CARESCAPE Monitor B650 Addendum for software ver 1.1.6 Jan 2011

Changes regarding the “CARESCAPE Monitor B650 Supplemental Information Manual”

Changes regarding the “CARESCAPE Monitor B650 Supplemental Information Manual” Parameter measurement modules compatibility PDM compatibility Note the following change: The monitor is compatible with PDM 1.3, 1.4 and 2.0 (Masimo and Nellcor).

CARESCAPE Network compatibility Central stations Note the following change:

•

CARESCAPE CIC Pro Clinical Information Center v4.0.7, v4.0.8, v4.1.1-1, v5.0.8, v5.1 and v5.2.

Unity Network ID compatibility Note the following change:

•

The monitor is compatible with the Unity Network ID v1A, v3B, v4A, v4B, v5A, v5B, v5C and v6A.

Additional information Invasive blood pressure acquisition modules Note the following change: Up to 7 channels can be active at the same time.

Alarms specifications Alarm priorities and escalation times Note the following additions: MESSAGE

NOTES

LOCATION

PRIORITIES AND ESCALATION TIMES info

Alarms audio S/5 Network paused from Central

• alarm

Arrhythmia paused

ECG, Alarm Priority = Escalating

• alarm

Audio OFF from Central

S/5 Network

• alarm

0 s according to priority setting: high, medium, low.

0s 0s

Information Center busy

S/5 Network

• alarm

0s

Information Center not responding

S/5 Network

• alarm

0s

2

medium

0s

• alarm

<Bed> Monitor disconnected

low

high

Changes regarding the “CARESCAPE Monitor B650 Supplemental Information Manual”

MESSAGE

NOTES

LOCATION

PRIORITIES AND ESCALATION TIMES

Loading failed. Wrong patient

S/5 Network

• alarm

0s

Network: <Central name>

S/5 Network

• alarm

0s

Network down: <central name>

S/5 Network

• alarm

0s

Noisy ECG

ECG, Alarm Priority = Escalating

• alarm

Saving to network

S/5 Network

• alarm

0 s, according to priority setting: high, medium, low

0s

Default settings Configuring care unit settings Note the following changes in the default settings:

Alarm settings Setting

Description

Audio Pause: For Remote Bed

Enable Audio pause for a remote bed from this monitor.

ED

ICU

NICU

OR

PACU

OR

PACU

Not Allowed

CARESCAPE Network only. Audio Pause: From Remote Location

Not Allowed

Select the alarm priority levels that can be remotely paused for this monitor. CARESCAPE Network only.

Parameter settings Setting

Description

ED

ICU

NICU

Apnea Alarm Deactivation

Enable the Apnea alarm deactivation/activation.

Not Allowed

SpO2 Probe Off Deactiv.

Enable the SpO2 probe off alarm deactivation/ activation.

Not Allowed

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Changes regarding the “CARESCAPE Monitor B650 User’s Manual”

Configuring current patient settings Note the following changes in the default settings:

Alarm priority settings Setting

ED

ICU

NICU

Arrhythmia paused

Escalating

Noisy ECG

Escalating

SpO2 high

Escalating

SpO2 low

Escalating

OR

PACU

Parameter settings Note the following changes in the default settings:

SpO2 default settings Setting

Description

Response

Select the averaging time.

ED

ICU

NICU

OR

PACU

Fast

PDM Nellcor only.

Changes regarding the “CARESCAPE Monitor B650 User’s Manual” System introduction Equipment symbols Note the following addition: Medical Equipment With respect to electric shock, fire and mechanical hazards only in accordance with IEC 60601-1, EN60601-1; UL 60601-1; CAN/CSA C22.2 NO.601.1-M90; IEC 60601-1-1.

Alarms Note the following changes:

Alarm warnings WARNING: The audible alarm signal may be paused temporarily from a central station or remote monitor. WARNING: There are no alarm indications until parameter specific alarm prerequisites have been met.

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Changes regarding the “CARESCAPE Monitor B650 User’s Manual”

Audible and visual alarm signals When physiological alarm messages are received from other monitors on the S/5 Network, only the most recent and highest priority message field alarm is shown. There are no flashing numerics or background color. No messages are shown in the parameter window area.

Selecting parameter alarm priority levels 1.

Select Alarm Setup from the monitor’s main menu.

2.

Select the Alarm Priorities tab.

3.

Select an alarm priority from Alarm Priority list. Choices are: −

HR/PR

−

ST Segment

−

Frequent PVCs

−

Noisy ECG

−

Arrhythmia paused

−

SpO2 high

−

SpO2 low

−

Art, ABP, Fem, UAC, PA, CVP, RAP, RVP, LAP, ICP, P1-P8

−

TcCO2/O2

Managing alarms from a remote location The remote alarm settings are defined in the care unit alarm defaults and allow you to define the following: −

Allow a Remote Audio Pause for this monitor from a central station or from a remote monitor.

−

Allow Audio Pause for a remote bed from this monitor.

−

Show the remote patient name.

−

Turn a remote monitor’s alarm light on/off.

−

Choose the remote alarm notification tone.

NOTE: When viewing a remote monitor via a bed-to-bed view on the S/5 Network, you cannot pause audio alarms. See the “CARESCAPE Monitor B650 Supplemental Information Manual” for details.

Setting up the monitor before use Selecting parameters to the screen Most parameters appear on screen automatically when their measurement starts. However, if you cannot see the parameter you are measuring, select it to the screen: 1.

Select Monitor Setup > Screen Setup.

2.

Select the parameter to the upper or lower parameter area:

• •

Select Upper Parameter Area >Show Parameter. Select Lower Parameter Area and activate it by selecting the radio button On. Then select the parameter from the dropdown list.

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Changes regarding the “CARESCAPE Monitor B650 User’s Manual”

Starting and ending monitoring Note the following changes: NOTE: PDM only. When monitoring is started, stored invasive pressure labels for those channels that have cables connected will be transferred from the PDM to the monitor. The labels for any disconnected channels will be transferred when those cables are connected. Note that the currently stored labels may differ from defaults. Exceptions:

•

If a cable is disconnected from the PDM and then reconnected, the label is not transferred; the label currently selected in the monitor will be used instead.

•

Continue menu: If you select Continue Current, Erase PDM Data or Discharge, the PDM current labels are set to defaults (P1:Art, P2:PA, P3:CVP, P4:LAP), and will be transferred to the monitor for those channels that have their cables connected.

NOTE: All labels have their specific alarm limit settings on the monitor.

Viewing other monitored patients Note the following changes: See the “CARESCAPE Monitor B650 Supplemental Information Manual” to configure the following remote alarm configuration settings: −

Alarm priority for an allowed Audio Pause: From Remote Location. Choices are: Not Allowed; Low; Medium, Low; and High, Med, Low. NOTE: CARESCAPE Network MC only.

−

Enable or disable pausing the audio remotely for another monitor (Audio Pause: For Remote Bed). Choices are Allowed and Not Allowed. NOTE: CARESCAPE Network MC only.

Pausing remote patient bed audible alarms NOTE: The monitors must be on the CARESCAPE Network. The remote monitor must be configured to allow Audio Pause: From Remote Location to occur. To pause the active alarms for the remote bed viewed from the bed-to-bed window, select Remote Audio Pause. If the selection is not available, this option has not been enabled during configuration.

System messages Note the following additions: Message

Location

Explanation

What to do

Alarms audio paused from Central

• al. area

The alarms were remotely paused from the iCentral.

• You can activate the alarms by

Audio OFF from Central

• al. area

The alarms have been turned off from the iCentral.

• You can change the selection

<Bed> Monitor disconnected

• al. area

Monitor with Alarm Notification enabled is disconnected from the network.

• Re-establish the connection.

Information Center busy

• al. area

S/5 Network has too many bed-tobed connections.

• Try again later.

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pressing the Audio Pause key. from Alarm Setup > Audible & Visual.

Changes regarding the “CARESCAPE Monitor B650 User’s Manual”

Message

Location

Explanation

What to do

Information Center not responding

• al. area

S/5 Network is busy and the central is not responding.

• Try again later.

Loading failed. Wrong patient

• al. area

Merging a case from the S/5 • Check that the Last Name, First Network was refused by the central. Name and Medical Record Number are identical on the monitor and central, or that the monitor has no information in these fields.

Network:<Central name>

• al. area

Connection to an iCentral is established.

• No action required.

Network down: <central name>

• al. area

The monitor has lost connection to an iCentral in the S/5 Network.

• Check the network connections.

Saving to network

• al. area

Connection to the S/5 Network was established and the monitor is saving patient data collected while disconnected from the network.

• No action required.

ECG Note the following changes: NOTE: 12RL measurement data is not sent to the S/5 Network.

ECG warnings WARNING: - NOISY ECG alarm - The “Noisy ECG” alarm indicates that the system is no longer monitoring ECG and there may be no HR high or HR low alarms. If you adjust the alarm priority level lower than the default value, keep the patient under close surveillance. Selecting alarm priorities for Noisy ECG and Arrhythmia paused You can set the alarm priorities for Noisy ECG and Arrhythmia paused through Alarm Setup > Alarm Priorities.

Arrhythmia detection

Arrhythmia alarm messages Note the following changes: Alarm message

Arrhythmia Alarm analysis priority

Arrhythmia detection criteria

A Fib

Full: All other software packages except NICU.

According to Absence of P-waves and irregular RR interval. priority setting

Accel. Ventric.

Full

According to Accelerated ventricular rhythm - Run of PVCs with a run length of at least priority setting six beats and the rate requirements have not met for V Tach or V Brady.

Asystole

Lethal

High

Bigeminy

Full

According to Every other beat is PVC (N-V-N-V-N-V). priority setting

HR decreased to zero.

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Changes regarding the “CARESCAPE Monitor B650 User’s Manual”

Alarm message

Arrhythmia Alarm analysis priority

Brady

Lethal: NICU According to PDM: Displayed 4/8-beat average ECG heart rate falls below the usersoftware priority setting selected common HR low limit or ECG HR low limit. package only. Full: All other software packages except NICU.

Couplet

Full

According to Two consecutive PVCs are detected between normal beats, N-V-V-N. The priority setting coupling interval between the PCVs must be less than 600 ms.

Irregular

Full

According to PDM in NICU software package only: Six consecutive normal RR intervals priority setting vary by 100 ms or more.

Missing beat

Full

According to E-modules: Actual RR interval more than 1.8 times the average RR priority setting interval.

Multifocal PVCs Full

According to E-modules: Over the last 15 beats two or more PVCs with different priority setting morphologies are detected.

Pause

Full

According to Actual RR interval more than a configured value (1-5 s). priority setting

Rapid VT

Lethal

According to E-modules: A run of PVCs is detected with a run length of six beats or priority setting more. In addition an effective HR that exceeds 160 bpm.

R on T

Full

According to Isolated PVC is detected within 100 ms of the peak of the T-wave of the priority setting patient’s predominant normal beat.

Single PVC

Full

According to PDM: Isolated PVC is detected. priority setting

Tachy (Tachycardia)

Full

According to PDM: Occurs when 4 consecutive RR intervals or the displayed 4/8-beat priority setting average ECG heart rate exceeds the user-selected common HR High Limit or ECG HR High Limit.

Trigeminy

Full

According to Every third beat is a PVC (N, N, V, N, N, V, N, N, V.) priority setting

V Brady

Full

According to Run of PVCs are detected with a run length of at least three beats. In priority setting addition, at least two consecutive RR intervals in the run must have an effective heart rate less than 50 bpm.

V Fib

Lethal

High

E-modules: ECG waveform indicates a chaotic ventricular rhythm.

V Fib/ V Tach

Lethal

High

PDM: ECG waveform indicates a chaotic ventricular rhythm.

V Tach

Lethal: All According to A run of PVCs is detected with a run length of six beats or more. In other priority setting addition an effective HR that exceeds 100 bpm. software packages except NICU. Full: NICU software package only.

VT>2

Full

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Arrhythmia detection criteria

According to A run of PVCs is detected with a run length of more than two beats but priority setting less than six beats. In addition at least two consecutive RR intervals in the run must have an effective HR that exceeds 100 bpm.

Changes regarding the “CARESCAPE Monitor B650 User’s Manual”

Airway gases Note the following changes:

CO2 measurement with E-modules Activating or deactivating the Apnea alarm NOTE: This feature is meant to be used when ending CO2 monitoring. It should not be used during active CO2 monitoring. This setting can be enabled during configuration. If it has been enabled, there will be a button in the CO2 Setup window that allows you to activate or deactivate the alarm: 1.

Select the gases parameter window.

2.

Select the CO2 > Setup.

3.

Select Deactivate Apnea Alarm or Activate Apnea Alarm. The text on the button will change accordingly.

NOTE: When the alarm is deactivated, there will be no audible or visual Apnea alarm indications. The alarm is automatically reactivated if CO2 vital signs are detected and alarm condition is met again. For more information on alarm activation, see the “Alarms” chapter.

WARNING: With deactivated ‘Apnea’ alarm, keep the patient under close surveillance.

Pulse oximetry (SpO2) Note the following additions:

Selecting the response time NOTE: PDM Nellcor only. You can select the response (averaging) time. Fast (default) is the recommended setting. 1.

Select the SpO2 parameter window.

2.

Select the SpO2 or SpO2(2) tab.

3.

Select the radio button for the response time: Normal or Fast.

Activating or deactivating the SpO2 Probe Off alarm NOTE: This feature is meant to be used when ending SpO2 monitoring. It should not be used during active SpO2 monitoring. This setting can be enabled during configuration. If it has been enabled, there will be a button on the SpO2 and SpO2(2) tabs that allows you to activate or deactivate the alarm: 1.

Select the SpO2 parameter window.

2.

Select the SpO2 or SpO2(2) tab.

3.

Select Deactivate SpO2 Probe Off or Activate SpO2 Probe Off. The text on the button will change accordingly.

NOTE: When the alarm is deactivated, there will be no audible or visual SpO2 Probe Off alarm indications. The alarm is automatically reactivated if SpO2 vital signs are detected and alarm condition is met again. For more information on alarm activation, see the “Alarms” chapter.

WARNING: With deactivated ‘SpO2 probe off’ alarm, keep the patient under close surveillance.

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Changes regarding the “CARESCAPE Monitor B650 Supplies and Accessories” document

Changes regarding the “CARESCAPE Monitor B650 Supplies and Accessories” document Note the following additions: Part number

TruSignal SpO2 accessory description

Approved for use with

TS-SP3-GE

TruSignal Integrated PediTip sensor with GE connector, 3 m/10 ft, 15 to 30 kg (33 to 66 lbs)

E-PRESTN, E-RESTN, E-PSM, E-PSMP

TS-SP-D

TruSignal PediTip sensor with GE connector, 1 m/3.3 ft, 15 to 30 kg (33 to 66 lbs)

E-PRESTN, E-RESTN, E-PSM, E-PSMP

Part number

Entropy accessory description

Approved for use with

M1174413

Entropy EasyFit Sensor, pkg of 25 pcs

E-ENTROPY

Entropy EasyFit SensorStart-up Kit, includes:

E-ENTROPY

M1174414

• Entropy EasyFitSensor (M1174413), 2 boxes • GE Entropy Cable (M1050784), 1 pc

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