Model 8100 CO2SMO plus Respiratory Profile Monitor Users Manual Aug 1999

Revision History 08-Jan-97

Release, Rev 00

17-Jan-97

Production release, Rev 01

10-Oct-97

Revision 02 software, Rev 02

15-Jan-99

Revision 03 software, Rev 03

30-Aug-99

Revision 3.1 software, R-N693, Rev 04

CO2SMO Plus! and CAPNOSTAT are registered trademarks and Y-Sensor, SuperBright and OxySnap are trademarks

of Novametrix Medical Systems Inc. Velcro is a registered trademark of Velcro USA, Inc. Cidex is a trademark of Arbook, Inc. Nafion is a registered trademark of Dow Corning Corp. The CO2SMO Plus! is Year 2000 compliant. Copyright 1999, Novametrix Medical Systems Inc. This document contains information which is proprietary and the property of Novametrix Medical Systems Inc., and may not be reproduced, stored in a retrieval system, translated, transcribed or transmitted in any form, or by any means, without prior explicit written permission from Novametrix Medical Systems Inc.

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Thank you . . . . . . for selecting the CO2SMO Plus! Respiratory Profile Monitor. You are the operator of one of the most advanced, state-of-the-art respiratory instruments available today. Our engineering staff, in collaboration with the medical community, has invested considerable effort to produce a highly accurate and extremely versatile instrument for respiratory monitoring. While we expect that the CO2SMO Plus! will meet your specific needs, we nonetheless are interested in receiving any comments you may have. Please review this manual prior to using the monitor. We are available to help you with servicing or applications questions. You may call toll-free at 1-800-243-3444. In Connecticut, call collect at (203) 265-7701. Sincerely,

WALLINGFORD, CT U.S.A. 06492

PHONE: TOLL FREE 1-800-243-3444 IN CONNECTICUT 203-265-7701 FAX 203-284-0753 WORLD WIDE WEB: http://www.novametrix.com INTERNET: Customer Service [email protected] Technical Service [email protected]

Declaration of Conformity with European Union Directives The authorized representative for Novametrix Equipment is: European Compliance Services Limited Oakdene House Oak Road Watchfield Swindon, Wilts SN6 8TD United Kingdom

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Contents General Description ...1 Indication for use ... 1 Unpacking ... 1 Operational Overview ... 2 Parameters Measured ... 2 Controls ... 2 Power Key ... 2 Contrast ... 3 Alert Silence ... 3 Set Alert Limits ... 3 Event/Freeze ... 3 CO2 Waveform/Plethysmogram ... 3 Flow/Pressure Waveforms ... 3 Trend ... 3 Data Screen ... 4 Setup/Configuration ... 4 Adjustment Keys ... 4 Indicators ... 6 Battery Alert Icon ... 6 AC Power Indicator Icon ... 6 Two Minute Silence Icon ... 6 Audible Alert Disabled Icon ... 6 Miscellaneous ... 6 Graphic Display ... 6 Alert Bar ... 7 Sampling System Input ... 7 CO2/Flow Sensor Connection ... 7 Rear Panel Connections and Labeling ... 8 Principle of operation ... 9 CO2 ... 9 Respiration Rate ... 9 SpO2 ... 9 Flow ... 10 Safety ...11 Preparation for Use ...15 AC/Battery Operation ... 15 Long Term Storage ... 15 Setup and Configuration Settings ... 16 Configuration Settings ... 19

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Sensors and Patient Connections ... 23 Initializing the CAPNOSTAT CO2 Sensor ... 23 Adapter Zero ... 24 On-Cable Verifier Cells ... 25 Combined CO2 and Flow ... 26 Patient/Sensor Selection Table ... 26 Monitoring Flow (Respiratory Mechanics) Separately ... 29 Monitoring CO2 Separately ... 30 Sampling Adapter ... 31 Flow Calibration/Zeroing ... 33 SpO2 Sensors ... 34 OxySnap™ Connectors ... 35 Finger Sensor ... 35 Finger Sensor Quick Check ... 36 Y-Sensor™ ... 36 Y-Sensor Application using Y-Strip Tapes or Foam Wrap ... 37 Y-Sensor Application using Ear Clip ... 42 Y-Sensor Quick Check ... 43 Single Patient Use SpO2 Sensors ... 44 Single Patient Use SpO2 Sensor Application ... 45 Single Patient Use SpO2 Sensor Quick Check ... 47 Monitoring ... 49 Display of Data ... 49 Parameters not displayed ... 54 Screen Displays ... 55 Waveform Screens ... 55 Trend Screens ... 57 Trend Memory ... 57 Data Screens ... 58 Data Set - Standard ... 58 Data Set - Protocol ... 60 Setup Screen ... 61 Alert Settings Screen ... 61 Notes on Patient Monitoring ... 62 CO2/Flow Sensor Tubing Purge ... 62 Automatic purge - Adult/Pediatric mode ... 62 Manual purge - Adult/Pediatric mode ... 62 Automatic Purge - Neonatal and Pediatric modes ... 62 Manual purge - Neonatal and Pediatric modes ... 62 Flow Sensor Zeroing ... 64 Automatic flow zero - Adult/Pediatric mode ... 64 Manual flow zero - Adult/Pediatric mode ... 64 Automatic flow zero - Neonatal and Pediatric modes ... 64 Manual flow zero - Neonatal and Pediatric modes ... 65 Intra-Aortic Balloon Pump ... 65 Reference Handbooks ... 65 Analog Module ... 65 Connecting the Analog Module ... 65 Selecting the Analog Module Interface ... 66 Calibrating an External Recorder ... 66

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HP VueLink Interface ...67 Transmitted Parameters ... 67 Transmitted Waveforms ... 68 Preparing for Use ... 68 Component Setup ... 69 Module Setup ... 70 Pre-selected Parameters ... 70 Auxiliary Plus Task Window ... 70 To change a waveform or parameter: ... 71 Trends/Calcs ... 72 Vital Signs Trends ... 72 Graphical Trends ... 72 Alarms and Messages ... 73 To Stop Monitoring with the CO2SMO Plus! ... 73 Blood Gas Monitor Interface ...75 Connecting the CO2SMO Plus! to the ABG Monitor ... 76 VIA Monitor ... 76 TrendCare Monitor ... 76 IRMA Monitor ... 76 Connecting the ABG Monitor and a PC ... 77 Selecting the COM1 Port for Communication to a PC ... 77 Selecting the COM2 Port for ABG Monitor Interface ... 77 Selecting the ABG Monitor ... 77 Selecting the TrendCare Data Transfer Parameters ... 78 Viewing ABG Data on the CO2SMO Plus! ... 79 CO2SMO Plus! Standard Data Mode ... 79 CO2SMO Plus! Protocol Data Mode ... 79 Ending the ABG Monitor Interface ... 79 Alerts and Messages ...81 Alerts ... 81 System Messages ... 81 Respiratory Mechanics (Flow) Messages ... 83 Oxygen Saturation Messages ... 83 Capnography Messages ... 84 Battery Status and Alerts ... 86 Alerts ... 86 Standby States ... 87 Setting Alert Limits ... 87 Manually Setting Alert Limits ... 87 Auto Alert Limits ... 88 Alert Latching ... 88 Alert Audio ... 88 Maintenance ...89 Cleaning and Sterilization ... 89 Monitor ... 89 SpO2 Finger Sensor ... 89 SpO2 Y-Sensor ... 89 SpO2 Y-Strip Tapes and Foam Wraps ... 90 Ear Clip ... 90 Flow Sensors and Combined CO2/Flow Sensors ... 90

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CAPNOSTAT CO2 Sensor ... 90 Reusable Adult Airway Adapter ... 90 Reusable Neonatal Airway Adapter ... 90 External Sampling System Components ... 91 Single Patient Use Airway Adapters ... 91 Internal Sampling System Components ... 91 Maintenance Schedules ... 92 Battery Maintenance ... 92 Mains Voltage Configuration ... 93 Fuse Replacement ... 93 Changing the Mains Voltage Setting ... 95 Specifications ... 97 General ... 97 Capnograph ... 97 Pulse Oximeter ... 98 Flow Sensor Specifications ... 98 Monitor Specifications ... 99 Additional Features ... 99 Warranty ... 101 Service Policy ... 102 Accessories ... 103

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Section 1

General Description

Through the combination of capnography, airway flow and pressure, and pulse oximetry, the CO2SMO Plus! provides the clinician with a respiratory profile of the patient. This includes information that was previously difficult to obtain continuously at the bedside, such as CO2 elimination (VCO 2) and deadspace parameters, as well as conventional capnography, pulse oximetry, and respiratory mechanics. The continuous respiratory profile provided by the CO2SMO Plus! provides the clinician with immediate feedback that allows precise and efficient patient/ventilator management.

Indication for use The CO2SMO Plus! is intended to be used for monitoring end tidal CO2, respiration rate, functional oxygen saturation, pulse rate and respiratory mechanics in monitoring environments such as ventilatory support, emergency and anesthesia. CO2SMO Plus! is designed to monitor adult, pediatric and neonatal patients. CO2SMO Plus! is not intended for any other purposes.

NOTE Components of this product and its associated accessories which have patient contact are free of latex. Gas compositions other than those selected in the SETUP screen can influence CO2 and flow measurement.

Unpacking The box that your CO2SMO Plus! was shipped in should contain the items shown below. Please contact us at 1-800-243-3444, or contact your local sales representative if any items are missing or damaged, or to order additional accessories. Combined CO2/Flow Sensor SpO2-Sensor CAPNOSTAT CO2 Sensor Monitor

User’s Manual

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Section 1

Operational Overview

Operational Overview Parameters Measured The CO2SMO Plus! measures and calculates various respiratory parameters for patient/ventilator management. Refer to “Monitoring” on page 49 for a complete parameters list.

Front Panel Controls and Indicators

Controls Power Key Press the POWER key to place the unit into operate mode (ON) or to place the unit into standby (OFF). There are four states of the unit: •

No AC Power, power icon

off, not in operate mode

In this condition the AC switch is off, or the power cord is not plugged into an AC outlet, or the outlet is not powered. No monitoring may occur in this state. Battery is not being charged. •

on, not in operate mode (standby)*

AC Power, power icon

In this condition the unit may be placed into operate mode by pressing the charging in this mode. •

AC Power, power icon

key. Battery is

on, in operate mode

In this condition the unit is in operating mode and the battery is being charged. •

Battery power, power icon

off, battery is not being charged

In this condition the unit is in the operating mode and the battery is not being charged. When the monitor powers up a self test is performed in which all indicators will temporarily illuminate and the monitor will emit a short beep. Following the self test the monitor will display: “ERASE STORED TRENDS? YES: NO: ” If the or for operation.

key is not pressed within five seconds, trends will be retained. The monitor is now ready

*The monitor must be in “stand-by” mode in order for the CAPNOSTAT CO2 sensor to remain heated when the monitor is off.

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General Description

Operational Overview

Contrast Press or hold to adjust the display’s contrast for different up/down viewing angles.

Alert Silence Press for 2 minute silence (audible alerts muted for two minutes). The duration of the two minute silence. Press again to cancel. Press and hold for 3 seconds to disable audible alerts, and the to cancel.

icon will illuminate for the

icon will flash. Press and hold again

Press to acknowledge a latched alert. If preconfigured not to allow the audio off function, the pressed (the two minute silence is still active).

key will not disable the audible alerts when

Set Alert Limits Press to set alert limits manually, or hold to set automatically. Press again to accept the displayed limits and return to the previous screen. For more detailed information on setting alert limits see “Setting Alert Limits” on page 87.

Event/Freeze Press the key to freeze the waveforms and loops for sixty seconds. An EVENT MARKER with time and date will appear in the message center for three seconds followed by “WAVEFORM FROZEN UNFREEZE: PRESS EVENT KEY”. To resume normal display press again, otherwise the waveform will resume again in 60 seconds. Pressing this key when viewing the DATA entry screen allows you to enter the patient’s PaCO2 for calculation of Vd/Vt phy, Vd phy and Vd alv.

CO2 Waveform/Plethysmogram Press to switch waveform display between capnogram and capnogram with plethysmogram.

Flow/Pressure Waveforms Press to switch waveform display between flow and pressure waveforms, or flow and volume waveforms, or flow vs. volume and volume vs. pressure loops.

Trend Press to switch between trend screens.

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Operational Overview

Data Screen Press to switch between data screens (numeric values only), and data entry screen (to enter weight and PaCO2 - see “Data Screens” on page 58 for details).

Setup/Configuration Press to display the SETUP screen, or hold for three seconds to display the CONFIGURATION screen (for advanced settings). Press again to accept the displayed settings and return to the previous screen. Refer to “Setup and Configuration Settings” on page 16.

Adjustment Keys Press to select different parameters in SETUP, CONFIGURATION, SET ALERTS or DATA ENTRY screen. Press and to change value or state of the currently selected parameter. The • •

key is also used to: Select different time bases on the Trend screens (see “Trend” on page 3) Rescale various waveforms if scaling is set to manual (see “Setup and Configuration Settings” on page 16).

The and TRENDS? YES:

keys are also used to respond to monitor prompts such as “ERASE STORED NO: .”

From the FLOW/PAW screen, use the

SET ALERTS

- moves pointer - press to change value

EVENT/FREEZE

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keys to adjust the spontaneous threshold line.

SETUP

- moves pointer - press to change value

SETUP (HOLD 3 SECONDS)

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Rev. 04

- changes time base

TREND

FLOW/PRES

CO2/PLETH

STANDARD DATA SCREENS

- press to change value

- moves pointer

PROTOCOL DATA SCREENS

CONFIGURATION menu. Press and . hold the SETUP key to access.

or PROTOCOL data * STANDARD screens are selected in the

NOTE: screens may vary with future software updates.

Operational Overview

General Description

*

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Section 1

Operational Overview

Indicators Battery Alert Icon Illuminates when the unit is on battery power and the battery charge is critically low. When battery is near exhaustion an audible alert will sound and “BATTERY VERY LOW PLUG IN AC POWER” will appear in the display screen. Refer to “AC/Battery Operation” on page 15 for information on connecting AC power and charging the battery.

AC Power Indicator Icon Illuminates when the monitor is connected to an AC power source and the rear panel power switch is ON “ | ”. In this condition the internal battery is charging.

Two Minute Silence Icon Illuminates when the two minute silence is active.

Audible Alert Disabled Icon Flashes when audible alerts have been disabled.

Miscellaneous Top cover instructions Explosion hazard WARNING

Carrying handle

Graphic display

Alert bar Sampling system inlet CO2/Flow sensor connection

Graphic Display Graphic blue/white 240 X 64 pixel dot matrix display.

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General Description

Alert Bar Flashes red when alert conditions are detected. When ALERTS LATCHED in the CONFIGURATION menu is set to YES, the alert bar is latched. This means that when an alert is active, the alert bar will flash even if the condition that caused the alert has been corrected. To reset the latched alert bar press, the key.

Sampling System Input Input connection for sampling system tubing. See “Sampling Adapter” on page 31 for more information.

CO2/Flow Sensor Connection Connection for CO2/flow sensors. See “Sensors and Patient Connections” on page 23 and “Monitoring Flow (Respiratory Mechanics) Separately” on page 29 for more information.

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Section 1

Rear Panel Connections and Labeling

Rear Panel Connections and Labeling Equipotential connection SpO2 sensor connection

25 pin D connector (for communications) CONNECT ONLY TO IEC601 APPROVED DEVICES

CO2 sensor connection Fuse/power setting compartment AC power switch Power cord receptacle Sampling system exhaust

Equipotentiality: Connection to monitor’s chassis

Patient isolation: Identifies connection as type BF

Attention: Consult manual for detailed information

Mains fuse rating for replacement fuses 250V

AC mains switch “ | ” ON-connection to mains; “O” OFF-disconnection from mains Recyclable item. This symbol is found on the internal battery and should not concern the common user. Refer to qualified service personnel when battery replacement is required. Separate collection. Appropriate steps must be taken to ensure that spent batteries are collected separately when disposed of. This symbol is found on the internal battery and should not concern the common user. Refer to qualified service personnel when battery replacement is required.

Pb

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Indicates heavy metal content, specifically lead. This symbol is found on the internal battery and the monitor enclosure and should not concern the common user. Refer to qualified service personnel when battery replacement is required.

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General Description

Principle of operation

Principle of operation CO2 CO2SMO Plus! uses the CAPNOSTAT CO2 sensor to measure CO2 by using the infrared absorbtion

technique, which has endured and evolved in the clinical setting for over two decades and remains the most popular and versatile technique today. The principle is based on the fact that CO2 molecules absorb infrared (IR) light energy of specific wavelengths, with the amount of energy absorbed being directly related to the CO2 concentration. When an IR beam is passed through a gas sample containing CO2, the electronic signal from the photodetector (which measures the remaining light energy) can be obtained. This signal is then compared to the energy of the IR source and calibrated to accurately reflect CO2 concentration in the sample. To calibrate, the photodetector’s response to a known concentration of CO2 is stored at the factory in the monitor’s memory. A reference channel accounts for optical changes in the sensor, allowing the system to remain in calibration without user intervention.

Respiration Rate The respiration rate is calculated from the flow signal generated whenever a flow or combined CO2/flow sensor is connected to the CO2SMO Plus!. If a flow or combined CO2/flow sensor is not connected, and a CAPNOSTAT CO2 sensor is connected, then the respiration rate is calculated from the CAPNOSTAT CO2 sensor signal. In the event that there is no flow, CO2/flow, or CAPNOSTAT CO2 sensor connected, the respiratory rate will not be calculated.

SpO2 The CO2SMO Plus! determines oxygen saturation using sensors that contain red and infrared (660 and 940 nanometer) light sources, called light emitting diodes (LEDs). The light energy from each LED is beamed through a tissue sample-a pulsating vascular bed such as the patient’s finger or toe. The remaining light energy not absorbed by the tissue sample reaches a photodiode light receptor in the sensor. Oxygen saturated blood absorbs different amounts of light at each wavelength as compared to desaturated blood. Therefore, the amount of light absorbed by the blood in each pulse can be used to calculate oxygen saturation. The CO2SMO Plus! is calibrated to display “functional” saturation. This differs from the “fractional” saturation value displayed by most co-oximeters. Functional saturation is defined as: HbO2

Functional Saturation =

100 - (COHb + METHb) HbO2 = Fractional Oxyhemoglobin COHb = Carboxyhemoglobin METHb = Methemoglobin This can be considered to represent the amount of oxyhemoglobin as a percentage of the hemoglobin that can be oxygenated. Dysfunctional hemoglobins (COHb and METHb) are not included in the measurement of functional saturation.

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Section 1

Principle of operation

Pulse Rate is calculated by measuring the time interval between peaks of the infrared light waveform. The inverse of this measurement is displayed as pulse rate. The oxygen saturation and pulse rate values are updated once each second. Presence of a pulse is indicated visibly by a plethysmogram graphic display and audibly by a “beep.” The CO2SMO Plus! must be used in conjunction with SuperBright™ Sensors. See “Accessories” for a list of available sensors and accessories.

Flow Flow measurements in the CO 2 SMO Plus! are made by a fixed orifice differential pressure pneumotachometer. Respired gas flowing through the flow sensor causes a small pressure drop across the two tubes connected to the sensor. This pressure drop is transmitted through the tubing to a differential pressure transducer located inside the monitor, and is correlated to flow according to the factory stored calibration. User calibration is not required due to the ability of the plastic injection mold to repeatedly produce precision flow sensors. The pressure transducer is automatically “zeroed” to correct for changes in ambient temperature and electronics. The CO2SMO Plus! system software compensations allow accurate flow and volume measurements in the presence of high oxygen concentrations, anesthetic gases and helium-oxygen mixtures. When compensated, gas density and viscosity effects do not cause significant errors in flow measurement. For maximum flow sensor performance: (1) keep the pressure sensing ports oriented upward; (2) keep the sensor clear of accumulations by proper breathing circuit maintenance; (3) confirm that the gas compositions entered correspond to ‘best’ known values (refer to “Setup and Configuration Settings” on page 16).

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Section 2

Safety

The CO2SMO Plus! monitor is electrically isolated. Patient leakage current flowing from the instrument to ground is limited to less than 100 uA at 120/220 VAC, 50-60Hz. For maximum patient and operator safety, you must follow the following warnings and cautions.

WARNINGS

!

Indicates a potentially harmful condition that can lead to personal injury. • • • • • • • • •

•

• •

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Explosion Hazard: DO NOT use CO2SMO Plus! in the presence of flammable anesthetics. Use of this instrument in such an environment may present an explosion hazard. Electrical Shock Hazard: Always turn CO2SMO Plus! off and remove the line cord before cleaning it. Refer servicing to qualified service personnel. Never sterilize or immerse the monitor in liquids. Do not operate CO2SMO Plus! when it is wet due to spills or condensation. Do not operate CO2SMO Plus! if it appears to have been dropped or damaged. Failure of Operation: If the monitor fails to respond as described, do not use it until the situation has been corrected by qualified personnel. The CO2SMO Plus! is not intended to be used as a primary diagnostic apnea monitor and/or recording device. Patient Safety: Care should be exercised to assure continued peripheral perfusion distal to the SpO2 sensor site after application. Inspect the SpO2 sensor site often for adequate circulation - at least once every four hours. When applying sensors take note of patient’s physiological condition. For example, burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate. Data Validity: As with all pulse oximeters, inaccurate SpO2 and Pulse Rate values may be caused by: - Incorrect application or use of sensor; - Significant levels of dysfunctional hemoglobin; carboxyhemoglobin or methemoglobin; - Significant levels of indocyanine green, methylene blue, or other intravascular dyes; - Exposure to excessive illumination such as surgical lamps-especially those with a xenon light source, or direct sunlight; - Excessive patient movement; - Venous pulsations; - Electrosurgical interference. A “NO RESPIRATION” alert is not generated when both the CAPNOSTAT CO2 sensor and the CO2/Flow or Flow sensor are disconnected from the CO2SMO Plus!. The CO2SMO Plus! automatically identifies the type of CO2/flow sensor (neonatal, pediatric or pediatric/adult) or flow sensor (neonatal or pediatric/adult) when it is connected. If a flow sensor identification message is not displayed when a flow or CO2/flow sensor is first connected, DO NOT use the sensor. If the condition persists, refer the monitor to qualified service personnel.

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Section 2

•

•

•

•

Periodically check the CO2/Flow sensor and tubing for excessive moisture or secretion build up. Although the CO2SMO Plus! automatically purges the lines, excessive moisture or secretions may still remain. While using the CO2/Flow sensor, a system leak, such as that caused by uncuffed endotracheal tubes or a damaged CO2/Flow sensor may significantly effect flow related readings. These include flow, volume, pressure, deadspace, CO2 production and other respiratory mechanics parameters. Connect the line cord to a grounded hospital-grade outlet. CO2SMO Plus! should be connected to the same electrical circuit as other equipment in use on the patient. Outlets of the same circuit can be identified by the hospital’s engineering department. The CO2SMO Plus! has no protection against the ingress of water.

CAUTIONS

!

Indicates a condition that may lead to equipment damage or malfunction. • • • • • • • • • •

• •

•

•

Do not operate CO2SMO Plus! when it is wet due to spills or condensation. Do not operate CO2SMO Plus! if it appears to have been dropped or damaged. Keep CO2SMO Plus! and its accessories clean. Never sterilize or immerse the monitor in liquids. Do not sterilize or immerse sensors except as directed in this manual. Do not apply excessive tension to any sensor cable or pneumatic tubing. Do not store the monitor or sensors at temperatures less than 14°F (-10°C) or above 131°F (55°C). Do not operate the monitor or sensors at temperatures below 50°F (10°C) or above 104°F (40°C). Federal (U.S.A.) law restricts this device to sale, distribution, or use by or on the order of a licensed medical practitioner. DO NOT attach an SpO2 sensor distal to a blood pressure cuff. Valid data CANNOT be processed when the cuff is inflated. Attach the sensor to the limb opposite to the site used for the blood pressure cuff. Excessive moisture in the CO2/Flow sensor may affect the accuracy of the flow measurement. To avoid the effects of excessive moisture in the measurement circuit, insert the CO2/Flow sensor in the ventilator circuit with the tubes upright. The striped tube is positioned closest to the patient. Improper placement will result in erroneous data. It is recommended that the CO2/Flow sensor be removed from the circuit whenever an aerosolized medication is delivered. This is due to the increased viscosity of the medications which may contaminate the sensor windows, causing the sensor to fail prematurely. In case of interference with our equipment or another manufacturer’s equipment, notify your Novametrix representative.

NOTES Indicates points of particular interest or emphasis for more efficient or convenient operation. • • •

12

Components of this product and its associated accessories which have patient contact are free of latex. As with all flow measuring devices, adverse conditions may affect the accuracy of the flow measurement. See page 10 for a discussion of flow measurement. If CO2 is being measured while not using a CO2/Flow sensor, certain rebreathing circuits, or the presence of artifacts such as cardiogenic oscillations, may cause CO2SMO Plus! to react to nonrespiratory CO2 fluctuations as if they were breaths. This condition affects only the numerical displays; the capnogram display continues to provide an accurate picture of the CO2 waveform.

CO2SMO Plus! User’s Manual

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Safety

•

•

•

•

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When a new CAPNOSTAT CO2 sensor is attached to the monitor, or is moved from one monitor to another, it must be initialized before use. The CAPNOSTAT CO2 sensor does not have to be initialized again as long as it is used with the same monitor. The Sample Pump will not turn on if a combined CO2/Flow or Flow sensor is connected to the CO2SMO Plus!. If the Sample Pump is already on and a combined CO2/Flow or Flow sensor is connected, the Sample Pump will turn off. If you use the CO2SMO Plus! for transport or if you drastically change the orientation of the CO2SMO Plus!, the CO2/Flow sensor must be manually re-zeroed. See page 33 for more information on the CO2/Flow sensor zero procedure. After the life cycle of our equipment and all accessories has been met, disposal of the equipment should be accomplished following the national requirements. Contact the local Novametrix representative for questions concerning disposal.

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