S5 Compact Critical Care Monitor Users Guide Part II Nov 2004

Datex-Ohmeda S/5 Compact Critical Care Monitor User’s Guide Part II: For Daily Use Related to software licenses L-CICU03 and L-CICU03A 053 7

Conformity according to the Council Directive 93/42/EEC concerning Medical Devices CAUTION: U.S. Federal law restricts this device to sale by or on the order of a licensed medical practitioner. Outside the USA, check local laws for any restriction that may apply. All specifications subject to change without notice. Document no. 8005879-1 November 2004 Datex-Ohmeda Inc. P.O. Box 7550 Madison, WI 53707-7550, USA Tel: +1-608-221 1551, fax: +1-608-222 9147 www.us.datex-ohmeda.com/

Datex-Ohmeda Division, Instrumentarium Corporation P.O. Box 900, FIN-00031 DATEX-OHMEDA, FINLAND Tel. +358 10 39411, fax: +358 9 1463310 www.datex-ohmeda.com/

1

About this guide

Intended purpose (Indications for use)

This User’s Guide describes the most common features and functions offered by the Datex-Ohmeda S/5 Compact Critical Care Monitor. Descriptions refer to S/5 software licenses L-CICU03 and L-CICU03A. If you are a new user of the monitor, we suggest you begin with the section "Starting and ending." Also read Part I of this User's Guide. The following conventions are used: − Names of the hard keys on the Command Board, Remote Controller and modules are written in the following way: ECG.

The Datex-Ohmeda S/5 Compact Critical Care Monitor with L-CICU03 or L-CICU03A software is intended for multiparameter patient monitoring. The S/5 Compact Critical Care Monitor with L-CICU03 and L-CICU03A software is indicated for monitoring of hemodynamic (including arrhythmia and ST-segment analysis), respiratory, ventilatory, gastrointestinal/regional perfusion, Bispectral index (BIS), and neurophysiological status of all hospital patients. The S/5 Compact Critical Care Monitor with L-CICU03 and L-CICU03A software when using BIS is for monitoring the state of the brain by data acquisition and processing of electroencephalograph signals and may be used as an aid in monitoring the effects of certain anesthetic agents. The S/5 Compact Critical Care Monitor with L-CICU03 and L-CICU03A software is indicated for use by qualified medical personnel only.

− − − −

Menu items are written in bold italic typeface: ECG Setup. Menu access is described from top to bottom. For example, the selection of the Screen 1 Setup menu item and the Waveform Fields menu item would be shown as Screen 1 Setup - Waveform Fields. Messages (alarm messages, informative messages) displayed on the screen are written inside single quotes: ‘Learning.’ When referring to different sections in this manual, section names are enclosed in double quotes: “Cleaning and care.”

Classifications In accordance with IEC 60601-1: − Class I and internally powered equipment - the type of protection against electric −

Related documentation Clinical aspects, basic methods of measurement and technical background: S/5 Compact Critical Care Monitor, User’s Reference Manual Monitor setup instructions: S/5 Compact Critical Care Monitor, User's Guide Part I Installation, technical solutions and servicing: S/5 Compact Anesthesia Monitor and S/5 Compact Critical Care Monitor, S/5 Modules, Technical Reference Manuals Datex-Ohmeda S/5 Network, Wireless LAN Installation Guide Options and selections of the software: Default Configuration Worksheet Supplies and accessories: S/5 Compact Critical Care Monitor, User's Guide Part I Other devices closely related to the S/5 Compact Critical Care Monitor: S/5 Central and S/5 Arrhythmia Workstation User’s Reference Manuals

−

shock. Type BF or CF equipment. The degree of protection against electric shock is indicated by a symbol on each parameter module. Equipment is not suitable for use in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide. Continuous operation according to the mode of operation.

− In accordance with IEC 60529: − IPX1 - degree of protection against harmful ingress of water. In accordance with EU Medical Device Directive: IIb In accordance with CISPR 11: Class B

Responsibility of the manufacturer Datex-Ohmeda Division, Instrumentarium Corp. is responsible for the safety, reliability and performance of the equipment only if: − assembly, extensions, readjustments, modifications, service and repairs are carried out by personnel authorized by Datex-Ohmeda. − electrical installation complies with appropriate requirements. − the equipment is used in accordance with this User’s Guide.

1

2

Contents Non-invasive blood pressure (NIBP) ...49 Invasive blood pressure ...51 Cardiac output (C.O.)...55 Mixed venous oxygen saturation (SVO2) ...57 Airway gases ...59 Patient Spirometry...61 Gas exchange...63 Tonometry ...65 Neuromuscular transmission (NMT)...67 EEG and evoked potentials ...71 Bispectral index (BIS) ...75

Starting and ending ... 3 Entering and loading patient data... 4 Screen setup... 5 Alarms... 7 Laboratory data and calculations ... 9 Trends and snapshots ... 13 Recording and printing ... 15 Troubleshooting ... 19 Messages ... 25 ECG/ST ... 37 Impedance respiration... 45 Temperature ... 46 Pulse oximetry (SpO2) ... 47

Trademarks Datex®, Ohmeda®, and other trademarks S/5, D-lite, D-lite+, Pedi-lite, Pedi-lite+, Mini D-fend, D-fend, D-fend+, TruTrak®+, OxyTip+, MemCard, ComWheel, EarSat, FingerSat, FlexSat, PatientO2, Entropy, Patient Spirometry and Tonometrics are property of Instrumentarium Corp. or its subsidiaries. All other product and company names are property of their respective owners.

© Instrumentarium Corp. All rights reserved.

2

3

Starting and ending Preparations

During monitoring

NOTE: Before using the monitor for the first time, charge the batteries to their full capacity (charging time 10 hours). 1. Plug in the measurement modules. Ensure that the module is properly orientated (i.e. the module release latch is facing downward) before insertion. 2. Turn on the monitor from the power switch. 3. If necessary, change the user mode: Press the Admit/Discharge key and select Select Mode. NOTE: Changing the mode also changes settings, such as the alarm limits. For details, see the "User's Reference Manual."

To remove a patient temporarily from the monitor, use standby: 1. Disconnect patient cables and ensure that the monitor receives no vital signs and that the NIBP autocycling is turned off. 2. Press the Admit/Discharge key. 3. Select Stand-by and one of the options. 4. Accept with YES. Alarms are silenced and all the gathered data is saved. New data is not collected.

Retrieving information after standby If the monitor has been in the standby state: 1. Press any key or push the ComWheel. 2. Select YES in the opened Contin. Previous window. Alarms are activated. The previous data is retrieved and the monitor starts collecting new data.

Starting monitoring 1. Prepare the patient connections according to the setup picture in the measurement section. Use only Datex-Ohmeda approved supplies and accessories. The alarms and parameter default settings become active. 2. If necessary, adjust the waveform and digit fields; see "Screen setup." 3. Zero invasive pressure lines; see “Invasive blood pressure.” 4. Check the alarm limits; press the Alarms Setup key. Change them, if necessary; see "Alarms." 5. Start the measurement according to instructions in the measurement section. 6. Enter or load patient data by pressing the Admit/Discharge key; see "Entering and loading patient data.” The patient admission happens through Admit Patient selection or automatically when the monitor receives a patient's vital signs. Always observe the monitor and the patient carefully during start-up periods.

Automatic discharge of the patient The monitor discharges a patient automatically after 24 hours when vital signs for some parameters (ECG, Art, NIBP, SpO2, CO2, Resp, Tonometry, EEG, BIS) are not available. When this happens, all trend data will be cleared and alarm limits set to default values.

Ending monitoring 1. Print necessary data: press the Record/Print key. 2. Wait until the printing is finished. Then clear the patient data and return the settings to their defaults through Admit/Discharge Discharge - YES. 3. Turn the monitor to standby by pressing the power switch if the monitor will not be used. 4. Clean the monitor according to the instructions.

3

4

Entering and loading patient data When loading trends of patient data without the patient’s name or ID, select the data according to time indicated in the message field.

Entering patient data When you admit a patient, you must enter all relevant data: 1. Press the Admit/Discharge key and select Admit Patient. 2. Enter patient data by pushing and turning the ComWheel.

Receiving data from other sites Once the monitor is connected to the Datex-Ohmeda network, you can view and receive data from other monitors in the network. • Press the Other Patients key. • To receive alarms from other patient sites, select Receive Alarms (and the correct network if there are several available). • To view other patients’ vital signs, select Show Vital Signs (and the correct network if there are several available). NOTE: The heart rate is always calculated from ECG, independently from the selection made at the other site.

Loading patient data If the patient has already been admitted on the same or another monitor, press Admit/Discharge and select one of the following: • Contin. Previous Select this if neither memory cards nor network are in use. This loads the most recent patient trends from the monitor memory when less than 15 minutes has elapsed from the turn-off. If the monitor has been on but reset, the last patient trends from the previous 24 hours can be retrieved. • Admit Patient - Patient from Net. Select this when the monitor is connected to the network. This loads patient trends from the network. Note that the patient must have been discharged from the monitor less than 72 hours ago. • Admit Patient - Other Networks Select this to load patient trends from another network. • Admit Patient - Patient from Card Select this if the memory cards are in use. This selection loads patient trends from the Data Card. Note that the patient must have been discharged from the monitor less than 24 hours ago. NOTE: To load a patient from the Data Card, you need the Menu Card in the other PC card slot. NOTE: You can only load a case from (Compact) Critical Care Monitor to (Compact) Anesthesia Monitor if the total length of the case is less than 24 hours. This is the maximum case length for the L-(C)ANE03 and L-(C)ANE03A software licenses.

Saving data The S/5 Compact Critical Care Monitor continuously saves patient data, such as trends. Saving is activated once the patient is admitted. The monitor saves automatically: − in the monitor memory the most recent patient data if neither memory cards nor network are in use. − in the network patient data from 2 to 90 days depending on the configuration. − on the Data Card up to 72 hours of information depending on the data load. The green Data Card stores and transfers information.

WARNING: Connect only one patient to the monitor at a time. WARNING: Always make sure that necessary alarm limits are active and set according to the patient's clinical condition when you start monitoring a patient.

4

5

Screen setup Selecting a user mode

Selecting an appropriate page

Modes determine, for example, what is displayed on the screen and in trends and what the alarm limits are. The monitor starts in start-up mode. The start-up mode is one of the user modes chosen during configuration. To select a mode: 1. Press the Admit/Discharge key. 2. Select Select Mode and choose one of the options. Modes are preconfigured but if desired, can be changed. Changing the modes is described briefly in the User's Guide Part I, section "Setting up the monitor before use." For more information, please refer to the “User’s Reference Manual.”

In addition to Normal Screen, you can define up to five more pages for looking at the information on the screen. Pages are preconfigured but if desired, can also be changed. To move between different pages: 1. Close all menus. 2. Push the ComWheel to open the Select Page menu. 3. Select the page. For more information, please refer to the User's Guide Part I, section "Setting up the monitor before use" or the “User’s Reference Manual.”

Modifying the screen temporarily

Changing the split screen contents

• Press the Monitor Setup key and select Screen 1 Setup. Change the waveform and digit field measurements, split screen option, minitrend length and sweep speeds. • To make other setup changes, such as scale changes, press a parameter key and select its Setup menu. For example, press the ECG key and select ECG Setup. Changes are valid until the monitor is turned off (+15 minutes) or until you discharge the patient from the monitor. Only time and date settings are stored permanently.

You can split the Normal Screen page into two parts. The other half of the split screen shows trend, ST, spirometry, EEG or EP data. 1. Press the Monitor Setup key. 2. Select Screen 1 Setup. 3. Select Split Screen and choose from the options. ST shows current and reference QRS complexes and ST trends. Spiro1 is a basic view of spirometry information. Spiro2 is an enhanced view of spirometry with additional values. EEG shows EEG compressed spectral array. EP shows current evoked potential waveforms. Trend shows minitrends beside waveforms.

Modifying the screen permanently You can make permanent changes in the screen setup. This is described briefly in the User's Guide Part I, section "Setting up the monitor before use." For information on default configuration, refer to the "User's Reference Manual" and “Default Configuration Worksheet.”

5

6

Changing waveform and digit fields − When you select 4 invP, four invasive pressure waveforms are displayed together, using an area of two normal waveforms. The 4 invP choice removes the waveform under it.

Up to eight waveforms and four digit fields can be displayed simultaneously. • Press the Monitor Setup key. • Select Screen 1 Setup - Waveform Fields or Digit Fields.

− Selecting Combine Pressures displays invasive pressures in the same waveform field with the same zero line, but with individual scales.

Note that: − Waveforms are always evenly spread to fill the entire waveform area. The height of the waveforms depends on the number of waveforms configured to be displayed: When 2 or 3 waveforms are displayed, the waveforms are at least double the normal height, and when only 1 waveform is displayed, it fills the entire waveform area. − When less than four digit fields contain data, the remaining fields are automatically enlarged. − Any digit field having an empty digit field (="OFF") on the right is automatically enlarged.

− If 5- or 12-lead ECG is measured, up to three different ECG leads can be displayed simultaneously in different fields.

6

7

Alarms To enable the alarms, connect the patient cables. When an alarm becomes active, messages appear in the order of priority. See also section "Alarm basics" in the User's Guide Part I. NOTE: If the monitor is connected to the network, the alarms can be heard and seen on the S/5 Central as well. Please consult the "Datex-Ohmeda S/5 Central User's Reference Manual: Alarms" for details.

WARNING: Always make sure that necessary alarm limits are active and set according to the patient's clinical condition when you start monitoring. WARNING: When the alarms are silenced, observe the patient frequently.

Changing source For NIBP, P1, P2, P3, P4, P5, P6, O2 and Temp, you can select which measured values trigger the alarm. One or several alarm sources may be active at a time. 1. Press the Alarms Setup key and select Adjust Limits. 2. Select the measurement. 3. If the highlight is in the adjustment window, push the ComWheel until you get to the menu selections. 4. Select the desired alarm source ON.

Adjusting limits 1. Press the Alarms Setup key and select Adjust Limits. 2. Highlight the measurement or select Next Page if it is not displayed. 3. Push the ComWheel to open an adjustment window. 4. Turn the ComWheel to change limits and accept them by pushing it. Move between selections by turning the ComWheel.

Receiving alarms from other sites

NOTE: If the monitor is connected to the network, the alarm limits can also be changed using the S/5 Central if this feature is available and has been enabled in the Central configuration.

NOTE: The monitor needs to be connected to a network. 1. Press the Other Patients key and select Receive Alarms. 2. Select the correct network and one of the other sites.

Adjusting volume 1. Press the Alarms Setup key.

Showing alarm history • Press the Pt. Data & Trends key and select Alarm History. A list of the last 20 alarms is displayed.

2. Select Alarm Volume and adjust.

7

8

Silencing audible alarms temporarily

Silencing audible alarms permanently 1. Press the Alarms Setup key and select Audio ON/OFF.

To silence alarms for two minutes, press the Silence Alarms key. To silence them for five minutes, press the key for more than three seconds.

2. Select Silence Apnea, Silence ECG, Silence Apn&ECG or Silence ALL.

If the alarms are not active when you press the Silence Alarms key, they are pre-silenced for two or five minutes.

If an active alarm is silenced, the monitor gives a reminder beep every two minutes. By default, silencing alarms is set unselectable and can only be activated through the Installation menu. For more information, see "Setting up the monitor before use: Alarm options" in the User's Guide Part I or the "User's Reference Manual."

Exception: FiO2< 18%, EtO2 < 10% and Ppeak High alarms are silenced for 20 seconds. During silencing, all new alarms for the same reason and all alarms for a different reason are indicated visually.

Reactivating alarms

To silence the individual alarm that is currently active, press Silence Alarms key twice. This does not pre-silence the upcoming alarms.

• In Alarms Setup menu, select Audio ON/OFF and select Activate Alarms. NOTE: If the monitor is connected to the network, the bedside alarms can also be silenced using the S/5 Central if this feature is available and has been enabled in the Central configuration.

NOTE: If the monitor is connected to the network and the network connection is lost, the silenced alarms are reactivated and the volume level is automatically set to 7.

Reactivating silenced alarms • Press the Silence Alarms key during the silencing period. The alarm sounds of new alarms are activated. Silenced alarms are active after a two-minute period. Apnea alarm is activated after five breaths.

8

9

Laboratory data and calculations For more information, please refer to “User’s Reference Manual.”

Temperature correction

Entering laboratory values 1. Press the Pt. Data & Trends key.

In the laboratory, blood gas values are measured and calibrated at +37°C. These values may need to be adjusted to the actual patient temperature since an increase or decrease in temperature changes the volume of dissolved gas (PO2, PCO2, pH).

2. Select Lab Data - Enter Values. 3. Enter the values by turning and pushing the ComWheel.

The monitor has three options for temperature correction. To choose: 1. Press the Pt. Data & Trends key and select Lab Data. 2. Select Correct. and one of the following: • Lab = Temperature correction has been done in the laboratory and the values have already been adjusted to patient temperature. The entered blood gas values are stored without adjustments. • Yes = The monitor will perform correction calculations. Select Source to tell the monitor how the actual patient temperature is entered for the calculations (Manual, T1-T4, Eso, Naso, Tymp, Rect, Blad, Core, Tblood). The monitor corrects the entered blood gas values to patient temperature, and displays both corrected and uncorrected values. • No = No temperature correction is needed. The entered blood gas values are stored as such.

NOTE: When entering laboratory values, make sure that the units you are using are the same as the ones on the screen. If not, convert the values or change the units on the screen through Monitor Setup Install/Service - Installation - Units.

Loading laboratory values from an external device 1. Press the Pt. Data & Trends key. 2. Select Lab Data - Load Art Values or Load Ven Values. NOTE: These selections are available when there are unconfirmed values in the monitor memory. 3. Confirm the values with the ComWheel. The message ‘Lab data available’ remains in the message field until the values are confirmed.

NOTE: The monitor marks corrected values with the letter ‘c.’

9

10

Hemodynamic, oxygenation or ventilation calculations 1. Press the Wedge C.O. SvO2 key.

Viewing calculations To view values of the three most recent calculations: 1. Press the Wedge C.O. SvO2 key and select Calculations. 2. Select Hemodynamic Calcs/Oxygenation Calcs/Ventilation Calcs - Calc. Trends.

2. Select Calculations - Hemodynamic Calcs/Oxygenation Calcs/Ventilation Calcs. 3. Enter or edit the measurement data using the ComWheel. 4. Save data by selecting Save Calcs.

If the patient demographics have been entered, the monitor displays indexed values. You can select the non-indexed values with the ComWheel.

NOTE: The monitor marks the edited values with an asterisk (*). NOTE: The monitor uses the last measured and confirmed C.O. value as source data for hemodynamic and oxygenation calculations.

Recording calculations

Estimated values in oxygenation calculations

To record the current calculation page to a strip chart recorder: 1. Press the Wedge C.O. SvO2 key. 2. Select Calculations - Hemodynamic Calcs/Oxygenation Calcs/Ventilation Calcs 3. Select Record Calcs.

Only a couple percent of the total oxygen content is dissolved in the blood. The monitor measures SvO2 and also SpO2, which is used for estimating the SaO2. The oxygen content can be estimated by using monitored saturations only and disregarding the dissolved amount of oxygen. The monitor marks these estimated values and all the values derived from them with the letter ‘e.’

Printing calculations To print hemodynamic, oxygenation or ventilation calculations: 1. Press the Pt. Data & Trends key. 2. Select Calc. Trends - Hemodynamic/Oxygenation/Ventilation Print Page. NOTE: You can also print the calculations through Wedge C.O. SvO2– Calculations – Hemodynamic Calcs/Oxygenation Calcs/Ventilation Calcs – Calc. Trends – Print Page. To print all calculations: 1. Press the Record/Print key. 2. Select Print Calcs.

10

11

Drug calculator

Performing drug calculations 1. Press the Pt. Data & Trends key.

The S/5 Compact Critical Care Monitor also includes a drug calculator and a titration table, which can be used for determining the correct infusion or drip rates. These values and tables can also be recorded on a bedside recorder or printed on a laser printer.

2. Select Drug Calculator. 3. Select Calculator - Edit Values. 4. Enter the data you have available, for example, select the drug, enter the dose and the infusion time. Make selections with the ComWheel. 5. The monitor calculates all other values.

The drug list used by the calculator can include up to 20 drugs, one of which is always defined generic and cannot be deleted or renamed. This list is configured through the Installation menu (for more information, see the "User’s Reference Manual"). NOTE: The drug list can be saved to and loaded from the network or memory cards with the modes. However, it is not mode dependent. NOTE: Infusion rate calculations may require the patient weight. Enter it by selecting Demographics in the Drug Calcs menu.

11

12

Titration table

Printing or recording the titration table

The titration table gives 50 titration values for the selected drug. The monitor displays both infusion rates and drip rates. If required, both the starting dose and the increment steps can be edited through the Installation menu (for more information, see the “User’s Reference Manual”).

In some cases, the titration table may be required near the patient. You can print the table on a bedside strip chart recorder or on a laser printer. The Calculator and Table values are both printed at the same time. 1. Press the Pt. Data & Trends key. 2. Select Drug Calculator. • Select Record Calcs to print them on a strip chart recorder. • Select Print Calcs to print them on a laser printer.

To have a titration table for a given drug: 1. Press the Pt. Data & Trends key. 2. Select Drug Calculator. 3. Select Table - Edit Values. 4. Enter the data you have available, for example the drug name and concentration, by turning and pushing the ComWheel. 5. The monitor calculates the infusion rate and the drip rate.

12

13

Trends and snapshots Graphical trend view

Viewing graphical trends • Press the Pt. Data & Trends key and select Trends - Graphical. • To see more parameters, select Scroll Pages. • To see more data, select Cursor and scroll with the ComWheel. Graphical trends contain four trend pages each having up to six preconfigured fields with different parameters. Real-time ECG waveform is displayed at the top of each page. The graphical trend time scale varies from 20 minutes to 72 hours and the resolution from 10 seconds to one minute. With the 20 minute trend length, the displayed time period is 30 minutes and the resolution 10 seconds. With trend lengths from one to 72 hours, the displayed time period is 72 hours and the resolution is one minute. For HR, ST, PVC, PCWP, C.O., SpO2, PgCO2, VO2 & VCO2 and temperature measurements you can select the scale in the Trend Scales menu.

Symbols Trend bar: the gap shows the mean value.

Trends view (1) Trends menu (2) Measurement trend field (3) Real time ECG (4) Numerical value of a measurement at the trend cursor point (5) Time and marker field (6) Trend page number

NIBP trend bar Indicator of change -for example, ST relearning or zeroing of an invasive blood pressure channel

13

14

Viewing numerical trends • Press the Pt. Data & Trends key and select Trends -Numerical.

Automatic snapshots Automatic snapshot creation can be defined separately for each arrhythmia alarm. For more details, see section "ECG" and Part I section "Setting up the monitor before use." Snapshots are always taken automatically on Brady, Tachy and Art sys/dia/mean high/low alarms when they reach the red level if automatic snapshot creation is enabled (see Part I, section " Setting up the monitor before use.") Invasive pressure alarms reach the red level only when there is a simultaneous yellow HR alarm.

• To see more parameters, select Scroll Pages. • To see more data, select Cursor and scroll with the ComWheel. Numerical trends contain eight pages with the maximum of 72 hours of trend data. Real-time ECG waveform is displayed at the top of each page.

Creating snapshots manually

Viewing snapshots • Press the Pt. Data & Trends key.

A snapshot is a frozen frame of preconfigured waveforms or trends saved in the monitor memory. For configuration, see Part I section "Setting up the monitor before use."

• Select Trends. • Select Snapshot - Next Snapshot.

To create a snapshot: • Press the Take Snapshot key.

Turn the ComWheel to move to the next snapshot. In the upper righthand corner, you can see the time the snapshot was created. Five fields can be displayed on the snapshot page, and six fields can be printed.

The monitor saves an image of preconfigured waveforms or trends. You can take up to 400 snapshots, depending on the data load. When a snapshot is taken by pressing the Take Snapshot key, it is automatically numbered. This number also appears in the column 'Mark' in the numerical trends.

Erasing trends and snapshots • Press the Admit/Discharge key and select Discharge. If the power switch has been turned to stand-by but the patient has not been discharged, the trend data will be stored in the memory for 15 minutes.

14

15

Recording and printing You need − Laser printer for printouts (PCL5 compatible, min. 2Mb memory, serial or parallel printer) − Optional built-in recorder or recorder module, M-REC, for recording. NOTE: You cannot use both in the same monitor. In addition, M-REC is not compatible with all Compact Monitor versions. If it does not work with your monitor, contact service personnel for upgrade. − Thermal paper for the recorder

NOTE: Recordings on thermal paper may be destroyed when exposed to light, heat, alcohol, etc. Take a photocopy for your archives. NOTE: A vertical line in the printed trends means that the stand-by function of the monitor has been activated through menu selections.

Side panel keys Record Wave Stop

Records up to three real-time waveforms Stops recording

Starting and stopping the recording Use side panel keys to start and stop recording immediately. Recorder

Record Wave

Stop

15

16

Recording graphical trends 1. Press the Record/Print key.

Recording with the recorder Recording numerical trends You can record the current values of up to 11 preconfigured parameters. 1. Press the Record/Print key. 2. Select Record Trends - Record Numerical. 3. You can stop recording by selecting Stop Numerical.

2. Select Record Trends - Record Graphical. 3. You can stop recording by selecting Stop Graphical.

Alternatively, you can start recording with the Record Trends module key and stop recording with the Stop module key.

Trends are recorded for the time period that corresponds to the time scale of the graphical trends.

Alternatively, you can start recording with the Record Trends module key and stop recording with the Stop key.

To choose the time scale: 1. Press the Pt. Data & Trends key. 2. Select Trends. 3. Select Time Scale – 20 '/1 h/2 h/4 h/6 h/8 h/10 h/12 h/24 h/ 36 h/48 h/72 h.

Selecting the format for the recorded numerical trends You can select the format for the recorded numerical trend to be either Num (vertical, 11 parameters) or Tab. (horizontal, four parameters): 1. Press the Record/Print key. 2. Select Record Trends - Num Trend Type and Num or Tab.

To select the parameters for the graphical trends: 1. Press the Record/Print key. 2. Select Record Trends. 3. Select Graphic. Trend 1 or Graphic. Trend 2. 4. Select the parameter.

Selecting the default trend format You can select which trend format is recorded when recording is started with the module key: 1. Press the Record/Print key. 2. Select Record Trends - Default Trend and Num, Graph or Tab.

16

17

Recording on alarms 1. Press the Record/Print key.

Recording waveforms You can record three waveforms to a local recorder, and two to four waveforms to a network recorder:

2. Select Record Waveforms. 3. Select Start on Alarms - YES.

1. Press the Record Wave side panel key, or press the Record/Print monitor key and select Record Waveforms Record Wave. 2. If the monitor is connected to the network , you can also use the network recorder by selecting Record to Net. The network recorder uses the settings of the S/5 Central. 3. Stop recording by pressing the Stop side panel key, or by selecting Stop Wave.

Recording is activated when the following alarms reach the red level: Asystole, Tachy/Brady, Art High/Art Low, V Fib, V Tachy; V Run >3 with Extended arrhythmia analysis or Arrhythmia Workstation only and Rapid VT, X Brady and X Tachy with Arrhythmia Workstation only. Art and ECG1 waveforms are recorded. Selections are preconfigured.

Recording calculations 1. Press the Wedge C.O. SvO2 key.

Changing the paper speed To see the waveforms more clearly or more generally, change the paper speed:

2. Select Calculations - Hemodynamic Calcs/Oxygenation Calcs/Ventilation Calcs - Record Calcs.

1. Press the Record/Print key. 2. Select Record Waveforms - Paper Speed. • To select other waveforms for recording, press the Record/Print key and select Record Waveforms - Waveform 1, 2, or 3.

17

18

Printing currently displayed screen contents

Printing with a laser printer

You can print currently displayed trend data, calculation trends, ECG waveforms, EEG data, spirometry loop, and calculations.

Selecting a printer 1. Press the Record/Print key. 2. Select Printer Connection. 3. Select Serial or Paral. (local printer) or Net (network printer).

To print trend data: • Press the Pt. Data & Trends key and select: • Trends - Graphical/Snapshot/Numerical - Print Page

Printing everything

To print calculation trends: • Press the Pt. Data & Trends key and select: • Calc. Trends - Hemodynamic/Oxygenation/Ventilation Print Page

To print all graphical trends, calculations or saved loops: 1. Press the Record/Print key. 2. Select Print Graphical, Print QRS/ST, Print Calcs, Print Loops or Print EP's

To print ECG and ST data: • Press the ECG key and select: • ECG View - Print Page • ST View - ST Trends - Print Page • ST View - Print QRS/ST

Printing patient report 1. Press the Record/Print key. 2. Select Print Report.

To print Spirometry loops: • Press the Ventil. key and select: • Spirometry Loops - Print Loop To print EEG data: • Press the Others key and select: • EEG & EP - Print Page.

18