R Series NIBP Operators Guide Rev C Jan 2018.pdf
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R Series
Non-Invasive Blood Pressure
(NIBP)
®
9650-0914-01 Rev. C
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
The issue date for the R Series Non-Invasive Blood Pressure guide
(REF 9650-0914-01 Rev. C) is January, 2018.
Copyright 2018 by ZOLL Medical Corporation. All rights reserved. ZOLL and R Series
are trademarks or registered trademarks of ZOLL Medical Corporation.
SunTech Advantage is a registered trademark of SunTech Medical Group.
All other trademarks and registered trademarks are property of their respective owners.
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Non-Invasive Blood Pressure Monitoring (NIBP) Indication of Use
Non-Invasive Blood Pressure Monitoring (NIBP)
Indication of Use
The R Series system is indicated for the non-invasive measurement of arterial blood pressure
for resting patients in critical care and in-hospital transport. The NIBP feature is indicated to
measure blood pressure for patients from newborn (neonate) to adult.
NIBP Contraindications for Use
There are no known contraindications for the use of the NIBP monitor.
General Information
Federal (U.S.A.) law restricts this defibrillator to sale by or on the order of a physician.
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
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Non-Invasive Blood Pressure (NIBP)
Product Description
The Non-Invasive Blood Pressure (NIBP) option on the R Series® unit gives you the ability to
take a single blood pressure measurement, STAT measurements (automatically repeated
measurements over a 5 minute period), or automatic measurements at repeating pre-selected
intervals. The blood pressure information (including the patient’s systolic, diastolic and mean
blood pressure values) is shown on the R Series monitor in the NIBP display area, on the left
side of the screen.
For R Series BLS/Plus models, the NIBP option can only be used while the unit is in Manual
mode.
How To Use This Manual
This insert describes how to set up and use the R Series NIBP option. Important safety
information relating to the general use of the R Series NIBP option appears in “Safety
Considerations” on page 2.
Before attempting to use the NIBP option, you must read and understand all the information
contained in the R Series Operator’s Guide, which provides information that operators need for
the safe and effective use and care of the R Series unit.
Thoroughly read the Safety Considerations and Warnings sections in both the R Series
Operator’s Guide and the relevant inserts before operating your R Series product.
SunTech CE Contact
Direct all cuff, hose, and NIBP questions with regards to the Declaration of Conformity with
European Union Directives to the authorized representative for SunTech:
SunTech Medical Instruments Ltd.
Oakfield Industrial Estate
Stantom Harcourt Road
Eynsham, Witney
OX8 ITS
UK
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
Safety Considerations
General NIBP Safety
• Read the R Series Operator’s Guide and this manual insert before use.
• Ensure that the R Series NIBP option is operated by qualified personnel only.
• Consult a physician for the proper interpretation of pressure measurements.
• Do not use on patients known to be susceptible to bruising.
• Use caution when using on elderly hypertensive patients, as such patients may be more
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susceptible to bruising.
Route patient hoses carefully to avoid patient entanglement, strangulation or compression of
hose.
Do not select a cuff inflation pressure that exceeds the patient’s expected systolic pressure
by more than 30-40 mmHg (4.0-5.3 kPa). The factory-installed default adult cuff inflation
pressure is 160 mmHg (21.3 kPa) for adult patients, 120 mmHg (16.0 kPa) for pediatric
patients, and 90 mmHg (12.0 kPa) for neonatal patients.
Keep patient, hose and cuff as still as possible during measurement. Patient movement or
vibrations from outside sources, particularly moving vehicles, can degrade measurement
accuracy.
Check patient regularly for signs of skin irritation or impaired circulation in the monitored
limb.
Do not use the NIBP option on a patient when the R Series unit is connected to an ECG
simulator.
If an alarm occurs while the audible alarm indicators are disabled, alarms do not sound;
rather only the visual alarm indicators are displayed.
If the accuracy of measurements is suspect, first check the patient's vital signs by alternate
means. Then check the cuff, hose and R Series NIBP option for proper functioning.
The cuff, hose, and fitting are defibrillation-protected. Using the NIBP option introduces no
risk for shock due to defibrillation. The cuff and hose are non-conductive. Using the NIBP
option introduces no risk for burns due to electrosurgery.
Cuff safety and effectiveness have not been proven on pregnant women.
Do not attach the cuff to a limb being used for IV infusions or any other intravascular
access, therapy or an arterio-venous (AV) shunt.The cuff inflation can temporarily block
blood flow, potentially causing harm to the patient.
Applying the cuff over a wound can cause further injury.
For patients that have had a mastectomy, cuff should be applied to opposite arm.
Blood pressure measurements can be affected by the position of the patient, physiologic
condition, activity level, improper cuff size/application, environment and use outside of the
operating instructions detailed in this manual.
The NIBP module may not operate correctly if used or stored outside the relevant
temperature or humidity ranges described in the specifications on page 28.
Cuff and Hose Safety
• Only use cuffs, hoses, and connectors supplied or specified by ZOLL.
• Ensure that the hose is not kinked or obstructed before taking measurement.
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Cuff and Hose Safety
• Do not use damaged cuffs, hoses, or connectors.
• Ensure proper cuff selection and placement to avoid inaccurate measurements or patient
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injury.
Position the cuff so it is level with the heart during measurement.
Do not attach the cuff to a limb being used for IV infusion, SpO2 monitoring, or other
monitoring equipment. Cuff inflation might block the infusion, causing harm to the patient
or inaccurate SpO2 measurements.
Do not repeat NIBP measurements (particularly STAT measurements) at intervals less than
3-5 minutes over an extended period of time. Rapidly repeating measurement can impair
circulation in the monitored limb.
Do not sterilize or immerse the cuffs or hoses.
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NIBP Intended Use
NIBP Intended Use
The ZOLL R Series NIBP option is intended to be used for the non-invasive measurement of
arterial blood pressure for resting patients in critical care and in-hospital transport.
The R Series NIBP option is designed to measure blood pressure for adult patients (21 years of
age and older) and for pediatric patients, as described in the following table:
Pediatric Subpopulation
Approximate Age Range
Newborn (neonate)
Birth to 1 month of age
Infant
1 month to 2 years of age
Child
2 to 12 years of age
Adolescent
12-21 years of age
What Can I Do With the NIBP Option?
With the NIBP option you can do the following in MONITOR, PACER, or DEFIB (ON for
BLS/Plus units, then select Manual) mode:
• Take a single blood pressure measurement.
• Take a STAT measurement (as many measurements – up to 10 – as possible within 5
minutes).
• Take repeated measurements at user-programmable intervals.
• Immediately abort any measurement in progress by pressing one button.
• Set the cuff inflation pressure to adjust automatically based on the previously measured
systolic value.
• Display systolic, diastolic and mean blood pressure on the screen.
• Configure alarms to go off when the unit detects blood pressure values above or below
user-programmable limits.
• Display a history of NIBP measurements taken in the last 4 hours.
How Do I Use the NIBP Option?
To take safe and accurate blood pressure measurements using the R Series NIBP option, you
must perform the following steps, each of which corresponds to a subsequent section in this
document. Read each section carefully before you use the R Series NIBP option.
1. Select the proper size cuff.
2. Connect the hose to the R Series unit and to the cuff.
3. Apply the cuff to the patient.
4. Display the NIBP menu.
5. Select the correct patient type (if the current setting is not appropriate).
6. Set the cuff inflation pressure (if the current setting is not appropriate).
7. Configure alarms (if the current settings are not appropriate).
8. Take blood pressure measurement(s).
9. Read the display.
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
WARNING!
Do not use the NIBP option without proper training. Setting initial inflation pressure
too high can result in serious injury to the patient. Patient movement, very low pulse
volume, or vibration from outside sources can influence the accuracy of blood pressure
measurements.
How Does the NIBP Option Work?
The patient blood pressure cuff and hose connect to the R Series unit through the NIBP
connector on the rear panel of the unit. The NIBP button (
) on the front panel of the
R Series allows you to initiate and terminate non-invasive blood pressure measurements, whose
values display in the NIBP area of the monitor. You can also initiate and terminate Auto or
STAT mode measurements using the softkeys on the NIBP menu.
The ZOLL R Series NlBP Option non-invasively measures arterial blood pressure and pulse
rate in resting adult, neonate and pediatric patients. By incorporating the SunTech Medical
Advantage OEM BP A+ R-wave Motion Tolerance Module into the R Series
Defibrillator/Monitor/Pacemaker devices, the option facilitates the ability to monitor and assess
the physiological characteristics of the indicated patient populations.
The NIBP module measures the oscillometric pulses transmitted through the blood pressure
cuff and hose, and calculates the blood pressure measurements accordingly. The pressure
measurement cycle takes approximately 30 seconds and proceeds as follows:
1. The cuff inflates to a preconfigured pressure (configured default value for adult patients is
160 mmHg), above the patient’s systolic blood pressure, to occlude blood flow through the
arteries in the monitored limb.
2. The cuff deflates incrementally, allowing blood to flow through the cuff and into the
monitored limb.
3. As blood flows past the partially deflated cuff, it produces pressure oscillations that are
transmitted to the R Series unit through the hose.
4. The R Series unit measures the oscillometric pulses and uses them to calculate the
corresponding systolic, diastolic, and mean blood pressure, as well as the patient’s pulse rate.
5. The NIBP option automatically adjusts the blood pressure measurement procedure in
response to certain error conditions such as:
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Condition
Adjustment/Response
The unit cannot detect
systolic pressure
The unit automatically
increases the cuff inflation
pressure and completes
the blood pressure
measurement
The unit cannot detect
systolic, diastolic or
mean pressure after
3 minutes
The unit aborts the blood
pressure measurement
and deflates the cuff
The unit detects a
fault
The unit displays a
corresponding error
message on the monitor
and aborts the
measurement
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How Do I Read the Display?
How Do I Read the Display?
After each measurement, the NIBP display area displays measured systolic, diastolic, and mean
blood pressure values.
To facilitate quick reaction in emergency situations, you can control certain NIBP features by
pressing the NIBP button (
) at the lower left-hand corner of the unit. To access other NIBP
features, you must press a softkey with the appropriate softkey label.
3
CPR
IDLE
0:00
SpO2%
x1
Depth
Rate
99
2
LEAD
ECG
PADS
PPI
Ɔ
72
SHOCK
CHARGE
ANALYZE
SIZE
ALARM
SUSPEND
NIBP mmHg
122
80
ECG
ENERGY
SELECT
1
RECORDER
94
MONITOR
CO2 mmHg
--RR ---
DEFIB
OFF
PACER
MONITOR
11:24
Options
Param
Code
Marker
Report
Data
Alarms
OUTPUT
mA
4:1
RATE
ppm
NIBP Button
Softkey Label
Softkeys
Note:
Depending on the options included in your R Series unit, your display may differ
slightly from the illustrations in this insert.
The NIBP display area on the left side of the monitor screen consists of:
NIBP
Display
Area
• Symbols that represent the status of blood pressure measurements.
• Numbers that represent the measurement values (refer to the following figure).
NIBP mmHg
P
Systolic BP
Softkey Labels
Diastolic BP
120
80
*
Patient Type
(blank if Adult)
* = artifact
100
Mean BP
Alarm
When taking a reading, the screen will display only the current cuff pressure.
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
The symbols below show the current status or action being taken.
Display Symbols
Status
NIBP
Idle, or taking a single
measurement
STAT
alternating with
NIBP
Taking a STAT measurement
AUTO
alternating with
NIBP
Taking an Auto measurement
Alarms enabled
Alarms disabled
P
Pediatric Patient Type
N
Neonatal Patient Type
*
Artifact indicator
The artifact indicator is shown when the R Series unit detects artifact in the signal. Under such
circumstances, the displayed pressure values may be inaccurate. Perform additional blood
pressure measurements before taking clinical action. If you repeatedly obtain artifact, use
alternate techniques to obtain blood pressure prior to taking clinical action.
Note that the R Series default unit of measure is millimeters of mercury (mmHg), but you can
configure the R Series to display kilopascals (kPa). Refer to the R Series Configuration Guide
for information on configuring alternate units of measure.
Preparing to Take Measurements
The following sections describe how to prepare to take measurements.
Selecting the Proper Size Cuff
The NIBP option comes with a cuff that inflates to cut off the patient’s blood flow and then
deflates slowly to allow the blood flow to resume gradually. To take accurate measurements,
you must use the proper sized cuff. Bladder length should be at least 80 percent of the limb
circumference, while the cuff width should be equal to 40 percent of the limb circumference.
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Preparing to Take Measurements
Select the appropriate size cuff for the patient from the following table:
Caution
Limb Circumference
Cuff
38 to 50 cm
(14.96 to 19.69 in.)
Thigh
31 to 40 cm
(12.20 to 15.75 in.)
Large Adult
23 to 33 cm
(9.06 to 12.99 in.)
Adult
17 to 25 cm
(6.69 to 9.84 in.)
Small Adult
12 to 19 cm
(4.72 to 7.48 in.)
Child
8.0 cm to 15.0 cm
(3.1 to 5.9 in.)
Neonate #5
7.0 to 13.0 cm
(2.8 to 5.1 in.)
Neonate #4
6.0 to 11.0 cm
(2.4 to 4.3 in.)
Neonate #3
4.0 to 8.0 cm
(1.6 to 3.1 in.)
Neonate #2
3.0 to 6.0 cm
(1.2 to 2.4 in.)
Neonate #1
You must use the 3 m hose when making neonatal NIBP measurements with the R Series. The 3 m
hose (ZOLL Part No. 8000-0662) is standard on R Series units. Do not use the 1.5 m hose when
making neonatal NIBP measurements; the cuff may not inflate, causing the unit to abort the NIBP
measurement.
You can order additional cuffs and hoses from ZOLL Medical Corporation. See “NIBP
Accessories” on page 24.
Connecting the Hose
The NIBP option comes with a hose that has a plastic connector on one end and a metal
connector on the other end; you must attach the hose to both the R Series unit rear panel using
the metal connector and the cuff’s hose using the plastic connector. The cuff has its own short
length of hose with a connector on the end. This connector fits into the end of the hose that is
not connected to the R Series unit.
To connect the hose:
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
1. Insert the metal connector on the NIBP hose into the NIBP connector at the back of the
R Series unit and push the connector until it snaps into place.
NIBP connector
2. Insert the plastic connector on the NIBP hose into the cuff hose connector, and twist the
connectors until they lock into place.
You can now apply the cuff to the patient.
Applying the Cuff to the Patient
Using a cuff that is too small or is loosely applied results in values higher than the patient’s
actual blood pressure. Using a cuff that is too large results in values lower than the patient’s
actual blood pressure.
To apply the cuff to the patient:
1. Ensure the patient is sitting or lying down with the limb relaxed, extended, and placed on a
smooth surface for support. If the patient is seated, they should have legs uncrossed, feet flat
on the floor and back and arms supported. The patient should be comfortable, relaxed as
much as possible and not talking during the NIBP measurement.
2. Place the cuff 2 to 5 cm above the elbow crease or 5 to 10 cm (1.9 to 3.9 in.) above the knee
crease. The middle of the cuff should be at the level of the right atrium of the heart (heart
level).
Caution
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Do not place the NIBP cuff on the same arm/leg as an SpO2 sensor. Inflation of the cuff causes
the SpO2 monitor to read incorrectly. Also, do not attach the cuff to a limb being used for IV
infusion. Cuff inflation might block the infusion, causing harm to the patient.
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Preparing to Take Measurements
Caution
Ensure that the cuff is at the same level as the right atrium of the heart. If the cuff is located below
the patient’s right atrium, the blood pressure measurements display false high readings. If the
cuff is located above the patient’s right atrium, the blood pressure measurements display false
low readings.
3. Adjust the cuff so that the artery marker on the cuff is over the artery, pointing to the hand or
foot.
4. Check that the cuff ends between the range lines marked on the cuff. If not, use a different
size cuff.
5. Wrap the deflated cuff snugly around the limb without impeding blood flow.
6. Ensure that the hose is routed to avoid kinking or compression.
You can now access the NIBP features.
Accessing NIBP Features
Unless you are sure that the NIBP patient type, cuff inflation and alarm settings are appropriate
for the patient, display the NIBP menu before you take a blood pressure measurement. When
you first turn on the R Series unit, the NIBP settings are at their default values.
While the factory-installed default settings are appropriate for most adult patients, do not
assume the settings are at their default. A previous user may have:
• Changed the settings (if you did not turn on the R Series unit).
• Reconfigured the default settings.
Use the default settings unless they are clearly inappropriate for the patient. Any changes to
these settings remain in effect until either the settings are again changed, or for 10 seconds after
the R Series unit is turned off. If you have not received training on setting NIBP features, do not
use the NIBP option.
To facilitate quick reaction during emergency situations, you can directly access many NIBP
features without displaying the NIBP menu (see the following table).
WARNING!
Do not start NIBP measurements unless you are sure that the cuff inflation and alarm
settings are appropriate for the patient. Incorrect settings can result in patient injury or
inaccurate measurements.
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
Task
Action
Taking a single
measurement
Press the NIBP button
Taking STAT
measurements
Press and hold the NIBP
(
).
button (
) for two seconds
(if the NIBP Button Press and
Hold configuration option is
set to NIBP STAT), or see the
next section, “Displaying the
NIBP Menu.”
Taking automatic
measurements
Press and hold the NIBP
button (
) for two seconds
(if the NIBP Button Press and
Hold configuration option is
set to NIBP AUTO), or see
the next section, “Displaying
the NIBP Menu.”
Aborting
measurement in
progress
Press the NIBP button.
Changing NIBP
settings
See “Displaying the NIBP
Menu” on page 12.
Displaying the NIBP Menu
Unless it is an emergency situation where quick reaction is essential, you should always check
that the cuff inflation and alarm settings are set properly before taking a measurement. You can
display the NIBP menu without leaving MONITOR, DEFIB or PACER mode. BLS/Plus units
must be in Manual mode to display the NIBP menu.
To display the NIBP menu:
1. Press the Param softkey.
If the Param softkey label is not displayed, press the Return softkey until it is displayed.
The R Series unit displays the Parameter menu:
ECG
SPO2
NIBP
CO2
Return
2. Press the NIBP softkey.
The R Series unit displays the NIBP menu:
NIBP
Stat
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NIBP
Auto
NIBP
PT. Type Settings Trend
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Preparing to Take Measurements
• NIBP Stat: Take a STAT blood pressure measurement, as many as possible (up to 10) in
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5 minutes.
NIBP Auto: Take an automatic blood pressure measurement at regular intervals (the default
is 30 minutes)
NIBP PT. Type: Select the patient type of Adult, Pediatric, or Neonatal
Settings: Adjust the settings for Cuff Inflation or Auto Interval.
Trend: View the patient trend data.
Selecting the Patient Type
On R Series units, you can select a patient type for NIBP measurements: adult, pediatric, or
neonate. The patient type setting determines the default cuff inflation pressure, as well as
default alarm limits for high/low systolic, diastolic and mean blood pressure values.Unless
configured otherwise, the R Series defaults to adult patient mode when initially powered on.
See the R Series Configuration Guide for more information.
Note:
When you change the patient type setting, the unit clears any currently displayed NIBP
values from the display. You must reinitiate NIBP measurement to display new blood
pressure values.
To change the Patient Type setting:
1. Press the NIBP PT. Type softkey from the NIBP menu. If the NIBP PT. Type softkey label
is not displayed, see “Displaying the NIBP Menu” above.
The R Series displays the NIBP Patient menu. The current patient type setting is highlighted.
NIBP
Adult
NIBP
Ped
NIBP
Neonate
Return
2. Press the NIBP Adult, NIBP Ped, or NIBP Neonate softkey to select the appropriate patient
type setting.
The unit displays a Patient Type indicator in the NIBP display area (“P” for pediatric mode, or
“N” for neonatal mode, blank for adult mode), and automatically updates the default cuff
inflation pressure and default alarm settings accordingly.
Note:
If you press the Return softkey, the R Series unit returns to the NIBP menu without
changing the patient type setting.
Selecting Cuff Inflation Settings
Before taking a measurement, ensure that the cuff inflation settings are appropriate for the
patient. To measure a patient’s blood pressure, the cuff begins the measurement cycle by
inflating to a pressure higher than the patient’s systolic blood pressure. This value is called the
cuff inflation pressure. During an NIBP measurement, the R Series unit may increase the cuff
inflation pressure over the initial value to obtain a systolic reading.
By default, the cuff inflation pressure for the first measurement after power-up is set as follows:
• 160 mmHg (21.3 kPa) for adult mode
• 120 mmHg (16.0 kPa) for pediatric mode
• 90 mmHg (12.0 kPa) for neonatal mode
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
Use the default setting unless it is clearly inappropriate. Any changes to this setting remain in
effect until either the setting is changed or 10 seconds after the R Series unit is turned off
(returning the setting to its default).
As a safety feature, the cuff can never be inflated to more than 300 mmHg (40.0 kPa) in adult or
pediatric mode, and 150 mmHg (20.0 kPa) in neonatal mode.
Setting Cuff Inflation Pressure
Before taking a measurement, check that the cuff inflation pressure is appropriate for the
patient. The cuff inflation pressure options are:
Adult
Pediatric
Neonatal
120 mmHg (16.0 kPa)
80 mmHg (10.7 kPa)
60 mmHg (8.0 kPa)
140 mmHg (18.7 kPa)
90 mmHg (12.0 kPa)
70 mmHg (9.3 kPa)
160 mmHg (21.3 kPa)
100 mmHg (13.3 kPa)
80 mmHg (10.7 kPa)
180 mmHg (24.0 kPa)
110 mmHg (14.7 kPa)
90 mmHg (12.0 kPa)
200 mmHg (26.7 kPa)
120 mmHg (16.0 kPa)
100 mmHg (13.3 kPa)
220 mmHg (29.3 kPa)
130 mmHg (17.3 kPa)
110 mmHg (14.7 kPa)
240 mmHg (32.0 kPa)
140 mmHg (18.7 kPa)
120 mmHg (16.0 kPa)
260 mmHg (34.7 kPa)
150 mmHg (20.0 kPa)
130 mmHg (17.3 kPa)
See the R Series Configuration Guide for information on reconfiguring the cuff inflation
pressure default setting.
WARNING!
Do not set cuff inflation pressure too high, particularly for neonatal, pediatric, or frail
patients. Serious injury can result.
To set the cuff inflation pressure:
1. Press the Settings softkey, then the Cuff Inflation softkey from the NIBP menu. If the
Cuff Inflation softkey is not displayed, see “Displaying the NIBP Menu” on page 12.
The R Series unit displays the Cuff Inflation menu:
Prev
Adult Inflation Pressure
160 mmHg
Auto Adjust
On
Inc
Dec
Next
Return
2. Press the Next softkey if “Inflation Pressure” is not highlighted.
3. Press the Inc or the Dec softkey to select cuff inflation pressure.
4. Press the Return softkey to return to the NIBP menu.
The cuff inflation pressure is set.
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Preparing to Take Measurements
Auto Adjust
The R Series unit automatically adjusts the cuff inflation pressure for all subsequent
measurements to 30 mmHg (4.0 kPa) greater than the systolic value of the previous
measurement. This default setting is called Auto Adjust. For example, the cuff inflates to
180 mmHg for the first measurement and the unit obtains a systolic reading of 110 mmHg. For
the next measurement, the cuff inflates to 140 mmHg (i.e., 110 + 30 = 140).
If the Auto Adjust feature is set to OFF, the selected cuff inflation pressure is used for all
measurements. If the Auto Adjust feature is set to ON, the selected cuff inflation pressure is
used for the first measurement only.
Turning Off Auto Adjust
You should turn off the Auto Adjust feature in situations where the R Series unit might inflate
the cuff to levels that can cause discomfort or harm to the patient. For example, when the
patient is:
• being transported over a very bumpy road
• moving the monitored arm
• a small child
When you turn the Auto Adjust feature off, the R Series unit repeats the same cuff inflation
pressure for every measurement. Because this method does not readjust to the patient’s
previously measured blood pressure, do not use fixed cuff inflation pressures unless you have
received the proper training.
To turn off Auto Adjust:
1. Press the Cuff Inflation softkey from the NIBP menu.
If the Cuff Inflation softkey is not displayed, see “Displaying the NIBP Menu” on page 12.
The R Series unit displays the Cuff Inflation menu:
Prev
Adult Inflation Pressure
160 mmHg
Auto Adjust
On
Inc
Dec
Return
Next
2. Press the Next softkey until Auto Adjust is highlighted.
3. Press the Inc softkey until Auto Adjust is set to OFF:
Prev
Adult Inflation Pressure
180 mmHg
Auto Adjust
Off
Inc
Dec
Next
Return
4. Press the Return softkey to return to NIBP menu.
The R Series unit repeats the selected cuff inflation pressure for every measurement.
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
Setting Alarms
The R Series NIBP option includes blood pressure alarms for the measurements shown in the
following table.
Before taking a measurement, ensure that all the NIBP alarms settings are appropriate for the
situation. See the R Series Operator’s Guide for instructions on setting alarms. When an NIBP
or heart rate alarm is triggered, the unit automatically initiates a single blood pressure
measurement. See the R Series Configuration Guide for instructions on how to enable/disable
this automatic measurement.
Patient Type
Alarm Parameter
Default Setting
Range (increments of 5)
Adult
Systolic
High
160 mmHg (21.3 kPa)
80-260 mmHg (10.7-34.7 kPa)
Low
90 mmHg (12.0 kPa)
40-140 mmHg (5.3-18.7 kPa)
High
110 mmHg (14.7 kPa)
50-200 mmHg (6.7-26.7 kPa)
Low
50 mmHg (6.7 kPa)
25-100 mmHg (3.3-13.3 kPa)
High
130 mmHg (17.3 kPa)
60-220 mmHg (8.0-29.3 kPa)
Low
60 mmHg (8.0 kPa)
30-120 mmHg (4.0-16.0 kPa)
High
145 mmHg (19.3 kPa)
80-160 mmHg (10.7-21.3 kPa)
Low
75 mmHg (10.0 kPa)
35-140 mmHg (4.7-18.7 kPa)
High
100 mmHg (13.3 kPa)
50-130 mmHg (6.7-17.3 kPa)
Low
35 mmHg (4.7 kPa)
20-100 mmHg (2.7-13.3 kPa)
High
110 mmHg (14.7 kPa)
60-140 mmHg (8.0-18.7 kPa)
Low
50 mmHg (6.7 kPa)
30-120 mmHg (4.0-16.0 kPa)
High
100 mmHg (13.3 kPa)
60-130 mmHg (8.0-17.3 kPa)
Low
50 mmHg (6.7 kPa)
25-120 mmHg (3.3-16.0 kPa)
High
70 mmHg (9.3 kPa)
30-105 mmHg (4.0-14.0 kPa)
Low
30 mmHg (4.0 kPa)
20-100 mmHg (2.7-13.3 kPa)
High
80 mmHg (10.7 kPa)
35-110 mmHg (4.7-14.7 kPa)
Low
35 mmHg (4.7 kPa)
30-105 mmHg (4.0-14.0 kPa)
Diastolic
Mean
Pediatric
Systolic
Diastolic
Mean
Neonate
Systolic
Diastolic
Mean
When the R Series unit is turned on, all alarm functions are disabled, and the alarm limits are
set to their default values for the selected patient type. Any changes to these settings remain in
effect until either the settings are changed for the patient type or for 10 seconds after the
R Series unit is turned off. You can configure the default alarm limits at power-up; see the
R Series Configuration Guide for more information.
Setting Alarm Limits
You can change all the alarm limits using standard R Series procedures. See the R Series
Operator’s Guide for instructions on setting alarm limits.
16
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Taking Measurements
You can set the alarm limits using the Auto function, or you can choose your own limits (see
the preceding table). The Auto function sets the high limit to 30 mmHg (4.0 kPa) above and the
low limit to 20 mmHg (2.7 kPa) below the last measurement.
Enabling, Disabling, and Suspending Alarms
You can activate and deactivate all NIBP alarms, as well as disable audible NIBP alarm
indicators, using standard R Series procedures; refer to the R Series Operator’s Guide for
instructions.
Changing the status of one NIBP alarm automatically sets all the other NIBP alarms to the same
status. For example, if you enable the systolic alarm, all other NIBP alarms are automatically
activated. Similarly, if you deactivate the diastolic alarm, all other NIBP alarms are
automatically deactivated. Activating or deactivating NIBP alarms or disabling audible NIBP
alarm indicators does not affect the status of other R Series alarms.
Suspending an NIBP alarm disables the audible indicators until after the completion of the next
measurement. All visual alarm indicators remain active.
Triggering NIBP Measurements
You can configure the R Series unit to take a single NIBP measurement after the heart rate
alarm is triggered and/or the NIBP alarm is triggered. See the R Series Configuration Guide for
further details.
Setting Motion Tolerance
You can configure the R Series unit to compensate for motion tolerance during patient
movement, such as on a moving stretcher. The motion tolerance option is not supported for
neonatal patients. See the R Series Configuration Guide for details on how to change this
setting.
Taking Measurements
This section describes how to take each type of measurement (a single measurement, a STAT
measurement, or an automatic measurement). You can take any type of measurement whether
you are in MONITOR, DEFIB or PACER mode (ON for BLS/Plus models, in Manual mode
only) except in the following cases:
• The defibrillator is charged or charging.
• The previous measurement occurred within 30 seconds in automatic interval measurement
mode.
To immediately abort any measurement in progress and deflate the cuff, press the NIBP button.
As a safety feature, the R Series unit does not take measurements within 30 seconds of another
completed measurement when in automatic interval measurement mode.
If the R Series unit finds a fault, a message displays on the screen. See “Troubleshooting” on
page 26 for a list of NIBP display messages and their corresponding corrective action.
9650-0914-01 Rev. C
R Series Non-Invasive Blood Pressure (NIBP)
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
WARNING!
If the R Series unit takes a measurement but detects the presence of artifact in the
signal (denoted by “*” in the NIBP display area), the measurement may not be
accurate. Under such circumstances, perform additional blood pressure measurements.
If you repeatedly obtain artifact, use alternate techniques to determine blood pressure
prior to taking clinical action.
When reading the blood pressure values on the display, keep in mind that the following
conditions can influence NIBP measurements:
• Position of the patient
• Position of the cuff relative to the patient’s heart
• Physical condition of the patient
• Patient limb movements
• Convulsions or tremors
• Very low pulse volumes
• Premature ventricular beats
• Vibrations in the cuff or hose caused by moving vehicles
• Improper cuff size or application
WARNING!
Do not begin NIBP measurements unless the patient type setting is appropriate for the
patient. Taking NIBP measurements on a pediatric or neonatal patient while the unit is
in adult mode can result in inaccurate measurements and injury to the patient. Taking
NIBP measurements on an adult patient while in pediatric or neonatal mode can result
in inaccurate measurements.
Taking a Single Measurement
You can take a single measurement by pressing the NIBP button (
defibrillator is charged or charging.
) unless the R Series
Caution
Make sure that no measurement is being taken when you start a new measurement. If you press
the NIBP button while the R Series unit is taking a measurement, the measurement aborts
immediately and the cuff deflates.
Caution
Before taking the first measurement, a period of at least 5 minutes should elapse to give time for
blood pressure stabilization.
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9650-0914-01 Rev. C
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Taking Measurements
To take a single measurement, press the NIBP button on the R Series front panel.
3
CPR
IDLE
0:00
SpO2%
x1
Depth
Rate
99
2
LEAD
ECG
Ɔ
PADS
PPI
72
NIBP mmHg
122
80
ECG
ANALYZE
CHARGE
SIZE
ALARM
SUSPEND
ENERGY
SELECT
1
RECORDER
94
SHOCK
MONITOR
CO2 mmHg
--RR ---
DEFIB
OFF
PACER
MONITOR
11:24
Options
Param
Code
Marker
Report
Data
Alarms
OUTPUT
mA
4:1
RATE
ppm
NIBP Button
The R Series unit takes one blood pressure measurement.
Taking STAT Measurements
You can set the R Series unit to take a STAT measurement, which consists of the unit taking as
many blood pressure measurements as possible (up to 10) in five minutes. When the R Series
unit finishes taking a measurement and the cuff deflates, it immediately starts another
measurement.
Whenever practical, allow several minutes between STAT measurement sequences to restore
full circulation to the monitored limb. Before initiating STAT measurements, allow the cuff
pressure to deflate below 15 mmHg which will reset the adult mode safety pressure timer. In
order to meet adult safety regulations, the safety timer will time out if the pressure does not
drop down below 15 mmHg within 180 seconds regardless of how many measurements are
performed within that time period.
WARNING!
Repeated use of STAT measurements on the same patient over a short time interval can
affect blood pressure readings, limit circulation to the limb, and cause injury to the
patient.
You cannot set the R Series unit to take STAT measurements while the defibrillator is charged
or charging. Charging the defibrillator aborts all STAT measurements and deflates the cuff.
Starting STAT Measurements
To start STAT measurements, either:
• Press the NIBP button (
) and hold for two seconds (if the unit is configured to do so), or
• Press the NIBP Stat softkey.
If the NIBP Stat softkey label is not displayed, see “Displaying the NIBP Menu” on page 12.
9650-0914-01 Rev. C
R Series Non-Invasive Blood Pressure (NIBP)
19
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
If the R Series unit is configured to automatically generate strips, it prints a history of the STAT
measurements at the end of the 5-minute period.
Caution
Before taking the first measurement, a period of at least 5 minutes should elapse to give time for
blood pressure stabilization.
Aborting STAT Measurements
You can abort STAT measurements at any time. Doing so terminates the current measurement
and all subsequent measurements.
To abort STAT measurements, either:
• Press the NIBP button (
), or
• Press the NIBP Stat softkey.
If the NIBP Stat softkey label is not displayed, see “Displaying the NIBP Menu” on page 12.
The R Series unit immediately aborts all measurements, and the cuff deflates.
Taking Automatic Measurements
You can set the R Series unit to automatically take a series of measurements at selected
intervals. For example, if you set the R Series unit to take an automatic measurement with an
interval of 15 minutes, it immediately takes a measurement, waits 15 minutes, takes another
measurement, waits another 15 minutes, and so on.
To take automatic measurements at set intervals, you must:
1. Set the measurement interval (if not set to desired value).
2. Start automatic measurements.
Setting the Measurement Interval
Before you take automatic measurements, ensure that the measurement interval is properly set.
The measurement interval is the time period between when one measurement starts and the
next measurement starts. The measurement interval options (in minutes) are: 2.5, 3, 4, 5, 6, 7, 8,
9, 10, 15, 20, 30, 45, 60, 90, and 120.
When you turn on the R Series unit, the measurement interval is set to the default value of
30 minutes. To change the default, see the R Series Configuration Guide.
To set measurements intervals:
1. Press the the Settings softkey, then the Auto Interval softkey from the NIBP menu.
If the Settings softkey is not displayed, see “Displaying the NIBP Menu” on page 12.
The R Series unit displays the Auto Interval menu:
Repeat BP Meas Every
Inc
Dec
30 Min
Return
2. Press the Inc or the Dec softkey to scroll through the interval options.
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9650-0914-01 Rev. C
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Taking Measurements
3. Press the Return softkey to select the desired measurement interval and return to NIBP
menu.
The measurement interval sets and remains until 10 seconds after the R Series unit is turned off,
or the value is reset.
Starting Automatic Measurements
To start automatic measurements, either:
• Press the NIBP button (
) and hold for 2 seconds (if the unit is configured to do so), or
• Press the NIBP Auto softkey. If the NIBP Auto softkey label is not displayed, see
“Displaying the NIBP Menu” on page 12.)
The R Series unit takes a measurement, and repeats subsequent measurements at the selected
interval.
Note that if the defibrillator is charged or charging when the R Series unit is about to take an
automatic measurement, it aborts the blood pressure measurement. All subsequent automatic
measurements take place at their scheduled time.
Note:
Caution
If it is necessary to replace the battery of the R Series unit and AC power is not
connected during an automatic NIBP interval, the interval will be extended by the time
it takes to replace the battery up to 10 seconds.
Before taking the first measurement, a period of at least 5 minutes should elapse to give time for
blood pressure stabilization.
Taking an Additional Measurement
You can take an immediate measurement between the automatic measurements except when:
• The R Series unit is currently taking a measurement.
• The defibrillator is charged or charging.
To take an additional measurement, press the NIBP button (
).
The R Series unit takes an extra measurement without altering the timing of the other
measurements. It does not start a new automatic measurement unless 30 seconds have elapsed
since the end of the previous completed measurement cycle. If the extra measurement
completes less than 30 seconds before a scheduled measurement, the R Series unit omits the
scheduled measurement.
Aborting a Single Measurement
When the R Series unit is taking automatic measurements, you can stop a single blood pressure
measurement by pressing the NIBP button.
The R Series unit immediately stops taking the measurement and deflates the cuff, but takes all
subsequent automatic measurements at their selected interval.
Stopping All Automatic Measurements
You can stop all upcoming blood pressure measurements. If the R Series unit is taking a
measurement, it completes the current measurement, but does not take any subsequent
measurements.
9650-0914-01 Rev. C
R Series Non-Invasive Blood Pressure (NIBP)
21
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
To stop automatic measurements, simply press the NIBP Auto softkey. (If the NIBP Auto
softkey label is not displayed, see “Displaying the NIBP Menu” on page 12.)
Aborting Measurements
You can immediately abort a blood pressure measurement at any time whether you are in
MONITOR, DEFIB or PACER mode (ON for BLS/Plus models, in Manual mode only).
To abort the current measurement:
• Press the NIBP button (
) on the R Series front panel.
The R Series unit immediately stops taking the measurement, displays the
NIBP MEAS ABORTED message, and deflates the cuff.
WARNING!
Make sure that a measurement has already started before attempting to abort. If you
press the NIBP button while a measurement is not being taken, the R Series unit starts a
new measurement.
3
CPR
IDLE
0:00
SpO2%
x1
Depth
Rate
99
2
LEAD
ECG
PADS
PPI
Ɔ
72
NIBP mmHg
122
80
ECG
ANALYZE
CHARGE
SIZE
ALARM
SUSPEND
ENERGY
SELECT
1
RECORDER
94
SHOCK
MONITOR
CO2 mmHg
-----
DEFIB
OFF
RR
PACER
MONITOR
11:24
Options
Param
Code
Marker
Report
Data
Alarms
OUTPUT
mA
4:1
RATE
ppm
NIBP Button
Note that:
• If you press the NIBP button while taking a STAT measurement, the R Series unit
terminates all subsequent measurements.
• If you press the NIBP button while the R Series unit is taking an automatic measurement, it
aborts the current measurement, deflates the cuff, and takes all subsequent measurements at
the set interval.
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9650-0914-01 Rev. C
Page 27
Printing Data
Viewing Trend Data
To view the patient’s trend data over the past 4 hours, press the Trend softkey. The time,
HR/PR, and readings will be displayed.
HR/PR
SpO2
%
SYS
NIBP mmHg
DIA
M
11:22
92
99
127
81
96
11:27
91
99
127
81
96
11:32
91
98
126
72
99
11:37
92
99
126
73
100
11:42
72
98
86
65
72
11:47
86
99
88
54
65
11:52
87
97
81
53
62
11:57
91
98
125
72
99
12:02
92
99
127
81
96
TIME
Older
Newer
*
Return
Measurements with alarm values are highlighted; an asterisk (*) shows measurements that
contain artifact.
Press Older to view previous entries if available; press Newer to return to newer entries. The
screen updates automatically during automatic or STAT measurements.
Press the Print softkey to print the displayed measurements.
Press the Return softkey to return to the main menu.
The patient’s trend data is cleared when the R Series unit remains off for more than 10 seconds.
Printing Data
A strip recorder is provided with the R Series unit to document events and data. See the
“Recorder Operation” section of the R Series Operator’s Guide for instructions on how to
record data. If you have already taken NIBP measurements, press the RECORDER button to
print a stripchart that includes the following values for the currently displayed measurement:
• Systolic blood pressure
• Diastolic blood pressure
• Mean blood pressure
• Pulse rate
• Time of measurement
Checkout Procedure
Perform the following checkout procedure daily to ensure that the NIBP option is functioning
properly. This daily checkout procedure also ensures that medical personnel maintain
familiarity with the proper use of the NIBP option.
For more specific instructions on how to accomplish each step listed below, refer to the related
section in this manual.
Perform the daily checkout procedure as follows:
9650-0914-01 Rev. C
R Series Non-Invasive Blood Pressure (NIBP)
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
1. Select the proper size cuff, as described in “Selecting the Proper Size Cuff” on page 8.
2. Connect the hose to the R Series unit and to the cuff, as described in “Connecting the Hose”
on page 9.
3. Apply the cuff to a human test subject, as described in “Applying the Cuff to the Patient” on
page 10.
4. Set the cuff inflation pressure (if current setting is not appropriate), as described in “Setting
Cuff Inflation Pressure” on page 14.
5. Take a blood pressure measurement.
During cuff inflation, inspect cuff, hoses, and connectors for air leakage. If a leak is present,
correct, replace, or service item.
6. Verify that the unit displays no error messages.
7. Verify that the displayed blood pressure values are correct.
8. With alarms enabled, verify that the patient alarms are functional by adjusting the high and
low limits and repeating the above blood pressure measurement. Check that the unit:
• emits a continuous audio tone, and
• highlights the alarming parameter’s value and flashes the alarm symbol on the display.
9. Visually inspect hose, hose connector, and cuffs for signs of damage. If damaged, replace the
damaged item.
Cleaning the Hose and Reusable Cuffs
You can clean the hose and reusable cuffs by wiping the surface with a damp cloth and
disinfecting with a mild disinfectant solution. Blow dry air through the hose before use;
likewise, ensure the reusable cuff is dry before use.
NIBP Accessories
The following accessories can be used with the R Series NIBP option:
NIBP CUFFS
24
Cuffs
Limb
Circumference
Thigh
(Reusable)
38 to 50 cm
(14.96 to 19.69 in.)
8000-1654
Large Adult
(Reusable)
31 to 40 cm
(12.20 to 15.75 in.)
8000-1653
Adult
(Reusable)
23 to 33 cm
(9.06 to 12.99 in.)
8000-1651
Small Adult
(Reusable)
17 to 25 cm
(6.69 to 9.84 in.)
8000-1650
Child
(Reusable)
12 to 19 cm
(4.72 to 7.48 in.)
8000-1655
Neonate #5
(Disposable)
8.0 cm to 15.0 cm
(3.1 to 5.9 in.)
8000-0644
REF
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9650-0914-01 Rev. C
Page 29
NIBP Accessories
NIBP CUFFS
Cuffs
Limb
Circumference
Neonate #4
(Disposable)
7.0 to 13.0 cm
(2.8 to 5.1 in.)
8000-0643
Neonate #3
(Disposable)
6.0 to 11.0 cm
(2.4 to 4.3 in.)
8000-0642
Neonate #2
(Disposable)
4.0 to 8.0 cm
(1.6 to 3.1 in.)
8000-0641
Neonate #1
(Disposable)
3.0 to 6.0 cm
(1.2 to 2.4 in.)
8000-0640
REF
NIBP HOSES
Hoses
Length (m)
REF
Air hose with
pneumatic fittings
3 m (9.8 ft.)
8000-0662
Air hose with
pneumatic fittings
1.5 m (4.9 ft.)
8000-0655
9650-0914-01 Rev. C
R Series Non-Invasive Blood Pressure (NIBP)
25
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
Troubleshooting
The following table lists the error messages and problems associated with the NIBP option and
the associated corrective action(s). Read this section carefully. For further assistance, call
ZOLL Technical Service at 1-800-348-9011. International customers should call the nearest
authorized ZOLL Medical Corporation representative.
Message/Symptom
Problem
User Action
--- (dashed lines in
NIBP field)
No NIBP measurement has been taken.
None, normal operation.
The last measurement taken has expired
after 120 minutes.
The patient type has been changed.
Repeat NIBP measurement.
CALIBRATE NIBP
NIBP calibration is incomplete or failed
Recalibrate NIBP. (See the R Series
Service Manual for details).
NIBP COMM ERROR
There is a communication problem with the
NIBP module.
Cycle power and retry.
If problem persists, return for service.
NIBP FAULT
No communication from the NIBP module.
Cycle power, and retry.
NIBP module failed self-test.
If the problem persists, return for
service.
Cuff inflation pressure is set too high for
attached cuff.
Verify that you are using proper size
cuff.
Inflation is too fast.
Check for cuff and hose blockages.
R Series is unable to find systolic value for
180 seconds.
Confirm that the unit was not charging.
NIBP MEAS
ABORTED
Defibrillator is charged or charging. User
initiated abort.
NIBP NOT READY
NIBP OUT OF RANGE
If the problem persists, return for
service.
The defibrillator is charged or charging in
progress.
Wait until the unit discharges before
taking the next measurement.
NIBP module is performing power-up
self-test.
Wait for more than 10 seconds after
power-up before taking blood pressure
measurements.
The data from the NIBP module is out of
range.
Measure patient’s blood pressure with
other equipment.
Check cuff fit and positioning.
Switch cuff to other arm.
If problem persists, return for service.
REPEAT NIBP MEAS
The unit exceeded the maximum number of
inflation attempts.
Check cuff and hose.
Repeat NIBP measurement.
The unit exceeded the 180-second
measurement time limit.
26
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9650-0914-01 Rev. C
Page 31
Troubleshooting
Message/Symptom
Problem
User Action
REPEAT NIBP MEAS
Blood pressure cuff or hose is not installed
correctly.
Check cuff connection to hose.
alternating with
CHECK CUFF/HOSE
Cuff or hose is faulty.
Check for kinked hose or air leaks in the
hose.
Hose kinked or disconnected.
REPEAT NIBP MEAS
alternating with
NIBP ARTIFACT
Check hose connection to unit.
Inflation rate too fast or too slow.
If problem persists, replace cuff then
hose.
The unit is unable to detect systolic, diastolic
or mean blood pressure due to excessive
motion or vibration.
Take a single blood pressure
measurement.
Keep patient as still as possible.
Insulate patient, cuff and hose from
vibrations as much as possible.
REPEAT NIBP MEAS
alternating with
There is a weak or no oscillometric signal.
Check cuff fit and positioning.
Check hose connection to unit.
NIBP SIGNAL WEAK
Check for kinked hose.
Increase cuff inflation pressure if
clinically appropriate.
SYSTEM FAULT
Communication problem with the NIBP
module.
Cycle power, and retry.
NIBP box displays a
large “X”
Communication problem with the NIBP
module.
Cycle power, and retry.
NIBP M.T. OFF
The NIBP motion tolerance feature is not
functioning properly.
If problem persists, return for service.
False high reading
Cuff too small.
Select larger cuff.
Cuff not centered over brachial artery.
Readjust cuff.
Cuff too loose.
Reapply cuff or select smaller cuff.
Patient’s limb below level of heart.
Raise patient’s limb to heart level.
Cuff too large.
Select smaller cuff.
Limb above level of heart.
Lower patient’s limb to heart level.
False low reading
9650-0914-01 Rev. C
If problem persists, return for service.
If problem persists, return for service.
R Series Non-Invasive Blood Pressure (NIBP)
27
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
Specifications
Principle of Operation
Oscillometric
Warm-up Time
Operational in less than 10 seconds
Regulatory Standards
ANSI/AAMI SP10-2002;
EN 1060-1: 1996 Specification for Non-invasive sphygmomanometers;
EN 1060-3: 1997;
EN 60601-2-30: 2000
NIBP Measurement Range
Systolic
Adult: 40 – 260 mmHg; 5.3 – 34.6 kPa
Pediatric: 40 – 160 mmHg; 5.3 – 21.3 kPa
Neonatal: 40 – 130 mmHg; 5.3 – 17.3 kPa
Adult: 20 – 200 mmHg; 2.7 – 26.7 kPa
Pediatric: 20 – 120 mmHg; 2.7 – 16.0 kPa
Neonatal: 20 – 100 mmHg; 2.7 – 13.3 kPa
Adult: 30 – 220 mmHg; 4.0 – 29.3 kPa
Pediatric: 30– 133 mmHg; 4.0 – 17.7 kPa
Neonatal: 30 – 110 mmHg; 4.0 – 14.6 kPa
Diastolic
Mean
NIBP Measurement Accuracy
Per AAMI SP10 +/- 5 mmHg (0.7 kPa) mean difference;
8 mmHg (1.1 kPa) standard deviationa
NIBP Measurement Resolution
1 mmHg; 0.13 kPa
NIBP Measurement Cycle Time
Typical:
Worst Case:
Pulse Rate Range
30 – 220 pulses per minute
Pulse Rate Accuracy
±2% or ±3 bpm, whichever is greater
Pulse Rate Resolution
1 bpm (beats per minute)
Alarm Limits
Systolic
Diastolic
Mean
28
30 seconds
180 seconds
Adult
High 80 – 260 mmHg;
Low 40 – 140 mmHg;
High 10.7 – 34.7 kPa
Low 5.3 – 18.7 kPa
Pediatric
High 80 – 160 mmHg;
Low 35 – 140 mmHg;
High 10.7 – 21.3 kPa
Low 4.7 – 18.7 kPa
Neonatal
High 60 – 130 mmHg;
Low 25 – 120 mmHg;
High 8.0 – 17.3 kPa
Low 3.3 – 16.0 kPa
Adult
High 50 – 200 mmHg;
Low 25 – 100 mmHg;
High 6.7 – 26.7 kPa
Low 3.3 – 13.3 kPa
Pediatric
High 50 – 130 mmHg;
Low 20 – 100 mmHg;
High 6.7 – 17.3 kPa
Low 2.7 – 13.3 kPa
Neonatal
High 30 – 105 mmHg;
Low 20 – 100 mmHg;
High 4.0 – 14.0 kPa
Low 2.7 – 13.3 kPa
Adult
High 60 – 220 mmHg;
Low 30 – 120 mmHg;
High 8.0 – 29.3 kPa
Low 4.0 – 16.0 kPa
Pediatric
High 60 – 140 mmHg;
Low 30 – 120 mmHg;
High 8.0 – 18.7 kPa
Low 4.0 – 16.0 kPa
Neonatal
High 35 –110 mmHg;
Low 30 – 105 mmHg;
High 4.7 – 14.7 kPa
Low 4.0 – 14.0 kPa
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9650-0914-01 Rev. C
Page 33
Specifications
Operating Time (with SpO2, EtCO2 and
NIBP options)
For a new, fully charged lithium ion battery pack at 20°C (68°F):
• 90 defibrillator discharges at maximum energy (200 J), or
• 2.75 hours minimum of continuous ECG monitoring and blood
pressure measurements once every 5 minutes, or 2.25 hours of
continuous ECG monitoring/pacing at 60 mA, 70 beats per
minute.
Environmental
Operating Temperature: 0 to 40 C (32º to 104º F)
Storage Temperature: -20 to 60 C (-4º to 140º F)
Humidity: 5 to 95% relative humidity, non-condensing
Electromagnetic Immunity
AAMI DF-80; EN 61000-4-3: 2002, 10 V/m
Operating Pressure
594 to 1060 mBar
a
Blood pressure measurements determined with this device are equivalent to those obtained by
a trained observer using the cuff/stethoscope auscultation method, within the limits prescribed
by the American National Standard, Electronic or Automated Sphygmomanometers (AAMI
SP10). To receive a copy of the report containing the AAMI SP10 test results, contact ZOLL
Technical Support at (800) 348-9011 or (978) 421-9655.
9650-0914-01 Rev. C
R Series Non-Invasive Blood Pressure (NIBP)
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R SERIES — NON-INVASIVE BLOOD PRESSURE (NIBP) OPTION INSERT
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www.zoll.com
9650-0914-01 Rev. C