GE CARESCAPE - Page 520

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Abbreviations

kcalkilocalorie

KCC

KoreaCommunicationsCommission

kgkilogram

kJkilojoule

kPakilopascal

lliter

l/min

liters/minute

leftarm(describinglocation)

Lablaboratory

LAN

localareanetwork

LAP

leftatrialpressure

Lat.

lateral

lbpound

LCD

liquidcrystaldisplay

LCW

leftcardiacwork

LCWI

leftcardiacworkindex

LED

lightemittingdiode

leftleg(describinglocation)

LVEDP

leftventricularenddiastolicpressure

LVEDV

leftventricularenddiastolicvolume

LVSW

leftventricularstrokework

LCWI

leftventricularstrokeworkindex

MAC

minimumalveolarconcentration

MACage

MACcompensatedwithpatientage,patienttemperature,and

atmosphericpressure

Man

manual

Man/Spont

manual/spontaneous

MAP

meanarterialpressure

Max.

maximum

megabyte

mbarmillibar

MBC

modulebuscontroller

mcg/lmicrogramperliter

mcmol/lmicromoleperliter

Mean;M

meanbloodpressure

mEq

milliequivalent

mEq/lmilliequivalentperliter

520CARESCAPEModularMonitors2062971-001

Main Page

1 About this manual39
- Intended use of this manual39
  - Intended markets of this manual39
- Intended audience of this manual39
- Training requirements39
- Manual conventions39
  - Monitor naming conventions40
  - Acquisition module naming conventions40
- Illustrations and names41
- Related documents41
- Ordering manuals41
- Trademarks42
  - Third party trademarks42
- Manufacturer responsibility42
2 Safety43
- Safety message signal words43
- System safety43
- System warning safety messages43
- System caution safety messages46
- Notice safety messages47
- Safety symbols47
- Indications for use48
- Indications for use safety precautions50
  - Indications for use warnings50
  - Indications for use cautions50
- Training requirements50
- Electromagnetic compatibility51
3 System introduction53
- Monitor and module compatibility limitations53
- System safety precautions53
  - System warnings53
  - System caution54
- B850 system components55
  - B850 processing unit front view56
  - B850 processing unit back view56
  - B850 module frames F7 and F557
  - B850 Tram-Rac frames 2A and 4A58
- B650 system components58
  - B650 monitor front panel59
  - B650 monitor side views60
  - B650 monitor back panel60
  - B650 pivoting module frame61
- B450 system components62
  - B450 monitor front panel64
  - B450 monitor side views64
  - B450 monitor back panel65
- Monitor battery65
  - Inserting and removing the B650 monitor battery66
  - Inserting and removing the B450 monitor battery67
  - Checking the battery charge with monitor software67
  - Monitor battery charge symbols on screen68
  - Battery test button68
- Alarm light69
- Displays69
- Acquisition modules70
  - PSMP front view70
  - PDM front view71
  - TRAM module front view72
  - Single-parameter Tram-Rac front view72
  - Modules and parameters73
- Barcode reader77
- Keyboard77
- Mouse77
- Remote control and keypad78
- Recorders and laser printers78
- About the Unity Network Interface Device (ID)78
- CIC Pro Clinical Information Center79
- CARESCAPE Central Station79
- iCentral80
- Remote alarm box (nurse call)80
- iPanel software application81
- Equipment symbols81
- User interface symbols89
4 Monitoring basics93
- Module compatibility limitations93
- Identical modules93
- Connecting and removing modules: B85094
- Connecting and removing modules: B65096
- Connecting and removing modules: B45097
- Main keys98
- Main screen layout101
  - An example of a menu102
- Menu options102
- Data field entries103
  - Entering data with the on-screen keyboard103
  - Entering data with a keyboard103
- Putting the monitor into operation104
  - Operation warnings104
  - Operation caution104
- Monitor installation points to note104
- Turning on the monitor105
- Performance check105
- Message about PDM service105
- Pre-monitoring checklist105
- Supply mains interruption106
- Power failure alarm106
5 Setting up the monitor before use107
- Normal screen and other pages107
  - Selecting the normal screen (main page)107
  - Selecting pages107
- Adjusting sound volumes108
- Brightness settings108
- Screen setup modifications109
- Setting up printing options112
- Checking the PDM battery status113
- Checking the monitor battery status113
- Setting the touchscreen off113
- B850 with several screens113
- Other setup changes113
6 Starting and ending monitoring115
- Monitor and module compatibility115
- Software packages and terminology115
- About the user default settings115
- Invasive pressure labels and PDM or TRAM115
- Starting monitoring116
- About the combination monitoring mode117
- Entering patient data118
  - Entering patient data with the monitor118
  - Entering patient data with a barcode reader119
- About the roving functionality119
- Entering administrative information121
- Loading patient information from the CARESCAPE Network (ADT serv121
- Loading patient data and trend data from the S/5 Network121
- About standby122
  - Starting standby122
  - End of standby123
- About continuing monitoring123
  - How to continue monitoring when a case is not active/patient is123
  - How to continue monitoring when a case is active/patient is admi124
- About case reset/patient discharge125
7 Alarms127
- Alarm warnings127
- Alarm cautions129
- Alarm overview129
  - Alarm types129
  - Alarm conditions129
  - Alarm priority levels130
  - Alarm priority escalation130
  - Physiological alarms’ activation criteria130
  - Broadcast only alarms131
  - Checking alarm function133
- Alarm indications133
  - Alarm icons on the screen133
  - Description of alarm and information messages134
  - Setting the alarm light brightness135
  - Audible alarm signals135
  - Audible and visual alarm signals136
  - Auditory information signals136
  - Audible alarms off behavior136
- Pause audio behaviors137
  - Pausing alarms for 5 minutes138
  - Activating all audible alarms138
- Technical alarms’ deactivation with the pause audio key139
- Apnea alarms’ deactivation with the pause audio key139
- Pause audio with combination monitoring139
- Breakthrough alarms139
- Latched alarms140
- Setting parameter alarm limits140
  - Alarm locks140
  - Alarm guard limits140
- Setting arrhythmia alarms141
- Selecting parameter alarm priority levels141
- Setting alarm limits automatically142
  - Default auto alarm limits143
- Returning the default alarm limits143
- Turning off all local alarm indicators (sleep mode)144
- Remote management of alarms144
- Alarm settings after a power loss144
- Alarm data stored in Clinical logs145
- Stored alarm data during a power cycle or power loss145
8 ECG147
- ECG compatibility limitations147
- ECG safety precautions147
  - ECG warnings147
  - ECG cautions149
- ECG measurement limitations149
- ECG points to note149
- ECG measurement setup150
- About the ECG analog output signal154
- About the combination monitoring mode155
  - Selecting the ECG source156
- Using the ECG measurement156
- ECG measurement practicalities165
- ECG troubleshooting166
- 12 lead analysis166
- Pacemaker detection172
- Arrhythmia monitoring175
- ST detection182
9 Impedance respiration191
- Impedance respiration compatibility limitations191
- Respiration safety precautions191
  - Respiration warnings191
  - Respiration cautions192
- Respiration measurement limitations192
- Respiration points to note192
- Respiration measurement setup193
- Respiration measurement on the monitor screen196
- Using the respiration measurement196
- Respiration measurement description199
  - Respiration measurement with PSM199
  - Respiration measurement with PDM and TRAM199
- How to interpret the respiration values199
- Respiration troubleshooting199
10 Pulse oximetry201
- SpO2 compatibility limitations201
- SpO₂ safety precautions201
  - SpO2 warnings201
  - SpO2 cautions204
- SpO2 measurement limitations204
- SpO2 points to note204
- SpO₂ measurement guidelines205
- SpO₂ measurement setup207
- Using the SpO₂ measurement208
- How to interpret the SpO₂ values214
- SpO2 wavelengths and optical output power215
- SpO2 measurement and interference215
- SpO2 troubleshooting216
11 Non-invasive blood pressure219
- NIBP compatibility limitations219
- NIBP safety precautions219
  - NIBP warnings219
  - NIBP cautions220
- NIBP measurement limitations221
- NIBP points to note221
- NIBP measurement setup222
- NIBP measurement on screen223
- Manual NIBP measurements223
- Automatic NIBP measurements224
- NIBP cuffs226
- NIBP volume and display settings227
  - Adjusting the NIBP measurement completion tone volume227
  - Setting the NIBP display format228
- NIBP alarms228
- NIBP measurement description228
- NIBP calibration232
- NIBP troubleshooting233
12 Invasive pressures235
- Invasive pressures compatibility limitations235
- Invasive pressure safety precautions235
  - Invasive pressure warnings235
- Invasive pressure measurement limitations235
- Invasive pressure points to note235
- Invasive pressure measurement setup236
- Using the invasive pressure measurement238
- Setting an arterial invasive pressure disconnection alarm244
- Setting invasive pressure alarm limits244
- Invasive pressures alarm priorities245
- Systolic pressure variation and pulse pressure variation245
  - Changing the SPV source245
  - Measuring SPV manually245
- PA catheter insertion246
  - Selecting the PA catheter insertion mode246
- Pulmonary capillary wedge pressure (PCWP) measurement246
- Calibrating the invasive pressure measurement with PDM and TRAM248
- Invasive pressure calibration with E-modules249
- Invasive pressure practicalities249
  - Invasive pressure parameters249
  - Intra-aortic balloon pump249
- Invasive pressure troubleshooting252
13 Temperature255
- Temperature compatibility limitations255
- Temperature safety precautions255
  - Temperature warnings255
- Temperature measurement limitations255
- Temperature points to note255
- Temperature measurement setup256
- Temperature measurement on the monitor screen257
- Using the temperature measurement257
- Temperature practicalities259
- Temperature troubleshooting259
14 Cardiac output261
- C.O. safety precautions261
  - C.O. warnings261
  - C.O./CCO cautions261
- C.O. measurement limitations261
- C.O. points to note261
- C.O. measurement setup262
- Using the C.O. measurement264
- C.O. practicalities269
  - Cardiac output washout curve269
  - How to improve the C.O. accuracy269
- C.O. troubleshooting270
15 Mixed venous oxygen saturation (SvO₂)275
- SvO2 compatibility limitations275
- SvO₂ safety precautions275
  - SvO2 warnings275
- SvO2 measurement limitations275
- SvO2 points to note276
- SvO₂ measurement setup276
- Using the SvO₂ measurement277
- SvO2 measurement description279
- SvO2 troubleshooting279
16 Airway gases281
- Airway gases compatibility limitations281
- Airway gases safety precautions281
  - Airway gases warnings281
  - Airway gases cautions283
- Airway gases measurement limitations283
- Airway gases points to note283
- Airway gases measurement setup284
  - Airway gases equipment to patient connections with CARESCAPE res284
  - Airway gases equipment to patient connections with compact airwa285
  - Airway gases equipment to patient connections with compact airwa285
  - Airway gases equipment to patient connections with E-miniC, crit286
  - Airway gases measurement setup286
  - CARESCAPE respiratory module connectors287
  - Compact airway module connectors287
  - E-miniC module connectors288
  - E-miniC indications for use288
  - Airway gases alternative patient connections288
  - Checking the airway gases measurement289
  - Airway gases parameters290
- Using the E-modules for CO₂ measurement292
  - Available menu selections292
  - Selecting the CO2 scale292
  - Selecting the CO2 sweep speed292
  - Setting CO2 limit alarms292
  - Deactivating the apnea alarm292
  - Apnea alarms’ deactivation with the pause audio key293
  - Selecting what to show with EtCO2293
  - Selecting the FiO2 level293
  - Selecting the N2O level293
- Using the CARESCAPE respiratory modules and compact airway modul294
  - Selecting the O2 scale294
  - Selecting the O2 sweep speed294
  - Setting O2 alarms294
- Using the CARESCAPE respiratory modules and compact airway modul294
  - Selecting the agent scale294
  - Selecting the agent sweep speed294
  - Setting agent limit alarms295
- Gases alarm priorities295
- Preventing operating room pollution295
  - Scavenging through the ventilator reservoir295
  - Scavenging through the anesthesia gas scavenging system295
  - Connecting directly to the scavenging system295
- Stopping the airway gases measurement296
- Calibrating airway gases296
- Basics of airway gases measurement297
  - Airway gases measurement description, CARESCAPE respiratory modu297
  - Airway gases measurement description, E-miniC297
  - Sidestream gas sampling298
- Minimum Alveolar Concentration (MAC)298
  - MAC and MACage298
  - References used for MAC and MACage values299
  - MAC values of different anesthetics in oxygen299
  - MAC values of different anesthetics in 65% N2O300
- ET balance gas, CARESCAPE respiratory modules and compact airway300
- Automatic agent identification with E-sCAiO, E-sCAiOV, E-CAiO, E301
- Basics of CO₂ measurement301
  - Normal CO2 waveform301
  - The origin of the CO2 waveform301
  - Dips in capnogram302
- Oxygen measurement interpretation, CARESCAPE respiratory modules303
- Airway gases practicalities303
  - Ventilation management303
  - Prevention of the breathing system contamination304
  - How to prevent effects of humidity304
  - Oxygen delivery, CARESCAPE respiratory modules and compact airwa304
  - Level of anesthesia: E-sCAiO, E-sCAiOV, E-CAiO, E-CAiOV, E-CAiOV305
- Airway gases troubleshooting305
17 CO2 with CAPNOSTAT Mainstream, CapnoFlex LF, and Dual CO2 mod307
- CO2 compatibility limitations307
- CO₂ safety precautions307
  - CO2 warnings307
  - CO2 cautions309
- CO2 points to note309
- CO₂ measurement setup309
- Using the CO₂ measurement315
- Preventing operating room pollution with CAPNOSTAT Mainstream, D317
  - Scavenging to scavenging systems317
- Stopping the CO2 measurement317
- Basics of CO₂ measurement317
- CO₂ measurement practicalities319
- CO2 troubleshooting320
18 Patient Spirometry323
- Patient Spirometry compatibility323
- Patient Spirometry safety precautions323
  - Patient Spirometry warnings323
  - Patient Spirometry cautions323
- Patient Spirometry limitations323
- Patient Spirometry points to note324
- Patient Spirometry measurement setup324
- Using the Patient Spirometry measurement325
- Patient Spirometry measurement basics328
- Patient Spirometry practicalities336
- Patient Spirometry troubleshooting337
19 Gas exchange339
- Gas exchange compatibility limitations339
- Gas exchange safety precautions339
  - Gas exchange warnings339
  - Gas exchange cautions340
- Gas exchange measurement limitations340
- Gas exchange points to note340
- Gas exchange measurement setup341
  - Gas exchange equipment to patient connection341
  - Checking the gas exchange measurement342
- Using the gas exchange measurement342
- Gas exchange measurement basics343
  - Gas exchange measurement description343
  - How to interpret the gas exchange values343
- Gas exchange practicalities346
- Gas exchange troubleshooting347
20 Entropy349
- Entropy compatibility349
- Entropy safety precautions349
  - Entropy warnings349
  - Entropy cautions350
- Entropy indications for use350
- Entropy measurement limitations350
- Entropy points to note351
- Entropy measurement setup351
- Using the Entropy measurement353
- Entropy measurement basics355
- Entropy practicalities357
- Entropy troubleshooting358
- Entropy reference studies359
21 Neuromuscular transmission361
- NMT compatibility361
- NMT safety precautions361
  - NMT warnings361
  - NMT cautions362
- NMT measurement limitations362
- NMT points to note362
- Checking the NMT measurement362
- NMT measurement setup363
- NMT graphical trends on the monitor screen365
- Using the NMT measurement365
- NMT alternative uses367
  - Local nerve and plexus localization367
- NMT measurement basics368
  - NMT measurement description368
  - How to interpret the NMT values369
- NMT practicalities370
- NMT troubleshooting370
22 EEG and auditory evoked potentials373
- EEG compatibility373
- EEG safety precautions373
  - EEG warnings373
  - EEG cautions373
- EEG indications for use374
- EEG measurement limitations374
- EEG points to note374
- EEG measurement setup375
- EEG measurement on the monitor screen378
- Using the EEG measurement379
- EEG practicalities382
- EEG troubleshooting386
- Measuring auditory evoked potentials (AEP)387
  - Preparing the patient for AEP measurement387
  - AEP montage388
- Using the AEP measurement388
- AEP practicalities391
- AEP troubleshooting392
23 Bispectral index393
- BIS compatibility393
- BIS safety precautions393
  - BIS warnings393
  - BIS cautions394
- BIS indications for use395
- BIS measurement limitations395
- BIS points to note395
- BIS measurement setup396
- BIS measurement on the monitor screen397
- Using the BIS measurement397
- How to interpret the BIS values399
- BIS troubleshooting399
24 Laboratory data401
- About laboratory values401
25 Calculations405
- About calculations405
- Viewing calculation values405
- Source data for calculations405
  - Selecting source data for oxygenation calculations406
  - Selecting source data for ventilation calculations406
- Estimated values in oxygenation calculations406
- Estimated values in hemodynamic calculations406
  - Selecting the PCWP source407
- Indexing parameters for hemodynamic and oxygenation calculations407
- Editing calculation input values407
- Saving calculation values408
- Viewing saved calculations408
- Printing hemodynamic, oxygenation, or ventilation calculations408
- Printing all calculation trends409
26 Drug calculations411
- About drug calculations411
- Calculations menu description412
- Drug calculator413
- Titration table414
  - Calculating drug titrations414
  - Printing the titration table414
- Resuscitation medications415
  - Calculating resuscitation medication doses415
  - Printing resuscitation medication doses415
27 Trends417
- Monitor and module compatibility417
- Trend views417
- Graphic trends417
- Numeric trends419
- Invasive pressure trends420
- Heart rate (HR) trends420
- Gas consumption421
  - Viewing gas consumption data421
  - Printing gas consumption data421
- Minitrend split screen421
- Time change during a patient case423
28 Snapshots and events425
- Description of snapshots425
  - Snapshot configuration425
- Manually created snapshots425
- Creating automatic snapshots425
- Viewing snapshots426
- Changing the snapshot time scale426
- Changing snapshot trend scales427
- Printing snapshot pages427
  - Selecting snapshots to print automatically427
  - Selecting spirometry loops to print with snapshots427
- Erasing snapshots and trends427
- Snapshots and alarm history428
- Snapshot transfer to PDM428
- ST snapshots428
- Events429
29 Printing433
- Printing options433
- Laser printers433
- Recorders434
  - PRN 50–M recorder (B850 only)434
  - XE-50 recorder (B650 and B450 only)435
- Printing device selections435
  - Changing printer435
  - Checking the print status436
- Printing waveforms436
- Printing trends439
- Printing reports439
- Printing calculations440
  - Printing Hemo, Oxy, or Vent calculations440
  - Printing Hemo, Oxy, or Vent calculation trends441
- Printing drug calculations441
  - Printing drug calculator441
  - Printing titration table441
- Printing laboratory data and parameter printouts441
  - Printing laboratory data441
  - Parameter printouts441
- Print header information442
  - Laser printer print header442
  - Recorder print header442
30 Viewing other monitored patients443
- About viewing other monitored patients443
- Automatic view of remote beds in alarm444
- Next alarming remote bed to screen445
- Viewing remote patient beds445
- Audio pause for a remote patient bed alarms446
- Manual printing of remote bed waveforms446
31 Interfacing with peripheral devices447
- Interfacing safety precautions447
  - Interfacing warnings447
  - Interfacing cautions447
- Compatible peripheral devices448
- Unity Network Interface Device (ID)448
32 Cleaning and care453
- Cleaning and care safety precautions453
  - Cleaning and care warnings453
  - Cleaning and care cautions454
- Disposal safety precautions454
  - Disposal warnings454
  - Disposal cautions454
- Cleaning and care schedules454
- Regular calibration checks455
- Cleaning and care points to note456
- Permitted detergents456
- Permitted disinfectants456
- Cleaning and care instructions456
- How to store PDM and PSM458
- Monitor battery care459
  - Replacing the monitor battery459
  - Battery recycling459
- PDM battery care459
- About the internal lithium battery460
33 Messages463
- Messages related to ECG measurement463
- Messages related to impedance respiration measurement468
- Messages related to SpO2 measurement469
- Messages related to NIBP measurement472
- Messages related to invasive pressures measurement475
- Messages related to temperature measurement481
- Messages related to cardiac output measurement482
- Messages related to SvO2 measurement485
- Messages related to gases measurement488
- Messages related to spirometry measurement493
- Messages related to gas exchange measurement495
- Messages related to Entropy measurement496
- Messages related to NMT measurement498
- Messages related to EEG and AEP measurements500
- Messages related to BIS measurement501
- Messages related to TC measurement503
- Messages related to trends, snapshots, and laboratory data504
- Messages related to various situations505
34 Abbreviations513
- List of abbreviations513
A Skills checklist529
- System introduction529
- Starting and ending530
- Monitoring basics530
- Alarms531
- Trends532
- Snapshots and events532
- ECG533
- Impedance respiration534
- Pulse oximetry (SpO2)535
- Non-invasive blood pressure536
- Invasive pressures537
- Temperature538
- Cardiac output538
- Mixed venous oxygen saturation (SvO2)539
- Airway gases539
- CO2 with CAPNOSTAT Mainstream, CapnoFlex LF, and Dual CO2 module540
- Patient Spirometry541
- Gas exchange541
- Entropy542
- Neuromuscular transmission543
- EEG and AEP543
- BIS544

GE CARESCAPE - Page 520

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