WelchAllyn

WelchAllyn Patient Monitors & Systems

Propaq CS Models 242, 244, 246 Directions for Use Sw 3.5X

Directions for Use

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Propaq® CS Vital Signs Monitor

Directions for Use

Models 242, 244, 246 Software Version 3.5X

Copyright © 2004 by Welch Allyn. Welch Allyn® is a registered trademark of Welch Allyn. Propaq®, Propaq® CS, and Acuity® are registered trademarks of Welch Allyn. Welch Allyn is protected under various patents and patents pending. Masimo ® and SET® are registered trademarks and Signal Extraction Technology™ is a trademark of Masimo Corporation. NELLCOR®, DURASENSOR®, C-LOCK® and OXISENSOR® are registered trademarks of Nellcor Puritan Bennett, Inc. LIFEPAK 5® and LIFEPAK 6s® are registered trademarks of Medtronic Physio-Control Corporation. Copyright Notice: Software in this Product is Copyright© 2004 by 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 all over the world. Under such laws, you are licensed to use the copy of the software incorporated with this instrument as intended in the operation of the product in which it is embedded, but 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 remains with Welch Allyn or its vendors. Welch Allyn will make available specifications necessary for interoperability of this software on request; however, users should be aware that use of Welch Allyn hardware and software with devices or software not sold by Welch Allyn or its authorized dealers and affiliates may lead to erroneous results and consequent danger in patient care, and may also void Welch Allyn's warranty. This device complies with Part 15 of the FCC rules and the Canadian ICES-003. Operation is subject to the following conditions: (1) This device may not cause harmful interference, and (2) This device must accept any interference received, including any interference that may cause undesired operation. Disclaimers: Welch Allyn cautions the reader of this manual: • This manual may be wholly or partially subject to change without notice. • All rights are reserved. No one is permitted to reproduce or duplicate, in any form, the whole or part of this manual without permission from Welch Allyn. • Welch Allyn will not be responsible for any injury to the user or other person(s) that may result from accidents during operation of the Propaq monitor. • Welch Allyn assumes no responsibility for usage not in accordance with this manual that results in illegal or improper use of the Propaq monitor. • No implied license: Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized sensors or cables which would, alone, or in combination with this device, fall within the scope of one or more of the patents relating to this device. Welch Allyn Technical Support: USA Latin America European Call Center United Kingdom

1-800-535-6663

France

(+33) 1-60-09-33-66

Australia

(+61) 2-9638-3000

(+1) 305-669-9591

Germany

(+49) 7477-927-173

Singapore

(+65) 6291-0882

(+353) 469-067-790 0-207-365-6780

Canada South Africa

1-800-561-8797

Japan

(+81) 3-5212-7391

(+27) 11-777-7509

China

(+86) 21-6327-9631

For information concerning this document or any Welch Allyn product, contact: Welch Allyn Welch Allyn GmbH: Germany Customer Service Postfach 31, Zollerstrasse 2-4 8500 SW Creekside Place 72417 Jungingen, Germany Beaverton, Oregon 97008-7107 USA Phone: 49-7477-92-710 Fax: 49-7477-92-7190 Within USA, toll free: Phone: (800) 289-2500 Welch Allyn: France Phone Technical Services: (800) 535-6663 814 Rue Charles de Gaulle 77100 Mareuil les Meaux, France WorldWide: Phone: 01-6009-3366 Phone: (503) 530-7500 Fax: 01-6009-6797 Fax: (503) 526-4200 Fax Technical Services: (503) 526-4970 Welch Allyn: Pacific P.O. Box 39-293 Howick, Auckland, New Zealand Internet: http://www.welchallyn.com Phone: 64-9-532-9524 E-mail Technical Services: [email protected] Fax: 64-9-532-9526 E-mail Marketing Dept.: [email protected] Welch Allyn: Asia Welch Allyn European Customer Service Room1002, 10/F Tung Sun Comm. Centre IPA Business Park, Dublin Road 194-200 Lockhart Road, Wanchai, H.K. Navan, County Meath, Ireland Phone: (852) 9016-7812 Phone: 353-46-67700 Fax: (852) 2535-5650 Fax: 353-46-27128 Welch Allyn: Latin America Welch Allyn U.K. Ltd. MD International, 11300 NW 41st Street Cublington Road, Aston Abbotts Miami, FL 33172 USA Buckinhamshire HP22 4ND, England Phone: (305) 669-9003 Phone: 44-1296-682140 Fax: (305) 669-8951 Fax: 44-1296-682104 Reorder Kit No: 810-1441-XX Welch Allyn Italia Via Napo Torriani, 29, 20124 Milan, Italy Manual Part No: Phone: 39-02-6699-291 810-1097-03 Fax: 39-02-6671-3599 Rev. A 8/04 Printed in USA

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Contents 1 – General Information...5 Intended Use, Symbols, and Safety Information... 5 Controls and Connectors... 9 Display... 12 Menus... 13 Learn Propaq CS Operation with In-Service Mode... 15 2 – Setup...17 Prepare the Propaq CS Monitor for a New Patient... 17 Set Patient Alarms and Alarm Limits... 19 Change the Current Patient Mode... 20 Change Powerup Patient Mode or Store Customized Settings... 21 3 – Monitoring...23 Perform ECG/RESP Monitoring... 23 Use the Propaq CS Monitor With Pacemaker Patients... 28 Perform Invasive Blood Pressure (IBP) Monitoring... 29 Take a Non-Invasive Blood Pressure (NIBP) Reading... 32 Perform Temperature Monitoring... 36 Perform SpO2 Monitoring... 37 Perform Mainstream CO2 Monitoring... 42 Perform Sidestream CO2 Monitoring... 44 Set Up the CO2 Display and Alarm Limits... 46 4 – Alarms & Alerts...49 Respond to Patient Alarms... 49 Customize Alarm Limits Based on Patient’s Current Vital Signs... 50 Alarm Holdoffs... 51 Connect Nurse Call Option... 51 Respond to An Equipment Alert... 52 Troubleshooting Equipment Alert Messages... 53 5 – Printing & Trends...61 Print Patient Data... 61 Display or Print Trends... 62 Set Printer Options and Automatic Printing... 64 Print OxyCRG... 65

Propaq CS Directions for Use

6 – Acuity... 67 Understanding the Propaq CS, Acuity, and the FlexNet™ Network... 67 Hardwired (Serial) Connection to Acuity... 71 Wireless Connection to Acuity... 73 7 – Defibrillator Synchronization... 79 Synchronous Cardioversion with LIFEPAK 5 Defibrillator... 79 Synchronous Cardioversion with LIFEPAK 6s Defibrillator... 82 8 – Maintenance... 85 Connect the AC Power Adapter to Recharge the Battery... 85 Replace Monitor Input Power Fuse... 87 Install Printer Paper... 88 Inspect and Clean the Monitor and Accessories... 89 Service Interval Recommendations... 90 Change the Wireless Propaq CS Network Name... 91 9 – Reference... 93 Set the Time and Date... 93 Change the Date Format, ECG Filter, and Units... 94 Factory Default Settings... 95 Specifications... 97 10 – Index... 117

Welch Allyn

1 – General Information Intended Use, Symbols, and Safety Information Intended Use The Propaq CS monitor is intended to be used by skilled clinicians for multiparameter vital signs monitoring of neonatal, pediatric, and adult patients in health care facility bedside applications. It is also intended for intra-facility and ambulance transport. The ECG channel is intended for five-lead or three-lead ECG monitoring. The Respiration (RESP) channel is intended to detect the rate or absence of respiratory effort, deriving the signal by measuring the ac impedance between selected terminals of ECG electrodes. The Invasive Pressure (IBP) channel is intended for measuring arterial, venous, and intracranial pressures (and umbilical artery and vein pressures for neonates) using invasive transducers. The Noninvasive Blood Pressure (NIBP) channel is intended for indirectly measuring arterial pressures using an inflatable cuff. If ECG is also monitored, the Propaq CS Smartcuf™ software algorithm automatically synchronizes the NIBP measurement process to the occurrences of the R-wave, increasing accuracy in cases of extreme artifact and diminished pulses. The operator may disable or enable the Smartcuf algorithm in the NIBP Menu. The Temperature (TEMP) channel is intended to measure temperature using an attachable probe. The Pulse Oximetry (SpO2) channel is intended to noninvasively measure oxygen saturation of arteriolar hemoglobin at a peripheral measurement site. The Capnography (CO2) channel is intended to noninvasively measure the following vital signs or events: End-tidal CO2 (ETCO2), Inspired CO2 (INCO2), Breath Rate, and Apnea.

This guide was written for clinicians. Although this guide may describe some monitoring techniques, Welch Allyn expects that you are a trained clinician who knows how to take and interpret a patient’s vital signs. This monitor has been designed as a quality monitor; however, inherent limitations require that good clinical judgment always prevails.

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.

Note NOTE statements provide additional important information.

Propaq CS Directions for Use

The following symbols may appear on the Propaq CS monitor or accessories. They are defined by the International Electrotechnical Commission, IEC 878 and IEC 417A. Off (Standby)

Two way communication port

Input port

For continued fire protection, use only the specified fuse

Output port

Direct current

Alternating current1

Direct current or alternating current

Separate batteries from other disposables for recycling.

Caution: Refer to Directions For Use and accompanying documentation

Enclosure Protection Drip proof: Classification IPX1 per IEC Publication 529

IPX1

Battery charging when green indicator illuminated

Temperature sensor input

Patient connections are Type CF, isolated for direct cardiac application, and protected against defibrillation

Transformer meets requirements of a short-circuit-proof safety-isolating power transformer1

Patient connections are Type BF, and protected against defibrillation

For indoor use only (on power adapter only)

Protected during defibrillation

Stacking limit by number n

This way up

Temperature limits

Fragile

Humidity limit

Keep away from rain

Altitude limit

Patient connections are Type B

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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 product1

NRTL /C Evaluated to CSA 601-1 and UL2601-1

Urgent alarm notification (output to Nurse Call system) US

The Canadian Standards Association has evaluated this device according to CSA 601-1 and Underwriters Laboratory Standard UL 2601-11. This device has been tested and certified by the Canadian Standards Association International to comply with applicable U.S. and Canadian medical safety standards. Apply the NIBP cuff as shown.

NIBP cuff sizes: Thigh Large adult Adult Small adult Child Infant

Single-use only (not reusable).

1. This symbol is on the Universal Power Adapter.

Welch Allyn

Chapter 1 – General Information

General Warnings and Cautions Familiarize yourself with all warnings and cautions before using the Propaq CS monitor. In addition to the following, other warnings and cautions appear throughout this manual.

Warning Safe interconnection between the Propaq CS monitor and other devices must comply with applicable medical systems safety standards such as IEC 601-1-1. Within certain governmental jurisdictions, all interconnected accessory equipment must be labeled by an approved testing laboratory. After interconnection with accessory equipment, risk (leakage) current and grounding requirements must be maintained. This monitor is to be operated by qualified personnel only. The operator of this monitor should read this entire manual and all accessory Directions For Use before operating the monitor. Before you use a Propaq CS monitor on a new patient, always turn off the monitor for a few seconds, then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target. Always check the patient mode when monitoring a new patient. The patient mode determines default alarm limits, maximum cuff inflation pressure, and internal algorithm settings. The monitor may not meet its performance specifications if stored or used outside the specified temperature and humidity ranges. Place the Propaq monitor and accessories in locations where they cannot harm the patient if they fall from their shelf or mount. Lift the monitor only by its handle; do not lift it by any attached cables. Do not connect more than one patient to a monitor. Do not connect more than one monitor to a patient. Inspect the power adapter cord periodically for fraying or other damage, and replace the adapter as needed. Do not operate the apparatus from ac power with a damaged power adapter cord or plug. Make frequent electrical and visual checks on cables, sensors, and electrode wires. All cables, sensors, and electrode wires must be inspected, properly maintained, and in proper working order to allow the equipment to function properly and protect patient safety. As with all medical equipment, carefully route the patient cabling to reduce the possibility of patient entanglement or strangulation. 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. During defibrillation, keep the discharge paddles away from ECG and other electrodes, as well as other conductive parts in contact with the patient. Avoid contact with any accessories connected to the monitor’s left side panel. 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. Do not operate this product in the presence of flammable anesthetics or other flammable substance in combination with air, oxygen-enriched environments, or nitrous oxide; explosion can result. Electronic equipment that emits strong electromagnetic or radio frequency signals can cause electrical interference with ECG monitor operation. This interference may distort the displayed or recorded ECG signal, thereby preventing accurate rhythm analysis. Avoid operating this device near equipment of this type. When using a power adapter with this monitor, be sure to connect the power adapter to a three-wire, grounded, hospital-grade receptacle. Do not under any circumstances attempt to remove the grounding conductor from the power plug of the power adapter. Do not plug the power adapter into an extension cord. If there is any doubt about the integrity of the protective earth ground of the receptacle for the power adapter, do not plug in the power adapter; operate the monitor only on battery power. Contact your biomedical engineering department for assistance in identifying the proper power receptacle and making appropriate power connections.

Propaq CS Directions for Use

Warning To help protect against electrical shock due to leakage current, use only monitor ac power adapters recommended in the Welch Allyn Products and Accessories booklet (P/N 810-0409-XX). For best product performance and measurement accuracy, use only accessories supplied by Welch Allyn or recommended in the Welch Allyn Products and Accessories booklet. Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use. If a product has been dropped or severely abused, send it to a qualified service person to confirm proper operation and acceptable risk (leakage) current values. Some or all NIBP safety functions are disabled in the NIBP TEST screen in the Service Menu. Do not attempt to conduct NIBP TEST when the cuff is attached to a patient. When using the motion tolerant pulse oximetry channel, 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. Do not use the Propaq CS 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. Impedance pneumography and CO2 monitoring may not operate properly when used in conjunction with high-frequency jet ventilation or high-frequency oscillatory ventilation. This monitor should only be repaired by qualified service personnel. The operator should not attempt to open the monitor case or perform any maintenance on the monitor except for procedures explicitly described in this manual that can be performed by operators such as inspection and cleaning.

Caution Do not autoclave the Propaq CS monitor. Autoclave accessories only if the manufacturer's instructions clearly approve it. Many accessories can be severely damaged by autoclaving. Federal USA law restricts this device to sale, distribution, or use by or on the order of a licensed medical practitioner.

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 Propaq CS monitor should be serviced only by a Welch Allyn service technician while under warranty. The Propaq CS Service Manual (P/N 810-1101-XX) is available from Welch Allyn to assist the biomedical engineer during post-warranty period service.

Welch Allyn

Chapter 1 – General Information

Controls and Connectors Yellow antenna cap indicates Wireless Propaq CS Nurse Call Option

Alarm Light Alarm(s) Off Light Suspend/ Resume Alarm Suspends alarm tone for 90 seconds or resumes alarm tone (if active)

SpO2 Option

Start/ Stop NIBP Starts or stops NIBP reading

Home Mainstream CO2 Option

Returns the display to the Main Menu

Printer Option Printer Buttons Sidestream CO2 Option

Touch-Screen Controls The front panel touch-screen provides five softkeys along the bottom and three icon-labeled keys along the right side. An Acuity NET OFF key is displayed in the upper left corner if the monitor is connected to an Acuity system. These keys allow control of all monitoring and setup functions.

Note Avoid pressing more than one touch-screen key at a time. Touching more than one key area at a time can cause the touch-screen to misinterpret the command and respond to the wrong key.

Caution Do not touch the screen with a sharp object such as a pen or pencil. Sharp objects can damage the touch-screen. Use your finger to press the touch-screen keys.

Propaq CS Directions for Use

System Control and Connectors (Right Side Panel)

On/Off Switch

MONITOR

Defib Sync Connector

DEFIB SYNCHRO

Real-time ECG Output Connector Input Fuse

3A 2AG

EKG x 1000

Speaker

! !

Connector for Acuity or Modem-Propaq

Power Input Connector Battery Charging Light

12-28V, 3A

Patient Connectors (Left Side Panel) Model 242 ECG NIBP Temperature (two channels)*

ECG / EKG RESP

Model 246

Model 244 ECG Invasiv Pressure (one channel) NIBP Temperature (two channels)* INV. BP

ECG / EKG RESP

ECG Invasive Pressure (two channels) NIBP Temperature (two channels)* INV. BP

ECG / EKG RESP

! NIBP PSNI

NIBP PSNI !

T2 INV. BP

Propaq CS Model 242 ECG / EKG RESP

Propaq CS Model 244 INV. BP

P1 ECG / EKG RESP

Propaq CS Model 246 INV. BP

P1 ECG / EKG RESP

! COMPATIBLE HP

P S N I

! COMPATIBLE HP

NIBP

HP Model 242*

P S N I

HP Model 244*

INV. BP

NIBP

HP Model 246*

*The HP (Hewlett-Packard) side panels provide only one temperature connector.

Welch Allyn

Chapter 1 – General Information

Option Connectors CO2 CO2

! ! Mainstream CO2 Connector

Sidestream CO2 Connector

Nurse Call Connector

Cable: see Welch Allyn Products and Accessories Guide (810-0409-XX)

Masimo SpO2 Connector (motion tolerant)

SpO2 !

NELLCOR SENSORS/CAPTEURS

Nellcor SpO2 Connector (newer style, motion tolerant)

Propaq CS Directions for Use

Nellcor SpO2 Connector (older style, without motion tolerance)

Display You can select up to four waveforms to be shown on the Propaq CS monitor. When only one waveform is selected, a trend window automatically appears beneath the waveform. Patient mode NET OFF to disconnect monitor from Acuity network.

Time of day

17:05:10 NET ADULT OFF ON NETWORK ALLEN KIM

Patient name entered at Acuity Central Station.

Status messages can appear here.

BPM

II mV 1cm

MON

S (M) D ( 96) mmHg

mV 1cm MON

NIBP

130

TEMP

S D ( 85) mmHg (M)

P 100

°F

T1 100.4 T2 98.6 1.8 ∆T

70 30

MCO2

mmHg

Br/m

P 15

SpO2

STATSCALE automatically adjusts all waveform scales for optimum viewing.

79 25 9 122 58

S (M) D ( 15) mmHg

V When selected, trends are displayed here.

11121 2

PRINT FAULT

38 12

STATSCALE

ALARMS

ACUITY

Heart Rate Source: HR indicates ECG; PR indicates blood pressure or SpO2. Heart Rate in beats per minute. Bells indicate alarm limit status All numeric values are continuously displayed and updated. If the monitor detects a vital sign outside the measurable range, it displays - - - (below the range) or + + + (above the range).

TRENDS

While changing monitor settings, a status window may appear below the waveform: ECG1 waveform is always displayed if active. Status window

17:05:10 NET ADULT OFF ON NETWORK ALLEN KIM

PRINT FAULT

BPM

II mV 1cm

11121 2

HR P1

(M)

MON ECG/RESP

79 25 9 122 58

(M)

Systolic, diastolic, and mean pressures are uniquely labeled and displayed.

( 15) mmHg

: OFF

HR/PR TONE PACER DISPLAY

: ON

ECG BANDWIDTH

: MONITOR (0.5-40Hz)

RESP LEAD

: Ld2 (RA-LL)

RESP MONITORING : ON

NIBP (M)

TEMP °F

T1 100.4 T2 98.6 1.8 ∆T

MCO2

mmHg

Br/m

CHANGE

S D

( 85) mmHg

38 12

SpO2 NEXT

S D

( 96) mmHg P2 S

ETCO2 concentration Breath Rate from CO2 Oxygen saturation is a percentage value.

PREVIOUS MENU

Welch Allyn

Chapter 1 – General Information

Menus Menus for some patient vital signs are displayed only if the option is included in your Propaq CS monitor.

Main Menu MAIN MENU NIBP

ECG/ RESP

INVASIVE PRESSURE

SETUP

SpO2/ CO2

SpO2

CO2

PREVIOUS MENU

CO2 MENU 1 RANGE

mm/s

PREVIOUS MENU

CO2 MENU 2A (NO CO2 SENSORS) GAS COMP

RESPONSE

PREVIOUS MENU

CO2 MENU 2B (MAINSTREAM CO2 ACTIVE) GAS COMP

RESPONSE

SOURCE

PREVIOUS MENU

CO2 MENU 2C (SIDESTREAM CO2 ACTIVE) GAS COMP

RESPONSE

SOURCE

FLOW RATE

SpO2 MENU 1 SIZE

PREVIOUS MENU

SpO2 MENU 2 RESPONSE

C-LOCK

PREVIOUS MENU

INVASIVE PRESSURE MENU 1 RANGE

RESCALE

ZERO P1

ZERO P2

CANCEL

INVASIVE PRESSURE MENU 2 LABEL P1

FORMAT P1

LABEL P2

FORMAT P2

ECG2 SIZE

RESP SIZE

ECG/RESP MENU 1 ECG1 SIZE

ECG1 LEAD

ECG/RESP MENU 2 NEXT

CHANGE

AUTO/ MANUAL

INTERVAL

PREVIOUS MENU

NIBP MENU START STOP

Propaq CS Directions for Use

TURBOCUF

SMARTCUF

PREVIOUS MENU

Setup Menus ECG/ RESP

INVASIVE PRESSURE

SpO2/ CO2

SETUP

ALARMS

WAVE WAVE SEL SELECT

TRENDS

NIBP

SETUP MENU 1 STATSCALE

SETUP MENU 2 NEXT

ACUITY

CHANGE

WAVE SELECT

PRINTER

TREND MENU PRINT

NEXT TREND

PRINT OXYCRG

ACUITY MENU (HARDWIRED CONNECTION)1 NET OFF

SNAPSHOT

PREVIOUS MENU

ALL ALARMS

LIMITS

PREVIOUS MENU

DOWN

ON/ OFF

ALARMS MENU STAT SET

SUSPEND RESUME

ALARM LIMITS MENU2 NEXT PARAMETER

NEXT SETTING

Acuity Menu is displayed if the monitor is connected to Acuity. See page 67 for details about Acuity hardwired and wireless communication options.

TIME/DAY MENU NEXT

DOWN

ENTER

SERVICE

SpO2 TEST

CO2 TEST

NET TEST

PCMCIA TEST

SYSTEM

RADIO

SERVICE MENU 13 NIBP TEST

IBP TEST

SERVICE MENU 23

ON/OFF key is not displayed for HR/PR alarm limits if the HR/PR ALARM LIMITS setting is set to CANNOT TURN OFF.

PIXEL TEST

TEMP TEST

SERVICE MENU 33 SETTINGS

SCREEN CAL

SETTINGS MENU NEXT

Service menu tests are only for use by authorized service personnel and are only available in the Adult patient mode. RADIO key is only displayed for Wireless Propaq CS.

CHANGE

PREVIOUS MENU

PRINTER SETUP MENU NEXT

CHANGE CHANGE

PRINT TREND

PREVIOUS MENU

WAVE SELECT MENU NEXT

ON/ OFF

INSERVICE

PREVIOUS MENU

NO INSERVICE 4

Patient Mode menu is accessed when CHANGE is pressed for PATIENT MODE.

PATIENT MODE MENU4 NEONATAL

PEDIATRIC

ADULT

SETUP

PREVIOUS MENU

USE NOW

SAVE

PREVIOUS MENU

MODE SETUP MENU NEXT

Radio menu is displayed for Wireless Propaq CS.

POWERUP*

RADIO MENU5 NETWORK STATUS

CHANGE NET NAME

PREVIOUS MENU

NETWORK MONITOR

Welch Allyn

Chapter 1 – General Information

Learn Propaq CS Operation with In-Service Mode You can practice using the Propaq CS monitor with the in-service mode of operation. The in-service mode cannot be activated while you are monitoring a patient. During in-service mode, the monitor display and all printouts include the message SIMULATING or SIMULATED DATA. To practice with your Propaq CS monitor: 1.

Disconnect all patient cables connected to the monitor. You can leave the NIBP cuff connected to the monitor so you can take NIBP measurements.

If you have been monitoring a patient, turn off the monitor and turn it back on. If your monitor is programmed so that the NIBP Automatic Mode is selected at powerup, select one of the Factory Patient Modes as the powerup patient mode (see page 21). Then turn the monitor off and turn it back on. (The in-service mode is not available if the NIBP Automatic Mode has been selected.)

From the Main Menu, press SETUP, WAVE SELECT, INSERVICE. The Propaq CS monitor has two sets of simulated patient information. To change between the sets, from the Main Menu press SETUP, WAVE SELECT, and INSERVICE again. While in the in-service mode, you can press any monitor keys (except the AUTO/MANUAL key in the NIBP Menu) to change a function setting. For example, you can change ECG and RESP waveform sizes, set alarm limits, or set custom settings. You can also apply the NIBP cuff to yourself and take NIBP measurements.

To exit the in-service mode, turn off the monitor. If you changed the powerup patient mode in step 2, be sure to restore the appropriate powerup patient mode according to your local protocol.

Note The in-service mode is not available if the monitor detects that a sensor has been connected (except for an NIBP cuff) or the NIBP Automatic Mode has been selected. If the monitor is in in-service mode and you connect a sensor (except for an NIBP cuff) or press the NIBP AUTO/MANUAL key, the monitor will turn off power to exit the in-service mode, and then turn on in the normal operating mode. The pacemaker signal indicators are not displayed in the in-service mode.

Propaq CS Directions for Use

2 – Setup Prepare the Propaq CS Monitor for a New Patient Warning Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.

Press the gray recessed MONITOR button on the right side of the monitor to turn the monitor off (if it is on). Press it again to turn the monitor on. The monitor displays the powerup screen for about 10 seconds, then displays the Main Menu. The monitor is in the powerup patient mode with the associated settings.

Confirm that the monitor emits a tone. If the monitor has SpO2, listen for two tones and confirm both speakers are working.

Note Check the battery voltage level on the powerup screen (or check it on the Time/Day window: Home, SETUP, MORE, MORE). If the battery voltage is 7.4V or less or a low battery message is displayed, connect the monitor to an ac power adapter to recharge the battery (see page 22). Connecting the adapter does not interrupt patient monitoring.

Home

Confirm the monitor is in the correct patient mode according to the patient’s age. If the patient mode is not correct, from the Main Menu press SETUP, MORE, CHANGE to access the Patient Mode window: PATIENT MODE

BATTERY: 8.2 VOLTS

SELECT PATIENT MODE BASED ON AGE: NEO : < 44 WEEKS GEST. AGE PED : > 44 WEEKS GEST. AGE, < 9 YEARS ADULT: > 9 YEARS NEONATAL

PEDIATRIC

ADULT

SETUP

PREVIOUS MENU

Based on the patient’s age, press NEONATAL, PEDIATRIC, or ADULT. When the confirmation window appears, press YES to confirm your selection. Whenever you change the patient mode, the alarm limit settings, maximum NIBP cuff inflation pressures, and internal computations are automatically changed to the defaults for that patient mode. See page 21 for information about preset Factory patient modes or programmable Custom patient modes.

Note If you change the patient mode, the CO2 alarm limits in the new mode might vary slightly from the originally-programmed CO2 alarm limits for the new mode. Check the CO2 alarm limits.

Propaq CS Directions for Use

To select which vital sign waveforms will display, from the Main Menu press SETUP, MORE, WAVE SELECT. Use NEXT and ON/OFF to turn on the desired waveforms in the Wave Select window. .

SETUP

WAVE SELECT

ECG1 : ON

CO2 : ON

ECG2 : ON

RESP : ON

: ON

SpO2 : ON

: ON

NIBP : ON

PREVIOUS MENU

INSERVICE

ON/ OFF

You can turn on all waveforms, but only the first four waveforms selected as ON in the Wave Select window are displayed. You cannot turn off the ECG1 waveform.

To set the HR/PR source, display sweep speed, tone volumes, and display brightness, from the Main Menu press SETUP, MORE to access Setup Menu 2. Use NEXT and CHANGE to select settings. SETUP CURRENT SOURCE : SELECTED SOURCE : SWEEP (mm/s) :

HR/PR

RR/BR

??? ECG 25.0

??? --6.25

ALARM TONE HR/PR TONE

: LOW : OFF

PATIENT MODE

BRIGHTNESS

: NORMAL

CHANGE

The ? ? ? is displayed until a source is active.

ADULT

WAVE SELECT

PRINTER

CURRENT SOURCE

When the selected HR/PR source is no longer available, the current source is the active source with highest priority. The RR/BR source cannot be manually selected. It is always CO2 if CO2 is active. Otherwise, it is ECG/RESP.

SELECTED SOURCE

The user-selected HR/PR source is displayed along with the HR/PR source currently used by the monitor.

SWEEP (mm/s)

Selectable sweep speeds for HR/PR: 12.5, 25, 50 mm/sec. Selectable sweep speeds for RR/BR: 3.13, 6.25, 12.5 mm/sec.

ALARM TONE

Sets the Alarm Tone volume to HIGH, MEDIUM, or LOW.

HR/PR TONE

Sets the Heart Tone volume to HIGH, MEDIUM, LOW, or OFF.

BRIGHTNESS

Sets the display brightness to NORMAL or LOW.

Warning At the highest volume alarm level, the sound pressure level does not exceed safe limits (OSHA HSM 73-1101, 1972). However, additional precautions may be required in patients under treatment with ototoxic medications.

Welch Allyn

Chapter 2 – Setup

Set Patient Alarms and Alarm Limits 1.

From the Main Menu, press SETUP, ALARMS to access the Alarms Status Menu: P2

(M)

NIBP

RR/BR :

APNEA : HR/PR :

SpO2 :

NIBP :

TEMP :

CO2

(M)

TEMP °F

ALL ALARMS

T1 100.4 T2 98.6 1.8 ∆T

MCO2

mmHg

Br/m

38 12

SpO2

SUSPEND

S D

( 85) mmHg

STAT SET

25 9 122 58

S D ( 15) mmHg

ALARM STATUS

LIMITS

Bells also appear in numerics windows.

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All alarm limits are on. At least one alarm limit is off.

(No bell)

All alarm limits are off or the vital sign is not being monitored.

Press LIMITS to display the Alarms Limits window: ALARM LIMITS

Arrow indicates there are more parameters that are not displayed. Press NEXT PARAMETER to scroll down. After the selection reaches the last parameter, it returns to the top (HR/PR).

HR/PR RR/BR APNEA DELAY SpO2 ETCO2 INCO2 NIBP S NIBP D NIBP (M) T1 T2 ∆T NEXT PARAMETER

UPPER BPM 120 30 Br/M 20 sec 100 % mmHg OFF mmHg OFF 220 mmHg 110 mmHg 120 mmHg °F * 100.0 °F 100.0 °F 5.0

NEXT SETTING

(M)

25 9 122 58

S D

LOWER 50 5

NIBP

90 OFF

TEMP

75 35 50 95.0 95.0 0.0

MCO2

mmHg

Br/m

DOWN

( 15) mmHg S D ( 85) mmHg (M)

°F

99.8 98.6 1.2

38 12

SpO2 %

T1 T2 ∆T

ON/ OFF

An asterisk indicates this alarm limit was violated during monitoring. Red asterisk = alarm is occurring now. Yellow asterisk = alarm has occurred since the last time this window was entered. The asterisk is removed when you exit this menu. The asterisk reappears if the limit is violated again.

Press NEXT PARAMETER to highlight the parameter you want to change, then press NEXT SETTING to highlight the limit you want to change.

Press UP, DOWN, or ON/OFF to change the limits. The apnea alarm cannot be turned off at any time.

After setting the desired limits, press Home to return to the Main Menu. Home

Propaq CS Directions for Use

Change the Current Patient Mode 1.

To change the current patient mode, from the Main Menu press SETUP, MORE, CHANGE to access the Patient Mode window: PATIENT MODE

BATTERY: 8.2 VOLTS

SELECT PATIENT MODE BASED ON AGE: NEO : < 44 WEEKS GEST. AGE PED : > 44 WEEKS GEST. AGE, < 9 YEARS ADULT: > 9 YEARS NEONATAL

PEDIATRIC

ADULT

SETUP

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Note If you change the patient mode, the CO2 alarm limits in the new mode might vary slightly from the originally-programmed CO2 alarm limits for the new mode. Check the CO2 alarm limits.

Welch Allyn

Chapter 2 – Setup

Change Powerup Patient Mode or Store Customized Settings The Propaq CS monitor has standard, preset, default powerup settings and alarm limits for each patient mode: Adult, Pediatric, and Neonatal. These are “Factory Patient Mode” settings (listed on page 95). You can also choose to customize and store programmable powerup settings and alarm limits for each patient mode. These are “Custom Patient Mode” settings. The instructions below describe how to change the powerup patient mode and how to select and store new Custom Patient Mode settings.

Note When you change patient modes, you also change the alarm limits associated with the new patient mode.

Change the Powerup Patient Mode 1.

From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window. P2 MODE SETUP FACTORY: Asterisk indicates which patient mode is currently selected for powerup.

CUSTOM :

BATTERY: 9.2 VOLTS

*ADULT ADULT

PED PED

NEO

NIBP

NEO

( 85) mmHg

(M)

TEMP °F

* = PATIENT MODE ON POWERUP

USE NOW

SAVE

T1 100.4 T2 98.6 1.8 ∆T

mmHg

Br/m

POWERUP*

S D

MCO2

38 12

SpO2 NEXT

25 9 122 58

S D ( 15) mmHg (M)

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Press NEXT to highlight the desired Factory or Custom powerup mode, then press POWERUP* and YES. The new powerup selection is marked by the asterisk. Changing the powerup mode does not affect the patient mode currently used.

Propaq CS Directions for Use

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