patient. Clinical decision
Network. The Vista 120 CMS Central Station making based on the output of the Vista120 CMS is
displays waveforms, parameters, and alarm status left to the discretion of the provider.
of Vista 120 bedside monitors for up to 32 patients
on a single screen or up to 64 patients using two
screens.
Components
Application scope
Safety guidance
WARNING WARNING
The system should be installed by a qualified Vista 120 CMS system can only collect,
service engineer. Do not switch on power until supervise, record, store and display the
all cables have been properly connected and information from patient monitor but can not
verified. replace the monitoring function of the patient
monitor.
WARNING
The user of this system should get WARNING
professional training and read this manual The wireless monitors and Vista 120 CMS form
thoroughly before using it. a wireless local area network (WLAN), and
bidirectional data transmission between them
is achieved by radio. Its RF emissions may
WARNING
cause interference in nearby electronic
Do not use the PC workstation in the presence equipment. So the RF device must comply
of flammable anesthetic due to explosion risk. with the local standards and certification
requirements. Data transmission loss
WARNING between them may occur due to interference
To avoid the risk of electric shock, do not open caused by other RF signals.
the case of the PC workstation.
WARNING
WARNING Ensure that the system can meet the
Do not move the main unit and monitor while requirements of standard IEC/EN 60601-1
powering on the central monitoring PC before other devices are connected to the
workstation. system. Other equipments connected to the
interfaces of PC station must comply with the
WARNING respective IEC/EN standards (e.g. IEC/EN
60950 for data processing equipment and
Only the accessories supplied or
IEC/EN 60601-1 for medical equipment).
recommended by the manufacturer can be
Furthermore, all configurations should
connected to the PC workstation.
comply with the valid version of the system
standard IEC/EN 60601-1. Everybody who
WARNING connects additional equipment to the signal
Ensure that the environment in which the input connector or signal output connector
system is operated is not subject to any configures a medical system, and is therefore
sources of strong electromagnetic responsible for the system complying with the
interference, such as radio transmitters, requirements of the valid version of the
mobile telephones, etc. Keep them far away. system standard IEC/EN 60601-1. If in doubt,
consult our technical service department or
WARNING local distributor.
This equipment must be used by or under the
guide of medical professional. This equipment
is not intended for home use.
WARNING CAUTION
The Vista 120 central monitoring software can The user must check that the equipment, cables
only be installed on the device recommended and transducers do not have visible evidence of
by Dräger. damage that may affect patient safety or
monitoring capability before using it. The
WARNING recommended inspection interval is once per
week or less. If damage is evident, replacement is
Only use operating systems that are approved
recommended before using it.
by Dräger, such as Window 7. Using operating
systems that are not approved by Dräger may
compromise the system performance and CAUTION
cause a potential hazard. Turn off the system power before connecting or
disconnecting any accessory.
WARNING
Refer to Vista 120 CMS Central Monitoring CAUTION
System Installation Instructions for detailed Do not operate the system if it is not operating
information of installation and uninstallation. normally or requires service.
WARNING CAUTION
Restart Vista 120 CMS host once the prompt Turn off the system power and remove the power
“System running time is too long, please cable before maintaining the system.
restart” appears. According to the practical
situation, restart cycle is 3 to 6 months.
CAUTION
Preventive maintenance of the system including
WARNING
periodic cleaning and appearance check can be
When Network Encryption is turned on, only finished by the user.
monitors with AES or TLS encryption can be
connected to Vista 120 CMS. Contact
DrägerService for Network Encryption CAUTION
settings. Avoid using attrite material to clean the PC
workstation. Remove all dust from the exterior
surface of the equipment with a soft brush or
CAUTION
cloth, slightly dampened with a mild detergent
Read this manual prior to using the Vista 120 solution or cool disinfector. Especially the tie-in
CMS. and panel edge should be noticed.
CAUTION CAUTION
Keep the environment clean. Avoid vibration. Avoid pouring liquids on the equipment while
Keep it far from corrosive reagents, dust areas, cleaning, and do not immerse any parts of the
high-temperature and humid environment. equipment into any liquids.
CAUTION
The system data will be delayed for no more than
5 s.
CAUTION
Additional multi-socket outlet or extension cord
can’t be connected to the system.
CAUTION
The maintenance operations like software
upgrade of the system can only be completed by
qualified service professionals of the
manufacturer.
NOTE
Clinical decision making based on the output of the
device is left to the discretion of the provider.
NOTE
Prior to intervening based on data displayed on the
Central Monitoring System, providers must verify
this data with the corresponding bedside monitor.
NOTE
The illustrations in this manual are for reference
only.
Introduction
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
System functions . . . . . . . . . . . . . . . . . . . . . . 15
Mouse Operation . . . . . . . . . . . . . . . . . . . . . . 15
General
Vista 120 CMS connects bedside monitors via AG: etCO2, FiCO2, AwRR; EtO2, FiO2; EtN2O,
cable network and displays physiological FiN2O; HAL/ISO/ENF/SEV/DES: Et, Fi, MAC
information of the patients being monitored by
C.O.: C.O., TB
bedside monitors. This system can simultaneously
display the information from up to 64 bedside Parameters from ventilator/anesthesia
monitors. machine: PEEP, PIP, Pmean, AwRR, MV, MVi,
VT, VTi, etCO2, FiCO2, EtN2O, FiN2O, EtO2,
Physiological waveforms of each bedside monitor
FiO2, EtAA, FiAA, EtHal, FiHal, EtEnf, FiEnf,
that can be displayed on Vista 120 CMS include:
EtIso, FiIns, EtDes, FiDes, EtSev, FiSev, Mac
2 ECG waveforms (Up to 7 ECG waveforms
BIS: BIS, EMG, SQI, SR, SEF, TP, BC
in multi-lead interface of Single Bed View sub-
window) Vista 120 CMS can also generate both audio and
visual alarms from bedside monitor in order to
1 RESP waveform
attract the doctor's attention, thus the alarm event
1 PLETH waveform can be dealt with in time.
3 IBP waveforms (Only IBP waveforms Vista 120 CMS supports various kinds of
supported by the monitor will be displayed) peripheral devices such as printer that can output
monitoring report. The typical central monitoring
1 CO2 waveform
system network is shown in the following figure:
4 AG waveforms for CO2, O2, N2O and AA
3 waveforms from ventilator/anesthesia HIS/EMR System
machine
1 BIS waveform
Physiological parameters of each bedside monitor Mirth Connect
that can be displayed on the Vista 120 CMS
include:
ECG: HR, ST value, PVCs
RESP: RR CMS-WEB
Vista 120 CMS
observer
NIBP: SYS, DIA, MAP
SpO2: SpO2, PR, PI, SpO2 bar graph
TEMP: T1, T2, TD Wireless
Network
Wired
Network
Quick TEMP
Monitors with Monitors without
IBP: ART, PA, CVP, RAP, ICP, LAP, P1, P2, Wi-Fi module Wi-Fi module
PPV, PAWP
CO2: etCO2, FiCO2, AwRR
System functions
The standard Vista 120 CMS Central Station Review 240-hour Quick TEMP measurements
includes a PC and one display, mouse and (up to 20000 pieces)
keyboard, instructions for use, and the following
Review 240-hour PAWP measurements (up to
features:
20000 pieces)
Internal speaker
Comprehensive system help information
Patient data from bedside Vista 120 collected
Power off data storage function
and displayed including ECG (3-lead or 5-lead),
Respiration (ECG), ST, ARR, SpO2, TEMP, Drug calculation and titration table
Quick TEMP, NIBP, IBP, etCO2 C.O.,
Hemodynamic calculation
anesthesia gas monitoring data via Dräger
SCIO 4 module, data from Dräger ventilator or Oxygenation calculation
anesthesia machine, and BIS measurement
Renal Function calculation
data via BISx device.
Ventilation calculation
Audio alarm annunciation
Bidirectional alarms configuration and NIBP
96 or 240 hour full disclosure waveform
setting
Store and review 240-hour alarm events (up to
Supporting wired connected and wireless
20000 pieces) for each bedside monitor
connected monitor
Export of waveforms
Web observation in the hospital local area
240 hour graphical and tabular trends network
12-hour short trend per patient Perform information interaction with HIS system
or EMR system
Review 240-hour NIBP measurements (up to
20000 pieces) HL7
Review 240-hour C.O. measurements (up to
20000 pieces)
Mouse Operation
Usually, we use the following terms to describe 2 Double-click: move mouse to the target, then
mouse operation: quickly press left-key twice and release it.
Left-key: 3 Drag: move mouse to the target, press left-key
and move to the destination and then release it.
1 Click: move mouse to the target, then quickly
press left-key once and release it. Right-key:
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Main Screen . . . . . . . . . . . . . . . . . . . . . . . . . . 18
System Information Area . . . . . . . . . . . . . . . . . 18
Patient Sectors . . . . . . . . . . . . . . . . . . . . . . . . . 18
Quick Control Area . . . . . . . . . . . . . . . . . . . . . . 19
Auxiliary Screen . . . . . . . . . . . . . . . . . . . . . . . 22
Overview
Vista 120 CMS can display the monitoring data The patient sectors can be displayed in two modes:
using a single display or using dual displays. The the general display mode with waveforms and
main screen and the auxiliary screen are the main physiological parameter values displaying on the
operation screens. The main screen and auxiliary screen and the large font display mode with only
screen on a single display are different from those parameter values displaying on the screen. The
on dual displays. number of patient sectors which the user can
simultaneously view on the main screen and the
size of the patient sectors depend on the layout of
the patient sectors.
Main Screen
If a single display is used, Vista 120 CMS system System Information Area
will enter the main screen for the single display after
the system starts up. If dual displays are used, it will The following information will be displayed in this
enter the main screen for dual displays. area:
The hospital and department information.
Alarm sound pause indicator and alarm
mute indicator .
Alarm information and prompts of Vista 120 CMS.
If more than one piece of message occurs, they
will be displayed circularly.
The system time.
60 99 60 99 60 99 60 99
A patient is monitored by a monitor. This monitor
xxx xxx xxx xxx
xxx
60 99 xxx
60 99
xxx
60 99 xxx
60 99 will occupy a patient sector when it is connected to
Vista 120 CMS; meanwhile, the monitoring data will
xxx xx xx xx xx xxx xx xx xx xx xxx xx xx xx xx xxx xx xx xx xx
xxx
60 99 xxx
60 99
xxx
60 99 xxx
60 99
xxx
xxx
xx
60 99
xx xx xx xxx
xxx
xx
60 99
xx xx xx xxx
xxx
xx
60 99
xx xx xx xxx
xxx
xx
60 99
xx xx xx
be displayed in this patient sector. Vista 120 CMS
supports 64 monitors connected to the system;
therefore, a total of 64 patient sectors are available
in Vista 120 CMS. The layout of patient sectors may
cause some patient sectors temporarily invisible,
refer to Section Layout of Patient Sectors.
The patient sector has four types of state: Networked Monitoring: Display of patient
information, waveforms, trend data and alarm
Network Disconnected: The black background
information indicates the patient in this sector
with the white font Disconnected in a patient
has been admitted and is properly networked
sector indicates no device is assigned to this
and under observation.
patient sector or this patient sector has been set
to idle status (refer to Section Setting Idle Bed). Refer to Chapter Patient Sector for more
information about the patient sectors in networked
Patient discharged: The black background with
monitoring state.
bed No. at top left corner in patient sector
indicates patient has been discharged.
Improper Offline: Patient information and the Quick Control Area
message Monitor is offline with yellow
background are displayed in the patient sector
and accompany with low level alarm sound. Function Buttons
Improper Offline indicates the patient in this The quick control area contains the following
sector has been admitted but is offline. The function buttons:
alarm sound for improper offline will be given
out only once.
Auxiliary Screen
If the patient sector is either in improper offline The auxiliary screen contains a group of sub-
status or networked monitoring status, the user can windows including Single Bed View, Patient
access the auxiliary screen by clicking the Mgmt, Wave Review, Alarm Review, Trend
waveform area or parameter area (except for NIBP Review, NIBP Review, Parameter/Waveform
parameter area) on the patient sector. The auxiliary Setup, C.O. measure review, Quick TEMP
screen on a single display and dual displays are as Review, PAWP Review and Calculation. The sub-
shown below. window of Single Bed View will be displayed by
default when the user enters the auxiliary screen.
In the switch and setup area for the sub-window,
the user can:
Click a tag to switch the current sub-window to
another sub-window.
Click to scroll leftward and click to scroll
rightward in the tag bar.
Click to open the drop-down list in which the
user can set the tags to show/hide.
Click to exit the auxiliary screen and enter
the main screen.
1 System information area Drag a tag to adjust its location.
2 Patient sectors
3 Switch and setup area for sub-window Click or to switch between full screen
4 Sub-window of auxiliary screen display mode and half screen display mode for
5 Quick control area the auxiliary screen when using a single display.
Choose Display the window in large font from Choose Display all windows in large font from
the menu in the patient sector, and this sector will the menu in the patient sector, and all sectors will
be displayed in the large font display mode. be displayed in the large font display mode.
Choose Display the window in large font again, Choose Display all windows in large font again,
and the sector will be displayed in the general and all sectors will be displayed in the general
display mode. In the large font display mode, display mode.
parameter values are displayed in the patient
sector, but no waveform is shown. xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx
60 99 36.5 40 60 99 36.5 40
xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx
60 99 36.5 40 60 99 36.5 40
xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx
60 99 36.5 40 60 99 36.5 40
xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx
60 99 36.5 40 60 99 36.5 40
The number of patients the user can view on the Switch between the visible and invisible patient
screen and the size of each patient sector depend sectors, refer to Section Switching Patient
on the layout of the patient sectors. If 64 monitors sector.
are connected to the Vista 120 CMS and the
Click bed number to view the 64 patient sectors
number of patient sectors displayed on the main
in the networked state window.
screen is set to 32, the screen will only display 32
patient sectors and the other 32 sectors are Refer to Section Display Setup for more information
invisible. The user may: about setting the layout of the patient sectors.
Starting monitoring . . . . . . . . . . . . . . . . . . . . 26
Starting monitoring
NOTE
Before starting the system, verify that the dongle
has been installed. Otherwise, the user may fail to
access the system.
NOTE
Dongle will give out alarm sound if system gets
blocked till resuming normal status.
CAUTION
Ensure that the audio adapter of the PC is
activated and the loudspeaker is on.
CAUTION
The audio adapter and network adapter should be
correctly installed, or the user may not access
Vista 120 CMS.
WARNING
Shut down the system by strictly observing
the shutdown procedure to avoid losing the
central monitoring of bedside patients.
WARNING
When using an UPS (optional) do not switch
off the UPS by force. Otherwise it can result in
a system failure and can affect the future
operation of the system.
WARNING
If power cut-off occurs, turn off the system
before the UPS exhausts its electricity.
Patient Management
Admitting a Patient. . . . . . . . . . . . . . . . . . . . . 30
Discharging a Patient. . . . . . . . . . . . . . . . . . . 32
Transferring a Patient. . . . . . . . . . . . . . . . . . . 33
Monitoring Statistics . . . . . . . . . . . . . . . . . . . 33
Admitting a Patient
If configured, patient information from a Hospital 2 Input a query condition for ALL, MRN, Last
Information System (HIS) or Electronic Medical Name or First Name, and then click Query
Record (EMR) system can be obtained through button. The required patient information is
Mirth Connect (MC) and will display on Vista 120 displayed. The user also can select Display all
CMS. patients or Display pending patients to show
the required patient information.
There are two routes to obtain patient information:
3 Select a patient from the patient information list.
Route 1:
Click Confirm and then Admission, or click
1 Click Admission in the quick control area > Confirm and then Update Monitor. The
EMR Patient List or click on the patient sector corresponding patient information in Vista 120
and select Patient Mgmt > EMR Patient List, CMS and the monitor will be updated.
and the EMR patient list is displayed.
Route 2:
NOTE
Select User Maintain > HL7 and tick Auto If patient’s MRN is modified during monitoring,
Admitting via MRN. When the monitor is Vista 120 CMS will not perform automatical query.
networked with Vista 120 CMS and gets online for
the first time, Vista 120 CMS will automatically
search for the patient’s MRN in EMR patient list. If
the patient is found, the patient information will
automatically be updated to Vista 120 CMS and the
monitor.
NOTE
EMR Patient List button is available only when
Mirth Connect function is enabled. For Mirth
Connect settings, contact DrägerService.
The user can change the patient information on Modify the patient information via the monitor.
Vista 120 CMS when the information is incorrect. To For more information, refer to the user manual
modify the patient information, click on the patient of the monitor.
sector and select Patient Mgmt, enter the correct
Modify patient information via Vista 120 CMS.
information in the appropriate fields and click
Update Monitor. NOTE
There are two ways to modify the patient If the patient type is changed via Vista 120 CMS,
information: the patient type on the monitor will be changed
accordingly.
Discharging a Patient
When the monitoring on a patient is completed, the After discharging patient, open patient sector menu
user needs to discharge this patient by any of the by clicking on patient information area. The user
following methods: can set this patient sector to idle status by clicking
Set Idle Bed and switch patient sector by clicking
Choose Discharge Patient from the menu in
Show.
the patient sector.
Choose Patient Mgmt > Discharge Patient on
the auxiliary screen.
Discharge the patient via the Review window.
The operation of discharging a patient will cause
the patient offline from Vista 120 CMS, and there
will be no patient admitted in the related patient
sector. The discharged patient will be shown in the
history patient list.
A patient sector displays monitoring information for The user can set idle bed by following methods:
one monitoring device only. Setting idle bed will
Method 1: After discharging patient, click Set Idle
discharge monitoring device from the patient
Bed in patient sector menu;
sector.
Transferring a Patient
Monitoring Statistics
The monitoring statistics of the selected patients Analyze the average value, maximum/minimum
will be shown in the patient management window. value, and measure time of the
The monitoring statistics covers the total monitoring maximum/minimum value for the trend values.
time for waveforms and trends, the number of
alarm events, the number of NIBP measuring, the
number of C.O. measuring, the number of Quick
TEMP measuring and the number of PAWP
measuring.
Click Analysis, the system will:
Analyze the number of high and low limit alarms
for each physiological parameter and analyze
the percentage of the limit alarms of the
parameter in all limit alarms.
Analyze the number of arrhythmia events for
each type of arrhythmia and analyze the
percentage of a certain type of arrhythmia.
Patient Sector
Freeze . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Real-Time Printing . . . . . . . . . . . . . . . . . . . . . 39
Alarm Reset. . . . . . . . . . . . . . . . . . . . . . . . . . . 39
NOTE
Due to the delay of network transmission, data
1 Waveform area viewed on Vista 120 CMS has a delay of 5 s
compared with data generated at the
2 Parameter area corresponding bedside monitor.
3 Patient information area
NOTE
4 Technical alarm/ Prompts/ indicator area
Due to the operating system schedule, the
5 Physiological alarm area waveform scan of Vista 120 CMS might be
Waveform area and parameter area: It displays suspended for about 20 ms in very few occasions.
some of real-time monitoring waveforms and After the suspension, waveform scan will go back
parameter values. to normal status. The quality of patient monitoring
during the suspension will not be affected.
Patient information area: It displays the bed
number and patient name.
Technical alarm/ Prompts/ Indicator area: It
displays the technical alarm messages when a
technical alarm occurs. Click on the technical
alarm message, and the list for the current
technical alarms will be displayed. When no
technical alarms and no prompts occur, it
displays the indicators indicating the state of the
monitors:
Indicator Description
Pace on
Pace off
When the patient sector is in the improper offline state Monitor Parameter Setup: Switch to Monitor
or in the networked monitoring state, the user can Parameter Setup window on the auxiliary
open a menu by clicking on the patient information screen.
area. The available items in this menu are:
NIBP MEASURE: Start a NIBP measurement.
Display the window in large font: Switch
Discharge Patient: Discharge the patient in the
between the large font display mode and the
current patient sector.
general display mode for the current patient
sector. Freeze: Freeze/ unfreeze the waveform in the
current patient sector.
Display all windows in large font: Switch
between the large font display mode and the Print: Print the monitoring data in the current
general display mode for all patient sectors. patient sector.
Parameter/Waveform Setup: Switch to the Show: Switch between patient sectors.
Parameter/Waveform Setup window on the
Alarm Reset: Activate alarm reset function.
auxiliary screen.
Freeze
Real-Time Printing
To print real-time data from Vista 120 CMS, click collecting, a dialog box for printing setup will
Print from the menu in the patient sector or click the appear. The printout includes the 11-second
Print button in the single bed window. waveform data at the point of starting printing, data
of all physiological parameters at the time the user
After Print is selected, Vista 120 CMS starts to
selects Print and the latest NIBP measurement
collect data for printing and the system will indicate
before finishing collecting.
Collecting Data… at the top of the main screen.
After the system completes 11-second data
Alarm Reset
NOTE
If a new alarm occurs during the alarm reset
period, the new alarm on Vista 120 CMS will
recover normal. That is, the new alarm will be
sounded and displayed.
OxyCRG. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Freeze . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
The Single Bed View sub-window will be displayed Indicator area: It displays indicators indicating
by default when the user enters the auxiliary screen. the state of the monitors.
Technical alarm area/ Prompts area: It displays
technical alarm messages consistent with the
messages displayed in the patient sector. The
mouse operation here of technical alarm is the
same as the one in patient sector.
Physiological alarm area: It displays
physiological alarm messages consistent with
the messages displayed in the patient sector.
The mouse operation here of physiological
alarm is the same as the one in patient sector.
Short trend area: When the short trend display
is on, the short trend will be displayed in this
1 Patient information area
area. When the short trend display is off,
2 Toolbar waveforms will be displayed in this area.
3 Indicator area Waveform area: It displays all waveforms from
4 Technical alarm area/ Prompts area the networked monitor.
xxx
xxx
xxx
xxx
xxx
xxx
xxx
After entering the single bed view interface, choose Param Select and Interval. The user may select
View Selection > Trend Screen on the toolbar and the desired parameters to be displayed from the
the short trend will be displayed on the left of the drop-down list of Param Select. Also, the user can
interface. Click short trend area and a dialog box of choose Interval on the interface to open the list and
short trend settings will pop up. The user can set select an appropriate interval among 1h, 2h, 4h, 8h
the display mode of the short trend by configuring and 12h.
OxyCRG
In the Single Bed View window, choose View waveform by clicking RR and RESP. The user can
Selection > OxyCRG on the toolbar, and the also set the interval of the OxyCRG to 1 minute,
OxyCRG window will be open. The user can switch 2 minutes or 4 minutes.
the display between respiratory rate and respiratory
Freeze
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Standby Mode . . . . . . . . . . . . . . . . . . . . . . . . . 46
NFC Mode* . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Privacy Mode . . . . . . . . . . . . . . . . . . . . . . . . . 47
Overview
Standby Mode
When the monitor is in standby mode, 4 Vista 120 CMS can normally review the history
data.
1 Vista 120 CMS won’t update monitoring data,
and will display monitor's standby mode. The monitor exits standby mode in any of the
conditions:
2 Vista 120 CMS will neither store data
1 The user clicks Exit Standby Mode in the
transmitted from the monitor, nor display
waveforms/parameters/alarms. specific patient sector’ menu.
3 Vista 120 CMS cannot transfer or discharge the 2 Vista 120 CMS admits a new patient.
patient. Printing and freezing functions are
disabled. The patient information cannot be
modified.
NFC Mode*
* This is for French users only and NFC has nothing 5 The audio alarm off status will be finished and
to do with "Near Field Communication". Vista 120 CMS enters normal alarm response
status. Audio Pause will automatically switch to
When the monitor is in NFC mode,
2 minute, which can be set to 1 minute, 2
1 The HR physiological alarms on Vista 120 CMS minute, 3 minute manually.
are always on and can't be set to off by the user.
NOTE
2 Prompt information NFC: On is displayed in HR NFC mode and standby mode can't coexist. When
parameter area. the monitor enters the standby mode, the NFC
3 The user can't turn off the audio alarm mode will automatically pause. After exiting the
permanently. standby mode, the monitor will automatically
resume the NFC mode.
4 HR audio alarms can be turned off via Alarm
Reset in the specific patient sector’s menu.
Privacy Mode
Setting Parameters. . . . . . . . . . . . . . . . . . . . . 50
Configuring NIBP Measurement Settings. . . . . 50
Parameters Alarm Setting . . . . . . . . . . . . . . . . 50
Setting Parameters
The user can open the parameter setup window by parameter attributes, after which the user clicks
two methods: Update Monitor to update the relevant settings of
the monitor.
Method 1: Choose Monitor Parameter Setup in
the patient sector. Clicking button 5 can close parameter setup
window.
Method 2: Select the parameter area in the single
bed interface, and click on the chosen parameter
area.
Configuring NIBP Measurement Settings
2 5
Choose NIBP in the parameter list on the
parameter setup window, and the user can
configure the NIBP measurement settings on the
physiological parameter attribute and configuration
area. The user can modify the measurement mode
1 and measurement interval of NIBP. The operation
steps are shown as follows:
1 Choose a measurement mode.
2 If automatic measurement mode is chosen, the
user also needs to set the measurement
3 4 interval.
WARNING
Prior to monitoring, make sure that the alarm
limit settings are appropriate for the patient.
WARNING
When the alarm is set to OFF, Vista 120 CMS
will not give an alarm even if an alarm occurs.
In order to avoid endangering the patient’s
life, the user should use this function
cautiously.
WARNING
Setting alarm limits to extreme values may
cause alarm system to become ineffective. It
is recommended to use the default settings.
Review
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Patient List . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Patient Review . . . . . . . . . . . . . . . . . . . . . . . . . 54
History Patient Review . . . . . . . . . . . . . . . . . . . 54
Backup Patient Review. . . . . . . . . . . . . . . . . . . 55
Wave Review. . . . . . . . . . . . . . . . . . . . . . . . . . 55
Reviewing Normal Waveforms . . . . . . . . . . . . . 55
Reviewing ECG Compressed Waveforms . . . . 55
Setting Wave Speed . . . . . . . . . . . . . . . . . . . . . 55
Refreshing Waveform . . . . . . . . . . . . . . . . . . . . 55
Selecting Waveform . . . . . . . . . . . . . . . . . . . . . 55
Time Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Print . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Alarm Review . . . . . . . . . . . . . . . . . . . . . . . . . 56
Locking and Unlocking Alarm Information . . . . 56
Printing Alarm Information . . . . . . . . . . . . . . . . 56
Sequencing the Alarm List . . . . . . . . . . . . . . . . 56
Annotating Alarm . . . . . . . . . . . . . . . . . . . . . . . 57
Filtering Alarm Events . . . . . . . . . . . . . . . . . . . 57
Trend Review . . . . . . . . . . . . . . . . . . . . . . . . . 57
Setting Resolution . . . . . . . . . . . . . . . . . . . . . . 57
Viewing Parameters selectively . . . . . . . . . . . . 57
Refreshing Data . . . . . . . . . . . . . . . . . . . . . . . . 57
Printing Trend Review . . . . . . . . . . . . . . . . . . . 58
Selecting Trend Table, trend Graph . . . . . . . . . 58
NIBP Review . . . . . . . . . . . . . . . . . . . . . . . . . . 58
PAWP review . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Overview
Via Vista 120 CMS, The user can review the history PAWP. By clicking on the review button in quick
data of patients, which includes the list containing control area of main screen, the user can enter the
all patients, patient management, trend, alarm, review interface.
wave, NIBP, C.O. measure, Quick TEMP and
Patient List
Wave Review
The Vista 120 CMS can review the change process In this window, waveforms can also be dynamically
of the physiological waveform of one patient in the displayed.
latest 240 hours. Select User Maintain > Database
Maintain > Waveform Storage, and there are 96
hours and 240 hours for selection. 96 hours is the Reviewing ECG Compressed Waveforms
default selection.
To use waveform review, click on Main Screen > Compressed waveform review is only available to
Review > Wave Review or access the auxiliary ECG waveforms. In the compressed waveform
screen and choose Wave Review. On this screen, review window, the altitude of the ECG waveform
the user can: will be compressed so that the user can review the
waveform containing longer time of data.
Review normal waveforms or ECG compressed
waveforms
Set wave speed Setting Wave Speed
Select waveform By clicking on the Sweep button, a list of available
Set start time and end time wave speed (i.e. 6.25 mm/s, 12.5 mm/s, 25 mm/s
and 50 mm/s) will be displayed, from which the
Refresh waveform user can set the width of waveforms displayed in
Print the waveform area. Changing wave speed will
affect the time length of the waveform area.
Alarm Review
Alarm table and waveform will be generated when Printing Alarm Information
Vista 120 CMS makes physiological alarm
notification. Alarm review helps the clinician If the user wants to print alarm table, he/ she can
observe the details of the monitoring information. click on Print on the interface to print it by a laser
Alarm information can be stored by the user and printer.
thus become important alarm event.
NOTE
The alarm strip in alarm review is a 16-second The important alarm events can be deleted but not
waveform. User can also switch alarms by using automatically .The unimportant alarm events can
keyboard arrow keys. be automatically replaced by new alarm events
when they have accumulated to a certain amount.
NOTE
A maximum of 20000 alarm information (within NOTE
240 hours) can be stored. If the storage space is The alarm stripe displays the physiological
full and there are new alarms occurring, the waveform at 25mm/s when an alarm takes place.
earliest alarm information will disappear.
The symbol ▲ indicates ascending sequence, move the cursor out of the area of the input box,
and and Vista 120 CMS will automatically save the input
information.
The symbol ▼ indicates descending sequence.
NOTE
Input characters are limited to 256.
Annotating Alarm
The user can add notes to illuminate an alarm. To Filtering Alarm Events
annotate an alarm, select a certain alarm stripe and
the user will see the title Alarm Note on the bottom The user can filter alarm events by selecting or
of the alarm review interface. Move the cursor 1cm clearing the check boxes before the items in the
left to the title Alarm Note and a pop-up input box Alarm Level list, in the Event Type list and in the
in which the user can input detailed information for Param Select list. The Alarm Review window will
the alarm will appear. After completing the notes, only display the alarm events whose alarm level
/levels has/have be selected and the alarm events
of selected parameters.
Trend Review
Choose Main Screen > Review > Trend Review change the resolution, select Resolution Setting
or choose Trend Review on the auxiliary screen, on the interface and select the desired option from
and the user will enter the trend review interface, the list.
through which up to 240 hours of trend data can be
stored and reviewed. Change of trends can be
observed through trend table and trend graph. Viewing Parameters selectively
On this interface, the user can:
In the parameter list of Param Select, the user can
set the resolution
select modules or parameters by ticking their check
view parameters selectively boxes as required. Only the selected parameters
are displayed in the graph or table.
refresh the data
When a parameter module is selected or
print
unselected, all of its parameters will be selected or
set the starting and ending time for review. unselected accordingly.
The user can select a time period as the resolution Trend data will not update automatically. Therefore,
for viewing the graph and table as required. Options if the user wants to view up-to-date trend data,
are 1 s, 5 s, 1 min, 5 min, 15 min, 30 min, 60 min, refresh them manually. Click on the Refresh button
2 Hours, 3 Hours, 4 Hours, Display Time Points to refresh the data to up-to date. After refreshing
for NIBP Measurements and Display Time them, the status selected and order of parameters
Points for Quick TEMP Measurements. To remain unchanged.
NIBP Review
Results of four latest NIBP measurements are Click Show parameters, and the measurement
displayed in the NIBP area in the Single Bed View values of all physiological parameters at the
window. measure time specified in the selected item will
be shown in the lower portion of the window.
To review earlier NIBP measurement results,
Click Hide parameters, and these
choose Main Screen > Review > NIBP Review or
measurements values will not be displayed.
choose NIBP Review on the auxiliary screen to
enter the NIBP review interface, through which up Refresh
to 20000 groups of NIBP measurements of a
Print out the current page
patient (within 240 hours) can be viewed.
Print out all pages
The NIBP review window displays Serial No.,
Measure Time, SYS, DIA, MAP and PR for each
measurement. Additionally, in this window the user
can:
Choose Main Screen > Review > C.O. Measure In the C.O. Measure Review window, measure
Review or choose C.O. Measure Review on the results are arranged chronologically on the left.
auxiliary screen, and up to 20000 groups of C.O. Select a measure result and the measure value as
measurement of the current patient in this window well as the curve will be displayed on the right. A
(within 240 hours) can be reviewed. maximum of six groups of measure results can be
displayed simultaneously.
At the lower part of the window, the average values The user can print the selected measure results.
of C.O and CI of the selected measure results are
displayed.
Choose Main Screen > Review > Quick TEMP window can be reviewed. The Quick TEMP
Review or choose Quick TEMP Review on the measure result and measure time are available.
auxiliary screen, and up to 20000 groups of Quick The user can print the Quick TEMP measurement
TEMP measurement (within 240 hours) in this list.
PAWP review
System Setup
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Common Setup . . . . . . . . . . . . . . . . . . . . . . . . 62
Parameter Unit Setup . . . . . . . . . . . . . . . . . . . . 62
Color Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Display Setup . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
User Maintain . . . . . . . . . . . . . . . . . . . . . . . . . 63
Monitor Batch Settings . . . . . . . . . . . . . . . . . . . 63
Date/Time Setup. . . . . . . . . . . . . . . . . . . . . . . . 63
Alarm Setup for Vista 120 CMS . . . . . . . . . . . . 64
Changing Language . . . . . . . . . . . . . . . . . . . . . 64
HL7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Database Maintain . . . . . . . . . . . . . . . . . . . . . . 64
EMR database maintenance . . . . . . . . . . . . . . 64
Other Setups . . . . . . . . . . . . . . . . . . . . . . . . . . 65
User Password Setting . . . . . . . . . . . . . . . . . . . 65
Operation Log. . . . . . . . . . . . . . . . . . . . . . . . . . 65
Certificate Management . . . . . . . . . . . . . . . . . . 65
About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Overview
The System Setup function is used to modify the the parameter list as desired. There are Common
display information at the patient sector according Setup, User Maintain, and Factory Maintain to be
to the real requirements. By using this function, the set.
user can observe the waveform, parameter, and
Common Setup
It is mainly used to make some conventional After setting, the color displayed on Color Setup
monitoring settings, such as Param Unit Setup, column is the successfully chosen color. The color
Color Settings, Display Setup, and Help. on Initial Color column is set by default.
To get the default color, choose desired parameter
from Param Select and click Default Settings, and
Parameter Unit Setup then click OK to confirm.
The user can change the unit of IBP, NIBP, CO2,
(AG) CO2, (AG) O2, C.O. (TB), (RM) CO2 and
Display Setup
TEMP. For example, to change the unit of IBP,
select Main Screen > System Setup > Common
The user can set the number of beds to be viewed
Setup > Param Unit Setup, and select the desired
on the screen. To change the display to be viewed,
unit among mmHg, kpa and cmH2O from the pull-
select Main Screen > System Setup > Common
down list at the right of IBP.
Setup > Display Setup > Display Bed Number
and choose the desired bed number 3, 4, 6, 8, 10,
12, 14, 16, 32, 64 from the drop-down list of display
Color Setup bed.
The user can change the display color of all The user can also click the area which displays bed
parameters and the other information of the No., and then click Set Idle Bed.
parameter is displayed as the same color. And the There’re two routes to change the monitor’s
information includes waveform name, gain and position:
filter, real-time value (upper limit and lower limit),
review waveform and so on. To change the color of Route 1: Drag the area which displays bed No. to
the parameter: any position you want.
1 Select Main Screen > System Setup > Route 2: Select Main Screen > System Setup >
Common Setup > Color Setup. Click on the Common Setup > Display Setup > Sequence,
Param Select to choose desired parameter, the monitor’s position will be sequenced according
then choose desired color from the left color to the Bed No..
area or input desired RGB values of red, green, The monitor is assigned to the patient sector
blue directly. according to the sequence of left to right and top to
2 After this, click on OK to confirm. bottom.
NOTE Help
Two screens are needed if the user wants to
Help information is available on this interface.
simultaneously display the information of 64
bedside monitors.
User Maintain
Choose Main Screen > System Setup > User To change the display language, select Main
Maintain > Alarm Setup Screen > System Setup > User Maintain, and
input the correct password. Select Language
The user can configure the alarm setting for
Setup and select the desired language from the
Vista 120 CMS.
drop-down list.
The user can set the duration in drop-down list of
NOTE
Audio Pause to 1 minute, 2 minute, 3 minute or
Permanent. The system will restart automatically to make the
change effective.
When the option is 1 minute, 2 minute or 3
minute, the user can click audio pause symbol in
main interface to activate Audio Pause. System HL7
can exit the audio pause status automatically when
the duration time is out, or user can click audio In User Maintain window, users can set the interval
pause symbol again to exit. for HL7 data to be sent and set the format of HL7
When the option is Permanent, the user can click data package sent by Vista 120 CMS. The interval
audio pause symbol in main interface to activate can be set to 30 s (default) to 7200 s. HL7 data is
sent in the format of MLLP (HL7 Mini Lower Layer
Alarm Mute. The icon is displayed at the top Protocol) by default. If XML is selected, the data
area of the screen. Clicking audio pause symbol sent by Vista 120 CMS will be packed in XML
again can be used to exit alarm mute status only. format. NIBP uploading method can be set to
Upload for First Time or Upload for Every Time
The user can set alarm sound intervals for Vista
(default).
120 CMS.
NOTE
The user can set alarm sound intervals by choosing
the desired intervals from the drop-down list of HL7 data is sent via the port 9100 by default.
High Alarm Interval (s), Med Alarm Interval (s)
and Low Alarm Interval(s).
Database Maintain
The user can set alarm ringtone for Vista 120
CMS.
Refer to Section Database Backup for more
The user can choose different alarm ringtone as information about database backup.
desired from the drop-down list of Alarm Tone.
Click Play to confirm. Standard and Mode 1 are
optional. The default option is Standard. EMR database maintenance
NOTE
To delete the unnecessary HIS/EMR patient
In audio pause or alarm mute status, though a new information, select Main Screen > System Setup
alarm occurs, system will not give out alarm
> User Maintain > EMR Database Maintenance.
sound.
The patients are sorted according to the status. The
user can choose Admitted in CMS/Wait for
admitting/Discharged in CMS/All to delete the
unused information.
NOTE
If the password is forgotten, contact the technical
representative of Dräger. If the Factory Maintain
password is used to enter the Other Setups
menu, the user can directly reset the user
password without inputting the old password.
Operation Log
Alarm Management
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Physiological Alarm . . . . . . . . . . . . . . . . . . . . . 68
Technical Alarm . . . . . . . . . . . . . . . . . . . . . . . . 68
Alarm Mute . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Audio Pause . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Alarm Prompt/Response . . . . . . . . . . . . . . . . 69
Overview
Alarms, triggered by a physiological sign that Physiological alarms are implemented by alarm
appears abnormal or by technical problems of the limits, which define a range in which a certain
monitor, are sent to Vista 120 CMS by the monitors physiological parameter is considered to be in the
and then indicated to the users by Vista 120 CMS. normal status. When a parameter value is beyond
Alarms coming from the monitors are displayed in the range, the system will consider it to be in an
the patient sectors and in the single bed view abnormal status and consequently give an alarm.
window.
The alarm and prompts coming from Vista 120
CMS system are displayed in the system
Technical Alarm
information area on the upper screen.
Technical alarms refer to the technical alarms of
bedside monitor. Technical alarms of bedside
NOTE
monitor refer to alarms other than physiological
The alarm signal will be delayed for no more than alarms, including hardware failure, communication
5 s. error, lead off, etc. For these technical alarms, the
system presents four different types of audible and
visual prompts.
Physiological Alarm
When a group of technical alarms (for example,
transducer falls off) produced by multi-parameter
It includes parameter alarm and arrhythmia alarm. monitors, a piece of alarm prompt information in
Physiological alarm arouses the doctors’ attention scrolling mode will appear on the main screen of
by means of visual and audible methods specified Vista 120 CMS. In addition, Vista 120 CMS will
in harmonized international standard. Visual sound corresponding alarm (high, medium or low
method is realized basically by the way of level alarm). The corresponding bedside monitor
lightening or flicking of the color light. Audible status indicator will also show corresponding signal
method is realized by the sound for different levels. color (high, medium or low level alarm signal color).
Alarm Mute
Audio Pause
Audio Pause means that during a period of time, When the duration of alarm pause has lasted for the
when an alarm occurs, the system will not give preset-time, the system will stop the status of alarm
alarm announcement. The duration setting is pause and resume normal alarm automatically.
introduced in Section Alarm Setup for Vista 120
CMS. By click the Audio Pause button on the main NOTE
screen, the audio pause function can be activated The alarm pause function is only valid for Vista 120
or deactivated. CMS itself. Vista 120 CMS cannot pause the
bedside monitor’s audible alarm.
Alarm Prompt/Response
Alarm information can be prompted by means of An asterisk or more will be displayed before the
visual and audible methods. Because the alarm physiological alarm message to indicate the
information is very important and timely response alarm level.
to the alarm information is highly required, Vista
High level alarm: ***
120 CMS provides the following methods to
indicate to the user the occurrence of the alarm. Medium level alarm: **
The alarm message will be displayed in the Low level alarm: *
technical area or physiological area of the For limit alarms of the parameter, the relevant
patient sector and of the single bed view parameter value and parameter alarm limit will
window. be respectively displayed with the color
High level alarm: displayed with red alternating between the parameter color and
background the alarm color.
Medium level alarm: displayed with yellow Alarm tone
background If the system mute, alarm mute or alarm pause
Low level alarm: displayed with yellow setup is deactivated, the system will warn the
background user about the alarm with the alarm tone.
NOTE
In good network status, if there are no patients
online, Vista 120 CMS will give out a high level
alarm sound with intervals of 20 s.
Printing
Vista 120 CMS can output the reports by equipped Trend table printing
with a laser printer. HP LaserJet Series printers are
NIBP review printing
recommended. The laser printer working with Vista
120 CMS is independent of the mainframe. The Printing for drug calculation, hemodynamic
printer has its independent power supply. It is calculation, oxygenation calculation, renal
connected to the mainframe via a USB interface or function calculation and ventilation
a network (wired or wireless). calculation
The laser printer generates the following types of Patient information printing
printing:
C.O. review printing
Waveform review printing
Quick TEMP review printing
Alarm wave printing
PAWP review printing
Alarm table printing
Trend graph printing NOTE
Vista 120 CMS only supports printing on A4 paper.
Before the reports are printed, the user can preview Click on Print on the preview interface, and in the
them on the screen. The user will access the Print setup menu select the printer, the print range
preview interface after selecting the function of and the number of copies in demand and then click
printing. If a report consists of more than one page, on OK to confirm it.
the user may select a certain page to preview by
turning to the page as desired. Besides, the user
can adjust the zoom setting by choosing a certain
option from the drop-down list of the SIZE.
Vista 120 CMS can export the PDF file by installing CMS installation disk. Also, the user may download
a PDF printer software. The software PDFCreator it from the website
is recommended. The user can obtain the http://www.pdfforge.org/pdfcreator.
installation version of PDFCreator in the Vista 120
Database Management
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Database backup . . . . . . . . . . . . . . . . . . . . . . 76
Overview
Database backup
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Drug Calculation. . . . . . . . . . . . . . . . . . . . . . . 78
Drug Calculation Formula. . . . . . . . . . . . . . . . . 79
Calculation of Titration Table . . . . . . . . . . . . . . 79
Hemodynamic Calculation. . . . . . . . . . . . . . . 80
Input Parameters . . . . . . . . . . . . . . . . . . . . . . . 80
Output Parameters . . . . . . . . . . . . . . . . . . . . . . 80
Oxygenation Calculation . . . . . . . . . . . . . . . . 82
Input Parameters . . . . . . . . . . . . . . . . . . . . . . . 82
Output Parameters . . . . . . . . . . . . . . . . . . . . . . 82
Ventilation Calculation . . . . . . . . . . . . . . . . . . 83
Input Parameters . . . . . . . . . . . . . . . . . . . . . . . 83
Output Parameters . . . . . . . . . . . . . . . . . . . . . . 84
General
Vista 120 CMS provides functions including drug Vista 120 CMS is able to save a maximum of 100
calculation and titration table, hemodynamic groups of results for every type of calculation. In the
calculation, oxygenation calculation, renal function calculation window, the user can use the Save
calculation and ventilation calculation; the button to save the calculation results and use
calculation results can be printed out. Click on Calculation Result List to review each calculation
Calculation in the status of single bed view to result.
access the drug calculation screen.
Drug Calculation
From the Drug drop-down list, the user can select 1 Confirm whether the patient type is correct and
one to calculate its amount, liquid volume, the weight is entered.
concentration, etc.
2 Select a drug to be calculated from the drug list.
Drug A
3 Input correct parameter values under the
Drug B direction of a doctor.
Drug C 4 Select Basic, Dose Type and Step for titration
table.
Drug D
5 Click on the Calc button, the calculation result
Drug E
will be displayed in the drug parameter area and
AMINOPHYLLINE titration table.
DOBUTAMINE WARNING
DOPAMINE Be sure to input correct parameter values. The
user must verify the correctness of the
EPINEPHRINE
calculations displayed on the screen before
HEPARIN using them.
ISUPREL
WARNING
LIDOCAINE The calculations in the titration table are
NIPRIDE subject to the drug calculations, therefore, the
correctness of the drug calculations must be
NITROGLYCERIN ensured. Besides, the basic, step and dose
PITOCIN type should be ensured correct.
NOTE WARNING
Drug A, Drug B, Drug C, Drug D and Drug E are We assume no responsibility for the results
user-defined drugs. arising from incorrect inputs and operations.
Drug Calculation Formula 1 The core method for the calculation of titration
table is: concentration = dose / flow rate. The
Formulas for drug calculation are: calculating method of titration table is to keep
the fixed concentration, change the dose to
Concentration = amount / volume calculate the flow rate or change the flow rate to
Flow rate = dose / concentration calculate the dose. Concentration here is
obtained from drug calculation.
Total dose = dose × duration
2 The titration table can be displayed by way of
Total volume = flow rate × duration dose and rate. The user can enter the rate step
from 1-10. There are four options available for
WARNING dose unit: mg/hour, mg/min, mg/Kg/hour and
Prior to performing drug calculation, the mg/Kg/min, among which mg will vary with the
above formulas must be confirmed. Our unit changes in drug calculation.
company will not be liable for any 3 The calculating result of titration table is
consequence resulted from using displayed in the list. The user can click on the
inappropriate formulas. scroll bar to browse more calculating results.
Hemodynamic Calculation
Input Parameters
Output Parameters
Input Parameters
Output Parameters
Oxygenation Calculation
Input Parameters
Output Parameters
English Full
Items Unit Formula
Name/Description
Hb × 1.34 × SaO2/100% +
CaO2 ml/L Arterial oxygen content
(0.0031 × PaO2)
Hb × 1.34 × SvO2/100% +
CvO2 ml/L Venous oxygen content
(0.0031 × PvO2)
Arterial venous oxygen
Ca-v O2 ml/L CaO2 – CvO2
content difference
O2ER / Oxygen extraction ratio (VO2 / DO2) × 100%
Alveolar-arterial oxygen
AaDO2 mmHg PAO2 – PaO2
difference
CC’O2 ml/L Capillary oxygen content PAO2 × 0.003 + 1.34 × SaO2/100% × Hb
Qs/Qt / Venous admixture (CC’O2 – CaO2) / (CC’O2 – CvO2) × 100%
C.O. L/min Cardiac output VO2 /( Ca-v O2 × BSA)
AaDO2/PaO2 / Spiro-index (PAO2 – PaO2) / PaO2× 100%
Oxygen consumption
VO2I ml/(min.m2) index VO2/BSA
Ventilation Calculation
Input Parameters
Output Parameters
English Full
Items Unit Formula
Name/Description
Partial pressure of oxygen PiO2-PaCO2 × [FiO2/100% + (1-
PAO2 mmHg
in the alveoli FiO2/100%)/RQ]
Alveolar-arterial oxygen
AaDO2 mmHg PAO2 – PaO2
difference
MV L/min Minute volume VT × RR/1000
AaDO2/PaO2 / Spiro-index (PAO2 – PaO2) / PaO2 × 100%
VA L/min Alveolar volume (VT – VD) × RR/1000
Volume of physiological
VD ml [(PaCO2 – PeCO2) × VT] / PaCO2
dead space
Physiological dead space in
VD/VT / (PaCO2 – PeCO2) / PaCO2 × 100%
percent of tidal volume
Cdyn ml/cmH2O Compliance dynamic VT / (Ppeak – PEEP – PEEPi)
CMS-WEB Observer
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
System Setup . . . . . . . . . . . . . . . . . . . . . . . . . 89
Common Setup. . . . . . . . . . . . . . . . . . . . . . . . . 89
Administrator Setup . . . . . . . . . . . . . . . . . . . . . 90
General
The CMS-WEB Observer system is a medical The CMS-WEB Observer displays patients’
information device applied in clinical monitoring physiological information collected by Vista 120
field. It realizes remote monitoring by reviewing CMS central monitoring system. The system
real-time and history data from central monitoring displays information of up to 32 bedside monitors
system through web page. A CMS-WEB network from Vista 120 CMS.
system is constructed by connecting multiple
NOTE
monitors and Vista 120 CMS central monitoring
systems. Being the center of the monitoring The CMS-WEB Observer is only available via the
network, the system realizes remote monitoring by hospital local area network.
collecting, processing, and analyzing the
physiological information from the central NOTE
monitoring systems. Medical staff can obtain Vista 120 CMS supports the maximum of 6
patient information by visiting the server of Vista accounts at the same time.
120 CMS via the browser.
The CMS-WEB shares similar screen features with displaying the system prompt information. The
Vista 120 CMS. The main screen of the CMS-WEB middle part is the main monitoring area. The bottom
has three areas. At the top of the screen is the area part is the system menu area.
Structure of the main screen: The red color in the alarm area of the patient
sector indicates the bedside monitor has high
1 Information area
priority alarm.
Displaying the hospital name and current system
The yellow color in the alarm area of the patient
time.
sector indicates the bedside monitor has a
2 Main monitoring screen medium or low priority alarm.
Indicating the current status of each bedside When four or less than four bedside monitors are
monitor: networked, the layout of patient sectors will be of
single row.
The onscreen bedside monitors are networked.
NOTE
The alarms on CMS-WEB may be delayed, and
the delay time depends on the actual network
environment. Refer to the displaying on Vista 120
CMS for alarms.
3 Main menu
The main menu is at the bottom of the screen. Click
on it to access corresponding windows or perform
corresponding functions.
Click on it, the volume adjustor icon appears. Tick the Mute check box,
the entire system become mute until a new alarm occurs. To deselect the
silence function, tick the Mute check box again. Additionally, the user can drag
the volume adjustor to the desired volume.
NOTE
The administrator is able to create other
administrators and users. The default password
for creating new users is “123456”.
System Setup
The user can access the system setup menu by Setting Parameter Unit
clicking on System Setup and configure the
Select System Setup > Common Setup > Unit
following items: Common Setup and
Setup; the user can change the units of IBP, NIBP,
Administrators Setup.
CO2, AG CO2, AG O2, C.O.TB and TEMP.
NOTE
The available setup items may vary with different Setting Multi-Bed Waveform
users due to different users’ access authority. Both Select System Setup > Common Setup > Wave
Common Setup and Administrators Setup are In Multi-bed; the user can set the physiological
available for the administrator while only Common waveforms displayed on the patient sectors. In this
Setup is available for general users. window, the left column displays the waveform
names; the right column displays the waveform
names which have been selected.
Common Setup Adding a waveform to be displayed:
To add a displayed waveform, choose one from the
Setting User Information left column and click on Add so that it can be added
Select System Setup > Common Setup > to the right column.
Personal Infor., and the user can change the user Deleting a displayed waveform
name, name, gender, department, and so on.
To delete a displayed waveform, choose one from
the right column and click on Remove so that it can
Setting Password be deleted from the waveform display area.
Select System Setup > Common Setup >
Password Change; the user can change the login
password.
NOTE
The user can only add or delete one waveform one
time.
NOTE
The paced symbol won’t be displayed on the CMS-
WEB observer.
Via the function of viewing single bed, the user can Click on Multi-lead in the window so that the user
check information of a patient. Click on any area of can view multiple channels of waveforms displayed
the patient sector and the user will access the onscreen. Click on it again to switch to single
single bed window. Available items including waveform display mode.
Patient Infor, Single Bed View, Wave Review,
Freezing waveform
Alarm Review, Trend Review and NIBP Review
will be displayed onscreen. Click on Freeze in the window so that the user can
freeze the waveform displayed onscreen, which
may help analyze the waveform of interest. Click on
Patient Information Freeze again to unfreeze the waveform.
The system allows to print the waveform with a Printing trend list: If the starting time is not set, the
maximum time of two minutes. If the starting time is system will output the latest data by default. If the
not set, the system will output the latest data by starting time is set, the system will start to output
default. If the starting time is set, the system will data at the point of the set time. The system allows
start to output data at the point of the set time. to output a maximum of 20000 pieces of data within
240 hours.
NOTE
The set starting time for printing will be invalid after
NOTE
the data is output.
The set starting time for printing will be invalid after
For more details about waveform review, refer to the data is output.
relevant content for Vista 120 CMS in Section
Wave Review. For more details about trend review, refer to
relevant content for Vista 120 CMS in Chapter
Review Section Trend Review.
Alarm Review
Safety
Characteristics . . . . . . . . . . . . . . . . . . . . . . . . 94
Characteristics
NOTE
The configuration above is for reference only.
Maintenance
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Overview
Every 24 months a regular inspection (functional If the product fails to function properly, or if
and safety check) according to IEC 60950 for the assistance is needed, for service and for spare
PC is recommended to be performed by trained parts, contact Dräger's service center. A
service personnel, in addition to national representative will assist in troubleshooting the
regulations and laws (for example, accident problem and will make every effort to solve it over
prevention regulations). the phone or e-mail, avoiding potential
unnecessary returns.
Dräger recommends that all repairs are carried out
by DrägerService and that only authentic Dräger If the user has any questions about maintenance,
repair parts are used. Using non-Dräger repair technical specifications, or malfunctions of devices,
parts may adversely affect the operation of the contact the local distributor.
device.
NOTE
Defective components may only be replaced by
Dräger original spare parts.
NOTE
The chapter of cleaning filter mat is only applicable
for the Hardware provided by Dräger.
NOTE
The UPS battery needs exchanging every two
years.
Accessories
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Accessories
Description Specification
Vista 120 CMS Host With Windows 7 embedded, central monitoring software, USB
key, industrial computer KTQ67/Flex
Vista 120 CMS Display 2 19" Check with Dräger for details.
Vista 120 CMS Display 3 22" Check with Dräger for details.
LAN switch Cisco 2960-24TC
LAN switch Cisco 2960-48TC (optional)
Printer 115 V/230 V (optional)
Extension cable mouse and keyboard 20 m (optional)
Specifications
Components Requirements
System Meet the IEC/EN control requirements for ITE device
PC workstation CPU: Intel Core i3 Duo 3.0GHz or above
Memory: 4G or above
Hard disk: 500GB or above
Display interface: 2
LAN port: 1 or above
USB port: more than one
OS: Windows 7 Pro 32/64 bit
Windows 8 Pro 32/64 bit
Windows 10 Pro 32/64 bit
Keyboard PS/2 or USB keyboard with CE mark
Mouse PS/2 or USB mouse with CE mark
Display Specifications:
Dimensions (inch) Resolution (pixel)
22 1920X1080
19 (widescreen) 1440X900
*19 (regular-screen) 1280X1024
17 (regular-screen) 1280X1024
*Recommended
Quantity:
For 1 to32 bedside monitors one display
For 33 to 64 bedside monitors two displays
Printer LaserJet
UPS 1000 W
Components Requirements
Network device Structure Ethernet 802.3
specifications
Device Network switch
Transmission rate 10M, 100M
Transmitted information Waveforms, parameters and
alarms of all networked bedside
monitors
Compatible monitors Patient monitors complying with
Dräger network protocol
Maximum number of networked 64
monitors
Speaker Built-in speaker is recommended.
Kontron system Compatible
CAUTION
Ensure that the computer hardware can meet the
requirements of the software installation and
running. Also, the video adapter, the audio
adapter, the network adapter and their respective
drivers should been installed well in the computer;
otherwise, the software may not run normally.
NOTE
The hardware specifications require the use of PC
that complies with IEC/EN requirements for ITE
equipment.
NOTE
The configuration mentioned above is for
reference and not permanent. Dräger preserves
the right to change and upgrade system settings.
NOTE
It is recommended to install the antivirus software
(recommend Kaspersky software) on the
computer which is used for Vista 120 CMS, and
also keep it updated in time.
Software Performance
CAUTION
Network configuration should strictly comply with
the recommended requirements.
CAUTION
Vista 120/Vista 120S is the only officially
appointed monitor for the CMS.
CAUTION
Some bedside monitors may not appear on the
CMS screen when the number of monitors
exceeds 64 monitors.
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Prompts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Alarms
Display
Alarms Cause Solution
Color
Prompts
Display
Prompts Cause Solution
Color
Refer to Section History Patient
Review and delete the out-of-
Database is full, date patient data. Or refer to
Less than 10 G space is left in
please discharge Section Database Backup to
the disk for data store.
or delete patient. back up the data in another disk
and delete the data in the current
database.
Collecting
Real-time printing /
Data…
White
Remind the user to admit the
Number of Refer to Section Admitting a
patients who has been
pending Patient for information about
connected to Vista 120 CMS but
patients: admitting patients.
has not been admitted.
No monitor is connected to the
No bed is online.
Vista 120 CMS because no Check if the cable is well
Please check the
monitor is connected to the connected with the monitor and
network
network or the network setup is with the switch.
connecting
incorrect.
Please clean the history patient
The system will display a prompt
Please clear data manually in time. (please
White when there is excessive amount
history patient refer to chapter Database
of history patient data.
Backup for detailed operations)
Directive 93/42/EEC
concerning Medical Devices
Manufacturer:
26 80 051 – GA 6498.020 en
© Drägerwerk AG & Co. KGaA
Edition: 8 – 2019-07
(Edition: 1 – 2012-12)
Dräger reserves the right to make modifications
to the equipment without prior notice.