cnap Monitor Quick Guide sw 5.2 ver 1.5.4 April 2016

2

CONTENT

SET UP

MEASUREMENT

FAQs

NAVIGATION

FUNCTIONS: FAST ACCESS

Hemodynamic Parameters...5 Set Up Checklist for fast Set Up...6 Power Up CNAP® Monitor... 7 Prepare CNAP® Monitor for Measurement - Components...8 Prepare CNAP® Monitor for Measurement - Connections...9 Connecting to a Patient Monitor...10 Zeroing of CNAP® and patient monitor...11 Overview CNAP® Monitor Patient Set Up ...12 Choose correct CNAP® finger sensor size...13 Place CNAP® finger sensor and CNAP® Controller...14 Place NBP Cuff ...15 Measurement Select Measurement Mode / Start Measurement...16 Started Measurement: Perfusion Index / Signal Quality...17 Choose Patient Category / Enter Biometric Data...18 Stop / Resume Measurement...19 Navigation Navigation Frames...20 Function of Navigation Frames...21 3

4

CONTENT Functions Fast Access

FAQs: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Main Keys and Status Indicators... 23 The “SETUP“ Key...25 Calibration Modes: Function / Benefits... 26 Triggering A Manual NBP - Fast Access...27 When is it recommended to trigger a manual NBP?...28 “Change Finger“ manually...29 How can I change alarm settings for current measurement?...31 How can I change alarm settings permanently?...32 Enabling hemodynamic parameters for a measurement?...33 How can I improve measurement quality?...34 How can I adjust trend, signal and time settings?...35 The battery?...36 Service intervals for the CNAP® Monitor? ... 37 What to do if CNAP® needs service ?...38 SERVICE HOTLINE ?...39 Where can I get additional information?...40 How can I contact CNSystems directly? ...41

HEMODYNAMIC PARAMETERS CNAP® Monitor Measurement Type BP

BP + PPV

BP + HD

CNAP

continuous noninvasive arterial pressure, sys, dia, mean

x

x

x

NBP

noninvasive oscillometric blood pressure sys, dia

x

x

x

Pulse

pulse rate

x

x

x

PPV

pulse pressure variation

x

x

SVV

stroke volume variation

x

CO

continuous noninvasive cardiac output

x

CI

cardiac index

x

SV

stroke volume

x

SVI

stroke volume index

x

SVR

systemic vascular resistance

x

SVRI

systemic vascular resistance index

x

®

5

SET UP

6

CHECKLIST

SET UP CHECKLIST STEP 1

Start the device and connect the CNAP® Controller Cable (orange connectors) to CNAP® Monitor and CNAP® Controller (see also p.7,9)

STEP 2

Use the indicator on the CNAP® Controller to find the correct CNAP® finger sensor size for the patient. (see p. 13)

STEP 3

Slide the finger sensor over two neighbouring fingers, and fix the CNAP® Controller on the forearm using the Velcro fixation cuff. (see p. 14)

STEP 4

Be sure that the CNAP® Controller is in the center of the forearm cuff so that the patient can freely bend his / her wrist. (see p.14)

STEP 5

Select the right NBP cuff size for the patient using the indicator on the inside of the NBP cuff and connect the black hose to the CNAP® Monitor. (see p.15)

STEP 6

Fit the NBP cuff on the patient‘s upper arm. The NBP cuff can be placed ipsilaterally or contralaterally to the CNAP® finger sensor. (see p.15)

STEP 7

Start measurement by clicking “Start New Measurement“. Choose patient category “Adult“ or “Pediatric“. (see p.16, 18)

During CNAP ® initialisation the patient needs to be in a stable position.

! ATTENTION During general anesthesia start CNAP before or after the induction phase! ®

POWER UP CNAP® MONITOR 1 Press POWER ON / OFF button

2 When alarm sounds,

confirm by pressing the yellow alarm button.

SET UP

7

SET UP

8

PREPARE CNAP® MONITOR FOR MEASUREMENT COMPONENTS 1 CNAP® Monitor 1

2 CNAP® Controller Cable 3 CNAP® Controller

2 6

3

4 CNAP® Finger sensor

5

5 NBP Cuff

4

2

6 NBP Air hose 3

4

5

6

PREPARE CNAP® MONITOR FOR MEASUREMENT CONNECTIONS

3 Connect NBP air

hose to NBP Cuff

1 Connect the controller cable to the orange connector of the CNAP ® Controller.

4

2 Connect finger

sensor to black connection of CNAP ® Controller.

Connect the NBP air hose and the CNAP ® Controller cable to the CNAP ® Monitor.

in straight, not ! ATTENTION Plug tilted!

SET UP

9

SET UP

10

CONNECTING TO A PATIENT MONITOR 1

Interface cable

Prepare patient monitor Interface Cable and connect it to the arterial port of your patient monitor.

2

Transducer Cable connect to

3

Connect Transducer cable and patient monitor interface cable.

! ATTENTION

Select right color from list in user manual (Chapter 4-5-2) and connect it to the BP wave out port on the CNAP ® Monitor.

Zeroing neccessary! (see next page)

BP Wave Out port

ZEROING OF CNAP® AND PATIENT MONITOR 1 Go to parameter frame on CNAP ® Monitor: *click* 2 Select IBP: Zeroing Start - *click* oi

n

f p a tie n t m o n go

*click* it o

r

Ze

*click*

r

then zero transducer on patient monitor

*click*

3 Stop Zeroing on CNAP ®: Select IBP: Zeroing Stop - *click*

TIP

SET UP

CNAP ® Zeroing is automatically active when the CNAP ® Monitor is on and connected to the patient monitor but no measurement has been started so far. 11

SET UP

12

OVERVIEW: PATIENT SET UP Connections

NBP Cuff

CNAP® Controller

CNAP® Finger sensor

STEP 1. CHOOSE CORRECT CNAP® FINGER SENSOR SIZE AVAILABLE SIZES: small, medium or large

1

Put proximal phalanx of index finger on indicator of CNAP ® Controller align with the grey line on the left.

SET UP

B 2

Choose the sensor size indicated on the shortest bar which is still visible.

! ATTENTION

2

Always choose the larger sensor if you are in doubt about the size!

13

SET UP

14

STEP 2. PLACE CNAP® FINGER SENSOR AND CNAP® CONTROLLER

! ATTENTION 1

Slide the finger sensor over two neighbouring fingers, make sure that it is not placed on the finger joints! NOTE

slide back fully!

2 Make sure that the

CNAP ® Controller is placed in central position of the slide and fix the strap.

12 hours before lifetime expiration of the finger sensor a message appears. It automatically disappears and does not affect measurements. Please make sure to contact your local distributor in time for a new sensor. See also: Operators Manual – chapter 16.1

STEP 3. PLACE NBP CUFF 1

Choose the right NBP cuff from 4 different sizes by using the size indicator on the inside of the cuff. See also: Operators Manual – chapters 3.2.3 and 10.

2

Fasten NBP cuff on the upper arm (ipsilaterally or contralaterally to arm with fingersensor). Align marker (white arrow) with the brachial artery in the crook of the arm.

SET UP

3 15

MEASUREMENT

16

SELECT MEASUREMENT MODE / START MEASUREMENT 1 Once the patient set up is completed, select the measurement mode in the pop-up menu from three options: > BP only > BP + PPV > BP + HD (full hemodynamics)

2 Confirm by clicking the wheel.

*click*

To start the measurement, select “Start New Measurement“ and confirm with the click wheel.

3

NOTE

BP + PPV and BP + HD must be enabled to be selectable. Contact your distributor for a licence key if you cannot select these options.

STARTED MEASUREMENT 1 Once measurement has started, finger sensor checks perfusion index (PI):

TIP If perfusion is poor (=red), try pushing the finger sensor to the back of the finger, warming the hand (use exam glove or towel), changing finger sensor size, or changing hands.

no signal

good perfusion

2 At the same time menu window

opens for choosing patient category and for entering biometric data (see next page). Calibration to NBP reference value also takes place. MEASUREMENT

! ATTENTION • •

Keep patient still, do not move hand! No changes in body posture!

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MEASUREMENT

18

CHOOSE PATIENT CATEGORY AND ENTER BIOMETRIC DATA 1 Choose patient category (Adult or Pediatric) in the pop-up menu and enter biometric patient data (for full hemodynamics). This is important as NOTE alarm ranges and NBP inflation pressure are different!

2 Confirm with “ok“ by clicking the wheel.

*click*

3 Calculation of hemodynamic parameters starts; display after a few seconds.

Before starting any interventions, make sure that the calibration has been completed: numerical values should not have gray background anymore!

! ATTENTION

*click*

STOP / RESUME MEASUREMENT 1

Press the Start/Stop Button to STOP measurement (e.g. when finished or to readjust set-up).

! ATTENTION Do not remove the CNAP ® finger sensor when measurement is still in progress! STOP MEASUREMENT FIRST!

2

MEASUREMENT

RESUME a measurement with the Start/Stop Button (e.g. after readjusting set-up, patient transfer, etc.) Patient data remain displayed! 19

NAVIGATION

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NAVIGATION FRAMES The monitor has a clickwheel and 5 different “frames“ on the screen to access all menus / functions.

Alarm frame Signal & Trend frame

Signal and Trend View selector frame

*turn*

*click* clickwheel

Parameter frame (= default)

Hemodynamic frame