Micropaq Monitor Models 402, 404 Directions for Use Sw 1.5X

Directions for Use

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Micropaq® Monitor

Directions for Use Model 402 and Model 404 Software version 1.5X

Welch Allyn Micropaq Monitor

Copyright 2007, Welch Allyn. All rights are reserved. No one is permitted to reproduce or duplicate, in any form, this manual or any part thereof without permission from Welch Allyn. Welch Allyn assumes no responsibility for injury or for any illegal or improper use of the product that may result from failure to use this product in accordance with the instructions, cautions, warnings, or indications for use published in this manual. Welch Allyn®, Acuity®, Micropaq®, FlexNet® and Flexible Monitoring® are registered trademarks of Welch Allyn, Inc. Nellcor® is a registered trademark of Nellcor Puritan Bennett. Masimo® and SET® are registered trademarks of Masimo Corporation. Software in this product is Copyright Welch Allyn or its vendors. All rights are reserved. The software is protected by United States of America copyright laws and international treaty provisions applicable worldwide. Under such laws, the licensee is entitled to use the copy of the software incorporated within this instrument as intended in the operation of the product in which it is embedded. The software may not be copied, decompiled, reverse-engineered, disassembled or otherwise reduced to human-perceivable form. This is not a sale of the software or any copy of the software; all right, title and ownership of the software remain with Welch Allyn or its vendors. For information about any Welch Allyn product, please call Welch Allyn Technical Support: USA 800 535 6663 315 685 4560 Canada 800 561 8797 European Call Center 353 46 9067790 Germany 49 7477 9271 86

Australia 61 2 9638 3000 800 074 793 China 86 21 6327 9631 France 33 1 55 69 58 49 Japan 81 3 3219 0071

Latin America 305 669 9003

Netherlands 31 157 505 000

Singapore 65 6419 8100

South Africa 27 11 777 7555

United Kingdom 44 1332 363812

Reorder Part Number 810-1464-XX Manual Part Number 810-1177-06 Rev. A, 02/2007 Welch Allyn 8500 SW Creekside Place Beaverton, Oregon 97008-7101 USA www.welchallyn.com Printed in USA

iii

Contents 1 - General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Summary of New Features. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 General Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Introducing the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Model 402 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Model 404 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Understanding the Monitor and the FlexNet Network . . . . . . . . . . . . . . . . . . . . . 7 Monitor Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Controls and Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Operating Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Default Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Demonstration Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

2 - Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Connect a New Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Connect to the Network. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Perform ECG Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Perform SpO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Install the Carrying Pouch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Monitor a Patient Out of Range of Acuity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Stop Monitoring a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Reconnect a Recently Monitored Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Reassign a Monitored Patient to a New Room in the Same Unit . . . . . . . . . . . . Transfer a Monitored Patient to a New Room in a Different Unit . . . . . . . . . . . . Reassign the Monitor to a New Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19 19 21 26 28 29 30 31 32 33 34

3 - Alarms & Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 About Alarms and Alerts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Alarm Holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Respond to a Patient Alarm at Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Customize Patient Alarm Limits at the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . Respond to an Equipment Alert at the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . Alert Messages and Display Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35 35 36 37 38 40

Contents

Welch Allyn Micropaq Monitor

4 - Monitor Patient at Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 5 - Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Change the Battery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recharge a Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Inspect and Clean the Monitor and Accessories . . . . . . . . . . . . . . . . . . . . . . . . Recycling Monitor Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Within the European Union . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Change the Network Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

43 43 45 46 46 47

6 - Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Operating Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Monitor Radio Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 ECG Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Heart Rate and Arrhythmia Analysis Option . . . . . . . . . . . . . . . . . . . . . . . . . 52 Pulse Oximetry (SpO2) Specifications - Masimo . . . . . . . . . . . . . . . . . . . . . 53 Pulse Oximetry (SpO2) Specifications - Nellcor . . . . . . . . . . . . . . . . . . . . . . 54 Patient Alarm and Equipment Alert Specifications. . . . . . . . . . . . . . . . . . . . 55 Display Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Environmental Specifications (with Battery Installed) . . . . . . . . . . . . . . . . . 56 Physical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Battery Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Battery Charger Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 EMC Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

General Information

Summary of New Features The following table summarizes the new features that are implemented in this software version 1.5. The version previously released was 1.4. Feature

Reference

Patient alarm tones are now discontinuous, and life-threatening alarms beep at a faster pace than other patient alarms.

See “Respond to a Patient Alarm at Monitor” on page 36.

If you press to silence a patient alarm tone and a new patient vital sign alarm or equipment alert occurs, a tone for the new alarm or alert will break the silence period at the monitor.

Intended Use The Micropaq™ monitor is intended to be used by clinicians for single or multiparameter vital signs monitoring of ambulatory and nonambulatory pediatric and adult patients in health care facilities. It is also intended for patient transport. The monitor is able to withstand light rain exposure over short periods of time (uniform distribution of approximately 1 mm of water/ minute for 10 minutes or less). The Micropaq monitor is intended to operate with an Acuity® Central Station through wireless communication over Welch Allyn’s FlexNet™ network. FlexNet connects multiple devices to the Acuity Central Station through hardwired Ethernet networks and Wireless Local Area Networks (WLANs). If the Micropaq monitor is moved out of range or loses communication with the FlexNet network, it continues to monitor the patient, display patient data, and generate local patient alarms or alert messages. •

The ECG channel is intended primarily for five-lead ECG monitoring, although three-lead ECG monitoring is supported.

•

The Pulse Oximetry channel is intended for continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate (measured by an SpO2 sensor).

Chapter 1 General Information

Welch Allyn Micropaq Monitor

The most likely locations for patients monitored by this device are step-down units, telemetry departments, general medical/surgical floors, emergency departments, and inhospital transport. This guide was written for clinicians. Although this guide may describe some monitoring techniques, Welch Allyn expects that the operator is a trained clinician who knows how to take and interpret a patient’s vital signs. Federal USA law restricts sale of the device identified in this manual to, or on the order of, a licensed medical practitioner.

Symbols Warning Warning statements in this manual identify conditions or practices that could result in personal injury. Caution Caution statements in this manual identify conditions or practices that could result in damage to the equipment or other property.

The following symbols appear on the monitor or accessories. Direct current

IPX1

Alternating current (battery charger) The CE Mark and Notified Body Registration Number signify the device has met all essential requirements of European Medical Device Directive 93/42/EEC Signifies the device has met all essential requirements of European Medical Device Directive 93/42/EEC for a Class 1 product (battery charger) Protective earth ground (battery charger) Li++

C kj

Enclosure Protection Drip proof: Classification IPX1 per EN60529: 1991 Fuse This device has been tested and certified by the Canadian Standards Association International to comply with applicable U.S. and Canadian medical safety standards. Patient connections are Type CF, isolated for direct cardiac application, and protected against defibrillation Protected during defibrillation

Lithium Ion battery

Separate batteries from other disposables for recycling Li++

Caution: Refer to Directions For Use and accompanying documentation

For indoor use only (battery charger)

This way up

Keep away from rain

Humidity limit

Stacking limit (by number)

Fragile

Altitude limit

Temperature limits

IATA/ICAO Hazard Class 9 Package (International Air Transport Association/ International Civil Aviation Organization) Single use only

Non-ionizing electromagnetic radiation

Directions for Use

Chapter 1 General Information

Monitor Front Panel Keys Scroll Up Key and Reset Alarm Tone KeySelect Key and Silence Patient Alarm/ Scrolls up menus on the display. During patient Equipment Alert Key- Selects the choice alarms, resets the tone at the monitor and at highlighted on the menu. During patient alarms, Acuity (if connected). silences the tone at the monitor and at Acuity (if connected) for 90 seconds. During equipment alerts, silences or acknowledges (dismisses) the alert. Nurse Call Key - When connected to Acuity, Scroll Down Key and Main Menu Key- Pressing pressing this key sends Acuity a Nurse Call this key scrolls down menus on the display, or message. causes the Main Menu to appear if no menu is displayed. Recycle the monitor and battery separately from other disposables. www.welchallyn.com/weee

Battery Charger Label and LEDs Green LED on continuously Battery is fully charged.

Green LED flashing

Battery is charging.

Green LED flashing very slowly

Battery detected and waiting to be charged.

Yellow LED on continuously

Something is wrong with the battery or the charger. (See “Battery Status and Possible Response” on page 44.)

General Warnings and Cautions Familiarize yourself with all warnings and cautions before using the monitor.

WARNING When considering a treatment protocol that involves wireless communication of patient data, be sure to recognize some limitations inherent in wireless communications. When the monitor is not connected to the network: • • • •

There are no patient alarms or alerts at the Acuity Central Station. Acuity does not perform arrhythmia and ST analysis on the patient data and does not generate related alarms. Patient data is not saved. Pressing (Nurse Call) on the monitor does not cause any response at Acuity.

WARNING Do not try to monitor neonatal patients with the monitor. The monitor is intended for adult or pediatric patients. It is not intended for use with pediatric patients (or infants) weighing less than 22 lbs (10 kg).

Chapter 1 General Information

Welch Allyn Micropaq Monitor

WARNING Always check the patient mode at Acuity when monitoring a new patient. The patient mode determines default alarm limits and internal algorithm settings. WARNING The monitor may not meet its performance specifications if stored or used outside the specified temperature and humidity ranges. WARNING Do not connect more than one patient to a monitor. Do not connect more than one monitor to a patient. WARNING During defibrillation, keep the discharge paddles away from ECG and other electrodes, as well as other conductive parts in contact with the patient. WARNING Do not operate this product in the presence of flammable anesthetics or other flammable substances in combination with air, oxygenenriched environments, or nitrous oxide; explosion can result. WARNING Do not use the monitor in a Magnetic Resonance Imaging (MRI) suite or a hyperbaric chamber. Such use can cause fire or explosion resulting in patient injury and monitor damage. WARNING Electronic equipment that emits strong electromagnetic or radio frequency signals can cause electrical interference with monitor operation. This interference may distort the ECG signal, thereby preventing accurate rhythm analysis. Avoid operating this device near equipment of this type. WARNING Exposure to Radio Frequency (RF) radiation. To comply with Federal Communications Commission (FCC) RF exposure requirements, this device shall be used in accordance with the operating conditions and instructions provided in this manual, including the section “Install the Carrying Pouch” on page 28. WARNING Pacemaker signals can differ from one pacemaker to the next. The Association for Advancement of Medical Instrumentation (AAMI) cautions that “in some devices, rate meters may continue to count the pacemaker rate during occurrences of cardiac arrest or some arrhythmias. Do not rely entirely upon rate meter alarms. All pacemaker patients should be kept under close or constant observation.” See “ECG Specifications” on page 50 for disclosure of the pacemaker pulse rejection capability of this instrument. WARNING For patients with a pacemaker, position the monitor to maintain a minimum 6-inch distance between the monitor and pacemaker. Immediately turn the monitor off and provide appropriate patient care if you have any reason to suspect that the monitor is interfering with the pacemaker. The Health Industry Manufacturers Association recommends this minimum 6-inch distance between a hand-held wireless radio and a pacemaker, which is consistent with the independent research by, and recommendations of, Wireless Technology Research.

Directions for Use

Chapter 1 General Information

WARNING Make frequent electrical and visual checks on cables, sensors, and electrode wires. All cables, sensors, and electrode wires must be inspected and properly maintained and in proper working order to allow the equipment to function properly and protect patient safety. WARNING Avoid electrosurgery burns at monitoring sites by ensuring proper connection of the electrosurgery return circuit so that the return paths cannot be made through monitoring electrodes and probes. WARNING Use of ECG cables not specified by Welch Allyn may negate defibrillator protection and risk patient injury due to shock. WARNING To ensure patient safety, the conductive parts of the ECG electrodes (including associated connectors) and other patient-applied parts should not contact other conductive parts, including earth ground, at any time. WARNING Motion artifact can affect the accuracy of patient vital sign measurements. Minimize patient motion whenever possible. WARNING For best product performance and measurement accuracy, use only accessories supplied by Welch Allyn or recommended in the Welch Allyn Products and Accessories booklet (810-0409-XX). Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use. WARNING As with all medical equipment, carefully route the patient cabling to reduce the possibility of patient entanglement or strangulation. Use the supplied garment clips to secure the cable properly. WARNING When positioning the monitor pouch on the patient, make sure the straps do not entangle the patient’s neck or cause choking. Make sure the straps do not restrict the movement of the patient’s limbs or create a hazard when walking or moving. WARNING If a product has been dropped or severely abused, send it to a qualified service person to confirm proper operation. Caution Do not autoclave the monitor. Autoclave accessories only if the manufacturer’s instructions clearly approve it. Many accessories can be severely damaged by autoclaving. It is possible for the monitor to detect a problem that prevents the monitor from operating properly. If this occurs, the monitor displays an error message and error number. Report such errors to Welch Allyn. The monitor should be serviced only by a Welch Allyn service technician while under warranty. Contact Welch Allyn for information about post-warranty period service.

Chapter 1 General Information

Welch Allyn Micropaq Monitor

Introducing the Monitor The monitor is a patient-worn vital signs monitor for use by adult or pediatric ambulatory patients. •

One or two ECG channels displayed

•

Up to 2 ECG leads displayed at the monitor: I, II, III, V, aVR, aVL, or aVF with 5-lead cable

•

Up to 7 ECG leads displayed at Acuity: I, II, III, V, aVR, aVL, or aVF with 5-lead cable

•

One ECG lead displayed at the monitor and at Acuity: Fixed lead II with 3-lead cable, or 5-lead cable with only RA, LA and LL electrodes attached.

•

Pulse oximetry (SpO2) monitoring (Model 404 only)

•

Two-way wireless communication within Welch Allyn’s FlexNet network

•

LCD for display of ECG waveforms, SpO2 and heart rate/pulse rate data, and messages from Acuity

•

Standalone operation with patient alarms when out of range of the network

•

Patient alarm limits that can be set at the monitor or at Acuity

•

Configurable formats for single- or dual-waveform ECG display

•

Internal antenna

•

Nurse call key

•

Lightweight (slightly more than 1 pound with battery)

•

Rugged and tolerant of brief water exposure

•

Rechargeable battery

•

Sleep mode to extend battery life

Model 402 ECG monitoring

Model 404 ECG monitoring and either one of two pulse oximetry (SpO2) monitoring options: •

SpO2 with Masimo® SET® technology

•

SpO2 with NELLCOR® OxiMax™ technology

Directions for Use

Chapter 1 General Information

Understanding the Monitor and the FlexNet Network The monitor is intended to operate with an Acuity® Central Station as part of Welch Allyn’s FlexNet network. FlexNet allows multiple devices to communicate through hardwired Ethernet networks and Wireless Local Area Networks (WLANs). The Acuity Central Station provides the primary display and entry of patient data for a patient connected to the monitor. To Other Acuity Central Stations

Access Points

Acuity Central Station

To Other Access Points

SpO2

Micropaq monitors

FlexNet Network

Each patient-worn monitor supports two-way communication with an Acuity Central Station through an access point in the FlexNet network. The access point is a digital radio transceiver that connects to the FlexNet network. During monitoring, the monitor sends the patient data to Acuity. Acuity and the monitor continuously analyze the data. Acuity provides appropriate alarm or alert messages at the Central Station and other network devices such as a hallway message panel and the monitor itself. Acuity also stores the patient data for viewing or report printing. If the monitor is moved out of range or loses communication with the FlexNet network and Acuity, it continues to monitor the patient and display patient data. While not communicating with Acuity, the monitor continues to generate local patient alarms or alert messages. Patient data is not stored and Acuity does not perform waveform analysis or generate arrhythmia messages while the monitor is not communicating with Acuity. When the monitor is returned to within range of the FlexNet network, it automatically reconnects to Acuity.

Chapter 1 General Information

Welch Allyn Micropaq Monitor

Monitor Features Controls and Connectors SpO2 Connector ECG Connector Visual Alarm Indicator

Liquid Crystal Display Select Key and Silence Patient Alarm/ Equipment Alert Key Scroll Up Key and Reset Patient Alarm Tone Key Scroll Down Key and Main Menu Key Nurse Call Key

Battery pack latch Battery

Back

Directions for Use

Chapter 1 General Information

Visual Alarm Indicator Green

Flashes slowly during normal operation.

Red

Flashes during patient alarm, remains on continuously when alarms are silenced or suspended.

Yellow

Flashes during an equipment alert or while not connected to the network. Remains on continuously if the operator suspends an alert at Acuity for 90 seconds or acknowledges (dismisses) a low battery alert from the monitor or Acuity.

Note

The flashing green LED indicates that the monitor is connected to the network but not necessarily connected to a patient. If the monitor is actively monitoring a patient, the green LED indicates no alarms or alerts are detected.

Audible Alarm Indicator Beeps to indicate a patient alarm, and beeps faster for life-threatening arrhythmia alarms (see “Patient Alarm and Equipment Alert Specifications” on page 55). Beeps to indicate when the equipment needs attention. This beep tone is slower than patient alarm tones (see “Patient Alarm and Equipment Alert Specifications” on page 55). Volume can be configured as high, low, or off (configured at Acuity). Volume can be configured differently for network connection or stand-alone operation (configured at Acuity).

Nurse Call Key When connected to Acuity, pressing this key sends a Nurse Call message to Acuity. Depending on how Acuity is configured, this will cause Acuity to: Generate a Nurse Call Alert at the Acuity Central Station. Print a “snapshot” of the patient waveform at the Acuity Central Station.

Scroll Up Key and Reset Patient Alarm Tone Key Scrolls up menus on the display. Resets a silenced patient alarm tone.

Chapter 1 General Information

Welch Allyn Micropaq Monitor

Scroll Down Key and Main Menu Key Scrolls down menus on the display. Displays the Main Menu.

Select Key and Silence Patient Alarm/Equipment Alert Key Selects the choice highlighted on the menu. During patient alarms, silences the tone at the monitor and Acuity (if connected) for 90 seconds. During equipment alerts, silences or acknowledges (dismisses) the alert at the monitor and Acuity.

Battery Insert the battery to turn on power. Remove the battery to turn off power. (While the battery is removed, the monitor does not perform patient monitoring.) Recharge the battery while it is removed from the monitor. (See “Recharge a Battery” on page 43.) To order a new battery, see “Battery Status and Possible Response” on page 44.

Directions for Use

Chapter 1 General Information

Display Although the Acuity Central Station is the primary location for viewing patient data, the monitor provides information to support patient care.

Waveform scale is selectable

Dashed lines indicate the monitor detects a pacemaker signal (display of pacer detection can be enabled or disabled at Acuity)

ECG lead is selectable HR indicates the heart rate is from ECG. PR (pulse rate) is displayed if SpO2 is active and ECG is not (pulse rate is derived from SpO2). If the monitor detects a vital sign outside the measurable range, it displays: - - - (below the range) + + + (above the range). Indicates the monitor is connected to Acuity. This symbol indicates the monitor is not communicating with Acuity: Flashing indicates the monitor is associated with an access point, but not communicating with Acuity. Continuous on indicates the monitor is not communicating with an access point or Acuity.

Patient name as entered at Acuity. If the patient name has not been entered, the monitor displays the last four digits of the monitor serial number, such as: ID:6472 Symbol is displayed at the monitor whenever the Nurse Call key is pressed. ECG waveform is displayed when active. SpO2 numeric data is a percentage value. SpO2 pulse amplitude indicator (not proportional to pulse volume)

Indicates one or more patient alarms are disabled (off).

Low battery icon flashes to indicate monitor will shut off in 30 minutes or less.

Display Sleep Mode In order to extend battery life, the display becomes blank after two minutes if no keys are pressed. The display becomes active again if an alarm or alert occurs, a key is pressed, the initial Acuity connection occurs, a cable is inserted, or an electrode is attached. The display will not become blank if a patient alarm is occurring, an Acuity message is displayed, or the monitor is in Demo mode or Service mode.

Chapter 1 General Information

Welch Allyn Micropaq Monitor

Main Menu When you first press

Press Press

, the Main Menu appears:

to move through the menu.

to select or change the highlighted choice.

EXIT

Exit the Main Menu (the menu disappears).

ACUITY...

Access the Acuity Menu with network options. The Acuity Menu is only accessible while connected to Acuity. EXIT

Exit all menus and return to the monitoring screen.

END TELE

Discontinue monitoring a patient.

NEW ROOM

Reassign a patient to a new room in the same unit.

TRANSFER

Transfer a patient to a new room in a new unit.

NEW PATIENT

Assign the monitor to a new patient.

PATIENT INFO

Display patient information such as ID, name, unit and room.

Whenever the monitor is connected to Acuity and you select ACUITY... from the Main Menu, the monitor displays the message ACUITY CONTACTED to confirm that Acuity has been contacted. The monitor continues to display this message until Acuity responds, or you press to acknowledge the message and clear the screen. If the monitor detects an alarm or alert, it clears the screen to display the appropriate alarm or alert message. The length of time required for Acuity to respond to your selection at the monitor can vary widely depending on the amount of network traffic and other conditions. ECG LEAD...

Access a menu to change the ECG 1 or ECG 2 lead selection (I, II, III, aVR, aVL, aVF, or V). Available vectors depend on the connected electrodes.

Directions for Use

Chapter 1 General Information

ECG SCALE...

Change the scale of the ECG waveform. If two waveforms are displayed, both have the same scale.

1 WAVEFORM

There are four possible ECG waveform display selections: 1 WAVEFORM

the default selection

2 WAVEFORMS 5 SECONDS FULL SCREEN Pressing changes to the next selection. This change does not take effect until after you exit the Main Menu. See “Display” on page 11 for descriptions. LIMITS...

Enter the Alarm Limits Menu (“Customize Patient Alarm Limits at the Monitor” on page 37) and change alarm limits.

SYSTEM INFORMATION

Display information about the network connection and SpO2 module.

SERVICE MENU Enter Service Mode for a demonstration mode (Demo, see “Demonstration Mode” on page 16) or service functions for technicians. Service Mode is not available if any cables are plugged in.

Note

To restrict access to the Main Menu, a Menu Lock option can be configured for the monitor at the Acuity Central Station. When the Menu Lock is enabled, the operator must press and hold down and for two seconds to gain access to the Main Menu. The Menu Lock is disabled if the monitor loses communication with Acuity.

Chapter 1 General Information

Welch Allyn Micropaq Monitor

Waveform Options There are four ECG waveform options as shown:

1 Waveform The single ECG 1 (lead II) waveform is displayed.

2 Waveforms ECG 1 (lead II) and ECG 2 (lead V) are both displayed.

5 Seconds ECG 1 (lead II) cascades from one line to the other.

Full Screen The single ECG 1 (lead II) waveform is allowed to occupy most of the screen.

To change the waveform selection during operation: 1.

Press

to display the Main Menu.

2. Press as needed to highlight the current waveform selection. Then press needed to select the desired display.

Directions for Use

Chapter 1 General Information

Messages from Acuity The monitor displays messages sent from Acuity as needed, including patient alarms and equipment alerts. When Acuity messages are displayed, they temporarily override information displayed on the lower half of the monitor screen.

Accessories 5-lead ECG cable

Battery

ECG electrodes

Battery charger (8-battery)

3-lead ECG cable (optional)

ECG extension cable (optional)

SpO2 cable (Masimo or Nellcor)

Carrying pouch

SpO2 sensors (Masimo or Nellcor)

Micropaq Directions For Use

WARNING For best product performance and measurement accuracy, use only accessories supplied by Welch Allyn or recommended in the Welch Allyn Products and Accessories booklet (810-0409-XX). Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use.

Operating Settings The following monitor operating settings can be set at the monitor or at the Acuity Central Station: •

Patient alarm limit settings (ECG and SpO2).

•

ECG lead and scale selection

•

ECG display format

Many other monitor operating settings (such as patient mode and alarms volume) can only be set at the Acuity Central Station. See “Operating Settings” on page 49 for a list of all settings and where they are set.

Chapter 1 General Information

Welch Allyn Micropaq Monitor

Default Settings When the monitor connects to Acuity for a new patient, the Acuity Central Station downloads the appropriate default settings stored at Acuity. While the monitor is connected to Acuity, settings can be changed either at the monitor or at the Acuity Central Station. If the monitor is temporarily disconnected from Acuity and the operator changes settings at the monitor, those settings are transmitted to and stored at Acuity when the monitor reconnects.

Demonstration Mode You can practice using the monitor with the Demo mode of operation, including connection to Acuity. The Demo mode cannot be activated while you are monitoring a patient or if any cables have been plugged into the monitor. During the Demo mode, the monitor and Acuity display the message SIMULATION. To practice with the monitor in Demo mode: 1.

Disconnect all patient cables connected to the monitor.

2. Remove the battery (if installed). 3. Insert the battery and watch for the Power-Up screen.

Power-Up Screen

4. After the Power-Up screen disappears, press

Main Menu

to display the Main Menu.

Directions for Use

Chapter 1 General Information

5. Press

to highlight SERVICE MENU, then press

to display the Service Menu.

Service Menu

6. Press

to highlight DEMO MENU, then press

to highlight DEMO 1 or DEMO 2, then press

Press

to display the Demo Menu. to start.

SIMULATION indicates the Demo mode is active.

A simulated waveform and numerics are displayed.

Demonstration Mode

Demo Mode Display Values and Alarm Limits Display

Demo 1

Demo 2a

Alarm Limits (On)

ECG Waveform

Normal sinus rhythm, normal ST

(not applicable)

ECG Heart Rate SpO2 Pulse Rate

125

Lower 50 Upper 120

SpO2 Saturation%

Lower 90 Upper 100

Demo 2 will cause patient alarms.

8. While in Demo mode you can practice changing settings such as ECG lead selection and alarm limit adjustment. (These changes only affect the Demo mode and are erased when you exit the Demo mode.)

Chapter 1 General Information

Welch Allyn Micropaq Monitor

9. To change to the other Demo selection, press to display the menu, then scroll down to highlight TOGGLE DEMO MODE and press . 10. To exit the Demo mode, either insert a patient cable or remove and insert the battery. The monitor restarts and enters the normal monitoring mode.

Monitoring

Connect a New Patient Connect to the Network 1.

Insert a battery into the monitor to turn it on. After a few seconds the monitor PowerUp Screen is replaced by an initial monitoring screen.

If any patient cables are connected, there will be some patient data displayed. The format depends on the monitor default settings.

The monitor is searching for a network connection. Example of Initial Monitor Screen

2. After the network connection is established, the monitor may prompt you to select an Acuity Unit (if your facility has more than one Acuity unit):

Possible Acuity Unit selections. Press to view more. Example of Acuity Unit Selection

Chapter 2 Monitoring

Welch Allyn Micropaq Monitor

3. Press

to highlight the desired Acuity unit, then press

When you press or to highlight the desired Acuity unit and then press , your selection will begin to flash between normal and reverse video to confirm that the monitor is communicating your selection to Acuity. You cannot scroll to another selection during this time. The selection continues to flash until Acuity responds back to the monitor. Then the monitor displays the next appropriate screen (such as a list of possible patients). The length of time required for Acuity to respond to your selection at the monitor can vary widely depending on the amount of network traffic and other conditions. Be sure to select an Acuity unit. Even though the monitor is connected to the network (as indicated by the green LED and network connection symbol), the Acuity Central Station may not Network Connection display any indication of this monitor until after you have selected an Symbol Acuity unit. 4. The monitor displays a list of possible patients. If your patient has been pre-admitted to the selected Acuity unit, they will be included in the list.

Possible patients to select.

Select Patient at Central SELECT PATIENT 428-02-2392, Hopkins, Bill J 520-29-0319, Phillips, Mary L ▼ 532-94-8372, Smith, Frank R Example of Patient List

5. Scroll through the patient list to look for your patient’s name. •

If your patient is not in the list, highlight Select Patient at Central and press The patient name will need to be entered later at the Acuity Central Station. WARNING If you do not select the patient name at the monitor at this time, do not adjust any alarm limits until after the patient name and ID are confirmed at Acuity. When the patient name and ID are confirmed at Acuity, Acuity downloads the default settings and patient alarm limits for that Acuity unit to the monitor, thereby overriding any previous settings and alarm limits.

Note

At power-up, the monitor retains the most recent patient mode. The patient mode can only be changed at Acuity. If the patient is being monitored when the patient mode is changed, there is a brief interruption in the display and recording of ECG and SpO2 patient data.

Directions for Use

Chapter 2 Monitoring

•

If your patient is in the list, highlight the name and press seconds the monitor displays a list of unassigned rooms.

Possible rooms to select.

Select Room at Central 1104A 1104B 1105A

. Within a few

SELECT ROOM ▼

Example of Room List

•

If you want to assign the patient to a room, highlight the room and press

•

If you do not want to assign a room at this time, highlight Select Room at Central and press . The patient room will need to be entered later at the monitor (see “Reassign a Monitored Patient to a New Room in the Same Unit” on page 32) or at Acuity (see “Monitor Patient at Acuity” on page 41).

6. If you need to customize alarm limits for your patient, see “Customize Patient Alarm Limits at the Monitor” on page 37.

Perform ECG Monitoring WARNING Motion artifact can cause incorrect heart rate readings. Minimize patient motion whenever possible. WARNING If a disconnected lead is in too close proximity to other electrical devices, it may cause false heart rate readings. WARNING The monitor does not provide internal arrhythmia analysis. Therefore, arrhythmias may cause the monitor to display inaccurate heart rates. WARNING The monitor will show + + + for HR numerics between 301 and 350 beats per minute. Above 350 beats per minute, it may display incorrectly low heart rates, due to intermittent picking of R-waves. WARNING Do not use the monitor in a Magnetic Resonance Imaging (MRI) suite or a hyperbaric chamber. Such use can cause fire or explosion resulting in patient injury and monitor damage. WARNING Pacemaker signals can differ from one pacemaker to the next. The Association for Advancement of Medical Instrumentation (AAMI) cautions that “in some devices, rate meters may continue to count the pacemaker rate during occurrences of cardiac arrest or some arrhythmias. Do not rely entirely upon rate meter alarms. All pacemaker patients should be kept under close or constant observation.” See “ECG Specifications” on page 50 for disclosure of the pacemaker pulse rejection capability of this instrument.

Chapter 2 Monitoring

Welch Allyn Micropaq Monitor

WARNING For patients with a pacemaker, position the monitor to maintain a minimum 6-inch distance between the monitor and pacemaker. Immediately turn the monitor off and provide appropriate patient care if you have any reason to suspect that the monitor is interfering with the pacemaker. The Health Industry Manufacturers Association recommends this minimum 6-inch distance between a hand-held wireless radio and a pacemaker, which is consistent with the independent research by, and recommendations of, Wireless Technology Research. WARNING High-intensity radio frequency (RF) energy from external sources, such as an improperly connected electrosurgical unit, can induce heat into electrodes and cables which can cause burns on the patient. Reading errors and damage to equipment may also result. This hazard can be reduced by (1) avoiding the use of small ECG electrodes, (2) selecting ECG electrode attachment points remote from the surgical site and from the electrosurgical return electrode, (3) using electrosurgical return electrodes with the largest practical contact area, and (4) assuring proper application of the electrosurgical return electrode to the patient. WARNING Verify patient mode at Acuity. Incorrect patient mode may result in inaccurate heart rates and inappropriate alarm settings. WARNING To help prevent injury, use the provided garment clips to route the ECG cables away from the patient’s head. WARNING Use of ECG cables with loose or faulty detachable lead wires may cause erratic behavior of the ECG waveform due to intermittent ECG lead wire connections. WARNING To ensure patient safety, the conductive parts of the ECG electrodes (including associated connectors) and other patient-applied parts should not contact other conductive parts, including earth ground, at any time.

Caution To protect the monitor from damage during defibrillation, for accurate ECG information, and for protection against noise and other interference, use only ECG electrodes and cables specified or supplied by Welch Allyn (these cables have the required current-limiting resistors). Follow recommended application procedures. Caution Do not use an ECG cable longer than 10 feet (3 meters). If the nominal length of the ECG cable, including extensions, exceeds this length, the monitor is not guaranteed to meet published electromagnetic compatibility (EMC) performance specifications. • • •

Even though the monitor contains fully isolated patient-connected circuitry, it has not been specially designed for direct application on a patient’s heart. Use only with accessories provided or recommended in the Welch Allyn Products and Accessories booklet (810-0409-XX). Severe artifact and interference (such as defibrillation interference) can cause the waveform to move off the display for a few seconds before it is restored.

Directions for Use

Chapter 2 Monitoring

Perform 5-Lead ECG Monitoring 1.

Inspect the ECG cable and replace it if it shows any signs of wear, breakage, or fraying. Plug the cable into the monitor.

2. Select electrode sites on the patient. Choose flat areas; avoid fatty or bony areas and major muscles. 3. Shave or clip hair from electrode sites, thoroughly clean skin, and lightly rub dry. You may use soap and water, isopropyl alcohol or special skin preparation pads. To avoid allergic reactions to electrodes, refer to the electrode manufacturer’s directions. 4. If you are using pre-gelled electrodes, make sure the electrode date is not expired and the gel is intact and not dried out. For best results, use only silver/silver chloride electrodes. If you are using ungelled electrodes, apply a 1/4- to 1/2-inch mound of gel over the electrode contact area. For best product performance and measurement accuracy, do not use stainless steel needle electrodes, squeeze bulb electrodes, or electrodes with dissimilar metals. Due to polarization, such electrodes can generate offsets beyond the monitor’s capabilities. Do not use electrodes from more than one manufacturer on the same patient. 5. Attach lead wires to the electrodes before applying them to the patient. Apply the electrodes to the patient in the proper locations. Flashing circle indicates the lead is not connected.

Right Arm

Left Arm

Right Leg

Left Leg

If the monitor detects that some lead wires are not properly connected, the monitor displays a chest diagram and indicates which leads are disconnected. The locations of the circles displayed on the monitor for each lead are fixed, and are not affected by the exact placement of the electrodes on the patient. For example, the C lead can be placed on the patient in any one of the V1-V6 locations desired, but will only be displayed on the monitor in the location shown above.

Chapter 2 Monitoring

Welch Allyn Micropaq Monitor

6. After leads are properly connected, confirm that the monitor displays the ECG waveform, heart rate, and other patient data. To change the ECG lead selection, press to display the Main Menu. Then press Scroll Down to highlight ECG LEAD . . . , then highlight ECG 1 or ECG 2 and press to change the lead.

3-Lead ECG Application with the 5-Lead ECG Cable Note

Be aware that there are some inherent limitations with this application, especially when compared to 5-lead ECG monitoring. These limitations include the restriction to only one displayed lead, ECG lead II. Because only one displayed lead is available (ECG lead II), factors such as a poor electrode connection at RA, LA, or LL can significantly affect performance. To overcome these limitations, the 5-lead ECG monitoring is preferred. The monitor’s 3-lead ECG monitoring is only available for use with Acuity software versions 6.1 or later.

You can perform 3-lead ECG monitoring in a similar manner as 5-lead ECG monitoring. You may use the 5-lead ECG cable with detachable electrode lead wires, and connect only the lead wires and electrodes for RA, LA, and LL. Refer to the Welch Allyn Product and Accessories booklet (810-0409-XX) for part numbers. Follow these steps: 1.

Perform Step 1 through Step 4 on page 23 as described for 5-lead ECG monitoring.

2. Before attaching electrodes to the patient, attach only lead wires for RA, LA, and LL to the 5-lead ECG trunk cable and to the electrodes. Make sure that lead wires for C and RL are DETACHED from the 5-lead ECG trunk cable. 3. Apply the electrodes for RA, LA, and LL to the patient in the proper locations. The monitor displays the chest diagram with two circles blinking confirming that the C and RL electrodes are not connected. 4. Observe the monitor and visually confirm that within about 30 seconds, the two circles disappear and the monitor displays the ECG waveform, heart rate, and other patient data. Be aware that if you connect the C or RL lead wires to the 5-lead ECG trunk cable and apply the C or RL electrodes to the patient, the monitor defaults to 5-lead ECG monitoring and does not enable 3-lead ECG monitoring. To enable 3-lead ECG monitoring, you must disconnect the ECG cable from the monitor for a few seconds, and then begin this procedure again.

Directions for Use

Chapter 2 Monitoring

Be aware that only ECG lead II is available for display with the monitor’s 3-lead ECG monitoring. No other ECG lead selections are available. WARNING Do not try to perform this 3-lead ECG monitoring with any 5-lead ECG cable that does not have detachable electrode lead wires as described above. Attempting to perform this procedure with a 5-lead ECG cable which has lead wires cut off or hanging loose and not connected to the patient would present a shock hazard to the patient or clinician.

3-Lead ECG Application with the 3-Lead ECG Cable Note

Be aware there are some inherent limitations with this application, especially when compared to 5-lead ECG monitoring. These limitations include the restriction to only one displayed lead, ECG II lead. Because only one displayed lead is available (ECG lead II), factors such as poor electrode connection at RA, LA, or LL can significantly affect performance. To overcome these limitations, the 5-lead ECG monitoring is preferred. The monitor’s 3-lead ECG monitoring is only available for use with Acuity software versions 6.1 or later.

Refer to the Welch Allyn Product and Accessories booklet (810-0409-XX) for part numbers. Follow these steps: 1.

Perform Step 1 through Step 4 on page 23 as described for 5-lead ECG monitoring.

2. Attach lead wires to the electrodes before applying them to a patient. 3. Apply the electrodes for RA, LA, and LL to the patient at the proper locations. If the monitor detects one of the lead wires is not properly connected, it will display a chest diagram indicating which lead is disconnected. 4. Observe the monitor and visually confirm it displays the ECG waveform, heart rate, and other patient data. Be aware that only ECG lead II is available for display with the monitor’s 3-lead monitoring. No other ECG lead selections are available. The monitor will not detect the presence of a 3-lead cable until two or more of its leads are connected to the patient.

3-Lead ECG Application with the 3-Lead ECG Cable and Cable Extension This combination functions the same way as the 3-lead ECG application with the 5-lead cable. For electromagnetic compatibility (EMC) reasons, do not use an ECG cable and extension cable length of more than approximately 10 feet total.

Chapter 2 Monitoring

Welch Allyn Micropaq Monitor

Perform SpO2 Monitoring WARNING Oxygen saturation measurements using pulse oximetry are highly dependent on proper placement of the sensor and patient conditions. Patient conditions such as shivering and smoke inhalation may result in erroneous oxygen saturation readings. If pulse oximetry measurements are suspect, verify the reading using another clinically accepted measurement method, such as arterial blood gas measurements on a co-oximeter. WARNING Use only accessories as listed in the Welch Allyn Products and Accessories booklet (810-0409-XX). Use only Masimo accessories and sensors with the Masimo SpO2 option. Use only Nellcor accessories and sensors with the Nellcor SpO2 option. WARNING Tissue damage can be caused by incorrect application or use of a sensor (e.g., wrapping the sensor too tightly, applying supplemental tape, failing to periodically inspect the sensor site, leaving a sensor on too long in one place). Refer to the Directions for Use provided with each sensor for specific instructions on application and use, and for description, warnings, cautions, and specifications. WARNING Sensors exposed to ambient light while not applied to a patient can exhibit semi-normal saturation readings. Be sure the sensor is securely placed on the patient and check its application often to ensure accurate readings. WARNING Inaccurate measurements may be caused by venous pulsations. WARNING The pulse oximeter can be used during defibrillation, but the readings may be inaccurate for a short time. WARNING The pulse oximeter should NOT be used as an apnea monitor. WARNING A very sudden and substantial change in pulse rate can result in erroneous pulse rate readings. Be sure to validate the patient data and patient condition before intervention or change in patient care. WARNING Interfering Substances: Carboxyhemoglobin may erroneously increase readings; the level of increase is approximately equal to the amount of carboxyhemoglobin present. Methemoglobin may also cause erroneous readings. Dyes, or any substances containing dyes, that change usual arterial pigmentation may cause erroneous readings.

Directions for Use

Chapter 2 Monitoring

Attach the SpO2 sensor to the patient according to the manufacturer’s directions for use, observing all warnings and cautions. Each SpO2 sensor is designed for application to a specific site on the patient within a certain size range. To obtain optimal performance, use an appropriate sensor and apply it as described in the sensor’s directions for use. If excessive ambient light is present, cover the sensor site with opaque material to block the light. Failure to do so may result in inaccurate measurements. Light sources that can affect performance include surgical lights (especially those with a xenon light source), bilirubin lamps, fluorescent lights, infrared heating lamps, and direct sunlight. If NIBP will be monitored while using SpO2, place the NIBP cuff on a different limb than the SpO2 sensor to help reduce unnecessary SpO2 alarms. For optimal measurements, avoid placing the SpO2 sensor on the same limb as an arterial catheter or intravascular line. Loss of pulse signal can occur if the sensor is too tight, there is excessive ambient light, an NIBP cuff is inflated on the same limb as the sensor, there is arterial occlusion proximal to the sensor, the patient is in cardiac arrest or shock, or the patient has hypotension, severe vasoconstriction, severe anemia, or hypothermia.

2. Inspect the SpO2 cable. Replace it if it shows any signs of wear, breakage, or fraying. Plug the cable into the sensor and the monitor. 3. After the cable is connected, confirm that the monitor displays SpO2 data within a few seconds. 4. If excessive patient movement interferes with measurements, consider the following possible solutions: •

be sure the sensor is secure and properly applied

•

use a new sensor with fresh adhesive backing

•

select a different type of sensor

•

move the sensor to a less active site

The SpO2 system is designed to work satisfactorily during normal patient motion.

Chapter 2 Monitoring

Welch Allyn Micropaq Monitor

Install the Carrying Pouch WARNING As with all medical equipment, carefully route the patient cabling to reduce the possibility of patient entanglement or strangulation. Use the supplied garment clips to secure the cable properly. WARNING When positioning the monitor pouch on the patient, make sure the straps do not entangle the patient’s neck or cause choking. Make sure the straps do not restrict the movement of the patient’s limbs or create a hazard when walking or moving.

Adult Carrying Pouch The Adult Carrying Pouch is intended for ambulatory adult patients. It is not intended for use while the patient is in bed. 1.

Put the carrying pouch on the patient and insert the monitor.

2. Carefully arrange the pouch and monitor on the patient to avoid bruising or other skin injuries. To maximize the monitor’s wireless transmission range, always make sure that the monitor display is facing out and away from the patient’s body.

Pediatric Carrying Pouch The Pediatric Carrying Pouch is intended for ambulatory pediatric patients (40 to 80 lbs.). It is not intended for use while the patient is in bed. 1.

Insert the monitor into the pouch.

2. Carefully arrange the pouch and the monitor on the patient to avoid bruising or other skin injuries. To maximize the monitor’s wireless transmission range, always make sure that the monitor display is facing out and away from the patient’s body.

Directions for Use

Chapter 2 Monitoring

Monitor a Patient Out of Range of Acuity While out of range of Acuity, the monitor continues to monitor the patient and provide local HR/PR and SpO2 alarms or alerts at the monitor as needed. When the patient wearing the monitor goes out of range of Acuity, do the following: 1.

A DROPOUT equipment alert occurs at the Acuity Central Station. Acknowledge the alert at Acuity.

2. An equipment alert occurs at the monitor with this message: ACUITY CONNECTION LOST Depending on how the monitor is configured (as controlled by Acuity), this alert can also cause the monitor to emit audible alert tones. If tones are enabled, the authorized person should press on the monitor to acknowledge (dismiss) the alert and silence this instance of the alert tone. Note

The person authorized to press to acknowledge the alert may vary, depending on the local protocol. Follow the protocol established by your institution.

When the patient returns within range of Acuity, the monitor automatically reconnects to Acuity. No clinician intervention is required.

Chapter 2 Monitoring

Welch Allyn Micropaq Monitor

Stop Monitoring a Patient If you want to discontinue monitoring the patient, follow these steps. 1.

Press

2. Press

to display the Main Menu. to highlight ACUITY, then press

Acuity Menu

3. Press

to highlight END TELE, then press

4. When the monitor displays the message SAFE TO REMOVE BATTERY, remove the battery. If the battery is not removed within 30 seconds, the monitor will automatically try to reconnect to the network. 5. Disconnect the leads and sensors from the patient. Note

If you do not use END TELE to disconnect from the network as described above, the Acuity Central Station generates a DROPOUT equipment alert at Acuity. If you want to monitor this same patient at a later time, you will need to reselect the patient name from the monitor or confirm the patient ID at Acuity.

Directions for Use

Chapter 2 Monitoring

Reconnect a Recently Monitored Patient 1.

Insert a battery into the monitor to turn on the monitor. Confirm that after a few seconds the monitor Power-Up Screen is replaced by the initial monitoring screen.

2. The monitor will then present a series of menus and messages requesting you to provide information about the connection and patient. The actual screens presented depend on how long the patient has been disconnected. Provide the information as requested. This may include: •

Select an Acuity unit.

•

Select a patient from the patient list.

•

Select a patient room from the room list.

Note

If you do not select the patient name or room while connecting the patient, you will need to do that later at the Acuity Central Station. See “Monitor Patient at Acuity” on page 41 for more information.

•

To perform ECG monitoring, see “Perform ECG Monitoring” on page 21.

•

To perform SpO2 monitoring, see “Perform SpO2 Monitoring” on page 26.

Chapter 2 Monitoring

Welch Allyn Micropaq Monitor

Reassign a Monitored Patient to a New Room in the Same Unit If a patient is being monitored and you want to assign them to a new room in the same unit, follow these steps. 1.

Press

to display the Main Menu.

2. Press screen.

again to highlight ACUITY and press

to display the Acuity Menu

3. Press

to highlight NEW ROOM, then press

New Room Selection

Within a few seconds the monitor displays a list of all available rooms, including the patient’s current room. •

If you decide not to change the patient’s current room assignment, press patient’s current room is the default selection in the list).

(the

•

To assign the patient to a new room, highlight the room and press

•

If you want to cancel the patient’s current room assignment, but do not want to assign a new room at this time, you can highlight Select Room at Central and press . You can then assign the room later from the Acuity Central Station, or you can repeat this procedure and assign a new room from the monitor.

Directions for Use

Chapter 2 Monitoring

Transfer a Monitored Patient to a New Room in a Different Unit If a patient is being monitored and you want to assign them to a new room in a different unit, follow these steps. 1.

Press

to display the Main Menu.

2. Press screen.

again to highlight ACUITY and press

3. Press

to highlight TRANSFER, then press

to display the Acuity Menu .

Transfer a Patient

Within a few seconds the monitor displays a list of units. 4. Press

to highlight the new unit, then press

The patient is not monitored at Acuity during the short time required by Acuity to process the transfer to the new unit (typically less than one minute). However, the patient continues to be monitored by the monitor. (If the selected unit is currently not available, the monitor displays an appropriate message; press to acknowledge the message and cancel the transfer.) 5. After the patient is assigned to the new unit, the monitor displays a list of unassigned rooms. (The patient’s previous unit and room assignment is cancelled.) •

To assign the patient to a new room, highlight the room and press

•

If you decide not to assign the patient to a new room at this time, you can highlight Select Room at Central and press . You can then assign the room later from the Acuity Central Station, or you can assign a new room from the monitor later using the procedure on “Reassign a Monitored Patient to a New Room in the Same Unit” on page 32.

Chapter 2 Monitoring

Welch Allyn Micropaq Monitor

Reassign the Monitor to a New Patient If you want to discontinue monitoring a patient and reconnect the monitor to a new patient, follow these steps. 1.

Press

to display the Main Menu.

2. Press screen.

again to highlight ACUITY and press

3. Press

to highlight NEW PATIENT, then press

to display the Acuity Menu .

Select a New Patient

The monitor then presents a series of menus and messages requesting you to provide information about the connection and patient. The actual screens presented depend on how the Acuity System is configured. Provide the information as requested. This may include: •

Select an Acuity unit.

•

Select a patient from the patient list. (After you select a new patient, all monitor operating settings are reset to the Acuity System default power-up settings.)

•

Select a patient room from the room list.

To perform ECG monitoring, see “Perform ECG Monitoring” on page 21.

•

To perform SpO2 monitoring, see “Perform SpO2 Monitoring” on page 26.

Alarms & Alerts

About Alarms and Alerts Alarms provide a warning about a patient condition (such as a vital sign limit violation). Alerts provide a warning about an equipment condition that needs attention (such as a low battery or detached ECG lead). Alarms and alerts may be detected either by the monitor or by the network. While connected to the network, alarms or alerts are displayed at the monitor and at the Acuity Central Station. Alarms have a higher priority than alerts.

Alarm Holdoffs To help minimize false alarms, the monitor briefly delays or “holds off” triggering alarms for limit violations for HR/PR or SpO2. After the alarm holdoff period begins, if the monitor detects that the patient’s vital sign has returned to acceptable limits, the monitor cancels the alarm holdoff. The next time a vital sign limit is violated, the monitor starts a new holdoff period. Vital Sign

Alarm Holdoff Period

3 seconds

% SpO2 or PR

10 seconds

Chapter 3 Alarms & Alerts

Welch Allyn Micropaq Monitor

Respond to a Patient Alarm at Monitor When a patient alarm occurs, the monitor produces an audible tone (if audible tones are enabled). Life-threatening arrhythmia alarms beep at a faster pace than other vital sign alarms (see “Patient Alarm and Equipment Alert Specifications” on page 55). The monitor also displays a message similar to the following:

Red LED flashes during alarm. After the alarm is silenced (or suspended at Acuity), the red LED is on continuously.

Flashing numerics indicate patient alarm. Press to silence the alarm tone.

Check the patient and provide appropriate care.

2. To silence the alarm tone at the monitor and the Acuity Central Station for 90 seconds, press . While the alarm tone is silenced, visual alarm indications continue, and the red alarm indicator on the monitor changes from a flashing display to a continuous display. If the alarm condition still exists after 90 seconds, the alarm tone resumes. Note

If you silence an alarm at the monitor and another patient alarm or an equipment alert occurs during the silence period, the tone resumes at the monitor. At Acuity, only life-threatening arrhythmia alarms interrupt the silence period. If you suspend an alarm at Acuity, only life-threatening arrhythmia alarms interrupt the silence period at the monitor and Acuity. To access the Main Menu during silencing, press

Directions for Use

Chapter 3 Alarms & Alerts

3. To reset the alarm tone at the monitor and Acuity before the 90 seconds has elapsed, press at the monitor, or press Resume at the Acuity Central Station. 4. After caring for the patient, make sure that the appropriate alarm limits are set and that alarms are on.

Customize Patient Alarm Limits at the Monitor WARNING If the patient’s name has not yet been assigned to the monitor, do not adjust any alarm limits until after the patient name and ID are confirmed at Acuity. When the patient name and ID are confirmed at Acuity, Acuity downloads the default settings and patient alarm limits for that Acuity unit, thereby overriding any custom alarm limits that were set at the monitor before selecting the patient. 1.

Press

2. Press Menu:

to display the Main Menu. to highlight LIMITS, then press

to display the Alarm Limits Adjust

Alarm limits can be adjusted for HR/PR and SpO2.

3. To change an alarm limit, press or to highlight the desired limit, then press to display the Threshold Adjustment Menu:

Select + or - to change the limit.

•

Scroll and select the + or - selections to change the limit as desired.

•

To turn the highlighted limit on or off, scroll to ON/OFF and press

Chapter 3 Alarms & Alerts

Welch Allyn Micropaq Monitor

WARNING If you turn off any alarm limits, be sure to restore the appropriate alarm limits before you resume monitoring. Only life-threatening arrhythmias will be indicated at the monitor and Acuity (if connected) when alarms are turned off. 4. To change other limits, scroll to PREVIOUS MENU, press limit to change.

, then select another

5. When you have completed all changes, scroll to PREVIOUS MENU, then EXIT on the Alarm Limits Adjust Menu and press to return to the normal monitoring screen. Note

While the monitor is connected to Acuity, settings can be changed either at the monitor or at Acuity.

Respond to an Equipment Alert at the Monitor When the network or the monitor detects an equipment problem, the monitor produces a an audible alert tone (if audible tones are enabled). Equipment alerts beep at a slower pace than patient vital sign alarms (see “Patient Alarm and Equipment Alert Specifications” on page 55). The monitor also displays a flashing yellow light (LED) and an equipment alert message similar to the following:

The monitor has detected that the ECG cable has been disconnected from the monitor.

In this instance, press message.

to acknowledge (dismiss) the alert tone and clear the

If the message says “PRESS TO SILENCE,” when you press silenced for 90 seconds instead of dismissed.

, the tone is

If the monitor displays a chest diagram with a missing lead flashing, you can press to silence the tone. Some alerts do not give you the option to acknowledge the alert or silence the tone. For these alerts, to remove the message and tone, you must correct the problem.

Directions for Use

Chapter 3 Alarms & Alerts

2. If possible, determine what caused the problem and correct it. Note

After you press to acknowledge or silence some types of alerts, the yellow LED remains on (either flashing or steady yellow) until you correct the problem. For low battery alerts and no Acuity connection alerts, specific icons also flash.

For a list of possible messages and suggested responses, see “Alert Messages and Display Information” on page 40.

Chapter 3 Alarms & Alerts

Welch Allyn Micropaq Monitor

Alert Messages and Display Information Message and Display Information

Possible Cause(s) and Suggested Response

LOW BATTERY

The monitor will shut down within approximately 30 minutes or less due to a low battery. • Replace the battery as soon as possible.

VERY LOW BATTERY

The monitor will shut down within approximately 5 minutes or less due to a low battery. • Replace the battery as soon as possible.

BATTERY TOO LOW SHUT DOWN IN PROGRESS

The battery is so low the monitor has to shut down operation. • Replace the battery immediately.

ACUITY CONNECTION LOST

The monitor is not connected to the network. • Press to acknowledge and silence the tone and cancel the message. While disconnected from the network, the off-network icon and the yellow LED continue to flash. NOTE: The monitor will continue to attempt to reconnect until it is successful.

EXCESSIVE ECG OFFSET REPLACE ELECTRODESa

The monitor detects poor ECG electrode contact. • Check and replace ECG electrodes as needed.

Chest icon is displayed with flashing ECG electrode(s).a

The monitor detects that one or more ECG electrodes are disconnected. • Check and replace or reconnect electrodes as needed.

NO ECG CABLE DETECTED

• If the ECG cable has been intentionally removed from the monitor, press to cancel the alert tone. • If the ECG cable has been unintentionally removed, plug it back into the monitor. Check the patient and monitor to make sure ECG monitoring resumes properly. • It is normal for this alert to appear with a 3-lead ECG cable when two or more of its leads are disconnected from the patient. Reconnect the disconnected lead wires.

NO SPO2 SENSOR DETECTED

The SpO2 sensor has been disconnected for more than 5 seconds. • If disconnection is intentional, press to acknowledge and silence the tone. • If disconnection is not intentional, reconnect the sensor or replace the sensor and reconnect.

The SpO2 sensor is either defective or not recognized. DEFECTIVE SPO2 SENSORa • Replace the SpO2 sensor with a new, compatible SpO2 sensor. or UNRECOGNIZED SPO2 SENSORa <key name> KEY STUCKa

During the power-up self test, the monitor detected that a key is stuck ( , , , or ). This can happen if you accidentally press a key down before the Main Menu is displayed during power-up. • Remove and then reinsert the battery to power up again and see if the key is still stuck. If it is, contact your biomedical engineering department.

System Error Thread: <nnn> Error ID: <nnn>

The equipment problem is so serious the monitor cannot be used. • Contact your biomedical engineering department.

This alert message can be acknowledged from Acuity, but not from the monitor.

Monitor Patient at Acuity While the Micropaq is connected to the FlexNet network, patient data gathered by the monitor is continuously stored at Acuity. You can access this patient information at the Acuity Central Station and perform administrative functions, including: •

Admit (and discharge) a patient in the Acuity unit.

•

Edit the patient description (name, physician, etc.).

•

Review and print patient data such as trends and waveforms.

•

Suspend patient alarm tones for 90 seconds and resume the alarm tones

For more information about using the Acuity Central Workstation, refer to: •

Acuity Directions For Use

Chapter 4 Monitor Patient at Acuity

Welch Allyn Micropaq Monitor

Maintenance This section provides information to help operators of the monitor and the battery charger perform routine maintenance activities such as changing or recharging batteries, inspection, and cleaning.

Change the Battery 1.

Remove the depleted battery.

2. Insert a fully-charged battery. Use only batteries supplied by Welch Allyn. WARNING Before installing a battery, carefully inspect the battery case. If there are any signs of damage, cracks, or leaks, discard the battery properly and do not use it. Note

The Acuity unit can be configured to allow you a short time (typically 30 seconds or more) to change the monitor battery while the monitor is connected to the network without causing an Acuity equipment alert. If the monitor is connected to the network and the battery is removed for longer than the allowable battery changing time, Acuity generates a DROPOUT equipment alert at the Acuity Central Station.

Recharge a Battery 1.

On the monitor battery charger, choose an empty battery well where the LED is off.

2. Insert the depleted battery into the battery well. 3. Confirm that the charger displays a flashing green LED by the battery to indicate the battery is detected or is charging. 4. When the green LED is on continuously, the battery is fully charged. Remove the battery. If the yellow LED is on continuously, the battery may have reached the end of its useful life. Refer to the table below for suggested responses.

Chapter 5 Maintenance

Welch Allyn Micropaq Monitor

Charger LED

Battery Charger Label - LEDs

Battery Status and Possible Response

Green LED on continuously

Battery is fully charged.

Green LED flashing

Battery is charging.

Green LED flashing very slowly

Battery is detected and waiting to be charged.

LED off

No battery is detected.

Yellow LED on continuously

Something is wrong with the battery or the charger. Remove the battery. • If the LED goes off, it is probably a battery problem. Insert a new battery into the same battery well. If the new battery charges correctly, then the battery has a problem; discard the battery. The battery reorder number is 008-0647-XX. If the same problem occurs with the new battery, the charger may need repair. Contact biomedical engineering. • If the LED does not go off when you remove the battery, it is probably a charger problem. Unplug the charger power cord, wait at least 5 seconds, then plug in the charger power cord again. Insert a new battery into the same battery well. If the new battery charges correctly, then the battery has a problem; discard the battery. If the same problem occurs with the new battery, the charger may need repair. Contact biomedical engineering.

The charger can accommodate up to eight batteries. The charger charges a maximum of four batteries at a time. After a battery begins recharging (as indicated by the green LED that flashes on one second, off one second), it is typically fully recharged within four hours at room temperature. After a battery is fully charged, the charger continues to maintain the full charge on the battery until the battery is removed. Leaving a fully-charged battery in the charger will not harm the battery. Remove batteries from the battery charger if the battery charger will be disconnected from ac power for more than a few days. Do not block the cooling vents at the rear of the battery charger. The monitor battery charger only charges four batteries at a time. A battery is not fully charged until the green LED is on continuously. Do not remove a battery until it is fully charged. WARNING The monitor battery is Lithium Ion. Do not incinerate, submerge, crush, disassemble, or autoclave. If a battery has been submerged in liquid, discard the battery properly; do not try to recharge or reuse the battery. Do not short the battery terminals. Do not try to connect the battery to any device except the monitor or the monitor battery charger. Do not expose to high temperature (above 60° C or 140° F). Use only the specified monitor battery charger.

Directions for Use

Chapter 5 Maintenance

Inspect and Clean the Monitor and Accessories WARNING Be sure to unplug the monitor battery charger power cord from the electrical power outlet before inspecting or cleaning the battery charger. Exposing the battery charger to liquids such as cleaning solutions while connected to electrical power could result in electrical shock or fire. WARNING Do not autoclave the monitor, battery, battery charger, or accessories. Do not immerse the monitor, battery, or battery charger in liquid when cleaning. Do not immerse accessories in liquid when cleaning unless the accessory manufacturer’s cleaning instructions explicitly instruct you to do so. Before cleaning, thoroughly inspect the monitor and all accessories for any signs of damage, cracks, or improper mechanical function of keys or connectors. While gently bending and flexing cables, inspect for damage, cracks, cuts, abrasions, extreme wear, exposed wires or bent connectors. Confirm connectors securely engage. Report damage or improper function to your service department. At least every 12 months, be sure to thoroughly inspect the battery charger case and power cord for damage or extreme wear. To clean the monitor, batteries, or battery charger: 1.

Wipe the equipment with a nearly dry cloth moistened with one of the approved cleaning solutions listed in the table on “Approved Cleaning Solutions” on page 46.

2. Thoroughly wipe off any excess cleaning solution. Do not let the cleaning solution run into or accumulate in connector openings, latches, or crevices. If liquid gets into a battery well or connectors, dry the area with warm air, then check the equipment to confirm that it operates properly. Caution Use only cleaning solutions which are recommended by Welch Allyn for this equipment. Use of solutions which are not recommended or which have a high acid content or are otherwise inappropriate can cause damage to the equipment, including cracking and deterioration of the plastic case. Do not use these solutions or similar products: Butyl alcohol, Denatured ethanol, Freon™, Mild chlorine bleach solution, Isopropyl alcohol (except for the SpO2 cable), Trichloroethane, Trichloroethylene, Acetone, Vesphene II, Enviroquat®, Staphene®, Misty®, Glutaraldehyde, Formula 409®, or Fantastik®.

Chapter 5 Maintenance

Welch Allyn Micropaq Monitor

Equipment

Cleaning Instructions

Approved Cleaning Solutions

Monitora Batterya Battery Chargera

• Wipe with a nearly-dry cloth moistened with cleaning solution. • Thoroughly wipe off any excess cleaning solution. Do not let cleaning solution run into connector openings or crevices.b

Warm water, Liquid soap, Coverage®, Windex®, Ovation®, Hydrogen peroxide solution, Wex-cide®c, T.B.Q.®c

ECG cable, extension cable

• Wipe gently with damp cloth moistened with a mild detergent solution. • Thoroughly wipe off any cleaning solution.

Mild detergent.

SpO2 cable, extension cable

• Wipe the cable with a 70% isopropyl alcohol pad and allow it to dry.

70% isopropyl alcohol pad.

Other accessories

• Consult manufacturer’s instructions.

Consult manufacturer’s instructions.

a. b. c.

The equipment may be disinfected to comply with OSHA requirements for cleaning and decontaminating spills of blood and other body fluids. (Federal OSHA Standard on bloodborne pathogens: 29 CFR 1910.1030, 12/6/91.) If liquid gets into the battery well or connectors, dry the area with warm air, then check the monitoring functions for proper operation. Wex-cide (Wexford Labs, Inc., Kirkwood, MO) and T.B.Q. (Calgon Vestal Lab., Calgon Corp., St. Louis, MO) are disinfectants that meet OSHA requirements, are EPA approved, and will not harm the outside of the monitor, battery, or battery charger. Wipe away disinfectants with a water-dampened cloth after the manufacturer’s recommended period.

Recycling Monitor Components When the battery, monitor, or battery charger reaches the end of its life, recycle it locally according to national, state, and local regulations. You can also return the battery, monitor, or charger to Welch Allyn for recycling. Li++

Within the European Union Do not dispose of this product as “unsorted municipal waste.” Prepare it for reuse or separate collection as specified by Directive 2002/96/EC of the European Parliament and the Council of the European Union on Waste Electronic and Electrical Equipment (WEEE). If the monitor or battery (Li++) is contaminated, this directive does not apply. For more specific information, see www.welchallyn.com/weee, or contact Welch Allyn Customer Service.

Li++

Recycle monitor batteries (Li++) according to the Directive 91/157/EEC (Batteries and accumulators containing certain dangerous substances) and Directive 93/86/EEC (Labeling of batteries and accumulators containing certain dangerous substances).

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WelchAllyn

Micropaq Monitors

Micropaq Monitor Models 402, 404 Directions for Use Sw 1.5X