Quick Reference
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Page 1
Corometrics
2120is Series Quick Reference Guide
Primary Labor Parameters: FHR1, FHR2, and UA.
Maternal Vital Signs: NBP, MECG/PULSE, and MSpO2.
Message Area: Paper low/out, remote alarm, remote bed disconnection notification. Test: Starts self-test routine. Volume: FHR1 and FHR2 rear panel speaker volume controls. VSHX: Displays 8 hours of local bed vital signs history in tabular format. Paper Advance: Advances strip chart paper as long as button is held. Record: Selects printing mode (on, off, maternal). NBP Go/Stop: Starts/stops manual and automatic blood pressure readings. (Holding down cycles through autointerval selections.)
Local: Displays Local window (as shown). Surveillance or QS: Displays remote bed surveillance window (built-in or QS, depending on network). ADT: Used to access the Admit, Discharge, Transfer, and Roster functions. Setup: Displays the system configuration buttons.
Alarm Silence: Silences audio alarm tones. Print: Prints 6-second waveform snapshot. Freeze: Freezes waveform display. Waveform Menu: Select OFF, FECG, MECG, or MSpO2. Strip Chart: Two hours of data for up to six trends: FHR1, FHR2, UA, MHR, MSpO2 (built-in or external device), and FSpO2 (collected). Trend Scrolling: Start, Reverse, Stop, Forward, and End buttons for navigating local bed 2-hour trend history.
Annotation: Access window to enter notes in strip chart margin. Mark: Stamps an event mark on the strip chart .
Offset: Hold to shift secondary FHR trend +20 BPM when trends overlap. UA Ref: Sets UA baseline.
Local Window
Setup About This Guide This guide provides a summary of monitor features you are most likely to use. For detailed instructions on patient application refer to the Maternal/Fetal Monitoring Clinical Application Operator’s Manual. For more information on the 2120is Series Monitor, refer to the 2120is Series Operator’s Manual. This guide describes options that may not be installed in your monitor. See back cover of this guide.
black squares on bottom; feed paper from top; make sure paper is flat in tray and under the bar; close door. Improper loading can cause paper jams. 4
On Password Access window, enter Unit (i.e. OB, LDRP) and bed location (i.e. 104, RR-4) if either field has changed. Enter password: CORO or 2120.
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Select the LOCAL button to display the Local window.
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Select the TEST button to run self-test. Check results printed on strip chart paper.
Monitor Setup 1
Prepare all accessories and supplies required for patient monitoring session.
2
Press the POWER button on both the monitor and the display.
3
Open recorder door; insert paper with
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Select the SETUP button to access system configuration buttons. Select MASTER ALARM, HR1, HR2, MHR/P, MSpO2, NBP, WAVEFORM, or SERVICE to set features and alarm limits. 1
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Adjust volumes using the VOLUME buttons or the individual setup windows. IMPORTANT POINTING DEVICE-Your system’s pointing device may be the touch screen, a stylus, a mouse, or a trackball on your keyboard. When you “select” or “choose” a button, a field, or a mode title: • If you have a mouse or trackball, you move the cursor over the item on the display, then click it to select. • If you have a touch screen, use the tip of your finger or a stylus to tap the item on the display.
Field
Time/Date SpO2 Scale Play Song Song Volume Light Paper Speed (cm/min) Paper Chime Chime Volume FSpO2 Trace FSpO2 Print Interval (min) MSpO2 Print Interval (min) General Setup Screen
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Available Selections (default in bold)
24-hour clock 12-month calendar Auto, 0–100% Off, Happy Birthday, Brahms’ Lullaby, Rock-a-Bye Baby, All 0–9 [5] On, Off 1, 2, 3 Off, Out Only, Low and Out 1–9 [5] On, Off Off, 2, 5, 10, 15, 30, 60 Off, 2, 5, 10, 15, 30, 60
FHR Singleton Monitoring External Method (Ultrasound) 1 Plug transducer cable into either US or US2 connector. 2
Apply transducer.
3
Verify heartbeat indicator with each sound.
4
Verify the FHR by checking the maternal pulse-ensure that the displayed FHR is different than the maternal pulse rate.
cable plug into the monitor’s FECG/ MECG connector; plug the legplate cable into the FECG/MECG adapter connector labeled FECG. 4
flashes
Internal Method (FECG) 1 Apply spiral electrode and insert connecting end into legplate. 2
Secure legplate to patient using a strap or attachment pad.
3
For round connector legplate cable plugs: insert the FECG/MECG adapter
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For rectangular connector legplate cable plugs: plug legplate directly into the monitor’s FECG/MECG connector. Verify heartbeat indicator with each sound.
FHR1/FHR2
FECG/US FECG/US2 US/US2
flashes
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Twins Monitoring Dual Ultrasound For presenting twin, plug transducer into US connector. For other twin, plug transducer into US2 connector.
Strip Chart Display
Strip Chart Paper
-FECG (black) -US (dark green) -FECG (black) -US2 (light green) -US (dark green) -US2 (light green)
FECG US FECG US2 US US2
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Verify the FHR by checking the maternal pulse-ensure that the displayed FHR is different than the maternal pulse rate.
(black) (bold black) (black) (bold black) (black) (bold black)
FECG and Ultrasound Apply the spiral electrode to the presenting twin. For other twin, apply ultrasound transducer; plug transducer into US2 connector. If transitioning from dual ultrasound monitoring, disconnect transducer from US connector (presenting twin).
Field
Beat Volume FM Detection (US only) HR Offset Activation (FHR2 only) Audio Alarms Alarm Volume Alarm Limits (BPM)
US/US2 Setup Window
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Available Selections (default in bold)
0–9 [5] On, Off On, 10 min, Off On, Off 1–9 [5] Low Off, 60–140 [120]
High 140–200 [160], Off
UA External Monitoring 1
Plug Nautilus tocotransducer into UA connector.
2
Verify that the display reads less than 30 relative units. Make a note of the reading.
3
Apply tocotransducer.
4
Tighten belt between contractions so that the UA reading shows about 25 relative units above the inital baseline noted in step 2.
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Internal Monitoring (Intrauterine Catheter)
TOCO
1
Plug IUPC intermediate cable into UA connector.
2
Insert catheter following package directions.
TOCO
Nautilus Tocotransducer
Select the UA Reference button between contractions. UA Mode
Strip Chart Display
Strip Chart Paper
TOCO
-TOCO (black)
TOCO
IUP
-IUP (black)
IUP
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(black) (black)
More About UA Referencing For external monitoring, the monitor provides relative pressure measurements compared to a baseline (the UA reference). The initial baseline automatically occurs when you plug in the tocotransducer. After the belt is adjusted, it is important to establish a new baseline so that belt tension is not counted as uterine pressure and so that readings don’t go out of scale range. •
•
Select and hold the UA Reference button to cycle through all the available settings; release the button at the desired value.
•
If pressure falls below 0 relative units (probably because the belt has loosened), automatic UA referencing occurs and a new baseline reference is set at 0 relative units.
Briefly select the UA Reference button to set the baseline at the default value configured on the Install Options window.
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MECG/Pulse Source 1
2
MECG Application
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Secure cable to patient gown.
Display the MHR/P Setup window by selecting the PULSE or MECG mode title-whichever is shown.
When MECG is selected as the source, make the following additional selections:
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For round connector MECG cable plug:
1
Select Lead I, II, or III in the Lead field.
Select MECG, MSpO2, NBP, or AUTO in the Source field. The source: displays in the MHR/P area; is used to evaluate an alarm condition; and is used to generate the strip chart trend.
2
For pacemaker patients, enable (check) the Pacer field, so that the monitor replaces each pacer spike with an event mark. (The indicator P displays in the waveform information.)
3
Enable (check) the MHR/P Trace field.
4
Apply electrodes and attach leadwires (if detachable).
• Insert the adapter cable plug into the monitor’s FECG/MECG connector. • Insert the MECG cable plug into the adapter connector labeled MECG. 7
For rectangular connector MECG cable plug: insert the MECG cable plug directly into the monitor’s FECG/ MECG connector.
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Verify heartbeat indicator with each sound.
Source
Mode
Strip Chart Display
Strip Chart Paper
MECG
MECG
-MECG (blue)
MHR
MSpO2
PULSE
-MSpO2P (purple)
MSpO2P
NBP
PULSE
(not applicable)
(not applicable)
Auto
The monitor selects the first available parameter in the order: MECG, MSpO2, then NBP. 7
(grey) (grey)
flashes
Audio
A beep is provided with each heartbeat-the pitch does not vary. Each pulse beat is indicated with a beep; the pitch rises/drops with respect to the saturation values. (not applicable)
MHR/P Setup Screen
Field
Available Selections (default in bold)
MHR/P Trace MHR/P Source Audio Alarms Alarm Volume Beat Volume MECG Pacer MECG Lead Select Alarm Limits (mmHg)
On, Off Auto, MECG, MSpO2, NBP On, Off 1–9 [5] 0–9 [5] On, Off I, II, III Off, 35–120 [50] 100–250 [120], Off
SITE
AHA
IEC
Right arm
RA (white)
R (red)
Left arm
LA (black)
L (yellow)
Left leg
LL (red)
F (green)
I
right arm
left arm
II
III
MECG Electrode Placement left leg
typical yp patient p pacemaker patient
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NBP Application 1
Apply appropriate size cuff.
2
Attach air hose to NBP connector on front of monitor.
3
Access the NBP Setup window by selecting the NBP mode title.
4
Choose a mode: manual or auto (with desired time interval).
Pressure values and the pulse rate from NBP stamp on the strip chart; a diamond marks the time. NBP nnn/nnn M nnn P nnn (where “n” represents a digit)
Manual Mode
Smart BP Feature
Select the NBP Go/Stop button to take a single determination.
The Smart BP feature recognizes uterine contractions from their onset and postpones current or upcoming Auto Mode readings until after completion of the contraction.
Manual readings can be taken any time and do not interrupt the Auto Mode cycles.
Automatic Mode Take an initial manual reading. The first automatic reading occurs after one complete interval. The clock icon indicates the auto mode is active. The corresponding countdown timer measures the time between readings.
Main Screen Shortcut for Setting Auto BP Time Intervals: Select and hold the BP Go/Stop button to cycle through the auto interval time choices-displayed in place of the countdown timer. Release when the desired time is shown. 9
•
The interval time must be set to 5 or more minutes.
•
A diamond with a slash and the annotation NBP (D) mark the postponement on the strip chart.
Stopping an NBP Reading Select the NBP Go/Stop button to cancel a determination-automatic or manual. The cuff deflates.
Field
Display Interval Mode and Auto Interval (min) Audio Alarms Done Volume Alarm Volume Alarm Limits (mmHg) Systolic Diastolic MAP MHR/P
NBP Setup Screen
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Available Selections (default in bold)
On, 1, 2, 3, 5, 10, 15, 30 Manual; Auto: 1–5, 10, 15, 20, 30, 40, 45, 60, 90, 120 On, Off 0–9 [5] 1–9 [5] Low High Off, 50–150 [90] 70–240 [160], Off Off, 30–120 [50] 70–130 [90], Off Off, 30–120 [50] 70–150 [140], Off Off, 35–120 [50] 100–250 [120], Off
MSpO2 Application 1
Plug the intermediate cable into the MSpO2 connector.
2
Connect the MSpO2 sensor to the intermediate cable.
3
Access the MSpO2 Setup window by selecting the MSpO2 mode title. • Choose a time in the Print Interval field.
4
Apply sensor to maternal finger following package instructions. (Use only Nellcor sensors.)
%MSpO2 values and the pulse rate from MSpO2 are annotated on the strip chart; a diamond marks the time. MSpO2 nnn% M nnn P nnn (where “n” represents a digit)
• Select a Response mode. • Enable (check) the %O2 Trace field.
Vital Sign
Display Trend
Paper Trend
%MSpO2
-MSpO2% (purple)
MSpO2%
(grey)
MSpO2P
-MSpO2P (purple)
MSpO2P
(grey)
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Refer to the MHR/Pulse card in this guide for information about selecting MSpO2 as the MHR/P source.
Field
MSpO2 Trace Response Time MSpO2 Print Interval (min) Audio Alarms Alarm Volume Alarm Limits (mmHg) MSpO2% MSpO2P
MSpO2 Setup Window
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Available Selections (default in bold)
On, Off Slow, Normal, Fast Off, 2, 5, 10, 15, 30, 60 On, Off 1–9 [5] Low Off, 80–99 [95] Off, 35–120 [50]
High 85–100 [100], Off 100–250 [120], Off
Popular Features Heart Rate Offset
Heartbeat Coincidence (HBC)
A shifted FHR2 trend is annotated on the strip chart as follows:
HBC alerts you when you may be monitoring a duplicate HR signal. When enabled, HBC displays to the right of the FHR2 mode title; and HBC is included in mode line on the strip chart. As soon as HBC is detected:
•
US2 + 20 : the US2 trend is shifted.
•
US + 20 : the US trend is shifted.
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To shift/unshift an overlapping FHR2 trend by +20 BPM: • Select and hold the Offset button for three seconds; or • Set HR Offset field on US/US2 Setup window (whichever is FHR2). To shift, select On or 10 Min (whichever option is enabled). To unshift, select Off. (If the 10-minute auto-revert feature is used, a shifted trace automatically unshifts after ten minutes.)
2
Document the actual heart rate of the shifted trend on the strip chart. (Tip: use the Annotations window.)
•
•
The heart rate numerics display in inverse video . (HBC can detect two or three coincident rates.) Two overlaid hearts mark the top of the strip chart; they are repeated twice per page for as long as coincidence is detected.
Once coincidence is resolved: •
The heart rate numerics return to standard video.
•
Two side-by-side hearts once on the strip charts.
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appear
Built-In Fetal Movement Detection (FMD) for US2 Only 1
Select US mode title to display US Setup window.
2
Enable (check) the FM Detect field.
When FMD is on: •
FMD displays in-between the FHR1 and FHR2 mode titles.
•
FMD appears on the strip chart mode line.
•
A solid line shows on the strip chart for the duration of detected movements.
Patient-Perceived Fetal Movement Use the Remote Event Marker accessory. Instruct patient to press and hold button for duration of movement. A marker prints on the bottom of the top grid indicating the perceived fetal movement. FM
Maternal Vital Signs History (VSHX) 1
Select the VSHX button on the Local window.
2
Select an interval time in the HX Interval field.
3
Use the scrolling buttons to view all the data (up to eight hours).
4
To print, select PRINT (displayed page) or PRINTALL (entire history).
5
Select the LOCAL button to return to the Local window.
Available Selections (default in bold)
Event; 1, 5, 10, 15, 30, 60
Annotations 1
Select the ANNOTATIONS button on the Local window.
2
Select any combination of buttons to place text in string window-or use the keyboard to type free text.
3
Select the ENTER button. The annotation appears on the strip chart.
4
Select the LOCAL button.
VSHX Window
Annotations Window 14
ADT Displaying the Admit, Discharge, Transfer, and Roster Windows 1
Select the ADT button.
2
Type the password: 2120 or CORO.
3
Select the OK button.
4
The Admit window displays; you can enter admission data or access the Roster, Discharge, or Transfer windows. From any of these four windows you can select the ADMIT, DISCHARGE, TRANSFER, and ROSTER buttons to move between windows.
Admitting a Patient
Discharging a Patient Record
4
The discharge function clears the patient data from the monitor.
Select the TRANSFER button at the bottom of the window.
5
Select the OK button when asked: This transfers the patient from . . .
6
Select the OK button when you see: Transfer Operation Complete.
7
Transfer the paper strip chart record from the starting monitor to the destination monitor.
CAUTION VSHX-You may wish to print the VSHX record prior to discharging the patient. 1
Display the Discharge window.
2
Select the DISCHARGE button at the bottom of the window.
3
Select the OK button when asked: Are you sure you want to discharge patient?
Transferring a Patient Record from One Monitor to Another
1
Display the Admit window.
1
Turn on the monitor in the new location.
2
Type the patient’s last name and first name.
2
Display the Transfer window.
3
3
Select the ADMIT button on the bottom of the window.
Use the patient.
buttons to select the 15
Displaying the Roster The Patient Roster window displays a summary of all networked monitors in the same unit, listed by bed number only.
Unit Settings The UNIT field is an important factor in inter-bed surveillance. Monitors can only communicate with other monitors configured on the same unit. In a large hospital, many monitors may be physically wired together; however, the monitors may be segmented into logical groups by using two or more unit settings. The unit setting can be changed at any time by turning the monitor off and then on again.
Transfer: Select the record you wish to transfer.
Admit and Discharge Fields Admit: The patient name entered here displays above the strip chart on the Local window only.
Roster: Displays a list of all powered-on monitors within the same unit.
Discharge: These fields display for confirmation purposes prior to discharging the record.
Unit: Change unit location only when you are switching to a different group on a network. Bed: Each time you turn on the monitor, check that the bed location field is correct; enter new name/number if necessary.
Power-On Sign-In Fields 16
Transfer and Roster Fields
Alarms Silencing Active Alarms Select the Alarm Silence button to silence an audio alarm. Visual indications remain until the condition is resolved. MECG and MSpO2 may re-alarm.
What Happens When an Alarm Condition is Resolved? Signal quality or maternal high/low: the audio and visual indications automatically clear once the condition is resolved-whether or not the alarm has been previously silenced.
FHR high/low: If you haven’t already silenced the alarm, both the audio and visual indications remain until you acknowledge the alarm by selecting the Alarm Silence button. If the alarm has been previously silenced, the visual indications clear once the condition is resolved.
ALARM
VISUAL
AUDIO
High/Low (FHR, NBP, MSpO2, and MHR/P)
Out-of-limit value flashes.
Alternating high/low tones.
FHR/MHR Signal Quality
Flashing dashes (– – –) replace the FHR or MHR value.
Alternating high/low tones.
MECG Leads Off
Dashes (– – –) replace the MHR value and the message MECG LEADS OFF flashes.
Alternating high/low tones.
MSpO2 Disconnect
Dashes (– – –) replace the %MSpO2 value.
Alternating high/low tones.
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Alarm Configuration Set alarm options via the individual setup windows or the Master Alarm Setup window. 1
Set the alarm limits.
2
Set the alarm volume.
3
Enable/disable the audio alarms for each parameter.
4
Select a re-alarm time for MECG and MSpO2 (Master Alarm Setup window only).
The Master Alarm Setup window provides an alarm volume control and a summary of maternal alarm settings. Fetal alarm limits must be set from the FECG/US/US2 setup windows. Pay close attention to the alarm setting indicators: • •
A bell indicates all alarm settings are enabled (audio and high/low limits). A bell (with slash) indicates at least one alarm setting is turned off.
Master Alarm Setup Window Field
Available Selections (default in bold)
Re-Alarm (sec)
30–120 [120]
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