Quick Reference Guide
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Quick reference guide
Infinity® Acute Care System Infinity M540 patient monitor Software VG7.n
This Quick reference guide is not a replacement or substitute for the Instructions for Use. Any use of the medical device requires full understanding and strict observation of the Instructions for use.
Contents Contents... Trademarks... Side view of the M540... Dialogs... Calibrating the touchscreen... To select a view... Discharging a patient... Selecting a new patient category... To adjust the alarm volume... Pausing acoustic alarm signals (audio pause) . . . Pausing alarms at the M540... Pausing alarm monitoring temporarily... Activating or deactivating alarm monitoring... Setting the upper and lower alarm limits... Archive function... To access stored events... Electrode placement... ECG parameter setup functions... Respiration parameter setup functions... SpO2 and Pulse CO-Ox monitoring with Masimo SET MCable... SpO2 and pulse rate monitoring with Nellcor OxiMax MCable... Temperature parameter setup functions... Non-invasive blood pressure parameter setup functions... To assign a pressure label manually... Zeroing a specific transducer... Invasive pressure parameter setup functions... Mainstream CO2 monitoring... Microstream CO2 monitoring...
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Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
Trademarks –
Infinity®
–
MCable®
–
MPod®
are trademarks of Dräger. –
Masimo®
–
SET®
–
Pulse CO-Oximeter Signal Extraction®
are trademarks of Masimo corporation. –
Microstream®
is a trademark of Oridion Medical 1987 Ltd. –
Nellcor®
–
OxiMax®
–
SatSeconds®
are trademarks of a Medtronic company.
Side view of the M540
A B F
C
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D E A Non-invasive blood pressure connector B Temp (2) / Aux connector C SpO2 connector D Hemo connector E CO2 connector F
ECG connector
Quick reference guide
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Dialogs To access parameter-specific setup pages directly, touch the corresponding parameter fields on the main screen.
Calibrating the touchscreen If the touchscreen is out of alignment, the user can calibrate it at any time.
To calibrate the touchscreen 1
Touch the Menu function key.
2
Touch the Screen setup tab > Settings tab > Touch calib.
3
Touch each cross appearing successively in each corner of the screen. or
1
Push and hold the following two keys simultaneously:
2
Touch each cross appearing successively in each corner of the screen.
To select a view Touch the currently selected function key several times (for example, View 5) to scroll through the available view labels.
Discharging a patient A patient discharge has the following effect at the M540: –
All demographic data are removed from the screen
–
Any active recordings are canceled at the Cockpit if the M540 is docked in an IACS configuration
–
Factory or user default limit settings are restored
–
The message Discharged, Touch screen to resume monitoring appears
To discharge a patient Press the Discharge function key (if available for display). or 1
Press the Menu function key.
2
Touch the Main tab.
3
Touch Discharge. The message Caution discharge will delete patient data appears.
4
Touch Discharge.
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Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
Selecting a new patient category After selecting the patient category, the new patient category label appears in the header bar. A patient category change does not affect the following settings: the patient and physician names, patient ID, birth date, admit date, height, and weight. To select a new patient category 1
Press the Menu function key.
2
Touch the Patient setup tab.
3
Touch Patient category and then select the appropriate category (Adult, Pediatric, Neonate). The message Changing category will change alarm settings and algorithmic processing appears.
4
Touch OK.
To adjust the alarm volume 1
Press the Alarms function key.
2
Touch the Alarm volume button and select the desired volume level (Off, 5%, 10 to 100% in increments of 10%).
When the M540 is on wireless transport in an IACS configuration or in standalone mode and it loses its connection to the ICS, the alarm volume setting is automatically set to 100%. The setting Off is no longer available until the connection to the ICS is restored.
Pausing acoustic alarm signals (audio pause) Active alarms can be paused, or silenced, at the M540 for two minutes. In addition to pausing alarms, the setting of the quiet mode feature determines how subsequent alarm conditions are announced. You can initiate an audio pause in several ways: –
From an M540 in standalone mode or on wireless transport
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From an ICS
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From the remote view of another Infinity monitor within the same monitoring unit
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From the Cockpit when the M540 is docked in an IACS configuration
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From a remote device when remote control and remote silence are activated at the remote device and the Cockpit (refer to the IACS Monitoring Applications IFU)
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When first turning on the device
Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
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Pausing alarms at the M540 The following happens at the M540 when you pause active alarms: –
All acoustic alarm signals are paused for a maximum of about two minutes.
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The Audio paused message appears in the alarm message header of the Cockpit along with the timer and the following symbol:
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The alarm message appears in the color corresponding to the alarm priority.
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The parameter field no longer flashes in the color corresponding to the alarm priority. It appears in solid color.
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The alarm bar no longer flashes for high-priority and medium-priority alarm conditions.
The behavior of new alarm condition while the systems is in an audio pause state is determined by the Quiet mode setting.
To initiate an audio pause at the M540 Press the yellow key on the M540:
Pressing the key again cancels the audio pause period and all alarm events are reported as usual.
To initiate an audio pause remotely Press the following key on the main menu bar of the ICS to audio pause alarms for all assigned patients:
Press the same button in the viewport area to pause alarm tones for an individual patient. For more information, refer to the instructions for use of the ICS. Refer to the instructions for use of any remote device within the same monitoring unit for instructions on how to initiate an audio pause. Pressing the key again cancels the audio pause period and all alarm events are reported as usual.
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Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
Pausing alarm monitoring temporarily If the password-protected alarm pause feature is activated, you can pause alarm monitoring temporarily. The alarm pause duration is adjustable from 1 minute to 5 minutes. The following happens when you pause alarm monitoring: –
Acoustic and optical alarm signals for new alarm conditions are suppressed for all parameters until alarm monitoring begins again
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Alarm signals for any active alarm condition stop immediately
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The alarming parameter field and alarm bar return to the pre-alarm state
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Alarm messages are removed from the alarm message field in the header bar
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The far right field of the header bar turns yellow and displays the alarm message All alarms pause, a timer, and the following symbol:
To pause alarm monitoring temporarily 1
Press the Alarms function key.
2
Touch All alarms pause.
As soon as the alarm pause period ends, the M540 generates acoustic and optical alarm signals as needed.
To activate alarm monitoring after pausing 1
Press the Alarms function key.
2
Touch All alarms pause before the alarm pause period ends to cancel the alarm pause.
Activating or deactivating alarm monitoring If the password-protected alarm pause feature is set to No timeout, the following happens when you deactivated alarm monitoring: –
All acoustic and optical alarm signals for new alarm conditions are suppressed for all parameters until alarm monitoring is manually activated again
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Acoustic alarm signals for any active alarm condition stop immediately
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The alarming parameter field and alarm bar return to the pre-alarm state
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Alarm messages are removed from the alarm message field of the header bar
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The far right field of the header bar turns yellow and displays a message that all alarms are off and the following symbol appears:
Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
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To deactivate alarm monitoring 1
Press the Alarms function key.
2
Touch All alarms off.
To activate alarm monitoring after deactivating 1 2
Press the Alarms function key. Touch All alarms off. The M540 provides acoustic and optical alarm signals again when it detects a new alarm condition.
Setting the upper and lower alarm limits You can configure the upper and lower alarm limits of a parameter manually to trigger acoustic and optical alarm signals if a parameter goes above or below the set limits. To set an individual parameter’s alarm settings 1
Touch the parameter field (for example, HR) to access that parameter’s dialog.
2
Touch the tab for configuring the parameter limits (for example, HR limits).
3
Touch the upper or lower alarm limit.
4
Touch the up or down arrow to change the alarm limit setting.
5
Touch OK.
Archive function The archive function setting determines what happens in response to an alarm limit violation. The available settings are: –
Off – no event is stored and no recording is generated.
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Store – stores the event for later review.
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Record – stores the event for later review when in standalone mode or on wireless transport. Once the M540 is docked, any stored event is transferred to the alarm history of the IACS where you can request a manual recording of the event.
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Str/Rec – generates a timed recording for an M540 docked in an IACS configuration and stores the event. When the M540 is in standalone mode or on wireless transport, this setting stores an event for later review. Once the M540 is docked, any stored event is transferred to the alarm history of the IACS where you can request a manual recording of the event.
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Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
To configure an individual parameter’s archive function 1
Touch the parameter field to access that parameter’s dialog (for example, HR).
2
Touch the tab for configuring the parameter limits (for example, HR limits).
3
Touch Archive and toggle to one of the following settings: Off, Store, Record, Str/Rec.
4
Touch X to close the dialog.
To access stored events Select the Review function key. The following diagram shows the Event recall dialog.
C A
B E 069
D A Event list with date, time, and cause of each event. B Arrow buttons for scrolling through the event list. C View button for viewing a single event in greater detail. D Delete button for deleting an event.
E Lock button for locking an event (if the M540 is docked in an IACS configuration, pressing this button has no effect on events at the Cockpit).
Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
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Electrode placement for adult and pediatric patients
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Standard configuration, three electrodes (IEC/AHA)
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Standard configuration, five electrodes (IEC/AHA)
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Quick reference guide
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Pacer configuration, five electrodes (IEC/AHA)
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12-lead configuration, ten electrodes for 12-lead Rest ECG monitoring (IEC)
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12-lead configuration, ten electrodes for 12-lead Rest ECG monitoring (AHA)
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Standard configuration, six electrodes (IEC/AHA)
Electrode placement for neonates IEC electrode placement (neonates)
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AHA electrode placement (neonates)
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ECG parameter setup functions All ECG parameter setup functions take place in the ECG dialog. Selection
Available settings
Description Settings – ECG 1 page
Tone vol- Off, 5, 10 (default) to 100% in increments of 10% ume1)
Selects the volume of the pulse tone. If you dock the M540 in an IACS configuration, this setting is replaced by the pulse tone volume setting of the Cockpit. When you undock the M540, this setting is replaced by the Transport pulse tone setting configured under the Alarm setup tab.
Tone source 1)
ECG (default), PI
Selects the source of the pulse tone.
ECG filter 1)
–
–
Off – provides the greatest sensitivity to noise or ar- Controls the sensitivity to various artifact tifact (the message Filter off appears in the wave- sources. form channel) When the M540 is set to OR alarms and the Passband: 0.08 - 40Hz filter selection is set to Monitoring: Monitor (default) – recommended for standard monitoring; reduces wandering isoelectric line, mus- – the hardware low pass ESU filter is activated. cle artifact, and power line interference. No mes-
sage appears in the waveform channel. Passband: 0.5 - 40Hz – ESU – reduces signal distortion during electrosurgery (the message Filter ESU appears in the waveform channel). This selection is not available when the M540 is in standalone mode. Passband: 0.5 - 16Hz 12-lead monitoring is not available when the ESU filter is enabled. Likewise, the ESU filter selection is not available when you are using 12-lead monitoring. HR source 1)
– –
12
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RRi is unavailable
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12-lead ECG monitoring is unavailable
None of these settings are of diagnostic quality.
ECG (default) – derives the heart rate from the ECG Selects a different source for the heart rate when the ECG channel is unavailable due signal. to artifact resulting from surgical proceArterial pressure – derives the heart rate from the dures. arterial blood pressure signal. The heart rate parameter field label changes to APR and appears in the color of ART.
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SpO2 – derives the heart rate from the pulse oximetry signal. The heart rate parameter field label changes to PLS and appears in the color of SpO2.
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Auto – derives the heart rate either from the ECG signal or other available sources. If an ECG signal is not available, the M540 switches to Arterial pressure, and then to SpO2.
Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
Selection
Available settings
Description
Show all leads
None
Shows all ECG waveforms. Press anywhere in the waveform area to access additional ECG waveforms. Press Menu to close all the ECG waveforms.
Size all ECG 1)
0.25, 0.5, 1 (default), 2, 4, 8 mV/cm
Sets the amplitude of ALL displayed ECG leads.
Color 1)
Red, White, Yellow, Green (default), Light blue, Blue, Determines the color of the ECG wavePurple, Orange forms, and the arrhythmia/ST parameter labels and values. Settings – ECG 2 page
Pacer de- – tection – (Not available in – neonatal mode)
On (default)
QRS sync marker
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On – displays QRS synchronization markers
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Off (default)
Cable type 1)
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Auto (default)
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3, 5, 6, and 12 leads (if activated)
Off – the message Pacer off appears in the waveform channel
Determines whether pacer impulses are detected.
Fusion – the message Pacer fusion appears in the waveform channel
(TruST is When using the ECG extension cable, the system alonly availways assumes the cable is a 6-wire lead set. able with a 6-wire lead set)
Determines whether vertical white markers appear on the waveform to identify QRS complexes. The markers help determine when it is safe to perform synchronized cardioversion. When set to Auto, it detects the number of connected lead wires automatically. If auto mode does not detect the connected lead set, it allows you to select the cable type manually. “12” denotes a combination of a 6-wire lead set and 4-wire lead set for 12lead monitoring.
ARR lead ECGI, ECGII (arrhythmia lead 1 default), ECGIII, Assigns the lead for QRS processing. 1 1) ECGaVR, ECGaVL, ECGaVF, ECGV (arrhythmia lead 2 default), ECGV+, ECGV1 to ECGV6 ARR lead 2 1) ARR pro- ECG1, ECG1&2 (default) cessing 1) The ECG1&2 selection is not available if the neonatal patient category is selected.
ECG1 setting – arrhythmia processing occurs only on the lead selected as arrhythmia lead 1. ECG1&2 setting – arrhythmia processing occurs on the leads selected as arrhythmia lead 1 and arrhythmia lead 2.
1)
This setting is a patient default which may be unique for each patient category; it is part of the profile.
QRS threshold
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Normal (default)
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Low
This function is only available for adult and pediatric patients. Normal – detects QRS complexes ≥0.5 mV. Low – detects QRS complexes ≥0.2 mV.
Quick reference guide
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Selection
Available settings
Description Rest ECG setup page
Gender
Race
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Unknown (default)
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Male
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Female
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Unknown (default)
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Caucasian
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Asian
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African
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Other
Respiration parameter setup functions All respiration parameter setup functions take place in the respiration dialog. Selection
Available settings
Description Settings 1 page
Resp. lead 1) I, II (default)
Selects the lead for respiration monitoring.
Relearn
None
Initiates a relearning of the respiration signal, only in Auto mode.
Marker 1)
On, Off (default)
Superimposes a vertical line on the respiration waveform when a breath is detected.
Monitoring 1) – –
On (default in neonatal mode)
Turns respiration monitoring on or off.
Off (default in adult/pediatric mode)
Apnea time 1) Off, 10, 15 (default), 20, 25, 30 s Apnea archive 1)
Determines how long an apnea has to last before an alarm is triggered.
–
Off
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Str/Rec – a recording as well as an event storage is triggered automatically in reIn case of false apnea alarms, it is advised to obsponse to an apnea. serve the patient’s breathing pattern (belly or chest), and reposition electrodes accordingly, or Store (default) – a waveform segment is to adjust the detection threshold manually. stored in response to an apnea.
– –
Determines what happens in response to an apnea.
Record – a recording is triggered automatically in response to an apnea.
Color 1)
Red, White, Yellow, Green, Light blue (default), Blue, Purple, Orange
Determines the color of the waveforms, and the parameter labels and values.
Change parameter
A list of currently available parameters.
Changes the parameter field to a different parameter.
1)
This setting is a patient default which may be unique for each patient category; it is part of the profile.
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Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
Selection
Available settings
Description Settings 2 page
Mode1)
Auto (default), Manual
Determines the processing mode for the breathrelated impedance change.
Coincidence 1)
On, Off (default)
Determines whether you are alerted when the respiratory rate is within 20% of the heart rate, which is an indication that the M540 is counting heart beats as respiration.
Resp. threshold
10% to 100% (in 10% increments) – default: 50%
Adjusts the breath detection threshold.
This setting is a patient default which may be unique for each patient category; it is part of the profile.
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AHA electrode placement (adult)
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IEC electrode placement IEC electrode placement (adult) (neonates)
IEC electrode placement (adult)
AHA electrode placement (neonates)
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AHA electrode placement (adult)
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1)
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SpO2 and Pulse CO-Ox monitoring with Masimo SET MCable All SpO2 parameter setup functions take place in the SpO2 dialog. Selection
Available settings
Description
Tone volume 1)
Off, 5, 10 (default), 20, 30, 40, 50, 60, 70, 80, 90, 100%
Adjusts the volume of the pulse tone. If you dock the M540 in an IACS configuration, this setting is replaced by the pulse tone volume setting of the Cockpit. When you undock the M540, this setting is replaced by the Transport pulse tone setting configured under the Alarm setup tab.
Tone source 1)
– –
ECG (default) – the heart blip pulsates with each Selects the source of the pulse tone which detected pulse. affects the ECG and SpO2 parameter field SpO2 display. For the SpO2 selection, the higher the pitch of the tone, the higher the SpO2 saturation percentage.
Bar graph 1) On, Off (default)
Displays a bar graph that is proportional to the pulse rate and strength.
Averaging time 1)
Determines how quickly the reported SpO2 value responds to changes in the patient’s oxygen saturation.
2 to 4, 4 to 6, 8 (default), 10, 12, 14, 16 s
A longer averaging time provides a more accurate result. However, in clinical situations where rapid physiological changes have to be monitored, use a shorter averaging time Sensitivity mode 1)
Fast SAT mode 1)
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Determines the level of detection sensitivity.
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Normal (default) – standard mode
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APOD (adaptive probe off detection) – the least sensitive mode for detecting a reading on patients with low perfusion. Provides the best detection for detached sensors. This mode is useful for patients at particular risk for sensors becoming detached such as children or patients who are restless.
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Max. – provides maximum sensitivity for poor signals (this mode is recommended for patients with low perfusion or when the low perfusion or low signal quality message is displayed in APOD or Normal sensitivity mode. Max. mode is not recommended for care areas where patients are not monitored visually, such as general wards. It is designed to interpret and display data at the measuring site when the signal may be weak due to decreased perfusion.)
On, Off (default) When the Averaging time setting is set to 2 to 4 s or 4 to 6 s, the Fast SAT mode selection is grayed out.
Quick reference guide
Activates rapid tracking of arterial oxygen saturation changes.
– Infinity Acute Care System – Infinity M540 VG7.n ®
Selection
Available settings
Description
Color 1)
Red, White (default), Yellow, Green, Light blue, Blue, Purple, Orange
Determines the color of the waveforms, and the parameter labels and values.
Change pa- A list of currently available parameters. rameter 1)
Changes the parameter field to a different parameter.
This setting is a patient default which may be unique for each patient category; it is part of the profile.
SpO2 and pulse rate monitoring with Nellcor OxiMax MCable All SpO2 parameter setup functions take place in the SpO2 dialog. Selection
Available settings
Description
Tone volume 1) Off, 5, 10 (default), 20, 30, Sets the volume of the pulse tone. 40, 50, 60, 70, 80, 90, 100% – If you dock the M540 in an IACS configuration, this setting is replaced by the pulse tone volume setting of the Cockpit. –
Tone source 1)
–
–
ECG (default) – the heart rate blip pulsates with each detected pulse. SpO2
When you undock the M540, this setting is replaced by the Transport pulse tone setting configured under the Alarm setup tab
Selects the source of the pulse tone which affects the ECG and SpO2 parameter field display. For the SpO2 selection, the higher the pitch of the tone, the higher the SpO2 saturation percentage.
Bar graph 1)
On, Off (default)
Displays a bar graph that is proportional to the pulse rate and strength.
Response mode 1)
–
Establishes the frequency the oximeter uses to calculate, record, and display SpO2 saturation levels.
– SatSeconds 1)
Normal (default) – 90% change within 5 to 7 seconds
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Fast – 90% change with– in 2 to 4 s
Normal mode responds to changes in blood oxygen saturation in 5 to 7 seconds Fast mode responds to changes in blood oxygen saturation levels in 2 to 4 seconds when calculating %SpO2.
Off (default), 10, 25, 50, 100 This selection does the following: –
Analyzes desaturation events by multiplying their duration (seconds) by the number of percentage points the patient exceeds the alarm limit.
–
Eliminates nuisance alarms caused by brief and numerous violations of lower and upper alarm limits.
–
Overrides the alarm validation setting and the SpO2 high priority desaturation alarm for neonatal patients.
Color 1)
Red, White (default), Yellow, Green, Light blue, Blue, Purple, Orange
Determines the color of the waveforms, and the parameter labels and values.
Change parameter
A list of currently available parameters.
Changes the parameter field to a different parameter.
1)
This setting is a patient default which may be unique for each patient category; it is part of the profile.
Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
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Temperature parameter setup functions All temperature parameter setup functions take place in the temperature dialog. Selection
Available settings
Description
Ta
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TOral
Tb
–
TEso
Ta configures the first temperature value on the M540.
–
TNasal
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TRect
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TBlad
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Tcore
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TBld1
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TBlnkt
–
TSkin
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TR
–
TL
Tb configures the second temperature value on the M540.
∆T
Difference Ta–Tb
T1a
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T1Oral
T1a configures the third temperature value.
T1b
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T1Eso
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T1Nasal
T1b configures the fourth temperature value.
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T1Rect
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T1Blad
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T1core
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T1Bld1
–
T1Blnkt
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T1Skin
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T1R
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T1L
∆T1
Difference T1a–T1b
Color 1)
Red, White (default), Yellow, Green, Light blue, Blue, Purple, Orange
Determines the color of the parameter labels and values.
Change parameter
A list of currently available parameters.
Changes the parameter field to a different parameter.
1)
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This setting is a patient default which may be unique for each patient category; it is part of the profile.
Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®
Non-invasive blood pressure parameter setup functions All non-invasive blood pressure parameter setup functions take place in the non-invasive blood pressure dialog. Selection
Available settings
Description Settings
Interval time 1) (Cardiac bypass mode automatically deactivates interval measurements)
Off (default), 1 min, 2 min, 2.5 min, 3 min, Defines intervals for the non-invasive 5 min, 10 min, 15 min, 20 min, 25 min, blood pressure measurements. 30 min, 45 min, 60 min, 120 min, 240 min
Inflation mode
Adult (default), Pediatric, Neonate
Sets a threshold for maximum cuff inflation.
Continuous mode 1)
On, Off (default)
Initiates successive non-invasive blood pressure measurements for 5 min.
Chime 1)
On, Off (default)
Determines if a tone sounds at the end of a completed non-invasive blood pressure measurement.
Venous stasis 1)
On, Off (default)
Stops blood flow to the lower part of the cuffed limb for a fixed time.
Color 1)
Red, White (default), Yellow, Green, Light blue, Blue, Purple, Orange
Determines the color of the parameter labels and values.
Change parameter
A list of currently available parameters.
Changes the parameter field to a different parameter.
1)
This setting is a patient default which may be unique for each patient category; it is part of the profile.
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To assign a pressure label manually 1
Touch the invasive pressure parameter field.
2
Touch the Settings tab.
3
Touch Edit label.
4
Touch the appropriate pod label Pod 1A label,Pod 1B label, and so on.
5
Touch the new pressure label.
6
Touch X to close the dialog. Or
1
Touch the Menu function key.
2
Touch Label IP.
Zeroing a specific transducer To zero a specific sensor 1
Touch the appropriate invasive pressure parameter field.
2
Touch the Settings tab.
3
Align the transducer to the level of the heart (phlebostatic axis point, fifth intercostal space and midaxillary line).
4
Close the transducer stopcock to the patient and open it to air.
5
Touch Zero on the M540. If the zeroing of the transducer is successful, the message Zero accepted appears. If zeroing fails, the message did not zero appears. In that case, repeat steps three to five.
6
Touch X to close the dialog.
Zeroing all pressure transducers To zero all pressure transducers from the hemodynamic pods 1
Align the transducer to the level of the heart (phlebostatic axis point, fifth intercostal space and midaxillary line).
2
Close the stopcocks to the patient, and open them to air.
3 Press the Hemo4 pod
key (A) on the Hemo4, Hemo2, or the MPod – QuadHemo. Hemo2 pod A MPod – Quad Hemo A A
4
Verify that the transducers have been zeroed. If zeroing failed, repeat steps two and three.
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Quick reference guide
– Infinity Acute Care System – Infinity M540 VG7.n ®