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CARESCAPE series Modules and Frames
CARESCAPE E-Modules Frames and Modules Service Manual 2nd edition May 2018
Service Manual
578 Pages
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GE Healthcare Module Frames and Modules Service Manual
CAUTION: U.S. Federal law restricts this device to sale by or on the order of a licensed medical practitioner. Outside the USA, check local laws for any restriction that may apply. All specifications subject to change without notice. English 2nd edition Order code #2106778-004
May 28, 2018 © 2018 General Electric Company. All rights reserved.
Master table of contents Module Frames and Modules Service Manual Order code #2106778-004 paper
Description
Tab
About this manual
1
Patient Side Module E-PSMP Rev.01
2
PiCCO Module, E-PiCCO
3
Cardiac Output Modules E-COP and E-COPSv Rev. 01
4
Pressure Temp Module, E-PT, Dual Pressure Module, E-PP
5
Masimo Module, E-MASIMO
6
Nellcor Compatible Saturation Module, E-NSATX
7
Respiratory Modules, E-sCAiOVX, E-sCAiOV, E-sCAiO, E-sCOVX, E-sCOV, E-sCO
8
Single-width Airway Module, E-miniC
9
E-LoFlo Module
10
Entropy Module, E-ENTROPY Rev. 01
11
EEG Module, E-EEG and EEG Headbox, N-EEG
12
BIS Module, E-BIS Rev. 01
13
NeuroMuscular Transmission Module, E-NMT Rev. 01
14
Module Frames F5, F7
15
PDM Module
16
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Module Frames and Modules
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Table of contents
Table of contents 1
About this manual 1.1 1.2 1.3 1.4
1-1
Intended use of the manual... 1-1 Intended audience of the manual... 1-1 Third party trademarks... 1-1 Service requirements... 1-1 1.4.1 Equipment identification... 1-2 1.4.2 Device plate location... 1-2 1.4.3 Access to Webmin... 1-3
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About this manual
1
About this manual
1.1 Intended use of the manual This Module Frames and Modules Service Manual must be used in conjunction with the CARESCAPE modular monitor’s service manual for important safety information. This manual contains instructions necessary to perform planned and corrective maintenance to the parameter modules and module frames. Use it as a guide for maintenance and repairs considered field repairable. Where necessary the manual identifies additional sources of relevant information and technical assistance. See the patient monitor’s service manual for an overview of the patient monitoring system, information needed for system installation and for planned and corrective maintenance. See the supplemental information manual for the technical specifications, default settings and compatibility information, including electromagnetic compatibility. See the patient monitor’s user's manual for the instructions necessary to operate the device safely in accordance with its function and intended use.
1.2 Intended audience of the manual This manual is intended for service representatives and technical personnel who install, maintain, troubleshoot, or repair this device.
1.3 Trademarks Listed below are GE Medical Systems Information Technologies, Inc. and GE Healthcare Finland Oy trademarks. All other product and company names contained herein are the property of their respective owners. GE, GE Monogram, and CARESCAPE are trademarks of General Electric Company. D-lite and Entropy are trademarks of GE Healthcare Finland Oy.
1.3.1 Third party trademarks All other product and company names are the property of their respective owners.
1.4 Service requirements General service requirements and qualification requirements for the service personnel. Follow the service requirements listed below.
•
Refer servicing of the equipment to qualified service personnel only. Service personnel servicing this product must have an appropriate technical qualification, or equivalent work experience, and be familiar with the service requirements described in this manual and in any related service documentation. Service training for the product is recommended.
• •
Any unauthorized attempt to repair equipment under warranty voids that warranty. It is the user’s responsibility to report the need for service to GE or to one of their authorized agents.
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WARNING
CAUTION
•
Failure on the part of the responsible individual, hospital, or institution using this equipment to implement a satisfactory maintenance schedule may cause undue equipment failure and possible health hazards.
•
Regular maintenance, irrespective of usage, is essential to ensure that the equipment will always be functional when required.
Pins of connectors identified with the ESD warning symbol should not be touched. Connections should not be made to these connectors unless electrostatic discharge (ESD) precautions are used. DISPOSAL - At the end of its service life, the product described in this manual, as well as its accessories, must be disposed of in compliance with the guidelines regulating the disposal of each product. If you have any questions concerning disposal of a product, please contact GE or its representatives.
1.4.1 Equipment identification Every GE device has a unique serial number for identification. The serial number is written in a device label. A sample of the information on a device label is shown below.
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About this manual
1.4.2 Device plate location The device plate is located between the docking rails of the PDM module and on the inside of the module frames F5 and F7.
Figure 1
Device plate location, Patient Data Module and module frames
The device plate is located beside the docking rails of the E-PSMP modules and on the left side of the plug-in E-modules.
Figure 2
Device plate location, E-PSMP and E-modules
1.4.3 Access to Webmin Webmin can be accessed locally through the CARESCAPE monitor or remotely from a configured service laptop connected to the CARESCAPE monitor. For information about Webmin, see the CARESCAPE monitor’s service manual.
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For your notes:
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Patient Side Module E-PSMP (Rev. 01) Service Manual
2
Table of contents
Table of contents 1
Product overview 1.1 1.2
1.3
2
3
3.2 3.3 3.4
4.2 4.3
2-20
Replacement of planned maintenance parts... 2-20 3.1.1 Required parts... 2-20 3.1.2 Replacement procedures... 2-20 Visual inspections... 2-21 Electrical safety tests *... 2-21 Functional check... 2-21 3.4.1 Setup... 2-21 3.4.2 ECG tests *... 2-25 3.4.3 Impedance respiration tests... 2-25 3.4.4 Invasive pressure tests *... 2-26 3.4.5 Temperature tests *... 2-26 3.4.6 SpO2 tests *... 2-27 3.4.7 NIBP tests *... 2-27 3.4.8 Test completion... 2-28
Calibration and adjustments 4.1
2-18
STP/TP /ST-Settings... 2-18 2.1.1 Configuration... 2-18
Maintenance and checkout 3.1
4
Introduction... 2-1 Measurement principle... 2-1 1.2.1 ECG... 2-1 1.2.2 Respiration... 2-2 1.2.3 Invasive blood pressure... 2-2 1.2.4 Temperature... 2-2 1.2.5 Pulse oximetry... 2-2 1.2.6 NIBP... 2-5 Main components... 2-6 1.3.1 Controls and connectors... 2-6 1.3.2 E-PSMP module... 2-7 1.3.3 ECG board... 2-7 1.3.4 STP board... 2-10 1.3.5 NIBP board... 2-15
Configuration 2.1
2-1
2-29
Invasive pressure calibration... 2-29 4.1.1 Setup... 2-29 4.1.2 Procedure... 2-30 Temperature calibration... 2-31 4.2.1 Setup... 2-31 4.2.2 Procedure... 2-31 NIBP calibration... 2-32
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4.3.1 Setup... 2-33 4.3.2 Procedure... 2-33
5
Troubleshooting 5.1 5.2 5.3
5.4
5.5
6
6.2
7
Visual inspection... 2-36 Troubleshooting checklist... 2-36 Service Interface... 2-37 5.3.1 Configuration Information... 2-37 5.3.2 Device Information... 2-37 5.3.3 Log files... 2-37 Messages... 2-38 5.4.1 ECG... 2-38 5.4.2 Impedance respiration... 2-40 5.4.3 Invasive Pressure... 2-40 5.4.4 Temperature... 2-42 5.4.5 SpO2... 2-42 5.4.6 NIBP... 2-43 Troubleshooting chart... 2-47 5.5.1 Invasive Pressure... 2-47 5.5.2 Temperature... 2-47
Disassembly and reassembly 6.1
2-48
Disassembly guidelines... 2-48 6.1.1 ESD precautions... 2-48 6.1.2 Before disassembly... 2-48 6.1.3 Required tools... 2-49 Disassembling and reassembling procedure, E-PSMP... 2-49 6.2.1 Removing the pump unit... 2-52 6.2.2 Removing the manifold unit... 2-53 6.2.3 Removing the module bus connector... 2-54 6.2.4 Replacing the NIBP air filter... 2-55
Service parts 7.1 7.2
2-36
2-56
Ordering parts... 2-56 Patient Side Module E-PSMP (Rev. 01)... 2-56 7.2.1 Front panel labeling, E-PSMP... 2-57
Maintenance check form
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Patient Side Module, E-PSMP
1
Product overview
1.1 Introduction This document provides information for the maintenance and service of the Patient Side Module E-PSMP.
Figure 1
Patient Side Module, E-PSMP
The E-PSMP module provides the following general hemodynamic parameters:
• • • • • •
ECG Impedance respiration Two invasive blood pressures Two temperatures Pulse oximetry NIBP
Equipment safety symbols Safety symbol for the E-PSMP module: This symbol on the module refers to defibrillator precautions. To ensure protection against the effects of cardiac defibrillator discharge, always use the recommended cables and leadwires only (see the supplemental information manual). Using other cables or leadwires may result in damage to the equipment and compromise patient and/or user safety.
1.2 Measurement principle 1.2.1 ECG Electrocardiography analyzes the electrical activity of the heart by measuring the electrical potential produced with electrodes placed on the surface of the body. ECG reflects:
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• • • •
electrical activity of the heart normal/abnormal function of the heart effects of anesthesia on heart function effects of surgery on heart function
See the patient monitor’s user’s manual for electrodes’ positions and other information.
1.2.2 Respiration Impedance respiration is measured across the thorax between ECG electrodes. The respiration signal is made by supplying current between the electrodes and by measuring the differential current from the electrodes. The signal measured is the impedance change caused by breathing. The respiration rate is calculated from these impedance changes, and the respiration waveform is displayed on the screen.
1.2.3 Invasive blood pressure To measure invasive blood pressure, a catheter is inserted into an artery or vein. The invasive pressure setup, consisting of a connecting tubing, a pressure transducer, an intravenous bag of normal saline, all connected together by stopcocks, is attached to the catheter. The transducer is placed at the same level with the heart, and is electrically zeroed. The transducer is a piezo-resistive device that converts the pressure signal to a voltage. The monitor interprets the voltage signal so that pressure data and pressure waveforms can be displayed.
1.2.4 Temperature The temperature is measured by a probe whose resistance varies when the temperature changes, called NTC (Negative Temperature Coefficient) resistor. The resistance can be measured by two complementary methods:
•
Applying a constant voltage across the resistor and measuring the current that flows through it.
•
Applying a constant current through the resistor and measuring the voltage that is generated across it.
These modules use the constant current method. The NTC-resistor is connected in series with a normal resistor and a constant voltage is applied across them. The temperature dependent voltage can be detected at the junction of the resistors, thus producing the temperature signal from the patient. The signal is amplified by analog amplifiers and further processed by digital electronics.
1.2.5 Pulse oximetry A pulse oximeter measures the light absorption of blood at two wavelengths, one in the near infrared (about 940 nm) and the other in the red region (about 660 nm) of the light spectrum. These wavelengths are emitted by LEDs in the SpO2 probe, the light is transmitted through peripheral tissue and is finally detected by a PIN-diode opposite the LEDs in the probe. The pulse oximeter derives the oxygen saturation (SpO2) using an empirically determined relationship between the relative absorption at the two wavelengths and the arterial oxygen saturation SaO2.
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Patient Side Module, E-PSMP
In order to measure the arterial saturation accurately, pulse oximeters use the component of light absorption giving variations synchronous with heart beat as primary information on the arterial saturation. A general limitation of pulse oximetry is that due to the use of only two wavelengths, only two hemoglobin species can be discriminated by the measurement. The modern pulse oximeters are empirically calibrated either against fractional saturation SaO2frac;
HbO 2 SaO 2 frac = ----------------------------------------------------------------------------HbO 2 + Hb + Dyshemoglobin
Formula 1
or against functional saturation SaO2func;
HbO 2 SaO 2 func = ---------------------------HbO 2 + Hb
Formula 2
Functional saturation is more insensitive to changes of carboxyhemoglobin and methemoglobin concentrations in blood. The oxygen saturation percentage SpO2 measured by the module is calibrated against functional saturation SaO2func. The advantage of this method is that the accuracy of SpO2 measurement relative to SaO2func can be maintained even at rather high concentrations of carboxyhemoglobin in blood. Independent of the calibration method, pulse oximeters are not able to correctly measure oxygen content of the arterial blood at elevated carboxyhemoglobin or methemoglobin levels.
Plethysmographic pulse wave The plethysmographic waveform is derived from the IR signal and reflects the blood pulsation at the measuring site. Thus the amplitude of the waveform represents the perfusion.
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Pulse rate The pulse rate calculation is done by peak detection of the plethysmographic pulse wave. The signals are filtered to reduce noise and checked to separate artifacts.
Figure 2
Absorption of infrared light in the finger
SpO 2 sensor connector
RED
Detector
Figure 3
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Pulse oximetry probe parts layout and schematic diagram
PSM_absorption_of_infrared.vsd
IRED
Em itter
Patient Side Module, E-PSMP
The standard probe is a finger clamp probe which contains the light source LEDs in one half and the photodiode detector in the other half. Different kinds of probes are available from GE Healthcare.
1.2.6 NIBP NIBP (Non-Invasive Blood Pressure) is an indirect method for measuring blood pressure. The NIBP measurement is performed according to the oscillometric measuring principle. The cuff is inflated with a pressure slightly higher than the presumed systolic pressure, and deflated at a speed based on the patient’s pulse, collecting data from the oscillations caused by the pulsating artery. Based on these oscillations, values for systolic, mean, and diastolic pressures are calculated. The following parts are necessary for the NIBP measurement:
• • •
a parameter module twin hose (adult or infant model) blood pressure cuffs (various sizes)
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1.3 Main components 1.3.1 Controls and connectors
NIBP Sta rt Au to Canc el On/ Off InBP Ze ro Ze ro P2 P1
Figure 4
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Front panel and connectors of E-PSMP module and the back of the module
Module keys
Description
Auto On/Off
Starts and stops autocycling NIBP measurements
Start Cancel
Starts a single NIBP measurement, and cancels any measurement.
Zero P1
Zeroes P1
Zero P2
Zeroes P2
Connector
Description
NIBP
NIBP connector (black)
P1-P2
InvBP connector (red)
T1-T2
Temperature connector (brown)
SpO2
SpO2 connector (blue)
ECG
ECG and impedance respiration connector (green)
Tab for removing the module
Detachment tab (gray)
5 pin connector
Module bus connector
Patient Side Module, E-PSMP
1.3.2 E-PSMP module The module contains three main PC boards, the STP board, the ECG board, and the NIBP board. Each of these boards contain a processor and software in the processor flash memory. The boards produce their own supply voltages from the Vmod 13.8-16 V line that is available via the module bus connector. In addition to this, the NIBP board provides +5V for the ECG and STP board non-isolated side components. The NIBP board provides also the synchronization signal for the ECG and STP board power supplies. There are two input boards; the STP input board and the ECG input board attached to the front panel of the module. The front panel has five connectors and four keys. There is one connector for two temperature measurements, one for two invasive blood pressure measurements, one for ECG, one for NIBP, and one for SpO2 measurement. The NIBP connector includes two plungers for NIBP hose identification. The keys are for NIBP Auto On/Off, NIBP Start/Cancel, P1 zero, and P2 zero.
1.3.3 ECG board The ECG measurement consists of the functions shown in the figure5. All functions are located in the ECG board except the ECG input unit.
Figure 5
ECG measurement block diagram 2-7 2106778-004
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ECG input unit The ECG input unit consists of the front panel connector and the ECG input connector board with the high voltage protection resistors. The connector for the ECG cable is a green 11-pin rectangle shaped connector.
Input protection and filtering The input protection is implemented with high voltage protection resistors in the ECG input unit and with protection diodes in the ECG board. The input filtering for ECG measurement is done with passive RC filtering.
ECG preamplifiers The buffer amplifiers are used for each lead. The “Leads off” detection is implemented by measuring the output level of the input buffer amplifiers with the A/D converter of the CPU. The ECG signals are measured using differential amplifiers.
ECG amplifiers and baseline restoration The function of the ECG amplifiers and baseline restoration is to amplify the signal and to restore the baseline of the signal in the middle of the display after the change of the signal level, e.g. after the change of the DC offset voltage.
Pacer detection Pacer detection has been made by using four slew rate detector circuits. The pacer detection amplifiers have been realized at the front of the slew rate detectors independently of the ECG measuring channels.
Respiration impedance supply The 31.25 kHz sine wave generator is used as the respiration measurement signal supply. Analog switches are used for connecting the sine wave to the ECG leads to be measured.
Respiration impedance amplifiers Buffer amplifiers are used in respiration measurement. Analog switches are used for selecting the measurement leads. There are also additional amplifiers for increasing the respiration signal gain. When ECG measurement is 5/12-lead, the respiration measurement is always done between R and F, independently on the ECG lead selection. When ECG measurement is 3-lead, then the respiration measurement is happened at the same lead as the ECG measurement (I, II, or III).
ECG CPU The CPU is a 16 bit H8/3052 single-chip microcomputer. It contains 128 kbytes of flash memory and 4 kbytes of RAM. The clock frequency is 16 MHz.
RS485 communication The communication to the CPU board of the monitor uses RS485 protocol. The RS485 driver circuits are optically isolated from the processor of the module.
Power supply The ECG board has a driver-controlled half-bridge switching power supply with 5 kV isolation. The supply voltages have been regulated with linear regulators.
ECG filtering There are three ECG filtering modes: MONITORING
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0.5 to 30 Hz (with 50 Hz reject filter) 0.5 to 40 Hz (with 60 Hz reject filter)