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shivering.
Nail polish and/or artificial fingernails can affect the accuracy of pulse oximetry and should be removed.
Pulse rate measurement is based on the optical detection of a peripheral flow pulse. While a pulse rate does
assist with the detection or absence of a peripheral pulse, the pulse oximeter should not be used as a replacement
or substitute for ECG-based arrhythmia analysis.
In certain situations such as low perfusion or weak signal strength, such as with patients who have pigmented or
thick skin, inaccurate SpO2 measurements may be reported. Verification of oxygenation should be made
through other means, particularly in preterm infants, and patients with chronic lung disease, prior to instituting
any therapy or intervention.
Always monitor ECG for arrhythmia detection purposes. HR calculated from pulsatile SpO2 waveform may
differ significantly from ECG HR measured values.
NIBP Warnings
Use only approved blood pressure (BP) cuffs specifically intended for use with the Surveyor patient monitors.
Use the correct size cuff for the intended limb (see indication of cuff size in cm printed on cuff) of the patient.
The terminology printed on some BP cuffs like “child,” “adult,” “thigh,” etc., is only an indication of the size of
the cuff and should not be used to determine if the cuff is suitable for the limb. Use the range markers on the BP
cuff’s to determine whether a particular cuff fits the patient’s arm or not.
The Surveyor patient monitor is not intended for use with neonates.
Do not fold, clamp, cut, or alter the pressure hose of the cuff or the monitor.
Periodically check the limb connected to the cuff for adequate perfusion, circulation, and function. Repeated
NIBP measurements can lead to hematomas, limb ischemia, and other limb injuries. Kinked or blocked hoses
can lead to prolonged impairment of blood circulation and lead to injury.
Educate the patient to relax, rest, and lie still during inflation and pressure measurements. Patient movement can
lead to artifacts or errors.
The pressure measurement might be influenced by patient position, physical conditions, and other factors.
Avoid placing the blood pressure cuff on the arm next to where a patient has had a mastectomy.
Avoid applying the cuff to a wounded limb as this can cause further injury. Use with caution in patients with
dermatological disease, subcutaneous laceration, or other integumentary compromise as there may exist a skin
damage hazard during electronic NIBP measurements. Follow prudent evidence-based clinical practice to
determine if an electronic blood pressure is safe for these patients.
There may be an increased risk of hematomas in patients with serious coagulation problems.
Avoid applying the cuff to a limb with a catheter, arterio-venous shunt or infusion pump applied. The cuff
pressure could produce damage to the tissues surrounding the catheter, shunt or the infusion needle, or
compromise the infusion flow.
To avoid the potential for spread of disease or infection, reusable blood pressure cuffs should be cleaned after
each patient use. Disposable blood pressure cuffs should not be used with multiple patients.
Inflation of the NIBP cuff can cause a temporary degradation of monitoring of other parameters derived from
the same limb, including invasive pressure and SpO2 measurements. If applicable, place the SpO2 sensor and
the NIBP cuff on different limbs.
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