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7 ECG, Arrhythmia, ST and QT Monitoring Switching QT Monitoring On and Off

142

Table of Contents

Installation11
- Installation Checklist11
- Unpacking and Checking the Shipment12
- Mounting the Monitor13
- Connecting the Monitor to AC Mains13
- Checking Out The Monitor13
- Loading Paper14
- Operating the Monitor15
- Setting the Date and Time16
- Checking Country-Specific Default Settings16
- Handing Over the Monitor16
Basic Operation19
- Introducing the Monitor19
  - MP5/MP5T Major Parts and Keys22
- Operating and Navigating23
- Operating Modes29
  - Standby Mode29
- Understanding Screens30
  - Switching to a Different Screen30
  - Changing a Screen’s Content30
- Using the XDS Remote Display (not MP5T)31
- Using the Visitor Screen31
- Understanding Profiles32
- Understanding Settings34
  - Changing Measurement Settings35
  - Switching a Measurement On and Off35
- Adjusting a Measurement Wave35
- Freezing Waves36
- Using Labels37
- Entering Measurements Manually39
  - Switching Manually Entered Measurements On and Off39
- Changing Monitor Settings39
- Checking Your Monitor Revision40
- Getting Started40
- Disconnecting from Power42
  - Monitoring After a Power Failure42
- Networked Monitoring42
- Using the MP5 with a Host Monitor43
What’s New?45
- What’s New in Release G.0?45
- What’s New in Release F.0?46
Alarms49
- Visual Alarm Indicators50
- Audible Alarm Indicators51
- Acknowledging Alarms53
  - Acknowledging Disconnect INOPs53
  - Alarm Reminder (ReAlarm)53
- Pausing or Switching Off Alarms54
- Alarm Limits55
- Reviewing Alarms60
  - Alarm Messages Window60
  - Review Alarms Window60
- Latching Alarms62
  - Viewing the Alarm Latching Settings62
  - Alarm Latching Behavior62
- Testing Alarms62
- Alarm Behavior at On/Off63
- Alarm Recordings63
Patient Alarms and INOPs65
- Patient Alarm Messages65
- Technical Alarm Messages (INOPs)71
Managing Patients95
- Admitting a Patient95
  - Patient Category and Paced Status97
  - Admitting a Centrally-Monitored Patient97
- Quick Admitting a Patient97
- Editing Patient Information97
- Discharging a Patient98
  - New Patient Check98
- Transferring Patients99
- Care Groups102
ECG, Arrhythmia, ST and QT Monitoring109
- Skin Preparation for Electrode Placement109
- Connecting ECG Cables109
- Selecting the Primary and Secondary ECG Leads110
- Checking Paced Status110
- Understanding the ECG Display110
- Monitoring Paced Patients111
  - Setting the Paced Status (Pace Pulse Rejection)112
  - Avoiding Pace Pulse Repolarization Tails112
- Changing the Size of the ECG Wave113
  - To Change the Size of an Individual ECG Wave113
  - To Change the Size of all the ECG Waves113
- Changing the Volume of the QRS Tone113
- Changing the ECG Filter Settings114
- Selecting Positions of Va and Vb Chest Leads (for 6- lead placement)114
- Choosing EASI or Standard Lead Placement115
- About ECG Leads115
  - ECG Leads Monitored115
  - Changing Lead Sets115
- ECG Lead Fallback116
- ECG Lead Placements116
  - Standard 3-Lead Placement117
  - Standard 5-Lead Placement117
  - 6-Lead Placement117
  - Chest Electrode Placement118
  - 10-Lead Placement119
  - Conventional 12-Lead ECG119
    - Modified 12-Lead ECG120
  - Choosing Standard or Modified Electrode Placement120
- Capture 12-Lead120
- EASI ECG Lead Placement121
- ECG and Arrhythmia Alarm Overview122
- Using ECG Alarms123
  - Extreme Alarm Limits123
  - ECG Alarms Off Disabled123
  - HR Alarms When Arrhythmia Analysis is Switched Off123
  - Enhanced Asystole Detection123
- ECG Safety Information124
- About Arrhythmia Monitoring125
  - Arrhythmia Options125
  - Where Can I Find More Information?125
- Switching Arrhythmia Analysis On and Off126
- Choosing an ECG Lead for Arrhythmia Monitoring126
  - Aberrantly-Conducted Beats126
  - Atrial Fibrillation Alarm126
  - Intermittent Bundle Branch Block127
- Understanding the Arrhythmia Display127
  - Viewing Arrhythmia Waves128
  - Arrhythmia Beat Labels128
  - Arrhythmia Status Messages129
    - Rhythm Status Messages129
    - Ectopic Status Messages130
- Arrhythmia Relearning130
  - Initiating Arrhythmia Relearning Manually130
  - Automatic Arrhythmia Relearn131
    - Arrhythmia Relearn and Lead Fallback131
- Arrhythmia Alarms131
  - Yellow Arrhythmia Alarms132
  - Arrhythmia Alarms and Latching132
  - Switching Individual Arrhythmia Alarms On and Off132
  - Switching All Yellow Arrhythmia Alarms On or Off132
  - Adjusting the Arrhythmia Alarm Limits132
  - Arrhythmia Alarm Timeout Periods133
    - What is a Timeout Period?133
    - Resetting the Timeout Period133
  - How are Yellow Arrhythmia Alarms Indicated?133
    - Arrhythmia Alarm Chaining134
  - Understanding PVC-Related Alarms135
- About ST Monitoring137
- Switching ST On and Off137
  - Selecting Leads for ST Analysis137
- Understanding the ST Display138
- Updating ST Baseline Snippets139
- Recording ST Segments140
- About the ST Measurement Points140
  - Adjusting ST Measurement Points140
- ST Alarms142
  - Single- or Multi-lead ST Alarming142
  - Changing ST Alarm Limits142
- Viewing ST Maps143
  - Current View143
  - Trend View144
  - Viewing an ST Map145
  - Working in the ST Map Task Window145
- About QT/QTc Interval Monitoring147
  - QT Measurement Algorithm147
    - Where Can I Find More Information?147
  - Indications For Use Of QT Interval Monitoring148
  - Limitations For Use Of QT Interval Monitoring148
  - Selecting The QT Leads148
  - QT View149
- QT Alarms150
  - Switching Individual QTc Alarms On and Off151
  - Changing QTc Alarm Limits151
- Switching QT Monitoring On and Off151
Monitoring Pulse Rate153
- Entering the Setup Pulse Menu153
- System Pulse Source153
- Switching Pulse On and Off154
- Using Pulse Alarms154
Monitoring Respiration Rate (Resp)157
- Lead Placement for Monitoring Resp157
- Understanding the Resp Display158
- Changing Resp Detection Modes158
- Changing the Size of the Respiration Wave159
- Changing the Speed of the Respiration Wave160
- Using Resp Alarms160
- Changing the Apnea Alarm Delay160
- Resp Safety Information160
Monitoring SpO2163
- SpO2 Sensors163
- Applying the Sensor163
- Connecting SpO2 Cables164
- Measuring SpO2164
- SpO2 Signal Quality Indicator (Fast SpO2 only)165
- Assessing a Suspicious SpO2 Reading165
- Changing the Averaging Time166
- Setting the Measurement Mode166
  - Making a Manual Measurement166
- Understanding SpO2 Alarms166
- Pleth Wave167
- Perfusion Numeric168
- Perfusion Change Indicator168
- Setting SpO2/Pleth as Pulse Source168
- Setting Up Tone Modulation168
- Setting the QRS Volume169
Monitoring NBP171
- Introducing the Oscillometric NBP Measurement171
- Preparing to Measure NBP172
  - Correcting the Measurement if Limb is not at Heart Level173
  - Understanding the NBP Numerics173
- Starting and Stopping Measurements174
- Enabling Automatic Mode and Setting Repetition Time175
- Enabling Sequence Mode and Setting Up The Sequence175
- Choosing the NBP Alarm Source176
- Switching Pulse from NBP On/Off176
- Assisting Venous Puncture177
- Calibrating NBP177
Measuring Predictive Temperature179
- Making a Temperature Measurement179
  - Selecting a Temperature Label181
  - Selecting Predictive or Continuous mode181
Monitoring Temperature183
- Making a Temp Measurement183
  - Selecting a Temperature for Monitoring183
  - Extended Temperature Label Set184
- Calculating Temp Difference184
Monitoring Invasive Pressure185
- Setting up the Pressure Measurement185
  - Selecting a Pressure for Monitoring185
  - Extended Pressure Label Set186
- Zeroing the Pressure Transducer186
- Adjusting the Calibration Factor188
- Displaying a Mean Pressure Value Only188
- Changing the Pressure Wave Scale188
- Optimizing the Waveform189
- Using the Wave Cursor189
- Non-Physiological Artifact Suppression189
- Choosing the Pressure Alarm Source189
  - Extreme Alarm Limits190
- Calibrating Reusable Transducer CPJ840J6191
  - Making the Pressure Calibration191
  - Troubleshooting the Pressure Calibration192
- Calculating Cerebral Perfusion192
- Calculating Pulse Pressure Variation192
Monitoring Carbon Dioxide195
- Using the CO2 Measurement196
  - Preparing to Measure Mainstream CO2196
  - Preparing to Measure Sidestream CO2197
    - Using the Sidestream Sensor Holder198
    - Removing Exhaust Gases from the System199
- Measuring Microstream CO2199
- Setting up all CO2 Measurements200
Assigning Two Devices to One Patient205
- How Can You Combine Devices?205
- Functions Available When the Telemetry Data Window is Displayed209
- Functions Available For Devices Connected Via SRR210
  - Temporarily Stopping the Short Range Radio Connection210
  - Setting Up Measurements211
- General Telemetry-related Functions211
  - ECG Source Tracking at the Information Center211
  - Synchronized Settings211
- Use Models With Telemetry212
Enhancing Telemetry Monitoring with the Monitor215
- Monitor and Telemetry Transceiver Requirements215
- Data Sent to the Information Center215
- Changing Assignment to a New Telemetry Transceiver215
Trends217
- Viewing Trends217
- Setting Up Trends220
- Documenting Trends223
- Trends Databases224
  - Aperiodic Trends Database224
  - Trending Multiple-Value Measurements224
- Screen Trends225
High Resolution Trend Waves229
- OxyCRG229
- Printing Hi-Res Trend Wave Reports229
- Hi-Res Trend Wave Recordings230
Event Surveillance231
- Event Episodes231
- Events Pop-Up Keys232
- Event Triggers232
- The Events Database234
- Viewing Events234
- Annotating Events236
- Documenting Events236
ProtocolWatch241
- Severe Sepsis Screening241
Recording247
- Starting and Stopping Recordings247
- Overview of Recording Types248
- All ECG Waves Recordings249
- Creating and Changing Recordings Templates249
- Changing ECG Wave Gain250
- Recording Priorities251
- Sample Recording Strip251
- Reloading Paper253
- Recorder Status Messages253
Printing Patient Reports255
- Starting Report Printouts255
- Stopping Reports Printouts256
- Setting Up Reports256
- Setting Up Individual Print Jobs258
- Checking Printer Settings259
- Printing a Test Report259
- Switching Printers On Or Off for Reports259
- Dashed Lines on Reports259
- Unavailable Printer: Re-routing Reports259
- Checking Report Status and Printing Manually260
  - Printing Manually260
- Printer Status Messages261
- Sample Report Printouts262
Using the Drug Calculator267
- Accessing the Drug Calculator267
- Performing Drug Calculations268
- Charting Infusion Progress270
- Using the Titration Table270
- Documenting Drug Calculations270
Using the Timer271
- Viewing the Timer271
  - Timer Types271
- Timer Setup Pop-up Keys271
- Setting Up Timers272
- Displaying a Timer On The Main Screen273
  - Main Screen Timer Pop-up Keys274
- Displaying A Clock On The Main Screen274
Laboratory Data275
- Viewing Received Data275
Care and Cleaning277
- General Points277
- Cleaning the Monitor278
- Disinfecting the Monitor278
- Sterilizing the Monitor278
- Cleaning, Sterilizing and Disinfecting Monitoring Accessories279
- Cleaning and Disinfecting the Predictive Temperature Accessories279
  - Probes279
  - Probe Holders279
- Cleaning Batteries and the Battery Compartment279
Using Batteries281
- Battery Power Indicators281
- Checking Battery Charge284
- Replacing a Battery284
- Optimizing Battery Performance284
- Battery Safety Information285
Maintenance and Troubleshooting287
- Inspecting the Equipment and Accessories287
- Inspecting the Cables and Cords287
- Maintenance Task and Test Schedule288
- Troubleshooting289
- Disposing of the Monitor289
- Disposing of Empty Calibration Gas Cylinders289
Accessories291
- ECG/Resp Accessories291
  - Recommended Cables291
  - Supported Cables293
- NBP Accessories295
- Invasive Pressure Accessories296
- SpO2 Accessories297
- Temperature Accessories301
- Predictive Temperature Accessories301
- Mainstream CO2 Accessories302
- Sidestream CO2 Accessories302
- Microstream CO2 Accessories302
- Recorder Accessories303
- Cable for Direct Connection of a Telemetry Device304
- Battery Accessories304
Installation and Specifications305
- Intended Use305
- Manufacturer’s Information306
  - Trademark Acknowledgement306
- Symbols306
- Installation Safety Information308
  - Connectors308
    - Left Side of Monitor309
    - Right Side of Monitor310
- Altitude Setting310
- Monitor Safety Specifications310
- EMC And Radio Regulatory Compliance311
- Out-Of-Hospital Transport - Standards Compliance312
  - Physical Specifications313
  - Environmental Specifications314
- Monitor Performance Specifications314
- M4605A Battery Specifications318
- Measurement Specifications319
- Safety and Performance Tests331
Default Settings Appendix337
- Country-Specific Default Settings337
- Alarm and Measurement Default Settings343
- Alarm Default Settings343
- ECG, Arrhythmia, ST and QT Default Settings344
- Pulse Default Settings347
- Respiration Default Settings347
- SpO2 Default Settings348
- NBP Default Settings349
- Temperature Default Settings349
- Predictive Temperature Default Settings350
- Invasive Pressure Default Settings350
- CO2 Default Settings352

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