Cardiocap 5 Manual Usuario

Cardiocap™/5 Anesthesia
Software S-XANE
User’s Reference Manual
Document Number 6050-0006-347

November 2002
NOTICE
Intended use
The Datex-Ohmeda Cardiocap/5 and accessories are indicated for indoor monitoring of
hemodynamic (ECG, impedance respiration, NIBP, temperature, SpO2, and invasive
pressure), respiratory (CO2, O2, N2O, respiration rate, anesthetic agent, and agent
identification), ventilatory (airway pressure, volume, and flow), and relaxation status (NMT)
of all hospital patients.
With the N-XOSAT option, monitoring of arterial oxygen saturation includes monitoring
hospital patients during conditions of clinical patient motion.
The Cardiocap/5 is indicated for patients weighing 5 kg (11 lb.) or more.
Impedance respiration measurement is indicated for patients ages 3 years and older.
The monitor is indicated for use by qualified medical personnel only.
CAUTION: US 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 restrictions that may apply.
Classifications
IEC 60601-1:
• Type of protection against electric shock: Class I equipment.
• Degree of protection against electric shock (indicated by a symbol on the monitor beside
each connector): Type BF applied part or Type CF applied part.
• The equipment is not suitable for use in the presence of a flammable anesthetic mixture
with air or with oxygen or nitrous oxide.
• Mode of operation: Continuous.
IEC 60529 (degree of protection against harmful ingress of water): IPX1
EU Medical Device Directive: IIb
Responsibility of the manufacturer

Datex-Ohmeda Division, Instrumentarium Corp. is responsible for the safety, reliability and
performance of the equipment only if:
• Assembly, operation, 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 the Cardiocap/5 User’s Guide and serviced
and maintained in accordance with the Cardiocap/5 Technical Reference Manual.
Trademarks
Datex®, Ohmeda®, and other trademarks (Cardiocap/5, AS/3, CS/3, S/5, S/5 Light, D-lite,
Pedi-lite, D-fend, D-fend+, MemCard, ComWheel, EarSat, FlexSat, OxyTip, PatientO2, and
Patient Spirometry) are the property of Instrumentarium Corp. or its subsidiaries.
Nellcor® is a registered trademark of Mallinckrodt Inc. Durasensor®, Dura-Y® Oxiband®,
OxiCliq®, and Oxisensor® are registered trademarks of Nellcor Puritan Bennett.
All other product and company names are the property of their respective owners.
© 2002 Datex-Ohmeda, Inc. All rights reserved.
Cardiocap/5 User’s Reference Manual—Anesthesia
Part I – Setup and General Use

Monitor Description 1
Monitoring Basics 2
Monitor Setup 3
Alarms 4
Trends and Snapshots 5
Patient Data Management 6
Recording and Printing 7
Troubleshooting 8
Maintenance and Cleaning 9
Part II – Measurement Parameters

ECG 10
Impedance Respiration 11
Pulse Oximetry 12
Non-Invasive Blood Pressure (NIBP) 13
Invasive Blood Pressure 14
Temperature 15
Airway Gases 16
Patient Spirometry 17
NeuroMuscular Transmission (NMT) 18
Contents
Chapter 1. Monitor Description

Introduction ....................................................................... 1-1
Additional information.............................................................................................................1-1
Clinical application...................................................................................................................................1-1
Configuration ...............................................................................................................................................1-1
Configuration passwords ........................................................................................................1-1
Cardiocap/5 model and options for Anesthesia software............... 1-2

Hemodynamic model with airway gas measurement (F-MXG) ....................................1-2
Data collection and management options ..................................................................................1-2
Parts of the monitor.............................................................. 1-3

Patient connectors panel....................................................... 1-4
Rear panel ......................................................................... 1-5
Rear panel connections..........................................................................................................................1-5
Symbols ............................................................................ 1-6

Delayed standby function....................................................... 1-7
Back-up battery................................................................... 1-7
Battery time ...................................................................................................................................................1-7
Safety precautions ............................................................... 1-8

Warnings.........................................................................................................................................................1-8
Failure of operation ....................................................................................................................1-8
Explosion hazard..........................................................................................................................1-8
Electrical shock hazard ............................................................................................................1-8
Patient safety...................................................................................................................................1-8
Cautions........................................................................................................................................................ 1-10
Airway gas measurement..................................................................................................... 1-10
Invasive blood pressure......................................................................................................... 1-10
Cleaning..........................................................................................................................................1-10
Disposal...........................................................................................................................................1-10
Specifications................................................................... 1-11
General.......................................................................................................................................................... 1-11
Power supply ............................................................................................................................... 1-11
Back-up battery........................................................................................................................... 1-11
Environmental conditions ................................................................................................... 1-11
ECG ................................................................................................................................................................. 1-11
ST segment analysis ................................................................................................................ 1-11
Heart rate .......................................................................................................................................1-11
Impedance respiration........................................................................................................... 1-11
NIBP................................................................................................................................................................ 1-12
Invasive blood pressure.......................................................................................................................1-12

Pulse rate ........................................................................................................................................1-12
Temperature ...............................................................................................................................................1-12
Pulse oximetry, standard ....................................................................................................................1-12
SpO2 ..................................................................................................................................................1-12
Pulse rate ........................................................................................................................................1-12
Default alarm limits..................................................................................................................1-12
Sensor emitter wavelength ranges..................................................................................1-13
Pulse oximetry, Datex-Ohmeda enhanced (N-XOSAT option)....................................1-13
SpO2 ..................................................................................................................................................1-13
Pulse rate ........................................................................................................................................1-13
Pulse oximetry, Nellcor compatible (N-XNSAT option) ..................................................1-13
SpO2 ..................................................................................................................................................1-13
Pulse rate ........................................................................................................................................1-14
Airway gases...............................................................................................................................................1-14
Respiration rate (RR) ...............................................................................................................1-14
Agent identification .................................................................................................................1-14
Carbon Dioxide (CO2), Oxygen (O2), and Nitrous Oxide (N2O)....................1-15
Anesthetic Agent (AA)............................................................................................................1-15
Patient Spirometry..................................................................................................................................1-15
NMT ................................................................................................................................................................1-16
Stimulator.......................................................................................................................................1-16
Regional block mode...............................................................................................................1-16
Recorder........................................................................................................................................................1-16
Table of Figures
Figure 1-1. Cardiocap/5 monitor (F-MXG) ................................................................................................1-3
Figure 1-2. Patient connectors (F-MXG)......................................................................................................1-4
Figure 1-3. Cardiocap/5 rear panel (F-MXG) ...........................................................................................1-5
Monitor Description
1. MONITOR DESCRIPTION
Introduction
This User’s Reference Manual contains detailed information about the features of the
Datex-Ohmeda Cardiocap/5 monitor with Anesthesia software (S-XANE) installed.
Additional information
The Cardiocap/5 User’s Guide—Anesthesia ships with the monitor. It contains basic
information for using the Cardiocap/5.
The Cardiocap/5 Technical Reference Manual describes installation, maintenance,
service, and repair procedures to be performed by authorized service personnel only.
For information about other devices closely related to the Cardiocap/5, see the
Datex-Ohmeda S/5 Network and Central, User’s Reference Manual
Licensed accessories are listed in the Datex-Ohmeda Supplies and Accessories Catalog.
Clinical application
This manual contains specific information about clinical and technical aspects of the
Cardiocap/5. In addition, Datex-Ohmeda produces application guides that contain
detailed information about clinical applications, such as patient spirometry, CO2
monitoring, ST segment analysis, impedance respiration, etc.
Configuration
This manual describes most configurable features of the Cardiocap/5. Due to the
possibility of different factory configurations, some menus, displays, and functions
described in this manual may not be available in the monitor you are using.
When your monitor was delivered, it was configured with the default settings and
ready to use. Instructions for changing settings to make your own permanent
configuration are located within the appropriate chapters in this manual.
Configuration passwords
Some features can be configured only from the Install/Service menu. A password is
required to access the Install/Service options. The default password is 16–4–34.
To enter the Install/Service menu:
1. Press the ComWheel and select Monitor Setup from the Main Menu.
2. Select Install/Service.
3. Turn the ComWheel until the first number (16) appears in the adjustment window,
then press the ComWheel to select the number. Select the other password numbers
(4, then 34) in the same way. When you finish, the Install/Service menu opens.
Most modifications are temporary unless you save them in the Save Modes menu, a
password-protected submenu of the Install/Service menu. The default password for
entering the Save Modes menu is 13–20–31.
1-1
Cardiocap/5 model and options for Anesthesia software

The Cardiocap/5 F-MXG model is used for Anesthesia software. The F-MXG is a
hemodynamic model with airway gas measurement that can be equipped with built-in
options.
• All measurement parameter options (and the Recorder option, N-XREC) are
factory-configured and cannot be added after purchase.
• Data collection and management options (N-XNET and N-XDNET) can be added
later.
Hemodynamic model with airway gas measurement (F-MXG)

The F-MXG model with Anesthesia software installed measures NIBP, ECG (3-lead and
5-lead), pulse oximetry (SpO2), temperature (T1), impedance respiration, and airway
gases. Gas measurement depends on which airway gas option is installed (N-XC, N-XCO,
or N-XCAiO):
N-XC Carbon Dioxide (CO2)
N-XCO CO2, N2O, and Patient Oxygen (O2)
N-XCAiO CO2, anesthetic agents, agent identification, N2O, and O2
The F-MXG can also be equipped with each of these built-in options:
N-XP Two invasive pressure channels and second temperature (T2)
N-XV Patient Spirometry (N-XCO or N-XCAiO option required)
N-XREC Recorder
In addition, the F-MXG can be equipped with one of the following built-in options:
N-XOSAT Datex-Ohmeda enhanced pulse oximetry (SpO2)
N-XNSAT Nellcor® compatible pulse oximetry (SpO2)
N-XNMT NeuroMuscular Transmission (NMT) for relaxation measurement and
plexus stimulation (N-XCAiO option required)
Data collection and management options

These options can be factory-built or added later as upgrades:
N-XNET Network
N-XDNET Data card and Network
1-2
Monitor Description
Parts of the monitor

1
2
12
11
10 6
9
7
8
Figure 1-1. Cardiocap/5 monitor (F-MXG)
(1) Power On/Standby key

(2) External power indicator / Battery charge status LED
(3) Alarm indicators
(4) Insertion slots for two memory cards
NOTE: A cover for the slots is available.
(5) Direct access keys
(6) Adjustable rear support
(7) ComWheel
(8) Recorder (N-XREC option)
NOTE: The two-button recorder (shown) is for Cardiocap/5 monitors using
software version 3.0 or higher. A one-button recorder was available previously.
(9) Patient connectors
(10) Spirometry connectors
(11) NIBP connector
(12) D-fend housing
1-3
Patient connectors panel

1 2 3 4
Spirometry NMT P2 T2
NIBP ECG SpO2 P1 T1
10 9 8 7 6 5
Figure 1-2. Patient connectors (F-MXG)
(1) Spirometry (N-XV option)

(2) NMT (N-XNMT option)
(3) Invasive pressure, P2 (N-XP option)
(4) Temperature, T2 (N-XP option)
(5) Temperature, T1
(6) Invasive pressure, P1 (N-XP option)
(7) SpO2 (connector differs depending on pulse oximetry configuration)
SpO2
Connector for Datex-Ohmeda standard pulse oximetry
SpO2
Connector for Datex-Ohmeda enhanced pulse oximetry
SpO2
Connector for Nellcor® compatible pulse oximetry
(8) ECG
(9) NIBP
(10) D-fend housing
1-4
Monitor Description
Rear panel
1
2
13
3
4
12
11 10 9 8 7 6 5
Figure 1-3. Cardiocap/5 rear panel (F-MXG)
(1) Built-in handle

(2) Gas outlet, X6
(3) Remote Control connector, X5
(4) Ethernet connector, X4
(5) Network connection LEDs
(6) Network identification plug connector, X3
(7) Serial communication interface/local printer connector, X2
(8) Analog/digital output connector, X1
(includes nurse call and defibrillator synchronization signals)
(9) Mounting attachment
(10) Dust filter
(11) Potential equalization
(12) Fuse and voltage information
(13) Receptacle for mains power cord
Rear panel connections

WARNING: Electrical shock hazard. Use only hospital-grade, grounded electrical outlets.
CAUTION: Turn off the power before making any rear panel connections.
• Place the monitor on a flat surface that can hold at least 10 kg (22 lb.).
• Use only the power cord provided to connect the monitor to the wall outlet.
1-5
Symbols
Attention! Read accompanying instructions, including all warnings and
cautions, before using this device.
This symbol has the following meanings when it appears on the screen:
• When displayed beside the O2 value, indicates that the FiO2 low-alarm
limit is set below 21%.
• When displayed next to the HR value, indicates that there is a risk
that the monitor counts pacemaker spikes (pacer is set ON R) or the
monitor counts T-waves (a wide QRS is selected).
Alarm silence indicator. When displayed at the upper left corner of the
screen, indicates that all alarms are silenced. When in a menu or digit
field, indicates that the alarm source has been turned off.
Main Menu. Located beside the ComWheel to indicate you can open the
Main Menu by pressing the ComWheel when no other menu is displayed.
Submenu. Appears in a menu to indicate the selection will open a new
menu. A submenu contains functions that are used less frequently.
The monitor is connected to the Datex-Ohmeda Network.
Data card (green) and/or the Menu card (white) is inserted.
Flashes next to the heart rate value or pulse rate value to indicate the
beats detected.
Appears next to the respiration rate value to indicate that the respiration
rate is calculated from the impedance respiration measurement.
Battery operation and remaining capacity.
Charge Battery charging.
Type BF applied part (IEC 60601-1). Defibrillator-proof protection against

electric shock.
Type CF applied part (IEC 60601-1). Defibrillator-proof protection against
electric shock.
Gas outlet (in airway gas models only).
Ethernet connectors.
Equipotentiality. Monitor can be connected to potential equalization

conductor.
Alternating current.
Fuse.
Power On/Standby.
1-6
Monitor Description
Delayed standby function

A delayed switch-off mechanism makes it possible to return to monitoring if the
monitor is accidentally switched to standby.
When the Power On/Standby key is pressed, a message box is displayed in the center of
the waveform display and the waveform fields are frozen. After eight seconds, the
monitor display is switched off and the monitor enters standby mode.
Pressing the Power On/Standby key during this 8-second delay will allow you to continue
monitoring. The message box will be removed and all data and configurations will be
retained.
Back-up battery
If mains power is lost during monitoring, the Cardiocap/5 can run on power from the
internal battery. The capacity of a fully charged internal battery is 15 minutes
minimum.
NOTE: The monitor can be started only when connected to mains power.
Battery time
A symbol on the display indicates the remaining operating time of the battery. It is
displayed only when the monitor is not connected to mains power.
The operating time that remains is updated every minute.

• When about five minutes of battery operating time is left, a “Batt low” alarm is
activated and the monitor makes one beep.
• When about one minute of operating time is left, a “Batt empty” alarm is activated.
The battery is charged automatically when the monitor is connected to mains power.
Battery charging time is normally five hours.
A charging symbol is displayed during charging:
Charge
The symbol is removed from the display when the battery is fully charged.
During battery charging, the standby LED is flashing in standby mode.
1-7
Safety precautions
This section lists the warnings and cautions you should know before using the monitor.
Warnings
A WARNING indicates a situation in which the user or the patient may be in danger of injury
or death.
Failure of operation
It is possible for any device to malfunction; therefore, always verify unusual data by
performing a formal patient assessment.
Explosion hazard
To avoid an explosion hazard, do not use the monitor in the presence of flammable
anesthetics. The monitor measures only non-flammable anesthetics.
Electrical shock hazard

When you connect equipment to the Cardiocap/5 input and output connectors, you are
configuring a medical system and are responsible for ensuring that the system complies
with IEC/EN 60601-1-1 and with local requirements.
Do not connect external equipment to the system, except equipment specified by
Datex-Ohmeda.
Make sure external equipment is hospital-grade and grounded before connecting.
Use only hospital-grade, grounded electrical outlets and power cords.
NMT
Always stop NMT measurement before handling stimulation electrodes.
Do not place the NMT stimulation electrodes on the patient’s chest.
Cleaning
Before cleaning, disconnect the monitor from the electrical outlet.
After cleaning, or if liquid has accidentally entered the interior of the monitor, make
sure that every part of the monitor is dry before reconnecting it to the power supply.
Patient safety
All invasive procedures involve risks to the patient. Use aseptic technique. Follow the
instructions provided by the catheter manufacturer.
The output signals are not floating and they must not be connected directly to a patient.
Connect only one patient to one monitor at a time.
Constant attention by a qualified professional is needed whenever a patient is under
anesthesia or connected to a ventilator. Some equipment malfunctions may pass
unnoticed in spite of the monitor alarm.
Do not use antistatic or electrically-conductive breathing tubes. They may increase the
risk of burns when an electrosurgery unit is used.
Do not use the Cardiocap/5 during magnetic resonance imaging (MRI).
1-8
Monitor Description
ECG, Impedance respiration, Invasive blood pressure

Ensure proper contact of the return electrode of the electrosurgery unit to your patient
to avoid possible burns at sensor sites.
ECG, Impedance respiration, NMT

Make sure that the lead set clips or snaps do not touch any electrically conductive
material, including earth.
Impedance respiration
In obstructive apnea, respiration movements and impedance variations may continue.
NIBP
The monitor sets the inflation pressure automatically according to the first
measurement. Reset the case to reset the inflation limit before measuring a new patient.
Invasive blood pressure

Make sure that no part of the patient connections touches any electrically conductive
material, including earth.
Patients with pacemakers or arrhythmia

The monitor may count pacemaker pulses as heart beats during cardiac arrest, some
arrhythmias, and with certain types of pacemakers particularly in ON R mode. Do not
rely entirely upon rate meter alarms. Keep patients with pacemakers and arrhythmias
under close surveillance.
The impedance respiration measurement may cause rate changes in Minute
Ventilation Rate Responsive Pacemakers. Set the pacemaker rate responsive mode to
off or turn off the impedance respiration measurement on the monitor.
Gases
MAC values are empirical, not absolute. Cardiocap/5 MAC values correspond to those
of healthy adults and cannot be applied to children. Age and other individual factors
influencing the effect of volatile agents are not taken into account.
Pulse oximetry
A damaged sensor or a sensor soaked in liquid may cause burns during electrosurgery.
Use clean and dry sensors and cables only. Moisture and debris on connectors may
affect measurement accuracy.
Patient conditions (such as reddening, blistering, skin discoloration, ischemic skin
necrosis, and skin erosion) may warrant changing the sensor site frequently or using a
different style of sensor. For details, refer to the instructions supplied with the sensor.
Conditions that may cause inaccurate readings and impact alarms include interfering
substances, excessive ambient light, electrical interference, ventricular septal defects
(VSD), excessive motion, low perfusion, low signal strength, incorrect sensor
placement, poor sensor fit, and/or movement of the sensor on the patient.
To prevent erroneous readings, do not use an inflated blood pressure cuff or arterial
blood pressure measurement device on the same limb as the oximeter sensor.
Temperature
To prevent patient injury, use Datex-Ohmeda temperature probes only.
1-9
Alarms
Make sure that necessary alarm limits are set and alarms are on when you start
monitoring a patient.
When alarms are suppressed, observe the patient frequently.
Cautions
A CAUTION indicates a situation that may cause damage to the unit or devices connected to it..
US Federal law restricts this device to sale by or on the order of a licensed medical
practitioner.
The system is intended for use by qualified medical personnel only.
Do not apply pressurized air to any outlet or tubing connected to the monitor. Pressure
may destroy sensitive elements.
Do not store the monitor outside the specified temperature range (-10 to + 50 °C /
14 to 122 °F).
Do not subject memory cards to excessive heat, bending, or magnetic fields.
Leave space for circulation of air to prevent the monitor from overheating.
Turn off the power before making any rear panel connections.
Use only cables and accessories approved by Datex-Ohmeda. Other cables and
accessories may damage the system or interfere with measurement. Single-use
accessories are not designed to be reused.
Vibrations during transport may disturb SpO2, ECG, impedance respiration, and NIBP
measurements.
Airway gas measurement

Strong scavenging suction may change the operating pressure of the monitor and cause
inaccurate readings or internal damage.

Mechanical shock to the invasive blood pressure transducer may cause severe shifts in
zero balance and calibration and may produce erroneous readings.
Cleaning
Do not disinfect or open the water trap cartridge. To avoid damage, do not touch or try
to clean the water trap hydrophobic membrane (other than to rinse it with water).
Do not sterilize any part of the monitor with steam autoclave or ethylene oxide.
Do not immerse any part of the device in liquids or allow liquid to enter the interior.
Do not use hypochlorite, acetone-based, phenol-based, or ammonia-based cleaners.
Disposal
Dispose of the whole device and its parts in accordance with local environmental and
waste disposal regulations.
1-10
Monitor Description
Specifications
All specifications are subject to change without notice.
General
Power supply
Rated voltages and frequencies: 100-240 V 60/50 Hz
Allowed voltage fluctuations: ± 10%
Maximum power consumption: 80 VA
Fuses (2): T2AH/250V
Back-up battery
Type: 12V 2.6AH lead acid
Back-up battery time: at least 15 minutes when fully charged
Charging time (typical): 5 hours
Charging indicator: Green LED On: full charge, battery on the holding voltage
Green LED flashing: charging
Environmental conditions
Operating temperature: +10 to +40°C (50 to 104°F)
Storage and transport temperature: –10 to +50°C (14 to 122°F)
Relative humidity: 0 to 85% noncondensing; in airway 0 to 100% condensing
Atmospheric pressure: 660 to 1060 hPa (500 to 800 mmHg)
ECG
Waveform display (with 50 Hz power supply frequency):
Monitoring filter 0.5 to 30 Hz
ST filter 0.05 to 30 Hz
Diagnostic filter 0.05 to 100 Hz
Waveform display (with 60 Hz power supply frequency):
Monitoring filter 0.5 to 40 Hz
ST filter 0.05 to 40 Hz
Diagnostic filter 0.05 to 100 Hz
ST segment analysis
Measured and displayed simultaneously for up to three ECG leads
ST level range: –6 to +6 mm (–0.6 to +0.6 mV)
Display resolution: 0.1 mm (0.01 mV)
Averaging: Calculated from 16 QRS complexes
Display update interval: 5 seconds
Heart rate
Measurement range: 30 to 250 bpm
Measurement accuracy: ± 5% or ± 5 bpm
Pacemaker pulse detection level: 2 to 500 mV
Pacemaker pulse duration: 0.5 to 2 ms
Respiration range: 4 to 120 resp/minute
Accuracy: ± 5% or ± 5 resp/minute
1-11
NIBP
Measurement range:
Adult 25 to 260 mmHg; Child 25 to 195 mmHg; Infant 15 to 145 mmHg
Pulse rate range accepted: 30 to 250 bpm
Typical measuring time: Adult 23 seconds; Infant 20 seconds

Measurement range: –40 to 320 mmHg
Measurement accuracy: ± 5% or ± 2 mmHg
Transducer sensitivity: 5 µV/V/mmHg, 5 VDC, max 20 mA
Pulse rate
Accuracy: ± 5% or ± 5 bpm
Temperature
Measurement range: 10 to 45°C (50 to 113°F)
Measurement accuracy:
25 to 45.0 °C ± 0.1 °C (77 to 113 °F ± 0.2 °F)
10 to 24.9 °C ± 0.2 °C (50 to 76.8 °F ± 0.4 °F)
Probe type: Datex-Ohmeda only
Pulse oximetry, standard

Display update time: 5 seconds
Averaging time: adjustable
Plethysmographic waveform scaling: adjustable
SpO2
Calibration range: 50 to 100%
Calibrated against functional saturation
Measurement range: 40 to 100%
Measurement accuracy (% SpO2 ± 1SD):
80 to 100% ± 2 digits;
50 to 80% ± 3 digits;
Below 50% unspecified
NOTE: SpO2 measurement accuracy is based on deep hypoxia studies using Datex-
Ohmeda FingerSat sensors on volunteers. Arterial blood samples were analyzed by a
Radiometer OSM CO-oximeter. Refer to the sensor instructions for specific accuracy
data.
Pulse rate
Measurement accuracy: ± 5% or ± 5 bpm
Default alarm limits

SpO2: high Off, low 90%
Pulse rate: high 160, low 40
NOTE: Limits are adjustable.
1-12
Monitor Description
Sensor emitter wavelength ranges

Red LED: 660 nm
Infrared LED: 900 nm
Pulse oximetry, Datex-Ohmeda enhanced (N-XOSAT option)

Averaging time: 12 seconds
Plethysmographic waveform scaling: automatic
SpO2
Calibration range: 70 to 100%
Measurement accuracy (± 1SD):
70 to 100% ± 2 digits
70 to 100% ± 3 digits during conditions of clinical patient motion
NOTE: SpO2 measurement accuracy is statistically derived and correlated to
simultaneous arterial blood gases measured on a Radiometer OSM3 CO-oximeter.
Refer to the sensor instructions for specific accuracy data.
Pulse rate
Measurement accuracy: ± 2% or ± 2 bpm (whichever is greater)


Red LED: 650 to 665 nm
Infrared LED: 930 to 950 nm
Average power: ≤ 1 mW
Pulse oximetry, Nellcor compatible (N-XNSAT option)

Averaging time: 5 to 7 seconds
Plethysmographic waveform scaling: automatic
SpO2
Measurement accuracy (% SpO2 ±1SD):
70 to 100% (± 2 digits to ± 3.5 digits, depending on the sensor)
See the Pulse Oximetry chapter for a list of approved sensors and accuracy details.
NOTE: SpO2 measurement accuracy is based on testing healthy adult volunteers in
induced hypoxia studies.
1-13
Pulse rate
Measurement accuracy: ± 3 digits


Red LED: 660 nm
Infrared LED: 920 nm
Airway gases
Sampling rate (typical value): 200 ml/minute
Sampling delay: 2.5 seconds typical with a 3 meter sampling line
Total system response time: 2.9 seconds typical with a 3 meter sampling line, including
sampling delay and rise time
Warm-up time: 2 to 5 minutes, 30 minutes for full spec.
Default alarm limits:
NOTE: Limits are adjustable within the measurement range. Alarm limits and
their adjustment range may vary depending on the mode used.
EtCO2 high 8%, low 3% FiEnf high 5.1%, low Off
FiCO2 high 3%, low Off EtEnf high 3.4%, low Off
EtO2 high Off, low 10% FiIso high 3.4%, low Off
FiO2 high Off, low 18% EtIso high 2.3%, low Off
FiN2O high 82% FiDes high 18%, low Off
FiHal high 2.2%, low Off EtDes high 12%,low Off
EtHal high 1.5%, low Off FiSev high 5.1%, low Off
EtSev high 3.4%, low Off
Non-disturbing gases:
Ethanol C2H5OH (< 0.3%) Acetone (< 0.1%)
Methane CH4 (< 0.2%) Nitrogen N2
Carbon monoxide CO Nitric oxide NO (< 200 ppm)
Water vapor
Maximum effect on readings
CO2: < 0.2 vol%
O2, N2O: < 2 vol%
Anesthetic agents: < 0.15 vol%
Effect of helium: Decreases CO2 readings < 0.6 vol% typically
Respiration rate (RR)

Measurement range: 4 to 60 breaths/minute
Detection criteria: 1% variation in CO2
Agent identification
Identification threshold (typical value): 0.15 vol%
1-14
Monitor Description
Carbon Dioxide (CO2), Oxygen (O2), and Nitrous Oxide (N2O)

Measurement Carbon Dioxide (CO2) Oxygen (O2) Nitrous Oxide (N2O)
Range 0 to 15%, (0 to 15 kPa) 0 to 100% 0 to 100%
(0 to 113 mmHg)
Accuracy (typical) ≤ 0.3 vol% ≤ 2 vol% ≤ 3 vol%
Rise time < 400 ms typical < 400 ms typical < 450 ms typical
Gas cross effects < 0.2 vol% (O2, N2O, < 1 vol% < 2 vol%
and anesthetic agents) (anesthetic agents); (anesthetic agents)
< 2 vol% (N2O)
Anesthetic Agent (AA)

Measurement Halothane, Isoflurane, Enflurane Sevoflurane Desflurane
Range 0 to 6% 0 to 8% 0 to 20%
Accuracy (typical) ≤ 0.2 vol% ≤ 0.2 vol% 0 to 5% ≤ 0.2 vol%
5 to 10% ≤ 0.5 vol%
10 to 20% ≤ 1.0 vol%
Rise time < 400 ms typical
Gas cross effects < 0.15 vol% N2O
Patient Spirometry
Detection through D-lite™ or Pedi-lite™ flow sensor and gas sampler:
Measurement D-lite flow sensor Pedi-lite flow sensor

Tidal volume
Measurement range 150 to 2000 ml 15 to 300 ml
Accuracy (typical value) ± 6% or 30 ml ± 6% or 4 ml
Minute volume
Measurement range 2 to 20 l/minute 0.5 to 5 l/minute
Accuracy (typical value) ± 6% ± 6%
Airway pressure
Measurement range –20 to +100 cmH2O –20 to +100 cmH2O
Accuracy (typical value) ± 1 cmH2O not applicable
Flow
Measurement range 1.5 to 100 l/minute 0.25 to 25 l/minute
Compliance
Measurement range 4 to 100 ml/cmH2O 4 to 100 ml/cmH2O
Airway Resistance
Measurement range 0 to 40 cm H2O/l/second 0 to 40 cm H2O/l/second
Sensor specifications
Dead space 9.5 ml 2.5 ml
Resistance at 30 l/minute 0.5 cmH2O not applicable
Resistance at 10 l/minute not applicable 1.0 cmH2O
1-15
NMT
Stimulation modes:
Train of four (TOF)
Double burst (3.3) (DBS)
Single twitch (ST)
50 Hz tetanic + post-tetanic count (PTC)
Measurement intervals:
TOF and DBS: Manual; 10 seconds, 12 seconds, 15 seconds, 20 seconds, 1 minute,
5 minutes, 15 minutes
ST: Manual; 1 second, 10 seconds, 20 seconds
Stimulator
Stimulus pulse: Square wave, constant current
Pulse width: 100, 200 or 300 µs
Stimulus current range (supramax and manual): 10 to 70 mA with 5 mA steps
Stimulus current accuracy: 10% or ± 3mA (whichever is greater)
Max load: 3 kΩ
Max voltage: 300 V
Regional block mode

Stimulation mode: Single twitch (ST)
Intervals: 1 second, 2 seconds, 3 seconds
Stimulus pulse: Square wave, constant current
Pulse width: 40 µs
Stimulus current range: 0 to 5.0 mA with 0.1 mA steps
Stimulus current accuracy: 20% or 0.3 mA (whichever is greater)
Recorder
Principle: thermal array
Print resolution:
Vertical: 8 dots/mm (200 dots/inch)
Horizontal: 32 dots/mm (800 dots/inch) at speed of 25 mm/second and slower
Paper width: 50 mm; printing width 48 mm
Traces: selectable; 1, 2, or 3 traces
Print speed: 1, 6.25, 12.5, 25 mm/second
1-16
Contents
Chapter 2. Monitoring Basics

Introduction ....................................................................... 2-1
Keys and controls ................................................................ 2-1
Key functions................................................................................................................................................2-2
Remote control ................................................................... 2-3

Remote control keys.................................................................................................................................2-3
Using menus....................................................................... 2-4

Opening the Main Menu .......................................................................................................................2-4
Using the direct access keys................................................................................................................2-5
Choosing menu options .........................................................................................................................2-5
Returning to the normal display.......................................................................................................2-5
Monitoring a patient............................................................. 2-6

Preparations ..................................................................................................................................................2-6
Starting monitoring...................................................................................................................................2-6
During monitoring.....................................................................................................................................2-7
Ending monitoring ....................................................................................................................................2-7
Main Menu map .................................................................. 2-8

Direct access key maps ....................................................... 2-11
Abbreviations ................................................................... 2-12
Table of Figures
Figure 2-1. Cardiocap/5 keys and controls ...............................................................................................2-1
Figure 2-2. Remote Control ................................................................................................................................2-3
Figure 2-3. Parts of a menu.................................................................................................................................2-4
Figure 2-4. Main Menu..........................................................................................................................................2-4
Monitoring Basics
2. MONITORING BASICS
Introduction
You can control Cardiocap/5 monitoring with the ComWheel, the direct access keys, or
the optional Remote Control.
• The ComWheel provides access to all monitor functions.
• The direct access keys provide direct access to frequently-used functions that are
also available through the Main Menu.
• The Remote Control Menu key lets you enter all monitoring functions. Each
Remote Control direct access key lets you enter a common function.
See Main Menu map and Direct access key maps later in this chapter for the menus you
can access from the Main Menu and by pressing the direct access keys.
Keys and controls

1
2
Silence
Alarms
3
Trends
4
Invasive
Pressures
5
ECG
NIBP 6
NIBP
Start/Cancel 7
Normal
Screen
8
Figure 2-1. Cardiocap/5 keys and controls
(1) Power On/Standby key (5) ECG direct access key

(2) Silence Alarms key (6) NIBP direct access key
(3) Trends direct access key (7) NIBP Start/Cancel key
(4) Pulse Oximetry, Invasive (8) Normal Screen key
Pressures, or NMT direct access
(9) ComWheel
key (depending on configuration)
2-1
Key functions
Power On/Standby key.
NOTE: The monitor will start only when connected to mains power.
Silence Silences an active alarm or pre-silences all alarms for two minutes
Alarms
(press the key once) or five minutes (press the key for three seconds).
Pressing the key once again clears the alarm message field of all alarm
messages and enables new alarms. A lighted yellow LED indicates a
yellow alarm; a lighted red LED indicates a red alarm.
Trends
Displays trends (numerical and graphical) and snapshots. Press the
Normal Screen key to return to monitoring mode.
The next oval-shaped key can be Pulse Oximetry, Invasive Pressures, or NMT, depending on
which built-in options your monitor contains.
Pulse Displays the menu for adjusting Oxygen saturation measurement

Oximetry
settings (all models with no Invasive Pressure or NMT option)
Invasive Displays the menu for adjusting Invasive Pressure measurement

Pressures
settings (all models with the Invasive Pressure option and no NMT
option)
Displays the menu for adjusting NMT measurement settings

NMT
(all models with the NMT option).
Displays the menu for adjusting ECG measurement settings.

ECG
Displays the menu for adjusting NIBP measurement settings.

NIBP
NIBP Starts or cancels a single non-invasive blood pressure measurement,

Start/Cancel
STAT, and manual measurements; stops venous stasis.
Returns to the normal monitoring display.

Normal
Screen
The ComWheel is the main tool for all menu functions. You turn and/or
press it to access, navigate, and choose all menu options.
Pushing the ComWheel while no menu is displayed opens the Main

Menu from which you have access to all monitor functions.
Recorder keys
See the Recording and Printing chapter for descriptions of the keys on the optional
recorder.
2-2
Monitoring Basics
Remote control
The optional Remote Control (K-CREMCO) contains keys that help you in most
common situations and tasks. You can use these direct access keys to start or end a
function.
Silence
Alarms Record
Take
Snapshot Wave
Zero ALL
Pressures Other
Special Patients
Start
Start Wedge Start
C.O. NIBP
Freeze Normal
Menu Screen
Figure 2-2. Remote Control
Remote control keys

Key Function
Take Creates a freeze frame, which is saved to the monitor memory.
Snapshot Pressing the key also marks a number beside the numerical trend.
Menu Opens the Main Menu from which you can access all menus and
functions of the monitor.
Silence Silences an active alarm or pre-silences all alarms for two or five
Alarms minutes.
Zero ALL Zeroes all invasive pressure channels.
Pressures
Freeze Freezes the waveform sweep for 60 seconds. To unfreeze the

waveforms, press the Freeze key again (or press the Normal Screen key).
Record Records the selected real-time waveforms.
Wave
Other If the monitor is connected to the network, it is possible to view alarms
Patients and general views for another site.
Start Starts a single NIBP measurement and cancels any measurement.
NIBP
Normal Closes open menus and returns to normal monitoring display.
Screen
Start Displays the customized wedge view and starts wedge measurement.
Wedge
Special Not in use with Cardiocap/5.
Start Not in use with Cardiocap/5.
C.O.
2-3
Using menus
A menu is a list of functions or commands displayed on the screen.
1 2 3 14 33
ECG
aVR
NIBP Pacer 1 mV H Arrh.
Start Cycling
Cycle Time 3 min 1
hidden R
58 /min OFF
mm
Start STAT 2.5 1 mV S aVR 1.0
I
Start Manual 3 T I -1.5
-1.5
II 0.5
4 Start Ven. Stasis 5
Pleth
NIBP Setup 10 S %
P
NIBP Alarm
Parameters Menu
15
30
0
2 97
60 02 21 %
5 O ET
16 FI 21
2
16
FI-ET 5.0
Change interval between
6 automatic cuff inflations.
C02 5 C
%
O ET
2
5.0 FI 0.0
RR 15 /min
0
NIBP T1 Paw TV Gases O2:
mmHg Sys Dia C cmH2O Adult O2% N2O% Des%
Mean
128/81
(93) Manual
T1
38.8 Ppeak
PEEP
25
7
TVexp ml
790
ET
FI
16 77 2.3
21 77 3.0
Figure 2-3. Parts of a menu
(1) Header of the menu (4) List of menu selections

(2) Indicates the present selection (5) Entry indicator to submenus
(3) Adjustment window with other options (6) Short instructions
Opening the Main Menu

If you press the ComWheel when no menu is displayed, you will open the Main Menu.
The Main Menu provides access to all other
Main Menu menus. To display a different menu, such as the
Parameters Parameters menu, select it from the Main Menu.
Alarms Setup You can enter the Main Menu from other menus
Record/Print by using the ComWheel to select the previous
menu until you reach the Main Menu.
Patient Data
Reset Case To exit the Main Menu, select Normal Screen or
Monitor Setup press the Normal Screen key.
Trends
Normal Screen
Show parameter menus to

set parameter settings.
Figure 2-4. Main Menu
2-4
Monitoring Basics
Using the direct access keys

The direct access keys allow you to bypass the Main Menu and go directly to the menu
activated by the direct access key. For example:
To quickly enter the ECG menu, press

ECG ECG the ECG direct access key.
ECG1 Lead II
The menu related to the key you
ECG2 Lead I pressed is displayed.
ECG3 Lead I
ECG Size 1.0
ST Analysis
Beat Sound Volume 3
ECG Setup
ECG Alarms
Parameters Menu
Set HR source, filter, grid,

pacemaker settings and
QRS type.
Choosing menu options

Once a menu is displayed, you use the ComWheel to make selections and adjustments.
For example, to make adjustments in the ECG menu:
ECG Turn the ComWheel to move to and

ECG1 Lead II highlight the menu item.
ECG2 Lead I 10
ECG3 Lead I Then, press the ComWheel to enter

ECG Size 1.0 the adjustment window or a
ST Analysis submenu.
Beat Sound Volume 3
ECG Setup Turn the ComWheel to choose the
ECG Alarms adjustment.
Parameters Menu 0
Press the ComWheel to confirm the

Adjust volume of pulse/heart change.
beat sound.
Returning to the normal display

Press the Normal Screen key to exit a menu and return to the normal monitoring display.
2-5
Monitoring a patient
Use only supplies and accessories approved by Datex-Ohmeda for use with the
Cardiocap/5. See the Datex-Ohmeda Supplies and Accessories Catalog.
Preparations
1. Check that the monitor and patient accessories are clean and intact.
2. Press the Power On/Standby key to turn on the monitor.
NOTE: The monitor will start only when connected to mains power.
3. Tilt the monitor to the optimal viewing angle:
• Press the center of the foot and adjust.
• Make sure both feet are at the same angle.
NOTE: If wall mounting is used, make sure the monitor’s front and back
attachment bars fit tightly to the edges of the mounting plate and the locking bolt in
the back of the monitor locks into place.
4. If necessary, change the operating mode:
• Press the ComWheel and select Monitor Setup from the Main Menu.
• Select Select Mode.
The operating mode defines what is displayed on the screen and in the trends.
Note that changing the mode also changes, for example, the alarm limits.
Starting monitoring
1. Prepare the patient connections. Refer to the applicable measurement parameter
chapter(s) later in this manual.
2. Alarms are operative and the parameter default settings are active when the patient
is connected to the monitor. To review alarm limits, press the ComWheel and
select Alarms Setup from the Main Menu.
You can also select Alarms Setup through the corresponding parameter menu.
3. Check that you have the desired waveforms and digits in the fields.
To adjust them:
• Press the ComWheel and select Monitor Setup from the Main Menu.
• Select Screen Setup.
• Select Waveform Fields or Digit Fields.
2-6
Monitoring Basics
4. Carry out measurement-specific start-up. For example, start NIBP measurement to

get the reference values.
5. Enter patient data (press the ComWheel and select Patient Data from the Main
Menu).
During monitoring
If you need to suppress alarms, press the Silence Alarms key.
• To silence the alarms for two minutes, press the key once.
• To silence the alarms for five minutes, press the key for more than three seconds.
If you accidentally press the Power On/Standby key during monitoring, the “Switching to
standby mode in X seconds” message is displayed. If the Power On/Standby key is not
pressed again within eight seconds, the monitor will switch to standby mode.
To return to monitoring, press the Power On/Standby key again within eight seconds.
Ending monitoring
1. Press the ComWheel to open the Main Menu.
Main Menu
Parameters
Alarms Setup
Record/Print
Patient Data
Reset Case
Monitor Setup
Trends
Normal Screen
Show parameter menus to

set parameter settings.
2. To print necessary information, select Record/Print. Wait until printing is finished.

3. To clear patient data and return settings to their defaults:
• Select Reset Case in the Main Menu.
• Select Reset ALL and YES.
4. Turn the power switch to standby if the monitor will not be used.
5. Clean the monitor according to the instructions.
2-7
Main Menu map
Parameters Airway Gas Spirometry Loops Scaling
CO2 Setup CO2 Alarm Adjust Limits
Resp Rate Alarm Adjust Limits
O2 Setup O2 Alarm Adjust Limits
Agent/N2O Setup Agent Alarm Adjust Limits
Spirometry Setup Scaling
Gas Calibration Paw Alarms Adjust Limits
ECG ST Analysis MVexp Alarm Adjust Limits
ECG Setup
ECG Alarms Adjust Limits
NIBP NIBP Setup ST Alarms
NIBP Alarm Adjust Limits
Invasive Press. Wedge Pressure
P1 ‘Art’ setup P1 ‘Art’ Alarm Adjust Limits
P2 ‘CVP’ Setup P2 ‘CVP’ Alarm Adjust Limits
Pulse Oximetry SpO2 Alarm Adjust Limits
Resp Setup Resp Rate Alarm Adjust Limits
Temp Setup Temp Alarms Adjust Limits
NMT Regional Block *
NMT Setup
* Menu is displayed when the NMT Regional Block Adapter is connected to monitor.
2-8
Monitoring Basics
Alarms Setup Adjust Limits
Alarm Volume
Audio ON/OFF
Record/Print Record Waveforms
Record Trends
Print Graphical
Patient Data Demographics
Patient from Net.
Patient from Card
Other Patients Receive Alarms
Show Vital Signs
Reset Case
2-9
Monitor Setup Screen Setup Waveform Fields
Digit Fields
O2 Setup
Sweep Speeds
Select Mode
Time and Date
Install/Service Trends & Snapshot Graphical Trends
Snapshot
Colors ECG, SpO2, NIBP
Invasive Press. More Labels
Gases
More Parameters
Save Modes Load Modes
Installation Units Parameters
Alarms Options
Printer
Analog Outputs
Monitor Settings
Service
Trends Trend Scales
2-10
Monitoring Basics
Direct access key maps

Trends Trend Scales
Pulse SpO2 Alarm Adjust Limits

Oximetry
or
Invasive Wedge Pressure

Pressures
P1 ‘Art’ Setup P1’Art’ Alarm Adjust Limits
or
P2 “CVP’ Setup P2 ‘CVP’ Alarm Adjust Limits
NMT Regional Block *
NMT Setup
ECG ST Analysis
ECG Setup
ECG Alarms Adjust Limits
ST Alarms
NIBP NIBP Setup
NIBP Alarm Adjust Limits
* Menu is displayed when the NMT Regional Block Adapter is connected to monitor.
2-11
Abbreviations
The abbreviations that appear on the monitor screen and/or in this manual are listed
below.
AA anesthetic agent
ABP arterial blood pressure
AirW airway temperature
APN apnea
Art arterial
Asy asystole
ATMP atmospheric pressure
ATPD ambient temperature and pressure, dry gas
AVF augmented voltage foot—usually left (ECG)
AVL augmented voltage left (ECG)
AVR augmented voltage right (ECG)
Axil axillary temperature
B-To-B beat to beat

Blad bladder temperature
BP blood pressure
BSA body surface area
BTPS body temperature and pressure, saturated gas
°C degrees Celsius
Casc. cascaded (ECG)
CO2 carbon dioxide
Compl compliance
Cont. continuous recording
Contrl controlled ventilation
Core central temperature
CVP central venous pressure
DBS double burst stimulation (NMT)

Des desflurane
Dia diastolic pressure
Diagn diagnostic (ECG filter)
DIFF difference
Dyn dynamic
E expiratory
ECG electrocardiography
ECG1 first ECG waveform (top)
ECG1/r real time ECG
ECG2 second ECG waveform
ECG3 third ECG waveform
EMG electromyography (NMT)
Enf enflurane
Eso esophageal temperature
ET, Et end tidal concentration
2-12
Monitoring Basics
Exp expired
°F degrees Fahrenheit
FI, Fi fraction of inspired gas
FiO2 fraction of inspired oxygen
Flow airway gas flow
FVloop flow volume loop
Graph. graphical
Hemo hemodynamic
Hal halothane
Hgb hemoglobin
HR heart rate
I inspiratory
ICP intra cranial pressure
ID identification
Imped. impedance
indep. independent
Inv. invasive
Iso isoflurane
LAP left atrial pressure

LED light emitting diode
MAC minimum alveolar concentration

Mean mean of diastolic and systolic pressures
Monit monitoring (ECG filter)
MV minute volume
MYO myocardial temperature
N2O nitrous oxide

Naso nasopharyngeal temperature
Net network
NIBP non-invasive blood pressure
NMT neuromuscular transmission
NTPD normal temperature and pressure, dry gas
Num. numerical trends
O2 oxygen
Oxy oxygen
P1, P2 invasive pressure channels

PA pulmonary arterial pressure
PaCO2 arterial carbon dioxide level
Pedi pediatric
Paw airway pressure
PCWP pulmonary capillary wedge pressure
PEEPtot positive end expiratory pressure
Pleth plethysmograph waveform
2-13
Ppeak airway peak pressure

Pplat airway plateau (pause) pressure
PR pulse rate
Prev. previous
PTC post tetanic count (NMT)
PVloop pressure volume loop
PVC premature ventricular contraction
RAP right atrial pressure

Raw airway resistance
Rect rectal temperature
Resp respiration rate
Room room temperature
RR respiration rate
RVP right ventricular pressure
S/D systolic/diastolic
SaO2 arterial oxygen saturation
Sev sevoflurane
Skin skin temperature
Snaps. snapshot
Spiro spirometry
SpO2 oxygen saturation measured by pulse oximeter
Spont spontaneous breathing
ST single twitch stimulation (NMT)
ST ST segment of ECG
ST inf. ST segment on inferior leads (II, III, aVF)
ST lat. ST segment on lateral leads (I, aVL, V5)
STAT continuous NIBP cuff inflation for 5 minute
Stfilt ST filter (ECG)
STPD standard temperature and pressure, dry gas
Surf skin temperature
Sw software
Sys systolic pressure
T1, T2 temperature
T1% first stimulus as a percentage of the reference value (NMT)
Tab. tabular trends
Temp temperature
TOF train of four stimulation(NMT)
TOF% ratio of the fourth response to the first response (NMT)
TV tidal volume
Tymp tympanic temperature
V precordial (chest) lead (ECG)

Vol volume
2-14
Contents
Chapter 3. Monitor Setup

Overview ............................................................................ 3-1
Selecting a user mode........................................................... 3-1
Changing and saving configuration settings ............................... 3-2
Parts of the display .............................................................. 3-2
Display setup.................................................................................................................................................3-3
Changing setup temporarily................................................................................................................3-3
Modifying waveform fields...................................................... 3-4

Changing sweep speeds .........................................................................................................................3-5
Modifying digit fields ............................................................ 3-5

Splitting the screen display .................................................... 3-6
Minitrend view............................................................................................................................................3-7
Setting time and date ........................................................... 3-7

Display brightness ............................................................... 3-8
Displaying pulse rate ............................................................ 3-8
Other adjustable features ...................................................... 3-9
Changing parameter colors..................................................................................................................3-9
Changing units of measurement.................................................................................................... 3-10
Table of Figures
Figure 3-1. Parts of the display.........................................................................................................................3-2
Figure 3-2. Display fields .....................................................................................................................................3-3
Figure 3-3. Waveform field.................................................................................................................................3-4
Figure 3-4. Digit fields............................................................................................................................................3-5
Figure 3-5. Split screen view..............................................................................................................................3-6
Monitor Setup
3. MONITOR SETUP
Overview
The Cardiocap/5 has setup options for display, parameters, alarms, etc. You can change
the settings to suit your specific needs. General monitor settings can be changed in the
Monitor Setup menu. Other settings are changed in setup menus for each parameter.
Modifications remain in effect until the case is ended, a user mode is changed, or for
15 minutes after the monitor is turned off. Replacing the CPU Board also returns
settings to their defaults.
NOTE: You can load or reload the settings using the Datex-Ohmeda Network.
Selecting a user mode

User modes are predefined groups of settings that include general monitor settings and
some measurement-specific settings. A user mode defines, for example, what is
displayed on the screen and in trends. The preconfigured, factory-default user modes
are General, Regional, and Pediatric.
GENERAL Mode for basic general anesthesia and for low- and medium-risk adult
patients.
REGIONAL Mode for all types of regional anesthesia and anesthesia care.
PEDIATRIC Mode for basic general anesthesia and for low- and medium-risk
pediatric patients.
The monitor always starts in startup mode. Startup mode is one of your user modes,
chosen during configuration. You can change mode settings during monitoring.
To change the startup mode to another mode:
Monitor Setup 1. Press the ComWheel and select Monitor Setup

from the Main Menu.
Select Mode 2. Select Select Mode.
1. GENERAL 3 Apr 2001 3. Select GENERAL, REGIONAL, or PEDIATRIC.
2. REGIONAL 3 Apr 2001
3. PEDIATRIC 3 Apr 2001
4. 3 Apr 2001
Previous Menu
The mode you select is marked with an arrow.
Activate mode.
All preconfigured stettings
are loaded into monitor.
Changes made separately are maintained when returning to the previous mode.
3-1
Changing and saving configuration settings

Permanent changes to the configuration are made in the Install/Service menu, a
submenu of the Monitor Setup menu. You need a password to enter this menu and
change the configuration. Almost all modifications are only temporary unless you save
them in the Save Modes menu, which is a submenu of the Install/Service menu. A
password is also required to enter this menu and save changes.
See Configuration at the beginning of chapter 1 for the default passwords needed to
enter the Install/Service menu and the Save Modes menu.
If you wish to make permanent changes, we recommend that you contact the person
responsible for the entire configuration. When settings are changed and saved, they
should be recorded.
Parts of the display

1 2 3
GENERAL 14 00
1:44 +
aVR ECG
Pacer 1 mV
H
hidden
R
58 /min
02 21
%
O ET
2 16 FI 21
4
FI-ET 5.0
16
Art200
mmHg
A
100 r
t 130/82
(93)
0
Pleth
S%
p
O
2 97
T1 NIBP CO2 Gases O2:
C mmHg Sys Dia O2% N2O% Des
5
T1
38.8 128/81 ET 5.0 RR ET 16 77 2.3
Mean (93) Manual FI 0.0 15/min FI 21 77 3.0
Figure 3-1. Parts of the display
(1) Alarm silence indicator

(2) Alarm message field (for five messages)
(3) Actual time
(4) Waveform fields with corresponding numeric information on the right
(5) Digit fields
Waveform fields and digit fields are configurable.
3-2
Monitor Setup
Display setup
At startup, the display is arranged according to the startup mode definitions. Unused
parameters are not displayed and no space is reserved for them.
Alarms message field
Space for menus Waveform

and Real-time digits
split screen view
waveforms
or trends
Digit Field 1 Digit Field 2 Digit Field 3 Digit Field 4
Figure 3-2. Display fields
Changing setup temporarily

You can choose which waveforms and numeric information are displayed, and how
they are arranged on the screen.
To change the setup:
Monitor Setup 1. Press the ComWheel and select Monitor

Setup from the Main Menu.
Screen Setup 2. Select Screen Setup.
Waveform Fields 3. Select Waveform Fields, Digit Fields, Split
Digit Fields Screen, or Minitrend Length.
Split Screen None

Minitrend Length 30 min
Previous Menu
Set waveforms and

related digits displayed
on Normal Screen.
NOTE: Choosing to display the same parameter in the waveform field and the digit
field makes the previously chosen field disappear so that the same information is not
displayed in two fields at the same time.
3-3
Modifying waveform fields

You can choose which parameters are displayed on the waveform fields, and in which
order they are arranged.
aVR
ECG
1 mV H
R
58
/min
Figure 3-3. Waveform field
Up to six waveforms can be displayed at a time. When fewer than six waveforms are
displayed, the remaining waveforms are enlarged to fill the entire waveform area.
Changing the waveform also changes the numerical field on the right of the waveform.
It may also change the digit fields. If you choose the same measurement in the
waveform field that is currently in the digit field, the digit field will disappear so that
the same information will not be displayed in two fields at the same time.
To set the parameters for the waveform fields:
Screen Setup 1. Press the ComWheel and select Monitor

Waveform Fields 2. Select Screen Setup.
Field 1 ECG1
3. Select Waveform Fields.
Field 2 ECG2 OFF
4. Choose the parameter to be displayed in
Field 3 P1 ECG1 each field.
Field 4 P2 P1
Field 5 Pleth P2
Field 6 CO2 Pleth
CO2
Combine Pressures NO O2
Previous Menu AA
–More–
Change waveform in field 1.
Select OFF to clear field.
The invasive pressure waveforms are displayed only when the transducer is connected
to the monitor.
Selecting Combine Pressures in the Waveform Fields menu displays invasive pressures in
the same waveform field with individual scales.
When you use a 5-lead set in the ECG measurement, up to three different ECG leads
can be displayed simultaneously in different fields.
3-4
Monitor Setup
Changing sweep speeds

You can change the waveform sweep speed. Alternatives are Fast (6.25 mm/second)
and Slow (0.62 mm/second). Slow waveforms have a sweep speed one tenth of normal.
Slow waveforms show changes better than fast waveforms.
To change the sweep speeds:
2. Select Sweep Speeds.
3. Select the parameter and choose the the sweep speed.
Modifying digit fields

Measured patient data may be displayed in up to four digit fields, which are located on
the lower part of the screen. You may change the contents or turn each field OFF. If a
digit field is turned OFF, the digit field to its left is usually enlarged to fill the space.
T1 NIBP CO2 Gases O2:

ºC mmHg Sys Dia % O2% N2O% Des
T1
38.8 128/81
Mean (93) Manual
ET
FI
5.0
0.0
RR
15/min
ET
FI
16
21
77 2.3
77 3.0
Figure 3-4. Digit fields
The digit fields are numbered from left to right in the Digit Fields menu (Lower Field 1
is the left-most field; Lower Field 4 is the right-most field).
Changing the digit field may also change the waveform field setup. If you choose the
same measurement in the digit field that is currently in the waveform field, the
measurement waveform field will disappear so that the same information will not be
displayed in two fields at the same time.
To modify digit fields:
Screen Setup 1. Press the ComWheel and select Monitor

Digit Fields 2. Select Screen Setup.
Lower Field 1 SpO2
3. Select Digit Fields
Lower Field 2 NIBP OFF
Lower Field 3 HR HR 4. Choose the parameter to be displayed in
each digit field.
Lower Field 4 P2 ST
Previous Menu P1
P2
PCWP
NIBP
SpO2
–More–
Change contents of lower digit
field 1. Select OFF to clear
field.
3-5
Splitting the screen display

You can split a display so that one part always displays spirometry or trend data.
GENERAL 12:06
+
ECG
aVR
1200 Vol Pacer 1 mV H
ml
hidden
I
R
mm
58 /min
0
Paw
cmH20
40
1 mV S aVR
T I
1.0
OFF
aVR
) II OFF 1.0
Art 200 mmHg
A
100
0
r
t 130/82
(93)
Adult cmH20 TVinsp ml CVP 20
C
mmHg Contrl
Ppeak 25 800 10
0
V
P (12)
14/9
Pplat 21 TVexp ml Pleth
S %
P
PEEPtot
Compl
6 790
55 ml/cmH20
0
2
%
97
CO2 5 C
O ET
2
5.0 FI 0.0
0 RR 15 /min
T1 NIBP O2
C mmHg Sys Dia Mean %
T1
38.8 128/81 (93) Manual
ET
FI
16
21
FI-ET
5.0
Figure 3-5. Split screen view
To select a split screen view:

Screen Setup 2. Select Screen Setup.
Waveform Fields 3. Select Split Screen and choose the option
Digit Fields None you wish.
Split Screen Trend Spiro1 • Spiro 1: Basic spirometry view

information.
Minitrend Length 30 min Spiro2
• Spiro2: Basic spirometry view with
Previous Menu Trend additional values.
• Trend: Minitrend of the parameters
selected to the waveform field.
Minitrends of waveforms are

permanently displayed with
waveforms.
3-6
Monitor Setup
Minitrend view
You can choose to view the Minitrend data from the last five minutes or the last
30-minute period next to the waveform field for the parameter. 5-minute minitrend is
updated every 10 seconds, 30-minute minitrend is updated once every minute.
To modify the trend split screen view:
2. Select Screen Setup.
3. Select Minitrend Length and choose 5 min or 30 min.
Setting time and date

The time is shown in the upper right corner of the screen. The clock format is 24 hours.
Turning the monitor off does not affect the clock.
If the monitor is connected to the Datex-Ohmeda S/5 Network and Central, the Time
and Date menu is not available. The monitor follows the time and date settings for the
center.
NOTE: To prevent the loss of trend data, you cannot change the time settings after
starting a new case.
To set the time and date:
Monitor Setup 1. Press the ComWheel and select Monitor Setup

from the Main Menu.
Time and Date 2. Select Time and Date.
Hour 14 3. Select the option you want to adjust.
Minutes 4 • Hour, minutes, and seconds.
Zero Seconds 16
• Day, month, and year.
Day 3
Month Apr
Year 2001
Previous Menu
Set hour.
3-7
Display brightness
To adjust display brightness according to environmental conditions:
1. Press the ComWheel and select Monitor
2. Select Display Brightness.
3. Choose the desired adjustment
(30% to 100%).
Displaying pulse rate

Combined Heart Rate and Pulse Rate can be displayed next to the ECG waveform. The
current HR source is displayed with bigger font and the QRS symbol flashes next to it.
To display a combined Heart Rate and Pulse Rate:

1. Press the ECG key.
2. Select ECG Setup.
3. Select Display with HR.
3-8
Monitor Setup
Other adjustable features

This section describes other adjustable features associated with setting up the monitor.
A password is required for entering the Install/Service menu where the adjustments
are made. If you wish to make changes, we recommend that you contact the person
responsible for the entire configuration.
Changing parameter colors

You can select the color of each parameter to be yellow, white, green, red or blue.
To change the color:
2. Select Install/Service and enter the password.
3. Select Colors.
4. Select the desired parameter and the color you wish for it in the opened
adjustment window.
3-9
Changing units of measurement

You can choose the units for height, weight, and for individual parameters.
To change the units:
3. Select Installation.
4. Select Units and choose the units for Height and Weight.
5. To review and/or change the units for a specific parameter, select Parameters.
Install/Service Installation
Installation Units
Units Height cm
Alarms Options Weight kg
Printer Parameters
Analog Outputs Previous Menu
Monitor Settings
Previous Menu
Set unit of height, weight, Set units of parameters.

and parameters.
3-10
Contents
Chapter 4. Alarms
Overview ............................................................................ 4-1
Alarm categories ................................................................. 4-1
ISO pattern alarms ....................................................................................................................................4-2
ISO2 pattern alarms .................................................................................................................................4-2
General pattern alarms...........................................................................................................................4-2
Alarm activation .................................................................. 4-3

Displaying alarms ................................................................ 4-3
Alarms Setup menu options ................................................................................................................4-4
Adjusting alarm limits ........................................................... 4-5

Changing limits ...........................................................................................................................................4-5
Cancelling changes...................................................................................................................................4-5
Returning to default limits....................................................................................................................4-5
Choosing automatic limits....................................................................................................................4-6
Calculation formulas for automatic limits....................................................................4-6
Changing alarm sources ........................................................ 4-7

Suppressing alarms.............................................................. 4-8
Suppressing audible alarms permanently ..................................................................................4-8
Reactivating alarms ....................................................................................................................4-8
Suppressing audible alarms for two or five minutes............................................................4-9
Reactivating alarms ....................................................................................................................4-9
Suppressing alarms for individual parameters........................................................................4-9
Transferring alarms ............................................................ 4-10

Recording alarms automatically ............................................ 4-10
Other adjustable features .................................................... 4-11
Displaying limits......................................................................................................................................4-11
Changing the tone pattern................................................................................................................. 4-11
Latching alarms........................................................................................................................................4-12
Automatic snapshots and printouts of them .......................................................................... 4-12
Table of Figures
Figure 4-1. View of alarms ..................................................................................................................................4-1
Figure 4-2. Alarms Setup menu and limits screen ...............................................................................4-3
Alarms
4. ALARMS
Overview
When an alarm for the monitored parameter becomes active, an audible tone sounds
and the screen changes as shown and described below:
1 2 3
HR 16.09
low
ECG
aVR 1 mV H
R
58
I Learning
1 mV
S aVR 2.8
T I -2.8 I
IIR 2.8
-2.8
Figure 4-1. View of alarms
(1) Alarm messages appear in order of priority in the message field.

(2) The measurement value flashes. The background color signifies the alarm
category.
(3) In some cases, a message in the digit or waveform fields gives more detailed
information, using the color of the corresponding parameter.
WARNING: Patient safety. Make sure that necessary alarm limits are set and alarms are on
when you start monitoring a patient.
WARNING: Patient safety. When alarms are suppressed, observe the patient frequently.
Alarm categories
Alarms are classified into three categories according to their priority: RED ALARM
(highest priority), YELLOW ALARM, and NOTE (white color).
The alarm type depends primarily on the physiological significance and the duration
(generally a minimum of 20 seconds) of the alarm. Thus, for example, asystole
advances rapidly to a red priority, whereas apnea is allowed a slightly longer duration.
The monitor has three choices of alarm tones and patterns: ISO, ISO2 (the default), and
General.
NOTE: There is also a sound for catastrophic situations. A continuous beep sounds if
the FiO2 is less than 18% and EtO2 less than 10%, FiN2O is high, or Ppeak is high.
To change the alarm pattern, contact the person responsible for the configuration.
4-1
ISO pattern alarms

VISUAL TONE PATTERN MEANING
Red LED and Triple + double beep every 5 Life-threatening situation.
measurement seconds.
value flash ––– ——5––– ——5
Exception: The second tone
pattern is produced 1 second
after the first pattern.
Yellow LED and Triple beep every 19 seconds. Serious, but not a life-
measurement – – – 19 – – – 19 threatening situation.
value flash
White Single beep Advisory note that may be
– equipment-related, such as
“Leads off.”
ISO2 pattern alarms

The difference between the ISO pattern and the ISO2 pattern is the rising sound of the
tone pattern in the ISO2.
Red LED and Rising triple + double beep Life-threatening situation.
measurement every 5 seconds. Exception to
value flash this is the second tone pattern
which is produced 1 second
after the first pattern.
——5 –– ——5
––– –
Yellow LED and Triple beep every 19.5 Serious, but not a life-
measurement seconds. threatening situation.
value flash
– – – 19.5 – – – 19.5
White Single beep. Advisory note that may be
— equipment-related, such as
“Leads off.”
General pattern alarms

Red LED and Continuous beeping. Life-threatening situation.
measurement -----
value flash
Yellow LED and Double beep every 5 seconds. Serious, but not a life-
measurement ––5––5––5 threatening situation.
value flash
White Single beep. Advisory note that may be
— equipment-related, such as
“Leads off.”
4-2
Alarms
Alarm activation
To make the alarms operative, connect the patient cables. Alarms are operative even
when the measurement is not selected on the display (except for the respiration
measurement), unless the alarm source is selected Off.
Individual alarms have their own specific requirements before they become active:
• Apnea requires five breaths to be activated.
• Invasive pressures are required to be within alarm limits for 20 seconds after
zeroing.
Displaying alarms
Patient alarm limits can be viewed and adjusted in the Alarms Setup menu.
To display the Alarms Setup menu, press the ComWheel and select Alarms Setup from
the Main Menu.
Alarms Setup ALARM LIMITS AND 10 MIN TRENDS:
Adjust Limits Exit
Auto Limits HR NIBP Art CVP SpO2 CO2 CO2

Sys Sys Mean FI ET
Default Limits 160 180 180 15 100 3.0 8.0
Cancel Changes
1 3
Alarm Volume
Audio ON/OFF
Alarm History 40 80 80 0 90 0.0 3.0
Remove Menu 100 12.0 60 40 90 38.0
Main Menu
Push ComWheel
to adjust alarm 18 0.0 4 –20 0 34.0
limits manually O2 Des Resp P MV Temp Next
FI ET Rate peak exp T1 Page
Figure 4-2. Alarms Setup menu and limits screen
(1) List of selections.

(2) Exit the alarm limit adjustment area and return to the Alarms Setup menu.
(3) Parameter box with high- and low-limit values with a 10-minute trend displayed to
show the current status.
4-3
Alarms Setup menu options

Adjust Limits Adjusts individual measurement alarm limits. The adjustment menu
can also be accessed through each parameter menu.
Auto Limits Auto limits are calculated from the displayed patient reading at the
time when auto limits are selected. They are calculated from the last
two minutes.
Default Limits Sets the alarms to the default alarm limits. Default limits can be
changed and saved to modes.
NOTE: Resetting the case also returns alarm limits to their defaults.
Cancel Changes Returns all limits to the ones set before entering the Alarms Setup
menu, if you have not yet exited the menu.
Alarm Volume Adjusts the volume of the audio alarms. The range is from 1 (silent)
to 10 (loud). Alarm Volume does not totally silence audible alarms.
Alarms Setup
Adjust Limits Exit Alarm Volume 5
Auto Limits HR NIBP Art CVP SpO2 CO2 O2
Sys Sys Sys FI ET
Default Limits
72 170 172 22 100 3.0 100
Cancel Changes
Alarm Volume
Audio ON/OFF
Alarm History
43 86 87 5 92 0.0 10
Remove Menu
Main Menu 12.0 20 35 14 39.8
Adjust volume 0.0 9 15 10 37.7

of audible Des Resp P MV Temp
alarm tone. ET Rate peak exp T1
Audio ON/OFF Displays the following options:

• Activate Alarms activates the silenced alarms.
• Silence Apnea silences Apnea and disconnection alarms as well as
respiration rate, CO2, low Ppeak, PEEP, and minute volume limit
alarms.
• Silence ECG silences asystole alarm and heart rate limit alarms.
• Silence apnea & asy is the same as Silence Apnea and Silence ECG
combined (see above).
• Silence ALL silences all alarms permanently, except FiO2<18% (or
EtCO2< 10%), FiN2O>82%, and Ppeak > 70 cmH2O alarms.
Alarm History Displays a list of the last 20 alarms which have reached the yellow or
the red alarm level. The alarm list items have the occurrence time and
the type beside them.
Remove Menu Displays only the alarm limits and 10-minute trends.
4-4
Alarms
Adjusting alarm limits

Changing limits
To change alarm limits for parameters:
Adjust Limits 1. Press the ComWheel and select Alarms Setup from
the Main Menu.
100 8.0 3.0 100
2. Select Adjust Limits.
3. Turn the ComWheel to highlight the
measurement you wish.
4. Press the ComWheel to display an adjustment
90 3.0 0.0 18
window.
SpO2 CO2 CO2 O2 Next
ET FI FI Page
5. Turn the ComWheel to change the High alarm

limit and/or press the ComWheel to accept the
limit.
The cursor moves to the Low setting.
6. Turn the ComWheel to change the Low alarm

limit and/or press the ComWheel to accept the
limit.
7. To adjust other measurements, select Previous Menu.
or
To return to the Alarms Setup menu, select Alarms
Setup.
or
To return to the normal monitoring display, press
the Normal Screen key.
You can also enter the alarm limit adjustment window through the measurement
menus. When you are in a parameter menu, select the alarm for that parameter or
enter the setup menu for that parameter, then select the alarm.
NOTE: The ST alarm limits, located in the HR alarm limits menu, can be set after the
ST learning sequence. For ST, you receive advisory messages only.
Canceling changes
Before you exit the Alarms Setup menu, select Cancel Changes to return all limits to those
that were in effect before you entered the Alarms Setup menu.
Returning to default limits

Select Default Limits in the Alarms Setup menu to set the alarms to the factory default
alarm limits.
4-5
Choosing automatic limits

To get automatic patient-related alarm limits that enable close patient control, select
Auto Limits in the Alarms Setup menu. These limits are calculated using the displayed
patient readings during the two minutes immediately prior to the time when Auto Limits
is selected.
Calculation formulas for automatic limits

The basis for calculating automatic limits is shown below.
Parameter Calculation formula

Pulse Oximetry
SpO2 high (100) = OFF
SpO2 low SpO2 – 5%
Temperature
T1 high T1 + 1 °C
T1 low T1 – 1 °C
T2 high T2 + 1 °C
T2 low T2 – 1 °C
Hemodynamic Parameters
HR high HR * 1.25
HR low HR * 0.75
NIBP sys, dia, mea high NIBP sys/dia/mea * 1.25 + 10
NIBP sys, dia, mea low NIBP sys/dia/mea * 0.75 – 10
P1, P2 high P * 1.25 + 5/10 depending on the label
P1, P2 low P * 0.75 – 5/10 depending on the label
Gases
EtCO2 high EtCO2 + 1%
EtCO2 low EtCO2 – 1%
Resp high RR * 1.25 + 2
Resp low RR * 0.75 – 2
Spirometry
Ppeak high Ppeak + 10
Ppeak low Ppeak – 10
PEEP high PEEP + 5
PEEP low PEEP – 5
Mvexp high Mvexp + 2
Mvexp low Mvexp – 2
4-6
Alarms
Changing alarm sources

For NIBP, invasive pressure, O2, anesthetic agents, and temperature, you can select
which measured values trigger the alarm.
• For the pressures, the choices are Systolic, Diastolic, Mean, or OFF. If OFF is selected,
the parameter box with the 10-minute trend is not displayed.
• For O2 and anesthetic agents, the alternative alarm sources are ETO2 or FiO2.
• Temperature choices are T1 and T2. Only the last-modified source is active.
To change the alarm source:
1. Press the ComWheel and select Alarms Setup from the Main Menu.
3. Turn the ComWheel to highlight the measurement you wish, then press the
ComWheel.
An adjustment window is displayed.
4. Press the ComWheel as many times as required to get from the limit setting to the
menu selections.
5. Select the desired alarm and press the ComWheel to change the selection to
OFF or ON.
P2 ADJUST ALARM LIMITS:
Adjust Limits
Sys Alarm OFF
P2
Dia Alarm ON Dia
Mean Alarm OFF 300
High 20
Alarms Setup
Previous Menu Low 5
–40
mmHg
Push ComWheel to
turn alarm
ON/OFF.
4-7
Suppressing alarms
APN. When alarms are suppressed, this warning symbol is displayed.
ASY.
NOTE: If alarms are suppressed and a power interruption occurs, or if the monitor is
turned off for up to 15 minutes, check the alarm status before you resume monitoring
or begin monitoring a new patient.
Warning: Patient Safety. When alarms are suppressed, observe the patient frequently.
Suppressing audible alarms permanently

For special cases, such as lung operations, it may be desirable to suppress certain
audible alarms entirely.
2. Select Audio ON/OFF.
3. Select Silence Apnea, Silence ECG, Silence Apn&ECG or Silence ALL.
Alarms Setup ALARM LIMITS AND 10 MIN TRENDS:
Exit
Audio ON/OFF
P SpO2 CO2 O2
Activate Alarms Sys Sys Sys FI ET
Silence Apnea \ 22 100 3.0 100
Silence ECG
Silence Apn&ECG
Silence ALL
43
Previous Menu 86 87 5 92 0.0 10
12.0 20 35 14 39.8
Silence audible0.0
apnea, 9CO2, 15 10 37.7
RR, spirometry and ECG alarms
permanently. MV Temp
exp T1
If an active alarm is suppressed, a reminder beep sounds every two minutes. You can
adjust the volume of the reminder beep in the Audio ON/OFF menu.
Reactivating alarms
Select Activate Alarms to turn audible alarms on.
4-8
Alarms
Suppressing audible alarms for two or five minutes

• To suppress audible alarms for two minutes, press the Silence Alarms key once.
• To suppress audible alarms for five minutes, press the Silence Alarms key for more
than three seconds.
If the alarms are not active when you press the Silence Alarms key, they are pre-silenced
for two minutes or five minutes. Exception: FiO2< 18%, EtO2 < 10%, FiN2O > 82%, and
high Ppeak alarms are silenced for 20 seconds. New alarms are displayed.
Reactivating suppressed alarms

Press the Silence Alarms key during the silent period to activate new alarms immediately,
activate silenced alarms (after one minute), and the apnea alarm (after five breaths).
Suppressing alarms for individual parameters

You can turn off the alarms without changing the alarm limits for the following
parameters:
• FiCO2
• EtO2 and FiO2
• NIBP (Sys, Dia, and Mean)
• ST (Lat. and Inf.)
• Temperature (T1 and T2)
To turn off or turn on alarms for a parameter:
3. Turn the ComWheel to highlight the measurement and press the ComWheel.
4. In the adjustment window that is displayed, press the ComWheel as needed to
move to the menu selections.
5. Select the parameter alarm to be suppressed from the menu and press the
ComWheel to turn the selection OFF.
This symbol is displayed in the digit field for each alarm you suppress.
or
Select the parameter alarm to be reactivated from the menu and press the
ComWheel to turn the selection ON.
4-9
Transferring alarms
All alarms can be transferred to the Datex-Ohmeda S/5 Network and Central or to
another monitor that is connected to the Datex-Ohmeda monitor network.
1. Press the ComWheel and select Patient Data from the Main Menu.
2. Select Other Patients.
3. Select Receive Alarms.
4. Select one of the sites on the list that is displayed.
Recording alarms automatically

You can choose to generate an automatic strip chart recording when asystole, heart
rate, and pressure alarms reach the red alarm level. The recorder will print the ECG +
Art waveforms.
To record on alarms automatically:
Record & Print 1. Press the ComWheel and select Record/Print

from the Main Menu.
Record Waveforms
2. Select Record Waveforms.
Record Wave
Waveform 1 ECG1 YES 3. Select Start on Alarms and choose YES.
Waveform 2 OFF NO
Waveform 3 OFF
Start on Alarms YES
Delay 12 s
Paper Speed 25 mm/
Length 30 s
Previous Menu
Select YES for automatic start

of recording when serious
arrhythmias occur.
Recording will start from the following alarms:
Alarm Recorded parameters

Asystole ECG + P1 waveforms, 25 mm/sec
HR High/Low ECG + P1 waveforms, 25 mm/sec
P1 High/Low ECG + P1 waveforms, 25 mm/sec
Recording time is 30 seconds: 12 seconds recording from the recorder memory, 18

seconds real-time recording. Alarm recordings are annotated with the alarm source.
4-10
Alarms

This section describes the other adjustable features related to alarms. A password is
required for entering the Install/Service menu where the adjustments are made. If you
wish to make changes, we recommend that you contact the person responsible for the
entire configuration.
Displaying limits
Alarm limits can be displayed next to the numerical parameter value as shown below.
To display alarm limits:
Installation 1. Press the ComWheel and select Monitor Setup

from the Main Menu.
Alarms Options
Show Limits NO
Latching Alarms NO
NO
Reminder Volume 5 YES 4. Select Alarms Options.
Alarm Tones ISO2 5. Select Show Limits and choose YES or NO.
Previous Menu
Make sure the alarm source is selected. The

alarm limits become visible when patient
monitoring begins and the monitor receives
Select YES to display alarm patient data.
limits in digit fields.
Changing the tone pattern

The monitor has three choices of alarming tone patterns: ISO, ISO2, and General.
To change the tone pattern:
4. Select Alarms Options.
5. Select Alarm Tones and choose ISO, ISO2, or General.
4-11
Latching alarms
Latching alarms enables unattended monitoring. If Latching Alarms is active, alarm
messages continue to be displayed even if the initial alarm condition has ceased. A
reminder beep sounds every 10 seconds.
• To clear all inactive alarm messages and the beep, press the Silence Alarms key once.
• To clear all inactive and active alarm messages, enabling only new upcoming
alarm messages, press the Silence Alarms key twice.
To select latching alarms:
Installation 1. Press the ComWheel and select Monitor Setup
Alarms Options from the Main Menu.
Show Limits YES 2. Select Install/Service and enter the password.

Latching Alarms YES NO 3. Select Installation.
Reminder Volume 5 YES
4. Select Alarms Options.
Alarm Tones ISO2
Previous Menu 5. Select Latching Alarms and choose YES.
Alarm messages remain on screen

until Silence Alarms key is
pressed.
Automatic snapshots and printouts of them

When an Asystole, HR high or low, or P1 high or low alarm occur, the monitor can
automatically create and print a snapshot that you can view in the Trends menu. A
snapshot is created when the Asystole, heart rate, or P1 red alarm is activated. The
snapshot contains data from the last 15 seconds.
To create a snapshot on alarms and print it automatically:
Trends & Snapshot 1. Press the ComWheel and select Monitor Setup
Snapshot from the Main Menu.
Field 1 ECG1/r 2. Select Install/Service and enter the password.
Field 2 ECG1 NO
3. Select Trends&Snapshot.
Field 3 P1 Alarms
Field 4 ST ALL 4. Select Snapshot.
Field 5 P1+HR 5. Select Create on Alarms and choose YES.
Field 6 Num 1
6. Select Automatic Print and choose Alarms.
Print Loops NO
Create on Alarms YES
Automatic Print NO
Previous Menu
Automatic printing when
serious arrhythmias occur.
4-12
Contents
Chapter 5. Trends and Snapshots

Overview ............................................................................ 5-1
Trended parameters.................................................................................................................................5-1
Factory default parameters..................................................................................................................5-1
Most common tasks ............................................................. 5-2

Recording trend data ...............................................................................................................................5-3
Changing graphical trend parameters.............................................................................5-3
Printing trend data ....................................................................................................................................5-3
Printing selected pages of graphical trend data.........................................................5-3
Erasing trend data .....................................................................................................................................5-3
Graphical trend view............................................................. 5-4

Graphical trend view symbols .............................................................................................5-5
Changing the time scale (trend length and resolution).......................................................5-5
Moving on graphical trend pages.....................................................................................................5-6
Minitrend view .................................................................... 5-6

Adding a minitrend...................................................................................................................................5-7
Choosing the length of minitrend data.........................................................................................5-7
Removing a minitrend ............................................................................................................................5-7
Numerical trend view ............................................................ 5-8

Scrolling numerical trend pages.......................................................................................................5-8
Snapshots.......................................................................... 5-9
Viewing snapshots..................................................................................................................................5-10
Creating snapshots.................................................................................................................................5-11
Marking an event ...................................................................................................................... 5-11
Erasing snapshots ...................................................................................................................................5-11

Creating snapshots on alarms ......................................................................................................... 5-12
Printing snapshots automatically.................................................................................................. 5-12
Printing loops on snapshots.............................................................................................................. 5-13
Configuring snapshot and graphical trend pages................................................................ 5-13
Table of Figures
Figure 5-1. Graphical trend view.....................................................................................................................5-4
Figure 5-2. Minitrend view..................................................................................................................................5-6
Figure 5-3. Numerical trend page ...................................................................................................................5-8
Figure 5-4. Waveform snapshot page ...........................................................................................................5-9
Figure 5-5. Waveform snapshot ....................................................................................................................5-10
Figure 5-6. Snapshot fields...............................................................................................................................5-10
Figure 5-7. Marking numerical trends ......................................................................................................5-11
Trends and Snapshots
5. TRENDS AND SNAPSHOTS
Overview
A trend is a collection of the measured patient data. The monitor displays two types of
trend information: graphical and numerical. You can create snapshots (frozen frames
saved to memory) of this information.
The monitor collects graphical and numerical trend data automatically from the
trended parameters. You can select between 20 minutes and 24 hours of trend time.
You can view the trends in the Trends menu, or you can continuously display graphical
“minitrends” next to the waveform fields. A minitrend is a view of collected trend data
from the last 5-minute period or 30-minute period, depending on which period of time
you chose.
Trended parameters
The trend parameters are listed below
• Electrocardiograph (HR)
• ST analysis
• Invasive pressure
• Noninvasive blood pressure
• Oxygen saturation (Pleth, SpO2)
• Gases (CO2, O2, N2O, AA, MAC, Resp)
• Respiration rate (RR)
• Temperature
• Airway pressure
• Airway flow
• Derived values from airway pressure and flow
• NMT
Trend data is stored in memory for 15 minutes after the power is turned to Standby.
Factory default parameters

For factory default parameters, contact the person responsible for the entire
configuration.
The configuration and the mode determine which parameters are displayed.
The unit of the parameter matches the real-time waveform settings for that parameter.
To change the snapshot or graphical trend settings, see Configuring snapshot and
graphical trend pages at the end of this chapter.
NOTE: You cannot change the contents of numerical trend fields. Numerical trend
fields cannot be configured.
5-1
Most common tasks

To display trends Press the Trends key to open the Trends menu.
The trend (graphical or numerical) that was
displayed last appears beside the Trends menu.
To scroll time with the 1. Select Cursor.
trend cursor
2. Turn the ComWheel to move the cursor.
For the graphical trend, the numeric measurement
values for the displayed time are next to the
cursor.
3. Press the ComWheel to return to the Trends menu.
To see more parameters Select Next Page.
on other pages
To change time scale Select Time Scale and the trend time
(20 min or 1 , 2, 4, 6, 8, 10, 12, 24 hours).
To change trend type or Select Graphical, Numerical or Snapshot.
a snapshot to be viewed
To change scaling Select Trend Scales.
To select minitrend split screen 1. Select Monitor Setup in the Main Menu.
3. Select Split Screen and Trend.
To create snapshots Select Take Snapshot in the Trends menu.
To record trends Press the Record Trend/Stop key.
or
1. Select Record/Print in the Main Menu.
2. Select Record Trends.
3. Select Record Numerical or Record Graphical.
To print trends To print the currently viewed trend data, press the
Trends key and select Print Page.
To print graphical trend data, select Print Graphical in
the Record/Print menu.
To print numerical trend data, select Numerical and
then Print Page.
To erase trend history 1. Select Reset Case in the Main Menu.
2. Select Reset Trends and Yes in the adjustment
window.
5-2
Recording trend data

Press the Record Trend/Stop key.
or
1. Press the ComWheel and select Record/Print from the Main Menu.
3. Select Record Numerical or Record Graphical.
Graphical trends are recorded from the time period that corresponds to the time scale
(20min - 24h) chosen for them in the Trends menu.
Changing graphical trend parameters

To change the recorded parameters for graphical trends:
3. Select Graphic Trend 1 and choose the parameter to be recorded.
4. Select Graphic Trend 2 and choose the parameter to be recorded.
Printing trend data

1. Press the Trends key.
2. Select Graphical or Numerical.
3. Select Print Page.
If you wish to print trend data located on other pages, select Next Page and
Print Page.
Printing selected pages of graphical trend data

2. Select Print Graphical.
3. Select the page (Page 1, Page 2, etc.).
Erasing trend data

1. Press the ComWheel and select Reset Case from the Main Menu.
2. Select Reset Trends.
3. In the opened window, select YES to erase the trends.
or
Select NO to cancel the function.
5-3
Graphical trend view

Graphical trend pages contain up to four pages with five fields on each page. All five
fields are usually visible and can be printed.
Parameter scale, label, unit, and color follow the real-time waveform settings for each
parameter. Exceptions: you can select the HR and temperature scales in the Trend
Scales menu.
1 2 3 4
9 37
+
aVR
Trends Pacer 1 mV
hidden
Take Snapshot
Next Page HR 240 56 100 Sp02 aVR
97 S aVR 1.0 1.0
Print Page 120 90 T I OFF
II OFF
Cursor 0 80
Time Scale 2 h Art 200 128/81 20 CVP A mmHg
Graphical
NIBP
100
(12)
10 r
t 130/82
(93)
Snapshot 0 0 Contrl
mmHg
C02 6 5.0/0.0 20 Des C
Numerical
Trend Scales
4
2
3.0/2.3
5
V
P (12)
14/9
0 0
Remove Menu S %
02 100 21/16 100 N20 P
Main Menu 50
0
77/77
50
0
0
2
%
97
Show graphical C FI
trends. Mark Trend O 5.0 0.0
Event 8:25 8:30 8:35 8: 8:43 1/4 2 RR 15 /min
HR NIBP Gases O2: T1
Lead aVR mmHg Sys Dia O2% N2O% Des% C
58 /min Mean
128/81
(93) Manual
ET
FI
16 77 2.3
21 77 3.0
T1
38.8
7 6 5
Figure 5-1. Graphical trend view
(1) Trends menu

(2) Trend measurement field
(3) Real-time ECG
(4) Numeric value of a measurement at the trend cursor point
(5) Trend page number
(6) Indication of the amount of data gathered and viewed
(7) Time and marker field
5-4
Graphical trend view symbols

Trend bar, parameter scale to the left. The gap shows the mean value (except in
the Paw field where it indicates Pplat).
Trend bar, parameter scale to the right. The gap shows the mean value (except
in the Paw field where it indicates Pplat).
NIBP trend bar.
A dotted vertical line across the trend field indicates a change, such as a
change of ECG lead, anesthetic agent, or zeroing the invasive blood pressure
channel.
A blue, white, or red line above the marker field indicates the following:
• Blue line: the left end of the line is the point at which gathering of trend data
started. The right end shows the last moment data was gathered.
• White line: the proportion of data shown on the screen. If the line is on the
left, leaving space on the right, there is more data to see after the current
view. If the line is on the right, there is more data before the current view.
If the line is in the middle, there is more data at the beginning and end of
the case.
• Red line: the time period during which a 20-minute trend was gathered.
Changing the time scale (trend length and resolution)

Adjust the time scale (and/or parameter scale) as needed to view the desired level of
trend detail.
To change trend length and resolution:
1. Press the Trends key and select Time Scale in the Trends menu.
2. Select the trend length.
Trend length on the display Resolution Trended Time Period

20 min 10 seconds last 30 minutes
1h 1 minute last 24 hours
2h 1 minute last 24 hours
4h 2 minutes last 24 hours
10 h 5 minutes last 24 hours
5-5
Moving on graphical trend pages

Numerical measurement values for trended parameters appear next to the cursor on
the graphical trend. The displayed values were measured at the time indicated by the
cursor.
To view trend values for specific times:
1. Press the Trends key and select Cursor.
2. Turn the ComWheel to move the cursor and scroll the values for specific times.
3. To return to the Trends menu, press the ComWheel.
4. To see more parameters on other pages, select Next Page in the Trends menu.
Minitrend view
17:00
240 5 min aVR ECG
Pacer 1 mV H
120
0
100 5 min
hidden
Pleth
R
S %
88 /min
90
80
6 5 min
P
0
2
C
%
97
C02 5
4
2 O ET
2
5.0 FI 0.0
0 0 RR 15 /min
100 5 min 02 21 %!
50 O ET
2 16 FI 21
0 16 FI-ET 5.0
3 2 min %
AA 2.5
2
1 1.0
A ET
A
2.3 FI 3.0
0 0 MAC ---
60 5 min Imped. R CO2
40 e
20
0
NIBP T1 Paw TV
s
p
Gases
15 /min
mmHg Sys Dia C cmH2O Adult ! O2% N2O% AA%
Mean
--- ---
(---) Manual
T1
38.8 Ppeak
PEEP tot
25
7
TVexp ml
790
ET
FI
16
21
77 2.3
77 3.0
Figure 5-2. Minitrend view
You can split the Normal Screen display so that one fourth of the display (on the left)
shows continuous graphical minitrends. Minitrends show the measurements selected
for the waveform fields.
NOTE: The split screen option is possible only with displays that have waveforms on
the Normal Screen.
5-6
Adding a minitrend
To split the screen and show minitrends:

Screen Setup
Waveform Fields
3. Select Split Screen and choose Trend.
Digit Fields None
Split Screen Trend Spiro1
Minitrend Length 30 min Spiro2
Previous Menu Trend
Minitrends of waveforms are

permanently displayed with
waveforms.
Choosing the length of minitrend data

You can view a minitrend consisting of the last 5 minutes or the last 30 minutes of
trend data. A 5-minute minitrend is updated every 10 seconds; a 30-minute minitrend is
updated once every minute.
To choose the length of the minitrend data:
3. Select Minitrend Length and choose 5 min or 30 min.
Removing a minitrend
To remove the minitrend from the display:
3. Select Split Screen and choose None.
5-7
Numerical trend view

Numerical trends contain:
• One to four pages of trend information (24 hours maximum).
• Real-time ECG at the top of each page.
The resolution is five minutes.
1 2 3 4
9 14
aVR ECG
Trends Pacer 1 mV H Arrh.
Take Snapshot
hidden
Page 1of4 HR SpO2 NIBP Art CVP CO2 O2 AA

R
58 /min OFF
Next Page Mark Time sys/dia ET FI FI mm
7:50
Print Page 7:55 S aVR 1.0
8:00 T I -1.5
Cursor II 0.5 -1.5
8:05
Time Scale 2 h 8:10
8:15 A mmHg
Graphical 8:20
Snapshot 8:25
8:30
r
t 130/82 (93)
Numerical 8:35
8:40
Trend Scales 8:45 S %
Remove Menu 8:50 P
Main Menu
8:55
9:00
9:05
9:10 58 97 128/ 81 130/ 82 ( 12) 5.0 21 3.0
0
2
%
97
Show numerical
trends. 9:11 58 97 128/ 81 130/ 82 ( 12) 5.0 21 3.0 C ET 5.0 FI 0.0
9:12 58 97 128/ 81 130/ 82 ( 12 ) 5.0 21 3.0 O
9:13 58 97 128/ 81 130/ 82 ( 12) 5.0 21 3.0 2 RR 15 /min
Gases O2: NIBP Comp Raw Resp
O2% N2O% Des% mmHg Sys Dia ml/cmH2O cmH2O/l/s CO2
ET
FI
16 77 2.3
21 77 3.0 Mean
128/81
(93) Manual
55 8
15 /min
Figure 5-3. Numerical trend page
(1) Trend menu

(2) Page number
(3) Real-time ECG
(4) Real-time digit fields, if the waveform display is Normal Screen
Scrolling numerical trend pages

Use the ComWheel to scroll the trend vertically.
When the highlight reaches the top or the bottom of the view, the next five minutes of
information appears.
5-8
Snapshots
A snapshot is a frozen frame that is saved to the monitor memory. A snapshot captures
the contents of the frozen frame chosen during configuration, not the image you are
currently viewing when you take the snapshot. A snapshot can contain waveforms,
numerical trends, and graphical trends.
1 2 3 4 GENERAL 9 45
+
Trends aVR
Pacer 1 mV
hidden
Take Snapshot
Waveform saved: 9:44:17
Next Page aVR mm
1 mV S
T aVR 1.0 aVR
Print Page I OFF
II 1.0
Next Snapshot OFF
ST 5 1.0/
–1.5/ A mmHg
Time Scale 0 r
Graphical -5
0.5
t 130/82(93)
Snapshot Art 200 128/81 20 CVP
NIBP C mmHg Contrl
100 (12) 10 V
Numerical
Trend Scales 0 0
P (12)
Waveform saved: 9:44:17 S %
Remove Menu
Main Menu
CO2 5%
0
p
O
2
97
%
Show snapshots. C
Snaps.
Mark s O
2
ET 5.0 FI 0.0
Event 9:30 9:35 9:40 9:44 1/1 RR 15/min
T1 NIBP HR Gases O2:
C mmHg Sys Dia Lead aVR O2% N2O% Des
16 77 2.3
T1
38.8 Mean
128/81
(93) Manual 58 /min
ET
FI 21 77 3.0
9 8 7 6 5
Figure 5-4. Waveform snapshot page

(1) Trends menu
(2) Real-time ECG
(3) Waveform snapshot
(4) Time of the snapshot (If created on an alarm, the cause of the alarm appears.)
(5) Real-time digit fields, if the waveform display is Normal Screen
(6) Page number
(7) Waveform cursor
(8) Graphical trend snapshot
(9) Time and marker field
To change the content of the snapshot page, see Configuring snapshot and graphical
trend pages at the end of this chapter.
5-9
Viewing snapshots
A snapshot includes 15 seconds of a waveform and/or graphical trend from the time
period that corresponds to the time scale selected for the graphical trend and/or the
numerical trend.
1 2
Art 244 Waveform saved: 17:01:49
122
Figure 5-5. Waveform snapshot
(1) Numerical label

(2) Time when saved
The rest of the settings depend on the current settings for each real-time waveform.
There is one configurable waveform snapshot page. The page contains up to six fields
that can include snapshots of waveforms and graphical and numerical trends.
You can see five fields on the display but six on the printout.
aVR Waveform saved: 16:41:16

1 mv
Art 244 mmHg Waveform saved: 16:41:16
122
0
ST 5 2.8/
0 -2.7/
2.8
-5
Art 200 128/81 240 HR
NIBP 100 58 120
0 0
Mark s‘ s‘ s‘ Snaps.
Event 15:30 16:00 16:42 17:00 1/1
Figure 5-6. Snapshot fields
To view snapshots:
1. Press the Trends key and select Snapshot from the Trends menu.
2. Select Next Snapshot.
3. Turn the ComWheel to move the cursor in the time and marker field.
4. When the cursor reaches the saving time of a snapshot (marked with an “S” in the
time axis), the snapshots that were saved at that time appear.
5. Press the ComWheel to return to the menu.
5-10
Creating snapshots
To create a snapshot, press the Trends key and select Take Snapshot.
The waveforms and trends that are currently selected to the Snapshot page will be
saved. You can take up to 16 snapshots, depending on the data load and the amount of
fields chosen to contain information on the snapshot page.
Marking an event
At the time Take Snapshot is selected, a number is inserted in the numerical trends
beside the trend information. This number marks the event at which a snapshot was
created.
Also, NIBP measurement marks a trend line. If there are several measurements during
one minute, a one-minute average appears instead of individual measurements.
Page 4 0f 4 T1 T2 SpO2
Mark Time T1 T2
12:25
12:30
12:35
1 12:39 38.8 20.0
12:40 38.8 20.0
2 12:43 38.8 20.0
12:45 38.8 20.0
Figure 5-7. Marking numerical trends
The event number also appears on numerical trend printouts.
Erasing snapshots
The snapshots will be erased when you reset the case or reset the trends. They are also
erased after 24 hours automatically.
To erase snapshots:
1. Press the ComWheel and select Reset Case from the Main Menu.
2. Select Reset Trends or Reset ALL, and choose YES.
As memory fills up, older snapshots are overwritten automatically.
5-11

This section describes the other adjustable features related to trends and snapshots. A
password is required for entering the Install/Service menu where the adjustments are
made. If you wish to change the adjustments, contact the person responsible for the
entire configuration.
Creating snapshots on alarms

The monitor can automatically create snapshots when the following alarms occur:
Asystole, HR high, HR low, P1 high, P1 low.
from the Main Menu.
Snapshot
Field 2 ECG1 NO 3. Select Trends & Snapshot.
Field 3 ECG2 YES
4. Select Snapshot.
Field 4 P2
Field 5 P1+HR
5. Select Create on Alarms and choose YES.
Field 6 Num 1
Print Loops NO
Create on Alarms YES
Automatic Print NO
Previous Menu
Select YES to create a snapshot
automatically when Brady, Tachy
or ART High/Low alarm occurs.
Printing snapshots automatically

Snapshots can be printed on request, on alarms, or when they are created.
Snapshot from the Main Menu.
Field 2 ECG1 NO
3. Select Trends & Snapshot.
Field 3 P1 Alarms
4. Select Snapshot.
Field 4 ST ALL
Field 5 P1+HR 5. Select Automatic Print.
Field 6 Num 1 Choose NO, if you want printing to occur only
Print Loops NO on request.
Create on Alarms YES or
Automatic Print NO
Choose ALARMS, if you want to print only
Previous Menu snapshots that are created on alarms.
Automatic printing when
serious arrhythmias occur. or
Choose ALL, if you want to print all snapshots
immediately after they are created.
5-12
Printing loops on snapshots

You can have Patient Spirometry loops printed whenever snapshots are taken.
4. Select Snapshot.
5. Select Print Loops.
6. Select YES.
Configuring snapshot and graphical trend pages

You can change the parameters on the snapshot page and on graphical trend pages.
• For the snapshot page, you can also select graphical trend boxes.
• For graphical trend pages, you can also select events. An event list will appear if
there is no menu to hide it.
NOTE: Numerical trend pages cannot be configured.
To configure the snapshot page and/or graphical trend pages:
4. Select Snapshot.
or
Select Graphical Trends and select the trend page you want to configure.
5. Select the parameter for each field.
The field numbers start on the top of the display. Select one parameter for each
field on the trend page, or turn the field OFF.
When all fields are OFF, the page is displayed with empty fields. The time scale and
page number appear at the bottom of the page.
If several equal fields are selected on top of each other, they will form one higher field.
Equal fields can not be defined separate from each other.
5-13
5-14
Contents
Chapter 6. Patient Data Management

Overview ............................................................................ 6-1
Network options .................................................................. 6-1
Using the network .....................................................................................................................................6-2
Connecting to the network.....................................................................................................6-2
Using memory cards ................................................................................................................................6-2
Inserting a memory card..........................................................................................................6-3
Resetting a case.................................................................. 6-4

Adding demographics ........................................................... 6-4
Loading a previous case ........................................................ 6-5
Load Prev. Case.............................................................................................................................6-5
Patient from Net. (with N-XNET or N-XDNET)........................................................6-5
Patient from Card (with N-XDNET only) .....................................................................6-5
Marking events ................................................................... 6-6

Viewing other sites (with N-XNET or N-XDNET option) .................... 6-7
Viewing other site alarms (with N-XNET or N-XDNET option) ....................................6-8
Table of Figures
Figure 6-1. Inserting and removing a memory card............................................................................6-3
Figure 6-2. Marked events in trends .............................................................................................................6-6
Figure 6-3. Data from another site .................................................................................................................6-7
Patient Data Management
6. PATIENT DATA MANAGEMENT
Overview
The Cardiocap/5 monitor continuously collects and saves patient data, such as trends.
Saving is activated when the monitor receives vital signs. With a single, stand-alone
monitor, you can add patient demographics and place markers on the trends.
The data management capabilities can be expanded if your monitor is connected to the
Datex-Ohmeda S/5 Network and Central or if you use memory cards to store and
transfer data.
Network options
The monitor can be equipped with the following options to enhance network and data
continuity capabilities in Datex-Ohmeda information systems:
N-XNET Network
N-XDNET Data card and Network
• The N-XNET option allows real-time information sharing between your
Cardiocap/5 and monitors that are connected to the same Datex-Ohmeda monitor
network (the Datex-Ohmeda S/5 Network and Central). When the monitor is
connected to the network, patient information is saved to the network computer.
The network offers the possibility of viewing real-time patient information, such as
alarms, from another monitoring site.
• The N-XDNET option offers the same capabilities as the N-XNET option and, in
addition, it allows you to load trend data from a Data card. With this option, you
can assure the continuity of patient data by gathering all previously-collected
information for a patient, then adding new information to the same patient file.
6-1
Using the network

With the N-XNET or N-XDNET option, you can connect the monitor to the Datex-
Ohmeda S/5 Network and Central for central monitoring and printing services.
This symbol is displayed when the monitor is connected to the
network.
• Time and date are set by the network and cannot be adjusted in the monitor.
• The patient’s ID entered in the Patient Data menu can be displayed on the Datex-
Ohmeda S/5 Network and Central screen and printed on the laser printouts.
• Measured and entered patient data can be viewed on the Datex-Ohmeda
S/5 Network and Central.
• Measured patient data and alarms can be viewed on other Datex-Ohmeda S/5,
CS/3, and AS/3 monitoring systems, and vice versa.
Connecting to the network

To connect your monitor to the network:
• Connect the ethernet and location ID plug to the corresponding connectors on the
rear panel of the monitor.
• Configure the location IDs in the Datex-Ohmeda S/5 Network and Central.
Using memory cards

With the N-XDNET option, you can load collected patient data from a monitor that is
connected to the same Datex-Ohmeda monitor network or from a Data card.
The Data card and the Menu card are memory cards. Each is housed internally in a
built-in memory module.
• The Data card is for storing and transferring trend data.
• The Menu card is for storing menus.
When the Data card is inserted, continuous patient trend data is stored on it
automatically. The capacity of the card is approximately 48 hours, depending on the
complexity of the saved data. When the card is full, the oldest data is erased.
The trend data stored on a Data card can be transferred to and viewed at all S/5, AS/3,
and CS/3 systems as well as other Cardiocap/5 monitors.
See Loading a previous case later in this chapter for information about loading trend
data.
CAUTION: Do not subject memory cards to excessive heat, bending, or magnetic fields.
6-2
Inserting a memory card

You can insert a memory card into either slot. The monitor recognizes whether the
inserted card is a Data card or a Menu card.
Figure 6-1. Inserting and removing a memory card
Insert the end of the card with the small connectors first. Push the card firmly into
place. The release button will come up. To remove the card, press the release button,
then pull the card out of its slot.
This symbol appears on the display to indicate that a memory card is
inserted. The “Data card inserted” or “Menu card inserted” message
appears in the message field of the display.
6-3
Resetting a case
At the beginning of a new procedure, you should erase the screen layout, trend data,
and all alarm and parameter settings of the previous case.
To reset a case:
Reset Case 1. Press the ComWheel and select Reset Case from
the Main Menu.
Reset Trends
2. Select Reset ALL and choose YES.
Reset ALL
Main Menu
Selecting Reset ALL returns you to the starting mode

and its settings (screen layout, trend parameters,
alarm limits, etc.).
Erase previous trends and

snapshots for new case setup.
Adding demographics
To add demographics:
1. Press the ComWheel and select Patient Data
Patient Data from the Main Menu.
Demographics
2. Select Demographics.
Height
3. Enter the patient’s height and weight.
Weight
BSA
Previous Menu
Give patient’s height.
Height Adjustable from 15 cm to 250 cm.

Weight Adjustable from 1 kg to 250 kg.
BSA The body surface area is calculated automatically using the du Bois formula.
The body surface area is used when calculating index values of certain
parameters.
6-4
Loading a previous case

To load data from a previous case:
Patient Data from the Main Menu.
Patient ID 2. Select Load Prev. Case.

Demographics
Patient from Net. Cancel
Patient from Card Load
Load Prev. Case
Other Patients
Main Menu
Get data of prev. case. Unless

network or memory card in use,
length of internal memory=24h.
Load Prev. Case

When the network is not in use, you can retrieve the trend data of the previous case
from the monitor memory. You can retrieve trend data that was stored during the
previous 24 hours under these circumstances:
• The monitor was turned off for less than 15 minutes.
• The monitor remained on (even if the case was reset).
Reloading trend data after the case has been closed for several hours is not
recommended. The period that contains no information results in empty record pages.
Patient from Net. (with N-XNET or N-XDNET)

You can retrieve the last 24 hours of trend data from the network if the monitor is
connected to it.
Patient from Card (with N-XDNET only)

When the data memory card is inserted, you can load trend data from a case on that
card. The Data card saves previous patient data from the time it is inserted in the
monitor. You can retrieve approximately 24 hours of information. The memory
capacity depends on the complexity of the saved data.
6-5
Marking events
During monitoring, you can place numbers beside the numerical trend to mark the
event.
To mark events:
1. Press the Trends key.
2. Select Take Snapshot.
The events are numbered from 1 to 16, depending on the data load. A number is
displayed beside the numerical trend information that was recorded at the time Take
Snapshot was selected.
Page 4 0f 4 T1 T2 SpO2
Mark Time T1 T2
12:25
12:30
12:35
1 12:39 38.8 20.0
12:40 38.8 20.0
2 12:43 38.8 20.0
12:45 38.8 20.0
Figure 6-2. Marked events in trends
A trend printout is also marked with this number.

A snapshot is created at the same time. For more information about Snapshots, refer to
the Trends and Snapshots chapter.
6-6
Viewing other sites (with N-XNET or N-XDNET option)

With your Cardiocap/5 monitor you can see the numerics, waveforms, and alarms of
another Cardiocap/5, S/5 Light, S/5, AS/3 or CS/3 monitor if both monitors are
connected to the same Datex-Ohmeda monitor network.
To view data for a patient at another site:
Patient Data 1. Press the ComWheel and select Patient Data

from the Main Menu.
Other Patients
Receive Alarms
3. Select Show Vital Signs.
Show Vital Signs
4. Select the site you wish to view.
Main Menu
Show waveforms and numerical

trends from other monitors
in the network.
9:18
aVR ECG
Show Signs Pacer 1 mV H Arrh.
More Waveforms
Black Room
hidden R
58 /min OFF
TCP 20 ICP mmHg mm
Blue Room (IU) 10 / S aVR 1.0
Eye OR1 0 ( ) T I -1.5
II 0.5 -1.5
Eye OR3 HR SpO2 NIBP Art CVP CO2 O2 AA
Mark Time sys/dia ET FI FI
Green Room 9:03 A mmHg
9:04
Gyn OR1
Gyn OR3
9:05
9:06
r
t 130/82
(93)
9:07
Heart OR1 9:08 S %
9:09 P
More Monitors 9:10
Previous Menu
Push ComWheel
9:11
9:12
9:13
0
2
%
97
9:14 C
to activate 9:15 O ET 5.0 FI 0.0
trend cursor. 9:16 2 RR
9:17 15 /min
Gases O2: NIBP Compl Raw Resp
O2% N2O% Des% mmHg Sys Dia ml/cmH2O cmH2O/l/s CO2
ET
FI
16 77 2.3
21 77 3.0 Mean
128/81
(93) Manual
55 8
15 /min
Figure 6-3. Data from another site
6-7
Viewing other site alarms (with N-XNET or N-XDNET option)

With a networked Cardiocap/5 monitor, you can view the alarms of another monitor
on the same network, including the Cardiocap/5, S/5 Light, S/5, AS/3, or CS/3, or the
Central station.
To view the alarms of a monitor at another site:
from the Main Menu.
3. Select Receive Alarms.
4. Select the site you wish to view.
The sites from where the alarms are forwarded to your monitor are marked by a bell
next to the site name.
6-8
Contents
Chapter 7. Recording and Printing

Overview ............................................................................ 7-1
Recorder (N-XREC option)...................................................................................................................7-1
Recording waveforms............................................................ 7-2

Start/Stop recording waveforms.......................................................................................................7-2
Controlling paper speed.........................................................................................................................7-2
Selecting waveform parameters .......................................................................................................7-3
Controlling the recording time ..........................................................................................................7-4
Selecting the recording time initiation .........................................................................................7-4
Recording waveforms on alarms......................................................................................................7-5
Recording trends ................................................................. 7-6

Start/Stop recording trends .................................................................................................................7-6
Numerical trend printout......................................................................................................................7-6
Changing the resolution.........................................................................................................................7-7
Selecting graphical trend parameters............................................................................................7-7
Recorder paper replacement .................................................. 7-8

Printing to a laser printer ....................................................... 7-9
Changing the printer................................................................................................................................7-9
Printing trend data ....................................................................................................................................7-9
Printing spirometry loops .................................................................................................................. 7-10

Changing the format for recorded numerical trends........................................................ 7-10
Table of Figures
Figure 7-1. Built-in recorder...............................................................................................................................7-1
Figure 7-2. Sample recording............................................................................................................................7-2
Figure 7-3. Numerical trend printout ...........................................................................................................7-6
Figure 7-4. Recorder paper replacement....................................................................................................7-8
Recording and Printing
7. RECORDING AND PRINTING
Overview
You can record waveforms, values, and loops and print them to a laser printer that is
either connected to the monitor or accessible over the Datex-Ohmeda monitor network.
Recording and printing options are located in the Record/Print menu and its submenus.
• You can record or print just one loop or one view of trends from within the
corresponding measurement menu.
• You can record or print several pages, several parameters, or all gathered
information from the Record/Print menu.
Recorder (N-XREC option)

You can use the optional built-in recorder (N-XREC option) to do the following:
• Record the graphical or numerical trend and print up to 24 hours of trend data.
• Record up to three real-time waveforms simultaneously.
• Display recordings of numerical information (in horizontal and vertical plane).
NOTE: Thermal paper printouts may be destroyed when exposed to light, heat,
alcohol, etc. Make a photocopy for your archives.
3
5 4
Figure 7-1. Built-in recorder
NOTE: The two-button recorder (shown) is for Cardiocap/5 monitors using software
version 3.0 or higher. A one-button recorder was available previously.
(1) Record Waveform/Stop key. Press to start or stop recording selected real-time
waveforms. This key functions like the Record Start/Stop key on a one-button recorder.
(2) Record Trend/Stop key. Press to start or stop recording selected numerical or
graphical trend data. Since this key is not available on a one-button recorder, use
the Record/Print menu options to print trend data.
(3) Key to release and open the recorder paper compartment.
(4) Recorder paper.
(5) Recorder paper compartment.
7-1
Recording waveforms
Date Time
Selected 3Apr01 10:24
ECG aVR
waveform 0.5mV/div
Scale Pleth 28%
Recorder CO2 %
speed Speed: 12.5mm/s
Figure 7-2. Sample recording

NOTE: Waveform scaling follows the displayed parameter scaling, when applicable.
Start/Stop recording waveforms

To record waveforms:
1. Make sure paper is installed in the recorder.
2. Press the Record Waveform/Stop key.
or
Press the ComWheel and select Record/Print from the Main Menu.
Select Record Waveforms.
Select Record Wave.
The waveforms are recorded according to the current waveform selections.
3. To stop recording, press the Record Waveform/Stop key again.
or
Select Stop Wave in the Record Waveforms menu.
Controlling paper speed

To see the waveforms more clearly or more generally, you can adjust the paper speed:

from the Main Menu.
Record Waveforms
Record Wave
Waveform 1 ECG1 1 3. Select Paper Speed and choose the speed you
prefer (1, 6.25, 12.5, or 25 mm/second).
Waveform 2 OFF 6.25
Waveform 3 OFF 12.5
Start on Alarms NO 25
Delay 12 s
Paper Speed 25 mm/s
Length 30 s
Previous Menu
Change paper speed:

1, 6.25, 12.5 or 25 mm/s.
7-2
Selecting waveform parameters

To select the waveforms you want to record:

3. Select Waveform 1, Waveform 2, or Waveform 3 and choose the parameter to be recorded.
You can record up to three waveforms simultaneously. If you want to record only
one waveform, select OFF for the other waveform fields.
4. Choose the parameter for the waveform.
Scroll toward –More– to see additional options.
Record & Print

Record Waveforms
Record Wave
Waveform 1 ECG1 OFF
Waveform 2 OFF ECG1
Waveform 3 OFF ECG2
Start on Alarms NO ECG3
Delay 12 s P1
Paper Speed 25 mm/ P2
Length 30 s Pleth
Previous Menu CO2
–More–
Change waveform recorded
in upper field.
Select OFF to clear field.
7-3
Controlling the recording time

You can select 30 seconds (the default) or continuous as the recording time.
To select the length of the recording:
Record & Print 1. Press the ComWheel and select

Record/Print from the Main Menu.
Record Waveforms
Record Wave
Waveform 1 ECG1 30 s 3. Select Length and choose 30 s or Cont.
Waveform 2 OFF Cont.
Waveform 3 OFF
Start on Alarms NO
Delay 12 s
Paper Speed 25 mm/
Length 30 s
Previous Menu
Change length of recording:

30 s or continuous.
NOTE: When recording is activated by alarms, the recording time is always 30 seconds.
Selecting the recording time initiation

The recorder can record only real-time data (delay of 0 seconds) or the first 12 seconds
from memory (delay of 12 seconds, the recording delay default).
You can set the recording delay to 0 seconds and record only real-time data.
To change the delay:
3. Select Delay and choose 0 sec.
NOTE: When recording is activated by alarms, the delay is always 12 seconds.
7-4
Recording waveforms on alarms

You can generate a strip chart recording automatically when asystole, heart rate, and
pressure alarms reach the red-alarm level, by setting up the recorder to start recording
on alarms.
To start recording on an alarm:

from the Main Menu.
Record Waveforms
Record Wave
Waveform 1 ECG1 YES 3. Select Start on Alarms and choose YES.

Waveform 2 OFF NO
Waveform 3 OFF
Start on Alarms YES
Delay 12 s
Paper Speed 25 mm/
Length 30 s
Previous Menu
Select YES for automatic start

of recording when serious
arrhythmias occur.
The alarms listed below will start the recording:
Alarm Recorded parameters

Asystole ECG + P1 waveforms, 25 mm/second
HR High/Low ECG + P1 waveforms, 25 mm/second
P1 High/Low ECG + P1 waveforms, 25 mm/second
Alarm recordings are annotated with the alarm source.
7-5
Recording trends
Adjust the parameter and time scales to record the desired level of trend detail.
Start/Stop recording trends

To record numerical or graphical trends:
1. Make sure paper is installed in the recorder.
2. Press the Record Trend/Stop key.
or
Press the ComWheel and select Record/Print from the Main Menu.
Select Record Trends.
Select Record Numerical or Record Graphical.
A numerical or graphical trend is recorded according to the current selections.
3. To stop recording, press the Record Trend/Stop key again.
or
Select Stop Numerical or Stop Graphical in the Record Trends menu.
Numerical trend printout

You do not need to choose parameters for a numerical trend recording.
Date Unit Time
3 Apr 2001
Parameter Parameter value
Figure 7-3. Numerical trend printout
Numerical trend recordings contain the following parameters:
Parameter Printed values and units

HR and SpO2 bpm/SpO2
NIBP Sys/dia or mean mmHg
P1 “Art” Sys/dia or mean mmHg
P2 “CVP” Sys/dia or mean mmHg
T1 Celsius or Fahrenheit
T2 Celsius or Fahrenheit
CO2 Et/Fi %, kPa or mmHg
O2 Et/Fi %
AA Et/Fi %
Resp. Rate Breaths per minute
Either Sys/Dia or mean pressures are recorded, depending on the digit format selected
in the pressure setups.
7-6
Changing the resolution

To select the resolution for a numerical trend record:
3. Select Trend Resolution and choose from the options.
Selecting graphical trend parameters

You can record graphical trends for two parameters.
To choose the parameters for a graphical trend recording:
3. Select Graphic Trend 1 or Graphic Trend 2.
4. Choose the parameter for the graphical trend.
Scroll toward –More– to see additional options.
7-7
Recorder paper replacement
Figure 7-4. Recorder paper replacement
To change the paper in the recorder:

1. Press the key that releases the paper compartment door.
2. Remove the roll and insert a new roll.
3. Close the paper compartment door.
7-8
Printing to a laser printer

You can print the following to a laser printer:
• Graphical and numerical trends.
• Patient Spirometry values and loops.
You can print several pages, all saved loops, or trend data from the Record/Print menu.
You can print one page or one loop from the corresponding parameter menu.
Changing the printer

To check or change the printer connection:
1. Press the ComWheel and select Record/Print
from the Main Menu.
2. Select Printer Connection.
3. Select Serial, Net, or None.
• Choose Serial if the printer is connected to
your monitor.
• Choose Net if your monitor is connected to
the Datex-Ohmeda S/5 Network and
Central.
Printing trend data

Adjust the parameter and time scales to print the desired level of trend detail.
To print a specific trend view:
1. Press the ComWheel and select Trends from the Main Menu.
2. Select the trend type you wish to print: Snapshot, Numerical, or Graphical.
3. Select Next Page to choose a specific trend page.
To print all numerical trend data:
1. Press the ComWheel and select Trends from the Main Menu.
2. Select Numerical.
To print several pages of graphical trend data:
2. Select Print Graphical.
7-9
Printing spirometry loops

To print a pair of loops:
1. Press the ComWheel and select Parameters from the Main Menu.
2. Select Airway Gas.
3. Select Spirometry Loops.
4. Select Print Loop.
To print all saved loops:
2. Select Print Loops.

This section describes the other adjustable features related to recording and printing. A
made. If you wish to make changes, we recommend that you contact the person
Changing the format for recorded numerical trends

You can select the kind of numerical trend that will be recorded when you select Record
Numerical from the Record/Print menu
4. Select Printer & Recorder.
5. Select Num Trend Type.
6. Select Num. or Tab.
7-10
Contents
Chapter 8. Troubleshooting
Checklist ........................................................................... 8-1
General.............................................................................................................................................................8-1
ECG ....................................................................................................................................................................8-1
Impedance respiration............................................................................................................................8-1
Pulse oximetry .............................................................................................................................................8-2
Non-invasive blood pressure (NIBP) ..............................................................................................8-2
Invasive blood pressure .........................................................................................................................8-2
Temperature..................................................................................................................................................8-3
Airway gases .................................................................................................................................................8-3
Patient spirometry .....................................................................................................................................8-3
NeuroMuscular Transmission (NMT)...........................................................................................8-3
Messages .......................................................................... 8-4

Other situations .................................................................. 8-8
Troubleshooting
8. TROUBLESHOOTING
This chapter consists of three parts that should help you solve common monitoring
problems: Checklist, Messages, and Other situations.
Checklist
Check the following items to ensure you remember to make all essential preparations
before monitoring. They also help if problems occur during monitoring.
General
Check that
• The monitor has no visual defects, such as cracks or loose parts.
• The power cord is connected to an electrical wall outlet and to the monitor.
• The D-fend water trap is empty and properly pushed into its place (with F-MXG).
• The sampling line is connected to the monitor (with F-MXG).
• Patient connection cables are attached to the connectors so that the color coding on
the plug matches the color coding on the connector.
• Trends of the previous patient are erased.
• Alarm limits are suitable for the patient.
ECG
Check that
• Electrodes are positioned correctly, electrode gel is moist, and skin contact is good.
• Correct lead-wire set is selected (3-lead or 5-lead) and correct lead-wire type is
selected in the ECG Setup menu.
• Lead-wire set is properly connected to the ECG extension cable.
• ECG extension cable is plugged into the blue connector.
• Pacemaker selection in the ECG Setup menu is Show when a pacemaker is used.
• ECG is selected for display (Main Menu – Monitor Setup – Screen Setup).
Check that
• Correct lead-wire set is selected (either 3 or 5 lead) and correct lead-wire type is
selected in the ECG Setup menu.
• Lead-wire set is properly connected to the extension cable.
• ECG extension cable is plugged into the blue connector.
• Resp is selected for display (Main Menu – Monitor Setup – Screen Setup).
8-1
Pulse oximetry
Check that
• Correct sensor is selected for the size of the patient and sensor is positioned correctly
on the patient.
• The sensor is completely dry after cleaning.
• Sensor cable is plugged into the gray connector and is properly connected to an
extension cable or sensor, as applicable.
• SpO2 is selected for display (Main Menu – Monitor Setup – Screen Setup).
Non-invasive blood pressure (NIBP)

Check that
• Correct NIBP hose is used (black hose for adults and children; white hose for infants).
• NIBP cuff is not loose; correct cuff for patient size is used.
• O-rings on hose connectors and cuff connector are intact; cuff connector is firmly
pushed inside the cuff tube.
• NIBP hose is properly connected to the monitor connector and will not detach by
pulling.
• There are no holes or cracks in the cuff bladder or cuff tube.
• Symbol indicating the center of the bladder is over the artery.
• All residual air is squeezed out of the cuff before wrapping it around the arm.
• Cuff is at heart level.
• Cuff tubes and NIBP tube are not kinked or squeezed together.
• Non-invasive blood pressure is selected for display
(Main Menu – Monitor Setup – Screen Setup).
If a leak is suspected, start venous stasis and check that the pressure is stable during
stasis.

Check that
• Invasive blood pressure transducer cable is plugged into a red connector.
• Pressure transducer is connected to the cable.
• Patient catheter is connected to the pressure line.
• There is no air in the transducer dome or catheter line.
• Transducer is at mid-heart level.
• Pressure transducer is zeroed.
• Invasive blood pressure is selected for display
8-2
Troubleshooting
Temperature
Check that
• You are using a Datex-Ohmeda temperature probe.
• Temperature probe is positioned correctly.
• Temperature probe is inserted properly into the appropriate temperature connector.
• Temperature is selected for display (Main Menu – Monitor Setup – Screen Setup).
Airway gases
Check that
• D-fend water trap is properly placed in the monitor.
• Water trap container is empty.
• A new sampling line is used after each patient.
• Sampling line is connected to the water trap and to the airway adapter.
• Monitor is turned on and self-check is performed with the sampling line attached.
• Humidification and/or bacteria filter is placed correctly.
• Breathing circuit or accessories are free of residuals from alcohol-based disinfectants.
• Desired gas parameter is selected for display (Main Menu – Monitor Setup – Screen Setup).
Patient spirometry
Check that
• Correct flow sensor is used (D-lite for adults and Pedi-lite for pediatrics).
• Correct flow sensor type is selected
(Main Menu – Parameters – Airway Gas – Spirometry Setup).
• Straight luer connectors of the spirometry tube are attached to the connector on the
monitor and the angled luer connectors are attached to the sensor.
• Spirometry tube is not kinked or squeezed.
• D-lite and spirometry tube are free of water drops.
• Humidification and/or bacteria filter is placed correctly.
• Desired spirometry parameter is selected for display
NeuroMuscular Transmission (NMT)

Check that
• The application site of the electrodes is cleaned of oil and dirt.
Avoid placement over lesions or excessive body hair.
• NMT is selected for display (Main Menu – Monitor Setup – Screen Setup).
8-3
Messages
Message Explanation and/or Corrective Action
Acknowl. alarms silenced Acknowledged alarms are silenced. (Silence Alarms key pressed
during silencing period).
Air leakage Air leakage in NIBP cuff or hose. Check all connections and test
the cuff tightness using venous stasis.
Apnea No change detected in CO2 during the last 20 seconds.
(Impedance respiration) No change detected in impedance
respiration waveform for 20 seconds.
Apnea deactivated Apnea alarm is silenced until reactivation after five breaths.
Artifact(s) Unsuccessful NIBP measurement. Patient is moving, shivering, or
breathing deeply; also marked arrhythmia or irregular beats. Calm
the patient and start a new measurement.
Asystole Asystole, no QRS detected in ECG.
NOTE: This does not depend on the heart rate source.
Back-up batt. failure Backup battery is discharged or faulty. Use mains power for
4 hours, then switch to battery power. If the message reappears,
contact authorized service personnel.
Cable off NMT or regional block cable is not connected.
Calibrate Agent ID Agent identification error. Perform gas calibration.
Calibration not protected (NIBP) Contact authorized service personnel.
Calibration switch ON (NIBP) Calibration protection switch at the bottom of the monitor
is turned to the right. Contact authorized service personnel.
Call service: Error X NIBP hardware error. Note the error number (X) and contact
authorized service personnel.
Check D-fend Check that the water trap is properly attached.
Check SpO2 probe Pulse search active for 20 seconds but no acceptable pulse is
found. Either there is no detectable SpO2 signal, the sensor is
faulty, or it is detached from the patient.
Check stim. electrodes NMT stimulus current could not be delivered due to poor
stimulus electrode connection or damaged cable.
Control measurement NIBP alarm limit was exceeded and a new measurement was
started automatically.
Cuff loose NIBP cuff is loose or not attached to the patient. Hose is not
connected to the monitor.
Cuff occlusion Check NIBP cuff hose and tubes; restart measurement. If the
problem persists, contact qualified service personnel.
Cuff over-pressure NIBP cuff is squeezed during measurement and pressure safety
limits are exceeded.
EEPROM Error Faulty EEPROM circuit on the CPU board. Contact authorized
service personnel.
8-4
Troubleshooting

EMG electrodes off (NMT) EMG recording electrodes are off. Electrodes or stimulus
clip is loose.
EtAA high / EtAA low Measured EtAA is equal to or above/below the alarm limit.
EtCO2 high / EtCO2 low Measured EtCO2 is equal to or above/below the alarm limit.
EtO2 high / EtO2 low Measured EtO2 is equal to or above/below the alarm limit.
FiAA high / FiAA low Measured FiAA is equal to or above/below the alarm limit.
FiN2O high Measured FiN2O is equal to or above 82%.
FiO2 high / FiO2 low Measured FiO2 is equal to or above/below the alarm limit.
HR high / HR low Heart rate (ECG or invasive pressure) or pulse rate (pulse
oximetry) is equal to or exceeds the upper/lower alarm limit.
Infl. limits! Check setup Adult or child NIBP cuff is being used but the selected infant
mode keeps the inflation pressure too low.
Leads off One or more cables are disconnected or off the patient. Check
ECG cable, all leads, and the neutral electrode (RL/N).
NOTE: This message may appear during defibrillation.
Long measurement time NIBP measurement is prolonged over the maximum
measurement time (two minutes with adult or child inflation
limits; one minute with infant inflation limits). Reapply the cuff,
calm the patient, and start a new measurement.
Measurement off (NMT) Cable is connected but measurement has not started.
(Impedance respiration) Measurement has been turned off.
Monitor is overheating Temperature inside the monitor is above the maximum limit.
Check the dust filter at the back of the monitor.
MVexp high / MVexp low Measured expiratory minute volume value is above/below the set
volume limit.
MVexp<<MVinsp Exhaled volume is noticeably smaller than inhaled. Check the
whole system for leakage.
MVexp<0.5 l/min Measured volumes are too small for reliable calculation and, for
(MVexp<0.2 l/min with example, waveforms and loops may be unreliable.
Pedi-lite)
Network connection down Too many monitors may be active on the network.
NIBP high / NIBP low NIBP value is equal to or above/below the alarm limit.
NIBP manual Autocycling is interrupted because of air leakage or loose cuff.
No P1/P2 transducer Invasive pressure or transducer cable not connected.
No SpO2 probe SpO2 sensor is not connected to the monitor. Faulty or wrong
type of SpO2 sensor. Use only sensors approved for use with the
type of pulse oximetry installed in the monitor.
No SpO2 pulse Pulse signal is found but then lost for 10 seconds or longer. Try a
different site.
8-5

Noise (ECG) Unreliable heart rate (HR) calculation or distorted
waveform due to:
• Too much high frequency or electrical mains noise in ECG.
• The DC offset voltage between two electrodes is too high.
NOTE: This message may appear during defibrillation.
P1/P2 high Invasive pressure of marked channel is equal to or above/below
P1/P2 low the alarm limit.
PEEP high / PEEP low Measured PEEP value is above/below the set pressure limit.
Ppeak high / Ppeak low Measured peak pressure is above/below the pressure limit setting.
Printer error Printer is out of paper or paper is jammed. Printer is not online or
is not turned on. Printer cable is loose or broken.
Printer failure Printer is not responding, see Printer error. Select another printer.
Printing Laser printer is printing.
Pulse search Monitor is searching for pulse oximetry signal.
RAM Error Faulty RAM circuit on the CPU board. Contact authorized service
personnel.
Rebreathing Measured FiCO2 is equal to or above the alarm limit.
Recorder: cover open The lid of the recorder is open.
Recorder: input voltage high Call service to check the monitor.
Recorder: input voltage low
Recorder: out of paper Insert a new roll of paper.
Recorder: system error n (n can be 1, 2 or 3.) Contact authorized service personnel.
Recorder: thermal array Wait for the recorder to cool down.
overheat
Reference not stable (NMT) Deviation between the four reference stimulation responses
is too big, causing reference setting to fail. Can be caused by
movement artifact; may occur when patient is relaxed.
Replace D-fend D-fend water trap is partially blocked. This decreases air flow.
Resp high / Resp low Respiration rate (RR) is equal to or above/below the alarm limit.
Response too weak (NMT) The maximum gain is insufficient to increase the response
signal amplitude to a measurable level. Can occur if:
• Stimulation current is too weak.
• Stimulation electrodes are not connected or they are improperly
placed on the nerve.
• Recording electrodes are disconnected.
• One or more electrodes are dry and should be replaced.
• The skin at the electrode site is not properly prepared.
Reposition the stimulating or recording electrodes. Change the
site of the measuring electrodes.
Sample line blocked The gas sampling line inside or outside the monitor is blocked or
the water trap is occluded.
8-6
Troubleshooting

Sensor inop. Gas measuring sensor is inoperative or the temperature in the
monitor has increased. Contact authorized service personnel.
Setting reference NMT reference search in progress.
Small resp. curve (Impedance Respiration) Signal amplitude is less than 0.4 ohms.
Snapshot memory full Creating a new snapshot will erase older ones.
SpO2 high / SpO2 low SpO2 is equal to or above/below the alarm limit.
SpO2 probe off SpO2 sensor is not attached to the patient, site is unsuitable, or
sensor is faulty. Check connections; try a new site or sensor.
SRAM Error Faulty SRAM circuit on the CPU board. Contact authorized
service personnel.
Supramax not found (NMT) Supramaximal stimulus current (70 mA) was not found.
Stop measurement, reposition the stimulating or recording
electrodes, and restart the measurement.
Supramax search (NMT) Supramaximal stimulus current search in progress.
Temperature error Calibration was faulty. Recalibrate.
Tetanic (NMT) Tetanic stimulation is on.
Unable to measure Dia (NIBP) Accurate diastolic pressure not achieved because of
artifacts, weak pulsation, etc.
Unable to measure Sys (NIBP) Initial inflation pressure is not high enough to enable
proper measurement. Systolic pressure is higher than maximum
inflation pressure; artifacts interfere in systolic area.
Unstable zero pressure Pressure is unstable when starting the NIBP measurement. Calm
the patient and retry.
Voltage error Erroneous voltage level detected. Contact service personnel.
Wait for the measurement Venous stasis is attempted while a regular measurement is under
to be done way.
Weak pulsation (NIBP) Weak or unstable oscillation signal due to:
• Improper cuff position or attachment; small air leakage.
• Weak or abnormal blood circulation.
• Slow heart rate associated with artifacts.
• Patient is moving or disturbed during measurement.
… lead off A lead wire (…) is disconnected.
8-7
Other situations
Other problem situations which may occur during monitoring, with possible
explanations and instructions, are listed below.
Situation Cause and/or Recommended Action

Extra Asystole alarms Bad electrode quality or positioning.
• Remove the ECG cable from the monitor and insert
again.
• Enlarge the size from 1.0 mV to 2.0 mV.
ECG baseline is thick ECG lead cable is looped.
Other electrical power cables are near the ECG wires.
Incorrect ECG filter.
Incorrect power frequency of the monitor.
ECG is noisy Patient is shivering.
Incorrect ECG filter.
Bad electrode quality or positioning.
NIBP readings are high Cuff too small or loose.
Cuff is under mid-heart level.
Pacer markers are not Check that:
visible • The pacer markers have been selected ON.
• The pacemaker was adjusted correctly and is not
above R.
• The pacemaker functions correctly; check that ECG
cables, electrodes, and setup are correct.
Patient spirometry An adult sensor is used for a pediatric patient and the
accuracy is poor—TV less monitor’s spirometry sensor selection is Pediatric. Use a
than 50 ml reported as pediatric sensor.
0 (zero) ml
Patient spirometry values An adult sensor is used for an adult patient, but the
are 1/4 of real values monitor’s spirometry sensor selection is Pediatric.
Change the selection to Adult.
Patient spirometry values A pediatric sensor is used for a pediatric patient, but
are 4 times larger than the monitor’s spirometry sensor selection is Adult.
real values Change the selection to Pediatric.
Patient spirometry Paw- A pediatric sensor is used for an adult patient and the
Vol loop is vertical monitor’s spirometry sensor selection is Pediatric. Use
an adult sensor and change the selection to Adult.
8-8
Troubleshooting
Situation Cause and/or Recommended Action

Pressure readings are Air bubbles or a swinging catheter are causing a
high resonating waveform.
Wrong zero because the transducer position in relation
to the patient has changed (too low).
Transducer failure.
Incorrect calibration.
Pressure readings are low Dampened waveform because of air bubbles, clotting or
kinked tubes.
Transducer is positioned above patient’s mid-heart
level.
Transducer failure.
Incorrect calibration.
Temperature is not Datex-Ohmeda temperature probe is not being used.
displayed on monitor The temperature may be outside the measurable range
screen (10 to 45 °C).
If problem persists, contact authorized service
personnel.
Cannot see some trend Adjust the parameter and time scales to see the desired
details trend detail.
8-9
8-10
Contents
Chapter 9. Maintenance and Cleaning

Introduction ....................................................................... 9-1
Preventive maintenance ........................................................ 9-1
Daily tasks ......................................................................................................................................................9-1
ECG and respiration...................................................................................................................9-1
Pulse oximetry ...............................................................................................................................9-1
NIBP.....................................................................................................................................................9-1
InvBP ...................................................................................................................................................9-1
Temperature....................................................................................................................................9-1
Airway gases and spirometry................................................................................................9-1
Every month..................................................................................................................................................9-2
Cooling fan dust filter................................................................................................................9-2
Every two months......................................................................................................................................9-2
Black D-fend....................................................................................................................................9-2
Every six months........................................................................................................................................9-2
Gas calibration...............................................................................................................................9-2
Backup battery check ................................................................................................................9-2
Every 12 months.........................................................................................................................................9-2
Planned Maintenance check.................................................................................................9-2
Cleaning............................................................................ 9-3
Monitor ............................................................................................................................................................9-3
ECG cables .....................................................................................................................................................9-4
Pulse oximetry sensors ...........................................................................................................................9-4
NIBP cuff hose.............................................................................................................................................9-4
NIBP cuff.........................................................................................................................................................9-4
Cables for invasive pressure................................................................................................................9-4
Temperature probes .................................................................................................................................9-4
NMT sensor cable, sensors, and regional block adapter ...................................................9-5
Reusable D-lite sensor .............................................................................................................................9-5
Airway adapter............................................................................................................................................9-5
Sampling line................................................................................................................................................9-5
D-fend water trap .......................................................................................................................................9-5
Removing the water trap .........................................................................................................9-6
Other accessories .......................................................................................................................................9-6
Table of Figures
Figure 9-1. Emptying the water trap container ......................................................................................9-6
Maintenance and Cleaning
9. MAINTENANCE AND CLEANING
Introduction
For safe, reliable function and operation of the monitor, regular care has to be carried
out according to the instructions in this manual and the Planned Maintenance
procedures described in the Cardiocap/5 Technical Reference Manual.
If the monitor does not function as it should, and information in the Troubleshooting
chapter does not provide help, contact your sales representative. Do not perform
cleaning or maintenance procedures other than those described in the Cardiocap/5
manuals.
Preventive maintenance
Daily tasks
Check that all accessories, cables and monitor parts are clean and intact.
Clean the device as described in Cleaning later in this chapter.
Check the parameter items as directed below:
ECG and respiration

The “Leads off” message is displayed when the cable is connected to the monitor and
the leads are not connected. Shorting all the leads should make the message disappear
(ASY alarm appears).
Pulse oximetry
Sensor functions when properly connected to the patient.
NIBP
Cuff hose detection (Adult/Infant) works properly.
Pump is not restarting in Venous Stasis mode. If it starts, there may be a leak in the cuff.
InvBP
The monitor recognizes the cable connection (activates the display) for all the pressure
channels used.
Zeroing of all transducers is working correctly.
Temperature
Measurement starts when a temperature probe is connected.
Airway gases and spirometry

The “Sample line blocked” message appears within 30 seconds after you have occluded
the airway adapter; gas waveforms show zero at the same time.
The D-fend water trap is empty. If the green D-fend+ is used (patient with extensive
mucus secretion), replace it daily with a new one.
9-1
Every month
Cooling fan dust filter
Check the fan filter on the rear panel of the monitor. Replace the filter if it is damaged.
Clean the fan filter every month or whenever needed:
1. Pull the filter out.
2. Wash in detergent solution.
3. Allow to dry before reinserting. Do not use pressurized air.
Every two months

Black D-fend
Replace the D-fend water trap at least every two months, or when a “Sample line
blocked” or “Replace D-fend” alarm message persists.
Every six months

Gas calibration
Perform gas calibration according to the instructions in the Airway Gases chapter.
If gas measurement is in extensive use, calibration is recommended every two months to
ensure that measurement accuracy stays within specifications.
Backup battery check

The power supply includes a backup battery that saves up to 15 minutes of
information.
To check the battery:
1. Switch on the monitor.
When the battery is fully charged, the charging symbol is not displayed on the
screen.
2. Disconnect the monitor from mains power.
The monitor should function normally for 15 minutes.
Every 12 months
Planned Maintenance check
The Planned Maintenance check detailed in the Technical Reference Manual requires
trained service person and appropriate testing tools and equipment.
9-2
Cleaning
The appropriate cleaning procedure depends on where and how the part or accessory
is used, and on the condition of the patient.
Method Why? Which items? How?

Cleaning To remove dirt and All parts daily. 1. Wipe away visible organic
most microbes. Items to be disinfected material.
or sterilized. 2. Rinse as recommended by
the detergent manufacturer.
3. Allow to dry completely.
Disinfecting To kill and remove Accessories and supplies With heat:
pathogenic microbes. (other than SpO2 Wash in a washing machine at
sensors) in contact with 85 °C (185 °F) for at least one
the patient’s skin or minute.
airways.
With chemicals:
NOTE: Some SpO2
Immerse in 2% glutaraldehyde
sensors cannot be
for 10 minutes (pH=6.5). After
disinfected. Read the
tuberculosis, HIV, or hepatitis
sensor instructions
patient, immerse for 20 minutes.
before attempting to
disinfect a sensor. Rinse carefully or wipe with
alcohol and let dry.
Sterilizing To kill microbes and Accessories and supplies Steam autoclave for 15 minutes
bacterial spores. penetrating the patient’s at 121° C (250 °F ) maximum.
tissue. Use ethylene oxide mixture at
50 to 60°C (120 to 140°F). Follow
the sterilizer manufacturer’s
recommendations for required
aeration times.
Immerse in 2% glutaraldehyde
for three hours, rinse carefully,
and let dry.
WARNING: Electrical Shock Hazard. Before cleaning, disconnect the monitor from the
electrical outlet.
WARNING: Electrical Shock Hazard. After cleaning, or if liquid has accidentally entered the
interior of the monitor, make sure that every part of the monitor is dry before reconnecting it
to the power supply.
CAUTION: Do not sterilize any part of the monitor with steam autoclave or ethylene oxide.
CAUTION: Do not immerse any part of the monitor in liquids or allow liquid to enter the interior.
CAUTION: Do not use hypochlorite, acetone-based, phenol-based, or ammonia-based cleaners.
9-3
Monitor
To clean the monitor:
1. When the display surface becomes dusty, wipe it gently with absorbent cotton,
chamois or other soft material. The display may also be cleaned using a small
amount of normal hexane. Do not use acetone, toluene or alcohol because they
cause chemical damage to the polarizer.
2. Wipe the monitor with a mild detergent solution such as the Datex-Ohmeda
Cleaning Fluid. Do not leave liquid spills on any metal part.
3. Let dry completely before connecting to power source.
The internal sampling system does not need to be cleaned nor sterilized. The D-fend
water trap functions as a bacteria filter and there is no reverse flow to the patient.
ECG cables
Wipe the cables with a mild detergent solution. Disinfect when necessary.
Pulse oximetry sensors

WARNING: Patient Safety. A damaged sensor or a sensor soaked in liquid may cause burns
during electrosurgery.
Disposable sensors are for single-patient use only. Do not attempt to clean them.
For cleaning instructions and recommended cleaning agents for a reusable sensor,
consult the instructions for using that sensor.
Consider possible patient allergies when selecting the cleaning agent.
In general, to clean any reusable sensor or sensor cable, detach it from the patient and
the monitor. Wipe it with a pad moistened with a mild cleaning solution, such as 70%
isopropyl alcohol. Allow the sensor and/or cable to dry completely before use.
NIBP cuff hose

Wipe the cables and hose with a mild detergent solution. Disinfect when necessary.
NIBP cuff
Clean only when necessary. Remove the bladder from the cuff. Wash the bladder and
the cuff in mild detergent solution. Do NOT use alcohol.
Cables for invasive pressure

Wipe the cables with a sterile alcohol-based detergent. After cleaning, rinse surfaces by
wiping them with a cloth damped with sterile water. Dry with a dry cloth.
Temperature probes
Clean with a mild detergent solution and rinse with water. Disinfect or sterilize when
necessary.
9-4
NMT sensor cable, sensors, and regional block adapter

Wipe the cable, sensor, and adapter with mild detergent solution.
If disinfection is required, use ethanol or isopropyl alcohol. Do not use hypochlorite.
Do not immerse in liquid.
Reusable D-lite sensor

Reusable D-lite sensors can be washed in a dishwasher. After cleaning, allow the
sensor to dry thoroughly.
Make sure that the sensor is intact. Connections must be tight for exact measurements.
Airway adapter
Replace the single-use adapter after each patient.
A reusable adapter can be disinfected with glutaraldehyde or alcohol. A reusable steel
adapter may be autoclaved.
If you want to clean the adapter before use, submerge it in 70% alcohol solution for 30
seconds and rinse carefully with water.
Rinse away all traces of alcohol or detergent. Dry the adapter before connecting to the
patient.
Sampling line
Do not reuse the sampling line. Attempting to clean and reuse a sampling line may
affect measurement results.
D-fend water trap

The D-fend water trap contains a hydrophobic membrane that prevents water and
secretions from entering the measuring chamber. Condensed water and saliva are
collected into a washable container.
The green D-fend+ is for patients with extensive mucus secretion and for single-patient
use only. Replace it every 24 hours or when a “Sample line blocked” or “Replace D-
fend” message persists.
The water trap container can be cleaned with disinfecting solutions or sterilized using
cold chemicals or ethylene oxide.
CAUTION: Do not disinfect or open the water trap cartridge. To avoid damage, do not touch or try
to clean the water trap hydrophobic membrane (other than to rinse it with water).
9-5
To lengthen the lifetime of your monitor and minimize downtime:

• Empty the water trap container whenever it is more than half full.
• Do not open, wash, or sterilize the D-fend water trap cartridge.
• After washing or disinfecting the airway adapter or water trap container, make
sure no alcohol or detergent remains. Traces of alcohol or other organic cleaning
solutions may affect measurement.
• Do not force air or oxygen through the D-fend; do not allow smoke or dust to enter
the D-fend.
• While administering nebulized medication, disconnect the gas sampling line from
the patient circuit for 30 minutes.
• If a “Sample line blocked” alarm occurs, replace the sampling line and empty the
water trap container.
Removing the water trap
Figure 9-1. Emptying the water trap container
To remove the water trap:

1. Push the water trap latch to the right. The water trap is spring-loaded.
The “Check D-fend” message appears.
2. Detach the container from the water trap cartridge by pulling it carefully
downward.
3. Empty and clean the container.
4. Attach the container back into the cartridge tightly.
5. Push the whole unit into its housing on the front panel until the latch is set.
6. Press the Normal Screen key to restart monitoring. Check that the “Check D-fend”
message is no longer displayed.
Other accessories
See the accessory packages for checkout and cleaning instructions. Do not reuse
disposable accessories.
9-6
Contents
Chapter 10. ECG

Overview .......................................................................... 10-1
ECG and heart rate display............................................................................................................... 10-1
Patient connections ........................................................... 10-2

Patient preparation ................................................................................................................................10-2
Placing electrodes...................................................................................................................................10-2
Cable set ....................................................................................................................................................... 10-3
Color and letter coding........................................................................................................................ 10-4
Connecting the lead wires and the trunk cable.................................................................... 10-4
ECG setup menu ................................................................ 10-5

Selecting a lead ................................................................ 10-7
Viewing a cascaded ECG...................................................... 10-7
Adjusting ECG size ............................................................. 10-8
Adjusting beat sound volume ................................................ 10-8
ST segment analysis ........................................................... 10-9
Monitoring the ST segment .............................................................................................................. 10-9
Accessing ST analysis view .............................................................................................................. 10-9
ST display in a digit field....................................................................................................10-10
Setting ST point manually...............................................................................................................10-11
Setting ISO point manually.............................................................................................................10-11
Setting ECG alarms ...........................................................10-12

Pacemaker markers ..........................................................10-12
Other adjustable features ...................................................10-13
Analog signal output ...........................................................................................................................10-13
Table of Figures
Figure 10-1. ECG and HR display ................................................................................................................10-1
Figure 10-2. Standard electrode positioning with 3-lead set........................................................10-2
Figure 10-3. Modified electrode positioning, CB5, with 3-lead set..........................................10-2
Figure 10-4. Standard electrode positioning with 5-lead set........................................................10-3
Figure 10-5. ECG setup.......................................................................................................................................10-3
Figure 10-6. ST analysis view ......................................................................................................................10-10
Figure 10-7. ST number field .......................................................................................................................10-10
ECG
10. ECG
Overview
The electrocardiograph, ECG, reflects the electrical activity generated by the heart
muscle. ECG monitoring is used for heart rate measurement and to detect arrhythmias,
pacemaker function, and myocardial ischemia.
When you use a 5-lead set, you may monitor the waveforms of up to three different
ECG leads. When you use a 3-lead set, the monitor displays one ECG lead.
When monitoring ECG, the monitor simultaneously analyzes ST segment changes.
Changes of up to three different ECG leads are analyzed depending on your lead set.
ECG and heart rate display

4 5 6 7 8
16:48
aVR ECG 9
1 mV H
1
I
R
58
1 mV S aVR 2.8 II
2 T I –2.8
2.8 10
II 2.8
II 1 mV
3
13 12 11
Figure 10-1. ECG and HR display
(1) ECG1 displayed first

(2) ECG2 displayed below ECG1
(3) ECG3 displayed below ECG2
(4) Selected lead label
(5) ECG gain bar (1 mV reference)
(6) Heart rate (HR) label
(7) Heart rate calculation source and message field for HR messages
(8) HR value is always displayed with ECG1
(9) Heart beat detector is flashing with every detected heart beat
(10) ST values appear next to ECG1; the lead with the largest absolute ST value is also
displayed
(11) Selected ST leads
(12) ST label
(13) Message field for parameter messages
NOTE: You can choose the number of ECG waveforms on the display in the Monitor
Setup menu (select Screen Setup and Waveform Fields). You choose the ECG leads in the
ECG menu.
10-1
Patient connections
Patient preparation
Good signal quality requires good skin contact with the electrodes. Excessive body hair
or skin oil can affect the contact. Pre-gelled electrodes are recommended. Check that
the electrodes are moist and have not dried out during storage.
WARNING: Make sure the lead set clips or snaps do not touch any electrically conductive
material including earth.
Placing electrodes
When placing the electrodes, avoid bones close to the skin, obvious layers of fat, and
major muscles.
RED (IEC) YELLOW (IEC)

WHITE (AAMI) BLACK (AAMI)
LEAD I
LEAD III
LEAD 2
GREEN (IEC) *
RED (AAMI)
* The color might be BLACK in some older cables.
Figure 10-2. Standard electrode positioning with 3-lead set
You can use a CB5-lead when you want the 3-lead set connection to resemble the 5-lead
set V5 connection. The red (IEC standard) or white (AAMI standard) electrode, which
is shaded, is on the back.
RED (IEC)
WHITE (AAMI)
LEAD I
YELLOW (IEC)
BLACK (AAMI)
GREEN (IEC) *
RED (AAMI)
* The color might be BLACK in some older cables.
Figure 10-3. Modified electrode positioning, CB5, with 3-lead set
10-2
ECG
When you use routine positioning with a 5-lead set, place the chest electrode on one of
the six places indicated in the picture. If the lead set follows the IEC standard, the chest
electrode is white; if the set follows the AAMI standard, the chest electrode is brown.
RED (IEC) YELLOW (IEC)

WHITE (AAMI) BLACK (AAMI)
1 2
3
4 5 6
BLACK (IEC) GREEN (IEC)

GREEN (AAMI) RED (AAMI)
Figure 10-4. Standard electrode positioning with 5-lead set
Cable set
RED (IEC) YELLOW (IEC) RED (IEC) RED (IEC) YELLOW (IEC)
WHITE (AAMI) BLACK (AAMI) WHITE (AAMI) WHITE (AAMI) BLACK (AAMI)
LEAD I
LEAD III
1 2
LE LE 3
4 5 6
AD AD
II
I
GREEN (IEC) GREEN (IEC) YELLOW (IEC) BLACK (IEC) GREEN (IEC)
RED (AAMI) RED (AAMI) BLACK (AAMI) GREEN (AAMI) RED (AAMI)
Figure 10-5. ECG setup
(1) Trunk cable

(2) 3-lead set or 5-lead set
WARNING: Patient Safety. Ensure proper contact of the return electrode of the
electrosurgery unit to your patient to avoid possible burns on the patient via ECG electrodes
and probes.
10-3
Color and letter coding

3-LEAD IEC STANDARD 5-LEAD IEC STANDARD
L = yellow (left arm) R = red (right arm)
F = green (foot) N = black (neutral)
R = red (right arm) L = yellow (left arm)
F = green (foot)
C = white (chest)
3-LEAD AAMI STANDARD 5-LEAD AAMI STANDARD

LA = black (left arm) RA = white (right arm)
LL = red (left leg) RL = green (right leg)
RA = white (right arm) LA = black (left arm)
LL = red (left leg)
V = brown (chest)
Connecting the lead wires and the trunk cable

To make lead wires and trunk cable connections:
1. Attach the lead wires to the corresponding electrodes, paying attention to the color
codes.
2. Connect the lead wire set to the trunk cable and ensure a proper connection.
3. Plug the trunk cable into the corresponding monitor connector.
It takes about 10 minutes for the electrodes to stabilize. During this time errors may
occur in the signal.
10-4
ECG
ECG setup menu

To open the ECG setup menu:
2. Select ECG Setup.
ECG
ECG ECG Setup
ECG1 Lead II HR Source AUTO
ECG2 Lead I Display with HR None
ECG3 Lead I Filter STfilt
ECG Size 1.0 5-lead Cable 5elect
ST Analysis ECG Grid OFF
Beat Sound Volume 3 Pacemaker Hide
ECG Setup QRS Type Normal
ECG Alarms Previous Menu
Parameters Menu
Set HR source, filter, grid, Change origin of HR calculation.

pacemaker settings and Priority in AUTO selection:
QRS type. ECG, Art, ABP, Pleth.
HR Source Selects the heart rate source. When ECG is selected, the HR source is
always calculated from ECG 1. If the ECG signal is affected by too
much noise for a reliable heart rate calculation, heart rate can be
calculated from pressure (Art and ABP) or the plethysmographic pulse
waveform.
The selected heart rate source is shown above the numerical heart rate
display. The heart rate color is the same as the source parameter.
The AUTO selection priorities for heart rate calculation are: ECG,
Pressure (Art or ABP), and Plethysmographic pulse waveform. The
first heart rate source available is selected.
Display with HR Select PR to display combined Heart Rate and Pulse Rate next to the
ECG waveform. The current HR source is displayed in a larger font
size and the QRS symbol flashes next to the reading.
10-5
Filter Filters the ECG signal high frequency noise and slow respiratory
artifacts. The selections are Monit, Diagn, and STfilt.
• Monit (monitor) filter is used in routine monitoring. It effectively
filters the high frequency artifacts caused by the electrosurgery
unit and respiration, for example.
• Diagn (diagnostic) filter is used if more accurate information of the
waveform is needed (e.g., of P-wave or AV block). The diagnostic
filter is more susceptible to both high frequencies and baseline
wander than the monitor filter.
• STfilt (ST filter) permits more accurate of ST segment information.
It filters the high frequency artifacts caused by an electrosurgery
unit but catches the slow changes in ST segment. The ST filter is
more susceptible to baseline wander than the monitor filter.
5-lead Cable This selection is visible only when a 5-lead trunk cable is connected to
the monitor. Select 5elect if you are using 5 electrodes or 3elect if you
are using 3 electrodes with the 5-lead trunk cable.
ECG Grid Selects a background to be shown on the ECG waveforms, making it
easier to evaluate the waveform. The grid scale is 0.5 mV.
Pacemaker Selects how the pacing pulse of a cardiac pacemaker is displayed. The
selections are Show, Hide, ON R and Sensit.
• Show—the pacer pulse is filtered away from ECG data but the pulse
is displayed as a constant height marker.
• Hide—the pacer pulse is filtered away from ECG data.
• ON R—pacer pulses are not filtered away from ECG data. This
improves ECG monitoring with A-V pacemaker patients, as QRS
complexes are counted even if the pacer pulse hits the QRS
complex. However, during asystole the monitor may count pacer
pulses as heart beats.
• Sensit—uses a more sensitive pacemaker detection. A pacemaker
spike is displayed on ECG.
QRS Type QRS detection and HR calculation may be affected by the shape of the
QRS complex. Normal QRS type detects a heart beat between 40 and
120 ms. Wide QRS type detects a beat between 40 and 220 ms.
10-6
ECG
Selecting a lead
The following lead selections are possible:
• With 3-lead set: I, II, III
• With 5-lead set: I, II, III, aVR, aVL, aVF and V5
To select the ECG1 lead:
ECG
2. Select ECG1 Lead.
ECG1 Lead aVR
ECG2 Lead Casc. I You can select all the leads (ECG1, ECG2 and
ECG3) in the ECG menu.
ECG3 Lead Casc. II
ECG Size 1.0 III
ST Analysis aVL
Beat Sound Volume 3 aVF
ECG Setup aVR
ECG Alarms V
Parameters Menu
Change lead displayed as

first ECG waveform.
The label of the lead is displayed in the ECG field and above the numeric HR.
NOTE: It is possible to connect a 3-lead set to a 5-lead trunk cable. The combination
functions as a 3-lead set.
Viewing a cascaded ECG

If more than one ECG waveform is configured to be displayed in the waveform fields
when using a 3-lead set, the same ECG is displayed in each of these fields. Thus, more
QRS complexes are displayed at the same time.
With a 5-lead set, a cascaded ECG or different leads can be displayed. Select the
different leads in the ECG menu.
10-7
Adjusting ECG size

Increasing or decreasing the ECG gain affects the size of the 1 mV bar at the left end of
the ECG waveform, and the size of the ECG waveform accordingly.
To make adjustments in ECG size:
ECG
ECG1 Lead aVR 2. Select Size.
ECG2 Lead Casc.
ECG3 Lead Casc.
ECG Size 1.0
ST Analysis
Beat Sound Volume 3
ECG Setup
ECG Alarms
Parameters Menu 1 mV
Change size of ECG waveforms

by adjusting scale height.
Adjusting beat sound volume

When the monitor detects a QRS complex or a pulse (pleth or pressure), a beep tone
sounds. You can raise, lower, or turn off the beat sound volume. Adjusting the beat
sound volume also affects the SpO2 beat sound volume.
When SpO2 is monitored, the monitor provides a variable pulse beep, so that the tone
of the pulse beep rises with increasing oxygen saturation and falls as saturation
decreases. This also affects the ECG tone.
To adjust the beat volume:
ECG
ECG1 Lead II 2. Select Beat Sound Volume and turn the
ComWheel to choose the volume. The range
ECG2 Lead I 10
is from 1 (silent) to 10 (loud) or 0 (OFF).
ECG3 Lead I
ECG Size 1.0
ST Analysis
Beat Sound Volume 3
ECG Setup
ECG Alarms
Parameters Menu 0
Adjust volume of pulse/heart

beat sound.
10-8
ECG
ST segment analysis
The ST value illustrates the electrical activity difference between ISO points and
ST points. The points are based on R-wave detection.
Myocardial ischemia manifests itself in the ECG by causing the ST segment to deviate
from the isoelectric line (ISO point). The ST segment generally rises above the PQ
isoelectric line in the presence of transmural ischemia and is pressed below the
isoelectric line in the subendocardial ischemia. Ischemic heart disease may result in
myocardial infraction, fatal arrhythmias, or acute coronary insufficiency.
ST segment changes may also be affected by other factors than myocardial ischemia.
These factors can be, for example, drugs, or metabolic or conduction disturbances.
Monitoring the ST segment

The monitor continuously analyzes the ST segment changes in active leads. ST
numerical data is shown on the right of the second real-time ECG waveform field.
When monitoring begins or when a lead is changed, the monitor starts to learn the ST
segment. During a learning period of 16 accepted beats, the ST values are displayed
beat to beat.
Optimal leads for ST analysis are
• With 5-lead set: II, aVF and V5
• With 3-lead set: CB5.
NOTE: Select the ST filter (in the ECG Setup menu) as well as the monitored leads (in
the ECG menu) at the beginning of the case. Changing the filter and/or the lead affects
the ST measurement values.
Accessing ST analysis view

To access the ST analysis view:
ECG
2. Select ST Analysis.
ECG1 Lead aVR
ECG2 Lead Casc.
ECG3 Lead Casc.
ECG Size 1.0
ST Analysis
Beat Sound Volume 3
Relearn
ECG Setup
ECG Alarms
Parameters Menu
Review all ECG lead waveforms.
View QRS complexes and ST
analysis points.
10-9
When the ST analysis view is accessed, the display shows three measured ECG leads
and an averaged QRS complex for each ECG lead. In addition, a graphic trend display
for each ECG lead is shown. Changing the lead causes a new learning of the ST
segment. The learning period is shown as a line in the trend display.
1 2 3
ECG
II
5
0.7
Figure 10-6. ST analysis view
(1) ST view showing QRS complex average for each lead with ST and ISO point cursors
(2) Lead label, ST values
(3) ECG waveform area showing 3 ECG leads
(4) A trend of ST values of each selected lead
(5) Current ST values displayed continuously
ST display in a digit field

You can also select ST numerical data to the lower digit field.
1
(1) Message field
mm Learning
(2) The lead that has the largest absolute ST value
S II 0.9 II 2
T V5 0.0 (3) ST values of ECG1, ECG2, and ECG3
aVL 0.0 0.9
(4) Lead label
4 3
Figure 10-7. ST number field
To do this:
3. Select Digit Fields.
10-10
ECG
Setting ST point manually

In the monitor, the ST point is initially set 80 ms after the R detection. If this setting is
changed, the original point is shown as a dashed line. If the ST point is set manually,
the set value remains until the monitor is turned off or reset.
To set the ST point:
aVR
2.8
3. Select Set ST point.
4. Set the ST point by turning the ComWheel. To confirm the
setting, press the ComWheel.
I
-2.8
II
2.8
Set ST point.
Push ComWheel
to confirm.
Setting ISO point manually

The ISO (isoelectric) point is initially set 74 ms before the R detection. If this setting is
changed, the original point is shown as a dashed line. If the ISO point is set manually,
the set value remains until the monitor is turned off or reset.
To set the ISO point:
aVR
2.8
3. Select Set Set ISO point.
4. Set the ISO-point by turning the ComWheel. Confirm the
setting by pressing the ComWheel.
I
-2.8
II
2.8
Set ISO point.

Push ComWheel
to confirm.
10-11
Setting ECG alarms

You can set the ST alarm limit and change the high and low heart rate alarms from the
ECG menu (as described below). You can also make the adjustments by selecting Adjust
Limits in the Alarms Setup menu.
To adjust ST and heart rate alarms:
ECG
2. Select ECG Alarms.
ECG1 Lead II
ECG2 Lead I 3. Select Adjust Limits and make the desired
adjustments.
ECG3 Lead I
ECG Size 1.0
ST Analysis
Beat Sound Volume 3
ECG Setup
ECG Alarms
Parameters Menu
Change high and low HR alarm

limits. Set ST alarm limts.
Pacemaker markers
The monitor detects and rejects pacemaker pulses (see the Pacemaker selection in the
ECG Setup menu). Sometimes this may lead to unnecessary asystole alarms.
NOTE: The pacemaker may change the shape of the QRS complex so much that QRS
detection may be affected.
WARNING: Patients with Pacemakers or Arrhythmias. The monitor may count pacemaker
pulses as heart beats during cardiac arrest, some arrhythmias, and with certain types of
pacemakers particularly in ON R mode. Do not rely entirely upon rate meter alarms. Keep
patients with pacemakers and arrhythmias under close surveillance.
10-12
ECG

This section describes other adjustable features related to ECG measurement. A
made. If you wish to change a feature, we recommend that you contact the person
Analog signal output

WARNING: Output signals are not floating and must not be connected directly to a patient.
4. Select Analog Outputs.
For more information, refer to the Technical Reference Manual.
10-13
10-14
Contents
Chapter 11. Impedance Respiration

Overview .......................................................................... 11-1
Respiration detection............................................................................................................................11-1
Respiration rate calculation.............................................................................................................. 11-1
Impedance respiration display ....................................................................................................... 11-2

Activating the respiration measurement .................................. 11-4
Turning the measurement ON........................................................................................................ 11-4
Turning the measurement OFF...................................................................................................... 11-4
Choosing the respiration rate source ...................................... 11-5

Improving waveform readability ............................................. 11-5
Improving respiration rate detection....................................... 11-6
Measurement limitations..................................................... 11-6
Movement artifacts .................................................................................................................. 11-6
Electrical interference............................................................................................................ 11-6
Pacemaker patients.................................................................................................................. 11-6
Table of Figures
Figure 11-1. Respiration rate source indication for impedance and CO2 .......................... 11-1
Figure 11-2. Monitor display with impedance respiration measurement........................... 11-2
Figure 11-3. Impedance respiration waveform and respiration rate numeric value....11-2
Figure 11-4. Impedance respiration setup.............................................................................................. 11-3
Impedance Respiration
11. IMPEDANCE RESPIRATION
Overview
Impedance respiration is measured across the thorax. When the patient is breathing or
is ventilated, the volume of air changes in the lungs, resulting in impedance changes
between the electrodes. A respiration rate is calculated from these impedance changes,
and a respiration waveform is displayed on the monitor screen.
Respiration detection
The respiration rate is the sum of respirations that exceed the detection limit.
Imped.
The dotted lines are the zero line and the detection limit.
. . . . . . . The signal strength produced by a respiration should thus
% . . . . . . . exceed this minimum limit to be included in the respiration
rate calculation. Peaks within the grids are not calculated.
If AUTO detection mode is chosen, the grid lines are the minimum limits but the limits in
use may be larger. The RR value can include fewer respirations than indicated by the
gridline.
Respiration rate calculation

Respiration rate is calculated automatically when ECG is measured, unless respiration
measurement is turned off or CO2 is measured.
When CO2 is measured (only possible with F-MXG model), the respiration rate is
automatically calculated from the CO2.
Respiration rate calculation switches back to impedance respiration if you press the
Silence Alarms key during an Apnea alarm.
The respiration rate source is displayed above the respiration numeric value.
Imped. CO2
R R
e
s
p 20 /min
e
s
p 18 /min
Figure 11-1. Respiration rate source indication for impedance and CO2
The impedance respiration waveform is also displayed next to the RR value when the
RR value is calculated from CO2.
11-1
Impedance respiration display

9 14
aVR ECG
1 mV H
R
mm
58 /min
Casc.
1 mV S
T aVR 2.8
I -2.8
II 2.8 -2.8
Art244 mmHg
A
122
0
r
t 130/82
(93)
Pleth S %
p
O
2
97
Imped.
R CO2
e
s
p
15 /min
%
CO2 5 C
O ET
2
5.0 RR
0 FI 0.0 15/min
Gases NIBP T1 P2
O2% N2O% Des% mmHg Sys Dia C mmHg Contrl
ET 16 77 2.3
128/81 T1 38.8 (50)
FI 21 77 3.0 Mean (93) Manual 60/45
Figure 11-2. Monitor display with impedance respiration measurement
Figure 11-3. Impedance respiration waveform and respiration rate numeric value
11-2
Patient connections
The setup for impedance respiration is the same as for ECG measurement. If you do
not have the ECG setup, see Patient connections in the ECG chapter.
You can use 3-lead or 5-lead ECG sets.
Electrode positioning Modified positioning Electrode positioning

with a 3-lead set. with a 3-lead set. with a 5-lead set.
RED (IEC) YELLOW (IEC) RED (IEC) RED (IEC) YELLOW (IEC)
WHITE (AAMI) BLACK (AAMI) WHITE (AAMI) WHITE (AAMI) BLACK (AAMI)
LEAD I
LEAD III
1 2
LE LE 3
4 5 6
AD AD
II
I
GREEN (IEC) GREEN (IEC) YELLOW (IEC) BLACK (IEC) GREEN (IEC)
RED (AAMI) RED (AAMI) BLACK (AAMI) GREEN (AAMI) RED (AAMI)
Figure 11-4. Impedance respiration setup
(1) Trunk cable

(2) Lead set (3-lead or 5-lead set)
NOTE: Use of the impedance respiration measurement is recommended only for
patients over three years old.
WARNING: In obstructive apnea, respiration movements and impedance variations may

continue.
electrosurgery unit to avoid possible burns at sensor sites.
WARNING: Make sure that the lead set clips or snaps do not touch any electrically
conductive material including earth.
11-3
Activating the respiration measurement

The respiration information is not included in the trends and the alarms are not
operative unless respiration is selected in a waveform or in a digit field.
To select respiration in a waveform or a digit field:
Screen Setup Screen Setup 1. Press the ComWheel and select
Monitor Setup from the Main Menu.
Waveform Fields Digit Fields
Field 1 ECG1 –More– Lower Field 1 Compl –More–
Field 2 ECG2 ECG1 Lower Field 2 NIBP Resp 3. Select Waveform Fields or Digit Fields.
Field 3 P1 P1 Lower Field 3 Flow Paw
4. Choose Resp.
Field 4 P2 P2 Lower Field 4 Gases Flow
Field 5 Pleth Pleth Previous Menu Paw TV
Field 6 CO2 CO2 Compl
O2 T1
Combine Pressures NO AA OFF
Previous Menu Resp
–More–
Change waveform in field 1. Change contents of lower digit
Select OFF to clear field. field 1. Select OFF to clear
field.
Turning the measurement ON

To turn on the impedance respiration measurement:
Parameters 1. Press the ComWheel and select Parameters from

the Main Menu.
Resp Setup
2. Select Resp Setup.
Size 2.0
Resp Rate Source Imped. ON 3. Select Measurement and choose ON.
Measurement OFF OFF
Detection Limit 40%
Resp Rate Alarm
Parameters Menu
Select ON to enable
impedance respiration
measurement.
Turning the measurement OFF

In case the impedance respiration measurement signal interferes with other
measurements, such as ECG, you can turn it off:
3. Select Measurement and choose OFF.
11-4
Choosing the respiration rate source

To manually choose the respiration rate source:
Parameters 1. Press the ComWheel and select

Parameters from the Main Menu.
Resp Setup
Size 2.0 3. Select Resp Rate Source and choose AUTO,
Resp Rate Source Imped. AUTO CO2, or Imped.
Measurement ON CO2
Detection Limit 40% Imped.
Resp Rate Alarm
Parameters Menu
Change source of respiration

rate: AUTO, CO2 or Impedance
(received from ECG electrodes).
Improving waveform readability

To improve the readability of the waveform, increase its size:
Parameters 1. Press the ComWheel and select

Parameters from the Main Menu.
Resp Setup
Size 2.5
3. Select Size and turn the ComWheel to
Resp Rate Source AUTO change the size of the waveform.
Measurement OFF The bar at the left of the waveform
Detection Limit 40% always indicates a 1 Ω reference.
Resp Rate Alarm
Parameters Menu
1 mm
Change size of waveform by

adjusting scale height.
11-5
Improving respiration rate detection

When respirations are weak, you can adjust the detection limits (measurement
sensitivity) closer to each other to ensure that all respirations are included in the RR
value. In this case, the dotted line represents the absolute detection limits.
When there are numerous artifacts, you can separate smaller artifacts from larger, true
respiration peaks by adjusting the grids farther apart. The small peaks fall within the
grids and are not calculated; the larger peaks cross the grids and are calculated as true
respirations.
During spontaneous breathing, the ventilator may support the patient’s ventilation with
an extra inspiration. If these ventilator inspirations are substantially larger than the
spontaneous breaths, the respiration calculation may mistakenly count only the
ventilator-produced inspirations and expirations. You can correct this by adjusting the
detection limit.
To adjust the detection limit:
Parameters 1. Press the ComWheel and select Parameters

from the Main Menu.
Resp Setup
Size 2.5 3. Select Detection Limit.
Resp Rate Source AUTO AUTO The percentage is the ratio to the 1 Ω
Measurement OFF 20% reference bar, which is 100%.
Detection Limit 40% 40%
Resp Rate Alarm 60%
Parameters Menu 80%
100%
Select detection limit of

impedance respiration.
AUTO will adjust to signal.
Measurement limitations
Movement artifacts
Changing the patient position, moving the head or the arms, or shaking will result in
movement artifacts. Also, the heart may cause noticeable movement and sometimes
this may interfere with the respiration measurement.
Electrical interference
Electrical devices that emit electromagnetic disturbance, such as electrosurgery units
and infrared heaters, will result in artifacts or may disable the respiration measurement.
Pacemaker patients
WARNING: Pacemaker Patients. The impedance respiration measurement may cause rate
changes in Minute Ventilation Rate Responsive Pacemakers. Set the pacemaker rate
responsive mode off or turn the impedance respiration measurement off on the monitor.
11-6
Contents
Chapter 12. Pulse Oximetry

Overview .......................................................................... 12-1
Pulse oximetry options ........................................................................................................................ 12-1
Nellcor® sensors ....................................................................................................................... 12-1
Pulse oximetry display......................................................................................................................... 12-2
Opening the pulse oximetry menu .......................................... 12-2

Menu selections.......................................................................................................................................12-3
Plethysmographic pulse wave......................................................................................................... 12-3

Selecting the sensor............................................................................................................................... 12-4
Choosing a site..........................................................................................................................................12-4
Connecting the sensor ......................................................................................................................... 12-5
Disconnecting the sensor ................................................................................................................... 12-5
During monitoring .............................................................. 12-6

Measurement limitations..................................................... 12-6
Interfering substances.......................................................................................................................... 12-6
NIBP measurement and cold infusions..................................................................................... 12-6
Table of Figures
Figure 12-1. Display of SpO2 value and Pleth waveform ............................................................. 12-2
Pulse Oximetry
12. PULSE OXIMETRY
Overview
Oxygen saturation (SpO2) is the percentage of saturated hemoglobin compared to total
hemoglobin as measured by a two-wavelength pulse oximeter (also called functional or
in vivo oxygen saturation).
SpO2 is measured with light absorption techniques: red and infrared light are emitted
from the emitter side of the sensor. The light is partly absorbed when it passes through
the monitored tissue. The amount of transmitted light is detected in the detector side of
the sensor. When the pulsative part of the light signal is examined, the amount of light
absorbed by arterial hemoglobin is discovered and the saturation level is calculated.
The plethysmographic pulse wave is derived from variations of the intensity of the
transmitted light. It reflects the blood pulsation at the measuring site. Thus, the
amplitude of the waveform reflects the perfusion.
NOTE: See the pulse oximetry product specifications in chapter 1 for more details.
Pulse oximetry options

The Cardiocap/5 monitor offers three oxygen saturation measurement technologies:
• Datex-Ohmeda standard pulse oximetry.
• Datex-Ohmeda enhanced pulse oximetry (N-XOSAT option).
• Nellcor® compatible pulse oximetry (N-XNSAT option).
NOTE: Use only sensors identified for use with a specific option. For example, use only
Nellcor® sensors with the N-XNSAT option.
Consult the User’s Guide for appropriate Datex-Ohmeda sensors. Datex-Ohmeda Sat
sensors and OxyTip®+ sensors are latex-free.
Nellcor® sensors
Use the sensors listed below with the N-XNSAT option (* indicates latex-free).
Oxygen Transducer Name Patient Type Order Number SpO2 Accuracy (± 1 SD)
Oxisensor® II Adult D-25 * / D-25L *
Pediatric D-20 * 70-100% ± 2 digits
Infant I-20 / I-20LF *
Adult Nasal R-15 80-100% ± 3.5 digits
OxiCliq® Adult A*
Pediatric P* 70-100% ± 2.5 digits
Infant I
Durasensor® II Adult DS-100A *
Dura-Y® II Multisite Adult, Pediatric, Infant D-YS 70-100% ± 3 digits
Oxiband® II Pediatric, Infant OXI-P/I *
12-1
Pulse oximetry display

1 2
2 Pleth 5 S %
p
O
2
97 3
Figure 12-1. Display of SpO2 value and Pleth waveform
(1) Scale of Plethysmogram

(2) Label(s)
(3) Oxygen saturation (SpO2) value
(4) Pulse oximetry message field
Opening the pulse oximetry menu

NOTE: Models with the Invasive Pressures or NMT option do not have the Pulse
Oximetry direct access key.
To open the pulse oximetry menu:
1. Press the Pulse Oximetry key.
or
2. Press the ComWheel and select
Parameters from the Main Menu. Then,
select Pulse Oximetry.
12-2
Pulse Oximetry
Menu selections
Pleth Scale The scale of the plethysmographic waveform display is set
automatically during “Pulse search.” To adjust it further,
select 2, 5, 10, 20, 50, or AUTO.
NOTE: This selection is not available for the N-XNSAT or N-XOSAT
options, both of which are preset to AUTO.
When AUTO scaling is used, the scale changes automatically if the
amplitude of the pleth waveform exceeds the current scale or falls
below the maximum value of the next lower scale by 10% for
30 seconds or more. When the scale changes, the “Scale changed”
message is displayed.
The scale indicator number appears at the left of the waveform.
SpO2 Response Selects the SpO2 averaging time: b-to-b (beat to beat), Normal
(10 seconds), or Slow: (20 seconds, the default setting).
NOTE: This selection is not available for the N-XNSAT option,
which is preset to 5–7 seconds, or for the N-XOSAT option, which is
preset to 12 seconds.
Beat Sound Volume Adjusts the SpO2 beat volume. This adjustment also affects the ECG
beat volume.
When SpO2 is monitored, the tone of the pulse beep rises as oxygen
saturation increases and falls as it decreases.
HR Source Selects the heart rate source. If the ECG signal is affected by too
much noise for a reliable heart rate calculation, the heart rate can
also be calculated from the invasive pressure (Art) or from the
plethysmographic pulse waveform (Pleth).
The selected heart rate source is shown above the numerical display
of the heart rate. The color of the heart rate is the same as the source
parameter.
If AUTO is selected, the heart rate calculation priorities are:
ECG (the lead with the highest R-wave), invasive pressure (Art), then
Plethysmographic pulse waveform (Pleth).
SpO2 Alarm Select to adjust the SpO2 alarm limits as described in the Alarms
chapter.
Plethysmographic pulse wave

If the site is poorly perfused, use smaller scale indicators to display an optimal pulse
wave. A small pulse wave may be a sign of impaired circulation that may require
increased attention.
Higher scale indicators together with a well-defined pulse wave indicate strong
circulation and a relaxed patient.
12-3
Patient connections
Selecting the sensor
Choose a sensor that is appropriate for the patient and the monitoring requirements.
Sensors are categorized as reusable (durable) or disposable (single-patient use).
Examples of both types are shown and described below.
Reusable Sensors Description

Finger sensor. Widely-used. Quick application is
possible; some may be used on toes.
Ear sensor. Similar in appearance to finger sensor,

but smaller. Used on upper or lower part of ear.
Wrap sensor. Flexible sensor that wraps around

the site (usually fingers, toes, or the fleshy part of
a hand or foot). Useful for small children.
Disposable Sensors Description
Adhesive sensor that wraps around a finger or toe.
A separate sensor cable snaps into a connector on
the sensor.
O O
Adhesive sensor with integrated cable; wraps
around a finger or toe.
Adhesive sensor with integrated cable. The sensor
is positioned inside tape that is wrapped around
the site to hold the sensor in place. This sensor is
used on fingers, toes, and the fleshy part of a hand
or foot, depending on the patient.
A finger sensor is usually appropriate for short-term patient monitoring. For long-term
monitoring, a single-patient, disposable sensor or a wrap-type sensor is commonly used.
WARNING: Patient safety. Use clean and dry sensors and cables only. Moisture and debris
on connectors may affect measurement accuracy.
Choosing a site
Site selection depends on the type of sensor and the weight of the patient. When
choosing a site for a sensor, refer to the instructions for that sensor.
Choose a well-perfused site on a nondominant hand or foot, or the fleshy upper or
lower part of the ear when using an ear sensor.
• Clean the application site you choose, if necessary.
• Finger or toe—remove nail polish and artificial fingernails; clip long fingernails.
• Ear—remove earrings.
12-4
Pulse Oximetry
Connecting the sensor

WARNING: Patient safety. To prevent erroneous readings, do not use an inflated blood
pressure cuff or arterial blood pressure measurement device on the same limb as the
oximeter sensor.
1. Connect the sensor (or sensor extension cable) to the SpO2 connector on the monitor.
Monitor Connections
Datex-Ohmeda standard
pulse oximetry
Datex-Ohmeda enhanced
pulse oximetry
(N-XOSAT)
Nellcor pulse oximetry

(N-XNSAT)
2. If applicable, connect the sensor cable to the extension cable.
Cable Connections
3. Position the sensor and attach it to the patient. For proper sensor positioning and
application, consult the instructions that accompany the sensor.
4. To minimize movement, attach the sensor cable to the wrist or bed clothes.
The “Pulse search” message appears. After the pulse search is completed, the
plethysmographic pulse waveform and the SpO2 reading appear on the screen.
Disconnecting the sensor

When disconnecting a sensor, grasp the connector, not the cable. Some connectors
contain “buttons” on each side of the connector that you press to release the connector.
12-5
During monitoring
WARNING: Patient safety. Do not use a pulse oximeter with magnetic resonance imaging
(MRI).
WARNING: Patient safety. A damaged sensor or a sensor soaked in liquid may cause burns
during electrosurgery.
WARNING: Patient safety. Patient conditions (such as reddening, blistering, skin

discoloration, ischemic skin necrosis, and skin erosion) may warrant changing the sensor
site frequently or using a different style of sensor. For details, refer to the instructions
supplied with the sensor.
Patient condition or prolonged use may require changing the sensor site periodically.
Check skin integrity, circulatory status, and correct alignment.
For patients with poor peripheral blood circulation, change the site at intervals of 30
minutes to one hour. To confirm the circulatory status, observe the size of the
plethysmographic waveform with a fixed pleth scale.
Be especially careful when monitoring infants.
Measurement limitations
Use Cardiocap/5 pulse oximetry only for patients weighing 5 kg (11 lb.) or more, even
if the SpO2 sensor can be used for patients weighing less than 5 kg.
Interfering substances
WARNING: Data validity. Conditions that may cause inaccurate readings and impact alarms
include interfering substances, excessive ambient light, electrical interference, ventricular
septal defects (VSD), excessive motion, low perfusion, low signal strength, incorrect sensor
placement, poor sensor fit, and/or movement of the sensor on the patient.
The pulse oximeter cannot distinguish between oxyhemoglobin and dyshemoglobins

(methemoglobin or carboxyhemoglobin, for example). Dyes that change usual arterial
pigmentation, or substances containing dyes, may also cause erroneous readings.
Carboxyhemoglobin may erroneously increase readings in all pulse oximeters. The
level of increase is approximately equal to the amount of carboxyhemoglobin present.
Cigarette smokers and victims of smoke inhalation often have increased levels of
carboxyhemoglobin. Therefore, the saturation values may be somewhat higher for
smokers and for patients with carbon monoxide (CO) intoxication.
NIBP measurement and cold infusions

Do not attach the pulse oximetry sensor to a limb that is used for noninvasive blood
pressure measurement or for administrating cold infusions. These circumstances
reduce the pulsation and perfusion and may affect the pulse oximetry measurement.
12-6
Contents
Chapter 13. Non-Invasive Blood Pressure (NIBP)

Overview .......................................................................... 13-1
NIBP display ..............................................................................................................................................13-1

Selecting the cuff hose......................................................................................................................... 13-2
Selecting the cuff.....................................................................................................................................13-2
NIBP setup menu ............................................................... 13-3

NIBP calibration check........................................................................................................................ 13-3
Starting NIBP measurement ................................................. 13-4

During measurement .......................................................... 13-4
Automatic NIBP double-check........................................................................................................ 13-4
Canceling a measurement ................................................................................................................. 13-4
Autocycling ...................................................................... 13-5

Setting the cycle time ........................................................................................................................... 13-5
Starting/stopping autocycling ......................................................................................................... 13-5
Starting/stopping a continuous measurement (STAT)................. 13-6

Using venous stasis ............................................................ 13-6
Table of Figures
Figure 13-1. NIBP digit field display.......................................................................................................... 13-1
Figure 13-2. Cuff positioning.......................................................................................................................... 13-2
Non-Invasive Blood Pressure (NIBP)
13. NON-INVASIVE BLOOD PRESSURE (NIBP)
Overview
The non-invasive blood pressure (NIBP) measurement uses the oscillometric measuring
principle. The cuff is inflated with a pressure slightly higher than the presumed systolic
pressure, then slowly deflated at a speed based on the patient’s heart rate, collecting
data from the oscillations produced by the pulsating artery. Based on this data, the unit
calculates values for systolic, mean and diastolic pressures.
The measurement can be used for adults, children and infants. The monitor
automatically recognizes the type of cuff hose (black hose for adults and children,
white hose for infants) used for each patient type at the beginning of each
measurement.
It is possible to set an automatic cycling mode to make measurements at desired time
intervals. It is also possible to measure NIBP continuously for five minutes in STAT
mode or take separate single measurements.
NIBP display
NIBP can be displayed in the digit field:
1 NIBP
mmHg Sys Dia
2
Mean
128/81(91) 0 5 min
3 4 5
Figure 13-1. NIBP digit field display
(1) Label
(2) Systolic and diastolic pressure value of non-invasive blood pressure
(3) Mean pressure value of NIBP
(4) Time since the last autocycle measurement
(5) NIBP autocycle time indicator
13-1
Patient connections
Cuff hose Cuff

Over brachial artery
Use smaller cuff

E
X LIN
INDE
Correct size
Use larger cuff
Figure 13-2. Cuff positioning
Selecting the cuff hose

Two different cuff hoses with different cuff connections are available:
• BLACK hose for adults and children
• WHITE hose for infants
The monitor automatically recognizes the hose and selects the appropriate inflation
pressure. Another inflation limit can be selected in the NIBP Setup menu. Adult
inflation limits cannot be selected for an infant cuff.
NOTE: The NIBP system incorporates a safety circuit to prevent over-pressurization or
prolonged inflation of the cuff.
Selecting the cuff

To determine whether the cuff size is correct, check that the white index line on the
outer edge of the cuff falls between the range lines. If not, use a larger or smaller cuff.
Cuff Color Width Limb Circumference Hose

cm inch cm inch
Large adult Red 16 6.2 33 - 47 13 - 18 Black
Standard adult Blue 12 4.9 25 - 35 9 - 14 Black
Small adult Gray 9 3.7 18 - 26 7 - 10 Black
Child Green 7 2.8 13 - 19 5-7 Black
Infant Orange 5 2 9 - 14 3-5 White
Disposable infant cuffs:
#4 Blue 4.8 1.8 8 - 13 3-5 White
#5 Red 5.5 2.2 10 - 14 4-6 White
The material of the reusable cuffs is soft, durable Nylon.

The material of the disposable cuffs is soft, durable, latex-free vinyl.
NOTE: When using infant cuffs, the white infant cuff hose must be used. Also make
sure the Inflation Limits selection is set to Infant or Auto.
13-2
NIBP setup menu

To open the NIBP Setup menu, press the NIBP key and select NIBP Setup.
Ready Prompt Gives an audible tone when the NIBP measurement is ready. Adjust
the volume of the beep tone from 1 (silent) to 10 (loud), or to 0 (OFF).
Inflation Limits The selections are: Infant, Child, Adult, and AUTO.
When the selection is AUTO (default), the monitor automatically
identifies the cuff hose and selects the right inflation pressure and
alarm limits. The Child selection decreases the maximum inflation
pressure to 200 mmHg when using adult hoses/cuffs.
NOTE:
• When using infant cuffs, the white infant cuff hose must be used.
The Child selection increases the maximum inflation pressure to
200 mmHg when using infant hoses/cuffs.
• When using very large adult cuffs, use Adult limits to prevent a
“Cuff loose” message from appearing.
Calibration Check Enables a calibration check using an external manometer (see below).
NIBP calibration check

1. Remove the cuff from the connector before entering the NIBP Setup menu.
2. To enter the NIBP Setup menu, press the NIBP key and select NIBP Setup.
3. Attach an external manometer with pump to the NIBP connector.
4. Pump to about 200 mmHg.
5. Compare the readings of the manometer and the display.
If the difference is greater than 4 mmHg, calibration by authorized service
personnel is recommended.
13-3
Starting NIBP measurement

To start a single NIBP measurement:
Press the NIBP Start/Cancel key.
NIBP or
Start Cycling Press the NIBP key and select Start Manual.
Cycle Time 5 min
Start STAT
Start Manual
Start Ven. Stasis
NIBP Setup
NIBP Alarm
Parameters Menu
Start automatic cuff infla-

tions at cycle time interval.
In the beginning of the measurement, the sys and dia labels are replaced with the
inflation limit indication (adult, child, infant) for five seconds. The cuff pressure will be
displayed in the mean pressure value field.
If motion artifacts are detected, the monitor automatically holds deflation until the
motion stops (maximum of 30 seconds). If the artifacts prevent proper measurement, a
new measurement is automatically started.
When the measurement is ready, a short beep appears and result numbers flash.
WARNING: The monitor sets the inflation pressure automatically according to the first
measurement. Reset the case to reset the inflation limit before measuring a new patient.
During measurement
Observe the cuffed limb frequently. Measurement may impair blood circulation.
Make sure that the tubing is not bent, pressed or stretched. Otherwise, measurement
may be impaired.
Automatic NIBP double-check

If the NIBP value exceeds the alarm limits, a new measurement is taken automatically
(immediately, if Manual measurement is selected, and after 30 seconds, if AUTO
measurement is selected). If an alarm situation persists, an alarm will be given.
Canceling a measurement
To cancel any measurement, press the NIBP Start/Cancel key.
13-4
Autocycling
It is possible to set automatic NIBP measurement On and Off at selected intervals.
Autocycling is synchronized to real time. For example, if the first measurement is at
12:02 with a 5-minute cycle time, the next measurement will be at 12:05 and again at
12:10, 12:15, etc.
Setting the cycle time

The possible intervals for autocycling are 1, 2.5, 3, 5, 10, 15, 30, or 60 minutes.
To set the cycle time:
1. Press the NIBP key.
2. Select Cycle Time and choose the time.
Starting/stopping autocycling
• To start autocycling, press the NIBP key and select Start Cycling.
The bar at the bottom of the NIBP display shows the
remaining time until the next measurement.
• To stop autocycling:
Press the NIBP key and select Stop Cycling.
or
If you wish to cancel the present measurement but start a new one after the
selected interval time, press the NIBP Start/Cancel key.
13-5
Starting/stopping a continuous measurement (STAT)

The STAT mode initiates continuous measurement for five minutes. A new NIBP
measurement starts immediately after the previous one. After five minutes, the monitor
automatically returns to the previously selected cycling interval or to manual mode.
• To start a continuous measurement, press the NIBP key and select Start STAT.
In STAT mode, the earlier systolic value is measured
and displayed until the final result of a new one is
available.
• To stop a continuous measurement, press the NIBP Start/Cancel key.
Using venous stasis

Venous Stasis initiates and holds the pressure in the cuff to help venous cannulation. A
constant pressure of 40 (infant), 60 (child), or 80 mmHg (adult) is maintained in the
cuff for one (infant) or two minutes (child, adult). The value is selected automatically
after the inflation limits (adult, child or infant) are set.
• To start Venous Stasis:
1. Press the NIBP key.
NIBP
2. Select Start Ven. Stasis.
Start Cycling
Cycle Time 5 min
Start STAT
Start Manual
Start Ven. Stasis
NIBP Setup
NIBP Alarm
Parameters Menu
Start and hold cuff inflation

for venous cannulation.
The pressurization time is displayed in the NIBP field and STASIS flashes during the
last 15 seconds.
• To release the pressure before two minutes has expired, press the NIBP Start/Cancel
key before two minutes has expired.
13-6
Contents
Chapter 14. Invasive Blood Pressure

Overview .......................................................................... 14-1
Invasive blood pressure display..................................................................................................... 14-1
Displaying a combined pressure waveform ........................................................................... 14-2
Invasive blood pressure setup ............................................... 14-2

Patient connections ............................................................................................................................... 14-3
Invasive Pressures menu ..................................................... 14-3

Invasive line setup ............................................................. 14-4
Setup menu options............................................................................................................................... 14-4
Labeling the invasive line .................................................................................................................. 14-5
Invasive blood pressure labels and descriptions.................................................... 14-5
Adjusting alarm sources and limits.............................................................................................. 14-6
Starting with accurate values ............................................... 14-6

Measuring Pulmonary Capillary Wedge Pressure (PCWP)............. 14-7
Starting PCWP measurement.......................................................................................................... 14-8
Adjusting PCWP ........................................................................................................................ 14-9
Canceling PCWP measurement ....................................................................................... 14-9
Table of Figures
Figure 14-1. Top: Separated waveforms
Bottom: Waveforms combined in several fields ................................................... 14-1
Figure 14-2. Invasive blood pressure setup............................................................................................ 14-2
Figure 14-3. Position of Swan-Ganz catheter in pulmonary artery and
Pressure waveforms from balloon-tipped pulmonary
catheter during insertion...................................................................................................... 14-7
Invasive Blood Pressure
14. INVASIVE BLOOD PRESSURE
Overview
The Cardiocap 5 monitor with the Invasive Pressures option (N-XP) enables you to
measure and monitor two invasive blood pressures at the same time.
During the invasive blood pressure measurement, the transducer converts the pressure
variations into electrical signals. The electrical signals are amplified and displayed as
numeric pressure values and waveforms.
WARNING: All invasive procedures involve risks to the patient. Use aseptic technique. Follow
catheter manufacturer’s instructions.
Invasive blood pressure display

You can display the two invasive pressure waveforms separately (one above the other)
or you can combine them. Combining the waveforms increases the size of the
waveform.
2 3
Art 240
4 5
CVP 50
mmHg
A
r
t
130/82
(93)
1 120 25
mmHg
C
0
V
P
(14)
0 25/12
2 3
4 5
Art 240 CVP 50
mmHg
A
r
t
130/82
(93)
1 120 25
mmHg
C
0
V
P
(14)
0 25/12
Figure 14-1. Top: Separated waveforms

Bottom: Waveforms combined in several fields
(1) Invasive blood pressure waveforms with zero and reference lines
(2) Selected pressure label
(3) Selected pressure scale
(4) Field for messages and alarm limit settings
(5) Systolic, diastolic and mean pressure values of invasive blood pressures
14-1
Displaying a combined pressure waveform

To display combined pressure waveforms:
4. Select Combine Pressures and YES.
Invasive blood pressure setup
1
Disposable
3
Disposable
Reusable
Figure 14-2. Invasive blood pressure setup
(1) Heparinized fluid bag with pressure infusor

(2) Flushing set
(3) Transducer
(4) Adapter cable for using disposable transducers
NOTE: Patient connections made according to the picture above using Datex-Ohmeda
specified accessories are defibrillator proof.
WARNING: Mechanical shock to invasive blood pressure transducer may cause severe shifts
in zero balance and calibration, and cause erroneous readings.
WARNING: Patient Safety: Ensure proper contact of the return electrode of the
electrosurgery unit to your patient to avoid possible burns at sensor sites.
WARNING: Make sure that no part of the patient connections touches any electrically
WARNING: Use only defibrillator-proof transducers and cables.
14-2
Patient connections
Do the connections as follows:
1. Connect the pressure transducer to the transducer cable and the cable to the
monitor’s red connector.
2. Prepare the transducer kit according to the manufacturer’s instructions. Mount the
kit with the transducer zeroing port at mid-heart level.
3. Ensure that there is no air in the transducer dome or in the catheter line. Refer to
transducer manufacturer’s instructions on how to remove trapped air from the
transducer.
4. Connect the patient catheter to the pressure line.
5. Open the dome stopcock to room air.
6. Zero the transducer. See Starting with accurate values later in this chapter.
7. Open the dome stopcock to pressure catheter and check the quality of the
waveform.
Invasive Pressures menu

NOTE: Monitors with the NMT option do not have the Invasive Pressures key.
To open the Invasive Pressures menu:
Press the Invasive Pressures key.
Invasive Pressures
or
Zero ALL Press the ComWheel and select Parameters.
Zero P1 ‘Art’ Then select Invasive Press.
Zero P2 ‘CVP’
Wedge Pressure
P1 ‘Art’ Setup
P2 ‘CVP’ Setup
Ventilation Mode Contrl
Parameters Menu
Set label, scale, digit

format, HR source and alarm.
Wedge Pressure Used for Pulmonary Capillary Wedge Pressure Measurement (PCWP).
See Measuring Pulmonary Capillary Wedge Pressure later in this chapter.
P 1 ‘Art’ Setup and P2 ‘CVP’ Setup
Used to set the label, scale, and other attributes of the P1 or P2 channel.
See Invasive line setup.
Ventilation Mode Respiration causes artifacts in invasive pressures. The artifact is
smallest at the end of expiration. You can select Spont for spontaneous
respiration or Contrl for controlled ventilation.
14-3
Invasive line setup

To open the setup menu for an invasive pressure line:
Invasive Pressures 1. Press the Invasive Pressures key.

or
P1 ‘Art’ Setup Press the ComWheel and select Parameters.
Label Art Then select Invasive Press.
Scale 200 mmHg 2. Select P1 ‘Art” Setup or P2 ‘CVP’ Setup.
Digit Format S/D
Filter Frequency 22 Hz
HR Source AUTO
P1 ‘Art’ Alarm
Previous Menu
Change label. Scale, color,

filter, alarm source and limits
return to default settings.
Setup menu options

Label The label sets the features of the pressure channel. See Labeling the
invasive line.
Scale The scale is assigned when the channel is labeled. The scale can be
adjusted from 10 mmHg to 300 mmHg in steps of 10.
Digit Format With the numeric display format, you can choose to display the
Systolic/Diastolic (S/D) numbers or the Mean pressure value in a large
font size.
Filter Frequency Filters the measured signal to remove noise and artifacts. The filter
can be adjusted from 4 to 22 Hz.
HR Source If the ECG signal is affected by too much noise for a reliable heart
rate calculation, heart rate can be calculated mechanically from the
pressure (Art) or plethysmographic pulse waveform. The heart rate
source is shown above the numerical heart rate display. The color
used for the heart rate is the same as the source parameter.
The AUTO selection prioritizes the heart rate calculation in a specified
order: ECG (the lead with highest R-wave), pressure (Art), and
plethysmographic pulse waveform.
P 1 ‘Art’ Alarm Alarms can be adjusted in this menu or in the Alarms Setup menu.
See Adjusting alarm sources and limits later in this chapter.
14-4
Labeling the invasive line

When a pressure channel is labeled, the display scales, waveform color, filter, alarm
source, and alarm limits are also changed. The label sets the other features.
To change the label:
Invasive Pressures 1. Press the Invasive Pressures key.

or
P1 ‘Art’ Setup Press the ComWheel and select Parameters.
Label Art –More– Then select Invasive Press.
Scale 200 mm Art 2. Select P1 ‘Art” Setup or P2 ‘CVP’ Setup.
Digit Format S/D CVP 3. Select Label and choose the label.
Filter Frequency 22 Hz PA
HR Source AUTO RAP
P1 ‘Art’ Alarm RVP
Previous Menu LAP
ICP
ABP
Change label. Scale, color,
filter, alarm source and limits
return to default settings.
Invasive blood pressure labels and descriptions

The labels are as follows:
P1, P2 Standard, startup labels
Art Arterial pressure
CVP Central venous pressure
PA Pulmonary arterial pressure
RAP Right atrial pressure
RVP Right ventricular pressure
LAP Left atrial pressure
ICP Intracranial pressure
ABP Arterial Blood Pressure
Both Art and ABP labels are available for situations when two arterial lines are desired
but you want to use different settings or alarm labels.
Assigning a label automatically changes the other pressure settings as shown below:
LABEL P1, Art, ABP P2, CVP RAP, LAP ICP PA RVP
Scale 200 20 20 20 60 60
Digit Format Sys/Dia Mean Mean CPP Sys/Dia Sys/Dia
Filter 22 9 9 9 9 9
Alarm source Sys off off off off off
Color Red Blue White White Yellow White
14-5
Adjusting alarm sources and limits

You can adjust or turn off pressure alarm limits.
To do this:
1. Press the Invasive Pressures key.
or
Press the ComWheel and select Parameters. Then select Invasive Press.
2. Select P1 ‘Art’ Setup and P1 ‘Art’ Alarm.
or
Select P2 ‘CVP’ Setup and P2 ‘CVP’ Alarm.
You can choose Sys (Systolic), Dia (Diastolic), or Mean as a source for each pressure
channel. The limits are on for only one source at a time.
For more information about alarms, see the Alarms chapter.
Starting with accurate values

Pressure transducers generally produce a small signal even when no pressure is
applied to them. It is necessary to zero the monitor with the transducer to establish an
accurate electrical zero point.
The position of the transducer affects the accuracy of the measurement. An error of
10 mmHg of static pressure will be introduced for every 13.6 cm (5.4 inches) difference
in height between the mid-heart and the transducer.
To zero the transducer:
1. Open the transducer to air.
Invasive Pressures
2. Press the Invasive Pressures key.
Zero ALL or
Press the ComWheel and select Parameters.
Zero P1 ‘Art’
Then select Invasive Press.
Zero P2 ‘CVP’
3. Zero each channel.
Wedge Pressure
Zero ALL Zeros all transducers (except ICP)
P1 ‘Art’ Setup to atmospheric pressure.
P2 ‘CVP’ Setup Zero P1 … Zeros P1 transducer only.
Ventilation Mode Contrl
Zero P2 … Zeros P2 transducer only.
Parameters Menu
The “Zeroing” message is displayed during the zeroing process. After the transducer
has been zeroed, the “Zeroed” message appears in the digit field.
After each channel has been zeroed, the time when zeroing occurred appears in the
menu.
NOTE: Check the zero level after power interruptions.
14-6
Measuring Pulmonary Capillary Wedge Pressure (PCWP)

Pulmonary capillary wedge pressure (PCWP) is the occlusion pressure of the
pulmonary artery. PCWP can be measured with a pulmonary artery flotation catheter.
When the balloon at the tip of the catheter is inflated, the pulmonary artery is
occluded. The pressure (PCWP) indirectly reflects the filling pressure of the left
ventricle.
The monitor uses an algorithm to automatically detect the pressure values at the end of
expiration when the artifact caused by respiration is minimal. The mean pressure value
is PCWP.
RAP RVP PA PCWP40

mmHg
PA
PCWP
20
RA
RV 0
Figure 14-3. Position of Swan-Ganz catheter in pulmonary artery and

Pressure waveforms from balloon-tipped pulmonary catheter during insertion
The speed of the waveforms in the Wedge Pressure menu is 12.5 mm/s.
NOTE: During wedge pressure measurement, PA values are not trended and PA alarms
are disabled.
14-7
Starting PCWP measurement

NOTE: Because the PCWP measurement site is in an extremely delicate area, only
specially qualified medical personnel should perform the insertion of the Swan-Ganz
catheter. Follow the catheter manufacturer’s instructions.
1. Position the Swan-Ganz catheter in the pulmonary artery. Continuous monitoring
of the pressures along the route of the catheter tip will help to identify the location
of the tip. Use the distal lumen for the pressure line.
2. PCWP measurement is dedicated to the invasive pressure channel labeled PA.
To check the label:
• Press the Invasive Pressures key.
or
Press the ComWheel and select Parameters. Then select Invasive Press.
• Check that the wedge pressure channel is labeled PA. If it is not, label the
channel as described in Labeling the invasive line earlier in this chapter.
3. Check that the monitor has correct ventilation status information for the patient:
In the Invasive Pressures menu, select Ventilation Mode and choose Spont
(spontaneous) or Contrl (controlled).
4. Select Wedge Pressure.
5. Select Measurement.
6. Inflate the catheter balloon when the “Inflate the balloon” message is displayed in
the PA waveform field.
The monitor searches the end expiratory mean pressure value. The pressure is
displayed in the waveform field and menu. After 20 seconds, the waveform is
automatically frozen and the “Deflate the balloon” message is displayed.
7. Deflate the balloon when the “Deflate the balloon” message is displayed in the PA
waveform field.
The pressure waveform will stay frozen until you accept the PCWP level.
8. Adjust the PCWP level by turning the ComWheel. Press the ComWheel to accept
the PCWP level that represents the true PCWP level.
After accepting the PCWP level, normal pressure monitoring continues.
14-8
NOTE: You can also manually freeze the waveform before 20 seconds has elapsed by
selecting Freeze/Adjust.
Adjusting PCWP
To manually adjust the PCWP pressure level:
1. In the Wedge menu, select Freeze/Adjust.
2. Turn the ComWheel to move the cursor to a point on the waveform that represents
the true PCWP level.
3. Press the ComWheel.

4. Select Confirm.
Canceling PCWP measurement

If the measurement did not succeed, select Cancel.
This cancels the whole measurement. The first menu appears so you may start a new
measurement.
14-9
14-10
Contents
Chapter 15. Temperature

Overview .......................................................................... 15-1
Temperature display.............................................................................................................................15-1
Automatic temperature test .............................................................................................................. 15-1

Temperature menu ............................................................. 15-2
Changing the temperature label .................................................................................................... 15-2
Changing the temperature units .................................................................................................... 15-2
Table of Figures
Figure 15-1. Temperature digit display .................................................................................................... 15-1
Figure 15-2. Temperature setup.................................................................................................................... 15-1
Temperature
15. TEMPERATURE
Overview
You can use Datex-Ohmeda temperature probes to measure esophageal,
nasopharyngeal, rectal, and skin temperature, for example.
Monitoring perioperative body temperature is recommended when inducing
hypothermia or if unexpected temperature changes occur.
WARNING: Patient Safety. To prevent patient injury, use only Datex-Ohmeda temperature
probes.
Temperature display
1 2
T1
ºC
T1
38.8
Figure 15-1. Temperature digit display
(1) Label
(2) Temperature measurement value
Automatic temperature test

The temperature measurement function is tested periodically. The “Performing temp
test” message appears during the test. If the test fails, an error message is displayed.
Patient connections
Figure 15-2. Temperature setup
To make the connections:

1. Attach the temperature probe to the patient.
2. Connect the temperature probe to monitor connector T1 or T2.
15-1
Temperature menu
You can change the label of the temperature measurement site, the temperature units,
and set temperature alarms in the Temp Setup menu.
NOTE; The Temp Alarms selection in the Temp Setup menu opens a menu in which you
can adjust the temperature alarm limits. For instructions, see the Alarms chapter.
Changing the temperature label

2. Select Temp Setup.
3. Select T1 Label.
or
Select T2 Label.
Temp Setup
T1 Label Naso
T2 Label T2 T1
Unit °C Eso
Temp Alarms Naso
Parameters Menu Tymp
Rect
Blad
Axil
Skin
-More-
Change label of T1.
4. Select the label you wish to use for the temperature measurement site:
Eso Esophageal temperature Skin Skin temperature
Naso Nasopharyngeal temperature AirW Airway temperature
Tymp Tympanic temperature Room Room temperature
Rect Rectal temperature Myo Myocardial temperature
Blad Bladder temperature Core Core temperature
Axil Axillary temperature Surf Surface temperature
Changing the temperature units

2. Select Temp Setup.
3. Select Unit and choose °C or °F.
15-2
Contents
Chapter 16. Airway Gases

Overview .......................................................................... 16-1
Display of gases........................................................................................................................................16-1
Agent mixture..............................................................................................................................16-1

Airway gases setup alternatives ..................................................................................................... 16-3
Sample gas exhaust connections ........................................... 16-5

Returning gas to the patient circuit.............................................................................................. 16-5
Scavenging through direct connection...................................................................................... 16-6
CO2 setup........................................................................ 16-7

O2 setup.......................................................................... 16-8
N2O setup........................................................................ 16-9
Agent setup.....................................................................16-10
MAC values ..............................................................................................................................................16-11
Automatic agent identification.............................................16-12

Agent mixtures .......................................................................................................................................16-12
Selecting alarm sources .....................................................16-12

Gas calibration ................................................................16-13
Calibrating the monitor.....................................................................................................................16-13
Calibration adjustments....................................................................................................................16-15
Autozeroing intervals .........................................................................................................................16-15
Interfering gases ..............................................................16-15

Unit conversions...............................................................16-16
Changing units........................................................................................................................................16-16
Changing parameter colors.............................................................................................................16-16
Table of Figures
Figure 16-1. Airway gas waveform display............................................................................................16-1
Figure 16-2. Lower digit field for gases ....................................................................................................16-1
Figure 16-3. Airway gases setup....................................................................................................................16-2
Figure 16-4. Normal endotracheal intubation......................................................................................16-3
Figure 16-5. Tracheostomy...............................................................................................................................16-3
Figure 16-6. Mask ventilation.........................................................................................................................16-4
Figure 16-7. Endotracheal intubation of pediatric patients .........................................................16-4
Figure 16-8. Gas return to patient circuit through ventilator reservoir.................................16-5
Figure 16-9. Gas return to patient circuit in AS/3 ADU .................................................................16-5
Figure 16-10. Connection directly to a scavenging system...........................................................16-6
Figure 16-11. Attaching the regulator to the gas container .......................................................16-13
Figure 16-12. Connecting a sampling line to the gas valve and feeding gas...................16-14
Airway Gases
16. AIRWAY GASES
Overview
With the Datex-Ohmeda Cardiocap/5, you can measure and monitor the gases delivered
to an anesthetized patient and exhaled by the patient through the anesthesia circuit.
Respiratory rate is the frequency of peak (end tidal) CO2 measurements per minute. A
breath is defined as a change in the CO2 signal that exceeds 1% (8 mmHg). All
concentrations are measured and displayed breath by breath.
Display of gases
2 3 4 5 6
CO2 5 C %
O ET 5.0 FI 0.0
7
2
0 RR 15/min
O2 21 O %
2 ET 16 FI 21
1 16 FI-ET 5.0
Enf 5.0 E % 3
n ET 2.3 FI 3.0
f
2.0 MAC 0.8 8
0
Figure 16-1. Airway gas waveform display
(1) Gas waveforms

(2) Scale
(3) Message field for gases
(4) Gas label
(5) Symbol to indicate that FiO2 low alarm limit is set below 21%
(6) Digit field for ET and FI gas values, and FI-ET difference
(7) Respiration rate
(8) MAC value, based on measured AA and N2O ET values
Gases
O2% N2O% Enf%
ET 16 77 2.3
FI 21 77 3.0
Figure 16-2. Lower digit field for gases
Agent mixture
During an agent mixture situation, the “Agent mixture” message appears in the lower
digit field for gases. The labels of both agents and their concentrations are displayed.
16-1
Patient connections
CAUTION: Keep the monitor horizontal. Tilting the monitor may cause erroneous results in the
readings and damage the monitor.
CAUTION: Use only cables and accessories approved by Datex-Ohmeda. Other cables and
accessories may damage the system or interfere with measurement. Single-use accessories are
not designed to be reused.
Take the gas sample as close to the patient’s airway as possible.

1. Before making patient connections, check that:
• The airway adapter connections are tight and the adapter is operating properly.
• The D-fend container is empty and properly attached. The container should be
changed or cleaned between patients and emptied when it is more than half full.
2. Connect the sample gas outlet to gas scavenging if N2O or volatile agents are used.
3. Attach the gas sampling line to the connector on the D-fend water trap.
NOTE: The “Sampling line blocked” message may appear if you attach the
sampling line to the water trap after you turn on the monitor.
4. Turn on the monitor. A self-check is performed and automatic agent identification
is activated.
5. When the “Calibrating gas sensor” message disappears, make the patient
connections as described below.
1
4
Figure 16-3. Airway gases setup
(1) Gas sampling line (3) Airway adapter with sampling line connector
(2) Y-piece (4) Heat and moisture exchanger with filter HMEF
6. Connect the sampling line to the patient’s airway adapter. Position the adapter’s
sampling port upwards to prevent condensed water from entering the sampling line.
16-2
Airway Gases
NOTE: If you are administering medication using a nebulizer, disconnect the HMEF
and airway adapter while the nebulizer is in use.
CAUTION: Remove the airway sampling line from the patient airway while nebulized medications
are being delivered.
Airway gases setup alternatives
Figure 16-4. Normal endotracheal intubation
(1) Intubation tube with 15 mm connector

(2) Airway adapter
Figure 16-5. Tracheostomy
(1) Tracheostomy tube with 15 mm connector

(2) Heat and Moisture Exchanger (HME)
(3) Airway adapter
16-3
Figure 16-6. Mask ventilation
(1) Mask
(2) Bacteria filter
(3) Airway adapter
Figure 16-7. Endotracheal intubation of pediatric patients
(1) Endotracheal tube

(2) Pediatric airway adapter (Replaces regular pediatric endotracheal tube connector.
For sizes 2.5 to 4.0 endotracheal tubes.)
(3) Pediatric heat and moisture exchanger (HME)
(4) Fresh gas inlet
16-4
Airway Gases
Sample gas exhaust connections

When N2O or volatile anesthetics are used, take precautions against venting these
gases into room air. Return the sample gas to the patient circuit or remove it through a
scavenging system.
Returning gas to the patient circuit

To scavenge through the ventilator reservoir:
1. Connect an exhaust line to the sample gas outlet on the rear panel of the monitor.
2. Attach the other end of the line to the ventilator reservoir. Make sure that the
reservoir tube diameter is at least 2-3 times larger than the exhaust line.
Sample Gas Out
Figure 16-8. Gas return to patient circuit through ventilator reservoir
If you use the Datex-Ohmeda AS/3 Anesthesia Delivery Unit (ADU), connect an
optional adapter (881644, 5/pkg) to the patient breathing tubes.
Figure 16-9. Gas return to patient circuit in AS/3 ADU
16-5
Scavenging through direct connection

Connect the sample gas exhaust to an open scavenging system where gas is removed at
room pressure.
CAUTION: Strong scavenging suction may change the operating pressure of the monitor and
cause inaccurate readings or internal damage.
To scavenge through a direct connection:

1. Connect the exhaust line (733195, 5/pkg) to the sample gas outlet on the monitor.
2. Attach a T-fitting (882377, 5/pkg) between the exhaust line and the scavenging tube
to prevent vacuum in the tube.
Sample Gas Out
Figure 16-10. Connection directly to a scavenging system
16-6
Airway Gases
CO2 setup
3. Select CO2 Setup.
Airway Gas
CO2 Setup
Scale 6%
Resp Rate Source AUTO 6%
CO2 Alarm 10%
Resp Rate Alarm 15%
Previous Menu 20%
Change size of CO2 waveform

by changing scale height.
4. To change the scale, select Scale and choose the scale.

The 0 - 6% scale is used in normal situations. The 0 - 10% and 0 - 15% scales are used
if hypercarbia is expected.
5. To change the source used for the respiration rate, select Resp Rate Source.
You can choose to have the rate calculated from the ECG or the CO2 measurement.
If AUTO is selected, the respiration rate is calculated from CO2, when CO2 is
measured, and from the ECG measurement otherwise.
Respiration rate calculation switches back to impedance respiration if you press
the Silence Alarms key during an Apnea alarm.
6. Select CO2 Alarm or Resp Rate Alarm to open the corresponding alarms adjustment
menu where you can change the CO2 or respiration rate alarm limits.
16-7
O2 setup
To open the O2 Setup menu:
3. Select O2 Setup.
Airway Gas
O2 Setup
Scale DIFF6
Measurement ON DIFF6
O2 Alarm DIFF10
Previous Menu DIFF15
DIFF30
10-60%
100%
Change size of waveform by

changing scale height.
4. To select the scale for the waveform oxygram, select Scale.

The monitor measures inspiratory and expiratory O2 continuously and displays an
O2 waveform oxygram. It also calculates and displays the difference of inspired
and expired O2. The scale allows you to select the following ranges for oxygram:
difference scales DIFF 6, DIFF 10, DIFF 15, DIFF 30, 10 - 60%, 0 - 100%.
The monitor determines the maximum measured O2 concentration and
automatically sets the reference level for the difference scales. DIFF 30 and
10 - 60% are used in the recovery room when the patient is oxygenated, for example.
Scale 0 - 100% enables you to inspect the full range of O2. It is used during
pre-oxygenation, for example.
5. Select Measurement and choose ON or OFF.
You can turn off O2 measurement wen no O2 alarms or digit information is desired.
If OFF is selected, this symbol is displayed in the digit field and the
“Measurement OFF” message is displayed in the O2 waveform field.
6. Select O2 Alarm to open the O2 Alarms Adjustment menu where you can change the
O2 alarm limits as described in the Alarms chapter.
This symbol is displayed beside the O2 value when the FiO2 low alarm
limit is set below 21%.
16-8
Airway Gases
N2O setup
NOTE: N2O and Agent adjustments are made in the same menu. To adjust for agent
measurement, see Agent setup later in this chapter.
To open the Agent/N2O setup menu:
3. Select Agent/N2O Setup.
4. Select N2O Measurement and choose ON or OFF.
Airway Gas
Agent/N2O Setup
Agent Scale 10 %
Agent Measurement ON ON
N2O Measurement ON OFF
Agent Alarm
Previous Menu
Select ON to enable N2O

measurement and alarms.
• When the measurement is ON, the FiN2O alarm limit is FI x 82%.

• In cases where no N2O alarms or digit information is desired, you can turn off
the N2O measurement.
“Measurement OFF” message is displayed in the N2O waveform field.
16-9
Agent setup
NOTE: Agent and N2O adjustments are made in the same menu. To adjust for N2O
measurement, see N2O setup earlier in this chapter.
To open the Agent/N2O Setup menu:
3. Select Agent/N2O Setup.
Airway Gas
Agent/N2O Setup
Agent Scale 5%
Agent Measurement ON 1.2%
N2O Measurement ON 2.5%
Agent Alarm 5%
Previous Menu 10%
20%
Change size of agent waveform

by changing scale height.
4. To select the anesthetic agent waveform scale, select Agent Scale and choose
0 - 1.2%, 0 - 2.5%, 0 - 5%, 0 - 10% or 0 - 20%.
Scale 0 - 1.2% is used with concentrations < 1%. Scales 0 - 2.5% and 0 - 5% are
normal scales, 0 - 5% being used in induction, for example. The maximum scale is
0 - 20%.
5. Select Agent Measurement and choose ON or OFF.
You can turn off agent measurement when no agent alarms or digit information is
desired.
“Measurement OFF” message is displayed in the agent waveform field.
6. Select Agent Alarm to open the Agent Alarms Adjustment menu where you can
change agent alarms.
16-10
Airway Gases
MAC values
To display the MAC value on the screen:
4. Select one of the lower digit fields and choose MAC.
1 MAC (Minimum Alveolar Concentration) is the alveolar concentration (end-tidal) of
the agent at which 50% of individuals fail to move in response to a noxious stimulus,
such as a surgical incision.
WARNING: MAC values are empirical, not absolute. Cardiocap/5 MAC values correspond to
those of healthy adults and cannot be applied to children. Age and other individual factors
influencing the effect of volatile agents are not taken into account.
The monitor calculates MAC values according to the following formula:
%(EtAA) %EtN 2O
MAC( AA) = +
x( AA) 100
where x(AA) is Hal=0.75%, Enf=1.7%, Iso=1.15%, Sev=2.05%, Des=6.0%
Table 16-1. MAC numbers of different anesthetics in oxygen 1

HAL ENF ISO SEV DES N2O
1 MAC 0.75% 1.7% 1.15% 2.05% 6% 100%

2 MAC 1.5% 3.4% 2.3% 4.1% 12%
3 MAC 2.3% 5.1% 3.45% 6.2% 18%
Table 16-2. MAC numbers of different anesthetics in 65% N2O 1
HAL ENF ISO SEV DES N2O

1 MAC 0.3 0.7 0.45 0.8 2.8-4 —
1) Quasha AL. Eger EI II, Tinker JH. Determination and application of MAC.
Anesthesiology 1980; 53: 315.
16-11
Automatic agent identification

The agent identification option automatically identifies and selects Halothane,
Enflurane, Isoflurane, Sevoflurane and Desflurane on the basis of the identification.
Automatic agent identification is activated after power up.
When the monitor identifies and selects the agent, it displays the “XXX selected”
message (XXX being HAL, ENF, ISO, SEV or DES). The message is displayed for 60
seconds. The inspiratory and expiratory concentrations of the agent are shown in the
digit field.
The minimum concentration for the identification is 0.15 vol%. The agent selection
remains active even if the concentration decreases below 0.15 vol% during the case.
Automatic agent identification operates after the normal warm up of the monitor
(approximately five minutes).
Agent mixtures
The agent identification warns you if a mixture of anesthetic agents is detected. The
mixture warning is activated at the latest when the concentration of the minor agent is
greater than 0.3 vol% and more than 15% of the total anesthetic agent concentration.
When a mixed agent is detected, the “Agent mixture” message is displayed and an
audible alarm sounds. The message remains active as long as the situation persists.
When there is an agent mixture, the anesthetic agent concentrations and labels of two
anesthetic agents are displayed.
When changing the anesthetic agent, the monitor will detect an agent mixture until the
first agent is washed out of the patient and the circuit. When the second agent begins to
dominate, the measurement is based on the new agent. The “Agent mixture” message
disappears when the concentration of the first agent becomes insignificant. When this
event occurs, the exact limits depend on the mixture of agents.
Selecting alarm sources

Alarm sources can be selected in the Alarm Sources submenu under the Alarms Setup
menu. The selections are FI or ET as the high- and low- alarm limits. For more
information, see the Alarms chapter.
16-12
Airway Gases
Gas calibration
Perform a gas calibration every six months or whenever there are indications of errors
in the gas readings. The time of the last calibration is shown at the bottom of the Gas
Calibration menu.
Calibration is not available during the first five minutes of monitoring and during a gas
sampling warning.
NOTE:
• During gas calibration, % units are always used for CO2 regardless of selected
measuring units.
• Anesthetic agent is always calibrated with Desflurane.
Equipment and use
• Use only Datex-Ohmeda calibration gas to calibrate the gas measurement.
Otherwise, the calibration will not succeed.
• The calibration gas container may be used until the pressure indicator reaches the
red zone.
• If separate gas containers are used, each gas must be calibrated separately.
• If you use an older brass regulator, the feeding pressure should be adjusted
between 5 and 7 psi. The use of an old regulator with the new aerosol containers
requires an adapter available from Datex-Ohmeda. For ordering details see the
Datex-Ohmeda Supplies and Accessories Catalog.
Calibrating the monitor

To calibrate the monitor:
1. Turn on the monitor. For maximum accuracy, let the monitor warm up for 30
minutes.
2. Attach the regulator to the gas container.
Figure 16-11. Attaching the regulator to the gas container
16-13
3. Attach a new sampling line to the water trap. Connect the loose end of the
sampling line to the regulator on the gas container.
Figure 16-12. Connecting a sampling line to the gas valve and feeding gas
The Gas Calibration selection remains gray (inactive) until the “Calibrating gas
sensor” message is no longer displayed.
6. Select Gas Calibration.
Airway Gas
Airway Gas Gas Calibration
Spirometry Loops CO2 Zeroing

CO2 Setup O2 Zeroing
O2 Setup N2O Zeroing
Agent/N2O Setup Agent Zeroing
Spirometry Setup Previous Menu
Gas Calibration
Parameters Menu
Last calibration:
–––
—
Start gas calibration. Zeroing gases.
7. Wait until the “Zero ok” and then “Feed gas” messages appear on the screen after
each gas.
If the “Zero error” message is displayed, press the Normal Screen key and repeat the
calibration procedure. If the problem persists, contact authorized service
personnel.
16-14
Airway Gases
8. Open the regulator and feed the calibration gas until “Adjust” appears, then close
the valve.
NOTE: When the monitor is in automatic agent ID mode and it detects a calibration
gas and no anesthetic agent (from Datex-Ohmeda Quick Cal calibration gas, for
example), the “Cal gas found” message appears. If the identification sensor fails,
the “Agent id inop” message will be displayed.
9. Check that the displayed gas values match the values on the calibration gas
container.
Calibration adjustments
Calibration adjustments may be required if the gas values displayed during calibration
do not match the values on the calibration gas container.
If adjustments are required:
Airway Gas 1. Select Gas Calibration in the Airway Gas

menu.
Gas Calibration 2. Turn the ComWheel to highlight the first gas
to be adjusted. Press the ComWheel to open
CO2 5.00
an adjustment window.
O2 52.1 A 10.00
3. Turn the ComWheel until the displayed
N2O 31.4 A
value matches the desired value. Press the
Agent 2.60 A ComWheel to confirm the adjustment.
Previous Menu 4. Repeat steps 2 and 3 for each gas.
Last calibration:
––– 0
—
Adjust values to match
calibration gas.
Autozeroing intervals
Autozeroing intervals after startup are: 5 minutes, 5 minutes, 5 minutes, 15 minutes,
15 minutes, 15 minutes, and every hour thereafter. Autozeroing may also occur after
agent selection.
Interfering gases
Known effects of gases NOT MEASURED by the monitor:
Helium (He) Affects the CO2 measurement, decreases the CO2 readings.
For example:
5% CO2, 30% O2, balance He: CO2 reading decreases 8.5% relative.
Nitrogen (N2) The monitor compensates for the effect of nitrogen in the gas
measurement. Nitrogen is used as the balance gas in gas measurement.
16-15
Unit conversions
Relationship between gas concentration and its partial pressure:
Reading in mmHg (dry gas) =
(ambient pressure in mmHg * gas concentration in %) / 100.
Reading in mmHg (water vapor saturated gas) =
[(ambient pressure in mmHg – 47 mmHg) * gas concentration in %] / 100.
Reading in kPa (dry gas) =
(ambient pressure in mmHg * gas concentration in % ) / 750.
Reading in kPa (water vapor saturated gas) =
[(ambient pressure in mmHg – 47 mmHg) * gas concentration in %] / 750.
NOTE: 47 mmHg is the partial pressure of the saturated water vapor at 37oC.

This section describes other adjustable features related to measuring airway gases. A
Changing units
To change the CO2 measurement unit:
4. Select Units.
5. Select Parameters.
6. Select CO2 and choose the unit (%, kPa, or mmHg).

You can choose yellow, white, green, red, or blue as the color used in the waveform
and digit fields for CO2, O2, or agent gas readings. For gases, you can also select orange
or violet.
The factory default colors for anesthetic agents are:
Desflurane: Blue Halothane: Red Sevoflurane: Yellow
Enflurane: Orange Isoflurane: Violet
To change a color:
3. Select Colors.
4. Select Gases and choose the color.
16-16
Contents
Chapter 17. Patient Spirometry

Overview .......................................................................... 17-1
Measured parameters........................................................................................................................... 17-1
Measurement principles..................................................................................................................... 17-2
Display of patient spirometry ................................................ 17-2

Continuous waveforms ....................................................................................................................... 17-2
Lower digit field display..................................................................................................................... 17-3
Split screen display................................................................................................................................17-3

Selecting the sensor............................................................................................................................... 17-5
Adult D-lite sensor .................................................................................................................... 17-5
Pediatric Pedi-lite sensor ...................................................................................................... 17-5
Spirometry setup ............................................................... 17-6

Spirometry loops ............................................................... 17-7
Spirometry selections........................................................................................................................... 17-7
Scaling of loops and waveforms............................................. 17-9

Calibrating......................................................................17-10
Changing parameter colors.............................................................................................................17-11
Specifying measurement conditions.........................................................................................17-11
TV measuring conditions ...................................................................................................17-11
Table of Figures
Figure 17-1. Patient spirometry waveform display........................................................................... 17-2
Figure 17-2. Digit fields for Paw, Paw + TV, Flow, and Compl. + Raw................................. 17-3
Figure 17-3. Spiro1 (left) and Spiro2 (right) split screen options.............................................. 17-3
Figure 17-4. Patient spirometry setup ....................................................................................................... 17-4
Figure 17-5. Connector positioning............................................................................................................ 17-4
Figure 17-6. D-lite sensor ..................................................................................................................................17-5
Figure 17-7. Pedi-lite sensor............................................................................................................................17-5
Figure 17-8. Vol Scale, Paw Scale, and Flow Scale options.......................................................17-10
Patient Spirometry
17. PATIENT SPIROMETRY
Overview
The Patient Spirometry option (N-XV) enables monitoring of the patient’s airway
pressures, volumes, lung mechanics, and the ventilator operation.
In Patient Spirometry measurement, the airway pressures are measured as close to the
patient as possible (between patient circuit and intubation tube), using the D-lite and
Pedi-lite sensors. The same sensors are used for gas sampling.
The D-lite and Pedi-lite sensors measure kinetic pressure by a two-sided Pitot tube.
Pressure is transferred to the monitor through a spirometry tube and measured by a
pressure transducer. The pressure difference across a flow restrictor, together with the
gas concentration information, is used to calculate flow. The volume information is
obtained by integrating the flow signal.
Measured parameters
• Expiratory and inspiratory tidal volumes (TVinsp/exp)
• Expiratory and inspiratory minute volumes during controlled mechanical
ventilation and during spontaneous breathing (MVinsp/exp)
• Airway pressures:
Peak pressure (Ppeak)
Plateau pressure (Pplat, plateau)
Mean pressure (Pmean)
Real-time pressure waveform (Paw)
• End expiratory pressure (PEEP)
• Flow real-time waveform (Flow)
• Compliance (Compl)
• Airway resistance (Raw)
• Ratio of the inspiratory and expiratory time (I:E)
• Pressure-volume loop (Paw-Vol. loop)
• Flow-volume loop (Flow-Vol. loop)
NOTE: Airway resistance and PEEP are not measured with spontaneous breaths
compliance or with pressure-supported breaths.
17-1
Measurement principles
Pplat is the pressure at the reversal point of the flow, at the end of the inspiration phase,
after the inspiratory pause.
Ppeak is the maximum pressure during one breath.
PEEP is the pressure in the lungs at the end of the expiration, measured at the moment
when the expiratory phase changes to inspiratory flow.
Compliance (Compl) tells how big a pressure difference is needed to deliver a certain
volume of gas into the patient. Compliance is calculated for each breath from the
following equation:
TVexp
Compl =
Pplat − PEEP
Raw, the airway resistance, is calculated from an equation that describes the kinetics of
the gas flow between the lungs and the flow sensor. The pressure at the sensor can be
derived at any moment of the breath cycle from the following equation:
p(t) = Raw • V’(t) + V(t) / Compl + PEEP

where p(t), V'(t) and V(t) are pressure, flow, and volume measured at the sensor at a
certain time (t).
Display of patient spirometry

Continuous waveforms
2 3 4
Paw 40 P cmH2O Adult

20 a Ppeak 25 PEEP
0 w Pplat 21
1 Flow 60 F TV ml Adult
l insp exp
1 min 0 o
w 800 790 5
Figure 17-1. Patient spirometry waveform display
(1) Pressure and flow waveforms

(2) Label
(3) Scale
(4) Digit field for Ppeak, Pplat, and PEEP values
(5) Digit field for tidal or minute volume
17-2
Patient Spirometry
Lower digit field display

Paw Paw TV Flow Compl Raw
cmH20 Adult cmH20 Adult TV ml Adult ml/cmH2O cmH2O/l/s
Ppeak 25 PEEPtot 7 Ppeak 25 insp exp
Pplat 21 PEEPtot 7
TVexp ml
790 800 790
55 8
Figure 17-2. Digit fields for Paw, Paw + TV, Flow, and Compl. + Raw
You can choose to display tidal volume (TV) or minute volume (MV) in the Spirometry
Setup menu. This selection also affects the Spiro1 split screen display (see below).
Split screen display

1 2
1200 1200
Vol Vol
ml ml
Paw Paw 2
cmH2O cmH2O
0 40 0 40 1
Adult cmH2O TVinsp ml Adult cmH2O ml
Ppeak 25 TV insp 800
Ppeak 25 800
Pplat 21 TVexp 790
Pplat 21 TVexp ml Pmean 11 l/min
PEEPtot 7 MVinsp 12.0
PEEPtot 7 790
MVexp 12.0
Compl 55 ml/cmH20 I:E 1 : 2.0 4
Raw 8 cmH2O/l/s
Compl 55 ml/cmH2O
Figure 17-3. Spiro1 (left) and Spiro2 (right) split screen options
(1) Scale (3) Real-time loop

(2) Label (4) Digit field
Spiro1, the basic spirometry view, shows Ppeak, Pplat, PEEP, Compliance, TVinsp,
Tvexp, MVinsp, and MVexp.
Spiro2 shows the same parameters as the basic view plus Pmean, I:E, and Raw.
For both views, TVinsp/exp and MVinsp/exp values are displayed according to the
spirometry setup selections.
To select the spirometry values for the split screen display:
3. Select Split Screen and choose from the options.
17-3
Patient connections
To make the connections:
1. Connect a new spirometry tube to the flow sensor by inserting the angle
connectors into the sensor connectors.
2. Connect the other end of the spirometry tube to the pressure connectors on the
monitor.
3. Connect a gas sampling line to the luer connector on the other side of the flow
sensor.
4. Connect the other end of the gas sampling line to the sampling line connector on
the D-fend water trap. Confirm that the connections are secure.
5. Select the type of sensor you use, D-lite (the factory default) or Pedi-lite:
Press the ComWheel and select Parameters. Then, select Airway Gases and Spirometry
Setup. Select Sensor Type and choose the sensor.
6. Complete the other patient connections as shown below.
Patient tubes
1 2 3 4
Sampling line
connector
5
Spirometry
connectors
Figure 17-4. Patient spirometry setup
(1) Y-piece
(2) Spirometry tube
(3) D-lite sensor
(4) Bacterial filter
(5) Gas sampling line
To prevent condensed water from
entering the lines, position the gas
sampling line and the spirometry tube
connections so that they head upward
from the patient.
Figure 17-5. Connector positioning
The gas sampling line can be aligned along the groove of the spirometry tube for a
more serviceable setup.
17-4
Patient Spirometry
NOTE: If you are using a nebulizer to administer medication, disconnect the HME-F
filter and the flow sensor while the nebulizer is in use.
NOTE: When using a Bain circuit, the inspiratory volumes are erroneously high. This
can be corrected by using a filter.
Selecting the sensor

Adult and pediatric patients are measured with different sensors.
To select the correct sensor type:
3. Select Spirometry Setup.
4. Select Sensor Type and choose Adult or Pedi.
Both D-lite and Pedi-lite sensors also work as airway adapters with a connector for
airway gas monitoring.
Adult D-lite sensor

D-lite sensors are reusable (transparent yellow) or disposable (non-transparent yellow).
The D-lite sensor is for patients with

a tidal volume of 150 to 2000 ml.
The filter smoothes the flow profile
and prevents mucus or humidity
from entering the D-lite.
The outer diameter of the D-lite at
the patient end allows connection
of the D-lite sensor to a mask.
Figure 17-6. D-lite sensor
Pediatric Pedi-lite sensor

Pedi-lite sensors are reusable (transparent yellow).
The Pedi-lite sensor is intended for

patients having a tidal volume
from 15 to 300 ml.
Figure 17-7. Pedi-lite sensor
17-5
Spirometry setup
To open the Spirometry Setup menu:
3. Select Spirometry Setup.
Airway Gas
Spirometry Setup
Scaling
Sensor Type Adult Adult
TV or MV TV Pedi
Paw Alarms
MVexp Alarm
Previous Menu
Change sensor type:

Adult (D-lite) or
Pediatric (Pedi-lite).
NOTE: For detailed information about the Scaling selection, refer to Scaling of
loops and waveforms later in this chapter.
4. Select Sensor Type and choose Adult (the factory default) or Pedi (pediatric) according
to the flow sensor in use.
5. Select TV or MV and choose tidal volume (TV) or minute volume (MV) for display in
the digit field. Your selection also affects the Spiro1 Split Screen.
6. Select Paw Alarms to open the Paw Alarms Adjustment menu. You can adjust Ppeak
and PEEP alarms in the same menu.
7. Select MVexp Alarm to open the MVexp Alarms Adjustment menu.
17-6
Patient Spirometry
Spirometry loops
Spirometry parameters are viewed in the Spirometry display.
• If CO2 is detected and the respiration rate is below 15/minute, the loops are
updated every breath.
• If no CO2 is detected or the respiration rate is 15/minute or higher, the loops are
updated every other breath.
The values are always updated breath by breath.
To open this menu:
3. Select Spirometry Loops.
Spirometry 14:50 14:50 --:--

Saved loops : --:-- --:-- --:--
Print Saved 1200
Vol
ml
Paw-Vol Loop
Flow-Vol Loop
Scaling
Save Loop
Paw
Reference Loop cmH2O
Reference Off 0 40
Erase Loop Adult cmH2O
Previous Menu Ppeak 25 TVinsp 800 ml
Pplat 21 TVexp 790 ml
Pmean 11 Compl 55 ml/cmH2O
Show Paw-Vol PEEPtot 7 Raw 8 cmH2O/l/s
loop. I:E 1 : 2.0
Spirometry selections
Print Saved Prints the saved loops.
You can also print all saved loops by pressing the ComWheel and
selecting Record/Print from the Main Menu. Then select Print Loops.
Paw-Vol Loop Displays the pressure-volume loop. A 45° angle is equal to a compliance
of 30 ml/cmH2O for adults and 10 ml/cmH2O for pediatrics.
With pediatric measurement, the ratio of the loop axis is changed to
maintain the normalized 45° loop slope also in pediatric measurement.
Flow-Vol Loop Displays the flow-volume loop.
Scaling Changes the size of the Paw-Vol and Flow-Vol loops. See Scaling of
loops and waveforms later in this chapter.
17-7
Save Loop Saves up to six pairs of reference loops in memory. Both loops are
saved at the same time. When more than six pairs are saved, the most
recent one is erased from the memory and the “Saving next will
override last loop” message is displayed.
The time the saved loop pair is saved appears at the upper right of the
spirometry view. A frame around the time of saving indicates which
loop is currently displayed.
Reference Loop Recalls a selected reference loop from memory. One real-time loop and
one reference loop are displayed simultaneously.
To recall, highlight the stamp of the loop with the ComWheel and press
the ComWheel. The real-time loop is drawn with a blue line, the
reference loop is drawn with a white, dotted line.
Flow-Vol loop Paw-Vol loop
–––– Reference Loop

Real-Time Loop
Reference Off If you do not want the reference loop to be displayed, choose this
option.
Erase Loop Erases the selected reference loop from memory.
To erase, turn the ComWheel to highlight the number of the loop. The
loop is drawn with a blue line. Press the ComWheel to erase.
To return to the menu without erasing a loop, select Exit instead of the
number of the loop.
17-8
Patient Spirometry
Scaling of loops and waveforms

If the flow or pressure waveform, or flow, volume, or pressure axis of the loop is not
drawn to suit your needs you can change the scaling.
To change the scaling:
1. Press the ComWheel and select Parameters
from the Main Menu.
3. Select Spirometry Loops or Spirometry Setup.
4. Select Scaling.
Scaling AUTO (the factory default) automatically adjusts the scaling of parameters
to suit the situation. Complete loops and waveforms are always
displayed.
Vol results in interdependent scales. A change to one scale affects the
others so that the ratio between pressure and volume and flow and
volume scales remains constant.
Indep. allows independent and separate changes to the volume, pressure,
and flow scales. A change in one scale does not affect the scaling of
other scales. This selection may be needed, for example, with pediatric
or ARDS patients whose airway pressure is high but the tidal volume
low.
Scaling Speed Changes the speed at which loops and waveforms are rescaled during
AUTO scaling.
Slow rescales to a higher scale after two breaths are above the selected
scale. Rescaling to a lower scale occurs after four breaths are within the
limits of the lower scale.
Fast rescales to a higher scale after one breath is above the selected scale.
Rescaling to a lower scale occurs after two breaths are within the limits
of the lower scale. For example, select Fast as the scaling speed for
manual ventilation.
17-9
Figure 17-8. Vol Scale, Paw Scale, and Flow Scale options
Calibrating
The flow measurement should be calibrated once a year, or when there is a permanent
difference between inspiratory and expiratory volume.
Calibration should be performed by trained service personnel using a special
spirometry tester designed by Datex-Ohmeda. For more information, see the Technical
Reference Manual.
17-10
Patient Spirometry

This section describes other adjustable features related to patient spirometry
measurement. A password is required for entering the Install/Service menu where the
adjustments are made. If you wish to make changes, we recommend that you contact
the person responsible for the entire configuration.

You can choose yellow, white, green, red, or blue as the color used in the waveform
and digit fields for CO2, O2, N2O, agent gas readings, Paw, and Flow. You can also
select orange or violet for gases.
To change the color:
3. Select Colors.
4. Select Gases or select More Parameters and Paw or Flow.
5. Choose the color.
Specifying measurement conditions

You can specify measurement conditions of pressure, temperature, and humidity for
volume measurement.
4. Select Units.
5. Select Parameters.
6. Select TV based on and choose ATPD, NTPD, BTPS, or STPD.
TV measuring conditions
Condition Temperature Pressure Relative Humidity

ATPD Ambient Ambient 0%
NTPD 20 °C (68 °F) 760 mmHg 0%
BTPS 37 °C (98.6 °F) Ambient 100%
STPD 0 °C (32 °F) 760 mmHg 0%
17-11
17-12
Contents
Chapter 18. NeuroMuscular Transmission (NMT)

Overview .......................................................................... 18-1
Displaying NMT.......................................................................................................................................18-1
Selecting NMT on a digit field .......................................................................................... 18-1
Selecting NMT on a waveform field ............................................................................. 18-1

Stimulating electrodes ......................................................................................................................... 18-2
ElectroSensor setup............................................................................................................................... 18-3
Grounding electrode ............................................................................................................... 18-3
Recording electrodes .............................................................................................................. 18-4
Cable set..........................................................................................................................................18-4
MechanoSensor setup.......................................................................................................................... 18-5
Cable set..........................................................................................................................................18-5
Starting measurement ........................................................ 18-6

Supramaximal current search......................................................................................................... 18-6
Increasing pulse width......................................................................................................................... 18-7
Determining response reference level ....................................................................................... 18-7
Changing the stimulus mode ................................................ 18-8

Train of Four (TOF) stimulation .................................................................................................... 18-8
Double Burst Stimulation (DBS) .................................................................................................... 18-9
Single Twitch (ST) stimulation....................................................................................................... 18-9
Changing the cycle time .....................................................18-10

Changing the stimulus current .............................................18-10
Enabling recovery note .......................................................18-11
Activation principle.............................................................................................................................18-11
Stopping and restarting......................................................18-11

Measuring deep relaxation with PTC ......................................18-12
Regional block stimulation (Plexus stimulation).......................18-13
Measurement limitations and artifacts ..................................18-14
Stimulation artifact..............................................................................................................................18-14
Movement artifact ................................................................................................................................18-14
Electrosurgery.........................................................................................................................................18-14
Verifying reliability..............................................................................................................................18-14
Other adjustable features................................................... 18-15

Selecting NMT trend..........................................................................................................................18-15
Table of Figures
Figure 18-1. Ulnar nerve and the corresponding muscles............................................................18-2
Figure 18-2. Stimulating electrodes ............................................................................................................18-3
Figure 18-3. Grounding electrode of EMG measurement .............................................................18-3
Figure 18-4. Measurement from the adductor pollicis muscle...................................................18-4
Figure 18-5. NMT setup with ElectroSensor .........................................................................................18-4
Figure 18-6. MechanoSensor attachment ...............................................................................................18-5
Figure 18-7. NMT setup with MechanoSensor...................................................................................18-5
Figure 18-8. Perioperative stimulus response.......................................................................................18-9
Figure 18-9. Sensor cable, regional block adapter, and needle with syringe................18-13
18. NEUROMUSCULAR TRANSMISSION (NMT)
Overview
The Cardiocap/5 monitor with the N-XNMT option delivers stimulating electrical
pulses to a motor nerve and measures the muscle response to these stimulations.
Two electrodes are needed for electrical stimulation of a peripheral nerve. The
resulting response can be measured with a MechanoSensor or an ElectroSensor.
• The MechanoSensor is attached between the thumb and index finger. It is easier to
use and more suitable for routine clinical use. It measures movements with a
piezoelectric wafer.
• The ElectroSensor uses three recording electrodes for electromyography (EMG)
and is mainly intended for research purposes.
Displaying NMT
You can choose three different NMT views on the display: current numeric values,
waveforms illustrating the progression of the stimulation responses during measuring,
and graphical trends.
NOTE: When waveforms are selected for the display, the digit field with the NMT
measurement disappears automatically.
Selecting NMT on a digit field

To select an NMT digit field:
4. Select one of the fields and choose NMT.
Selecting NMT on a waveform field

During the NMT stimulation cycle, you can observe the progression of the stimulation
responses as waveforms. The waveform display is mainly for research purposes.
To select an NMT waveform field:
4. Select one of the fields and choose NMT.
The first waveform is saved as a reference waveform automatically. It appears on the
background of the display during other measurements. The reference waveform is a
different color than the real-time NMT waveform.
18-1
Patient connections
Before connecting the electrodes, clean the application site of oil or dirt. Avoid
placement over excessive body hair or lesions. Pay attention to the condition and
placement of the electrodes. Good signal quality requires good skin contact with the
electrodes. Only Datex-Ohmeda NMT electrodes are recommended.
Stimulating electrodes
To stimulate the motor nerve correctly on standard conditions, the stimulating
electrodes (white and brown) are recommended to be placed along the ulnar nerve on
a site where the nerve is as near to the skin as possible.
To locate the nerve, locate the ulnar artery which runs side by side with the ulnar
nerve. The wrist area is the easiest site for locating the artery, and thus the nerve. The
wrist area is a site where the nerve is near the skin. Fat or muscle does not hinder
detection at this site.
m.adductor pollicis
m.abductor digiti minimi

m.flexor pollicis brevis (hypothenar)
(thenar)
n.ulnaris
medial epicondyle
Figure 18-1. Ulnar nerve and the corresponding muscles
WARNING: Electrical Shock Hazard. Do not place the NMT stimulation electrodes on the
patient’s chest.
WARNING: Electrical Shock Hazard. Always stop the NMT measurement before handling the
stimulation electrodes.
electrosurgery unit to your patient to avoid possible burns at sensor sites.
WARNING: Patient Safety. Make sure that the lead set clips do not touch any electrically
18-2
The electrodes should not touch each other.
Brown
White
Figure 18-2. Stimulating electrodes
ElectroSensor setup
Grounding electrode
For measuring EMG response, the grounding electrode (black) may be placed where
convenient, but placing it between the stimulation and recording electrodes at the
palmar groove may reduce stimulation artifact.
Black (grounding electrode)
Brown
White
Figure 18-3. Grounding electrode of EMG measurement
18-3
Recording electrodes
Place one green recording electrode on the adductor pollicis. Place a second recording
electrode on the muscle's tendon or insertion site. The hand should be immobilized.
Red
Green
Black
Brown
White
Figure 18-4. Measurement from the adductor pollicis muscle
The adductor pollicis muscle is customarily used for the measurement. When the
thenar is preferred, electrode placement becomes crucial. The adductor pollicis and
flexor pollicis brevis muscles lie next to each other and may be recorded on the radial
surface of the palm between the first and second metacarpals. Interference due to
median nerve stimulation is more likely than on the hypothenar side.
Cable set
White
Brown
1 Black Green
Red
Figure 18-5. NMT setup with ElectroSensor
(1) NMT sensor cable

(2) ElectroSensor
18-4
MechanoSensor setup
The MechanoSensor is attached between the thumb and index finger with a piece of
tape. Make sure that the thumb can move freely.
Figure 18-6. MechanoSensor attachment
Cable set
White
1 Brown
Figure 18-7. NMT setup with MechanoSensor
(1) NMT sensor cable

(2) MechanoSensor
18-5
Starting measurement
NMT monitoring should be started before a muscle relaxant drug is administered. It is,
however, advisable to begin after the induction of sleep to prevent voluntary muscle
contraction and tension from interfering with the reference search.
If the patient is already relaxed, the reference level is not usually found, however,
monitoring can proceed without a reference level. In some cases, the reference level
may be found but may be erroneous.
To start a measurement:
1. Press the NMT key.
2. Select Start-Up.
Supramaximal current search

The monitor begins by searching for the supramaximal stimulation current, which is
needed for activating all the fibers of the stimulated (recorded) muscles. When a
stimulation pulse is delivered, a star (*) is displayed in the digit field for each pulse.
Optionally, a beep will sound at the same time. The delivered stimulus current is
measured and the star is displayed if the current is the same as adjusted.
The search for the supramaximal stimulation current begins with a 10 mA stimulus and
the response is measured. The current is increased by 5 mA steps until the increase in
current does not increase the response. This maximal current is automatically
increased by 15%, resulting in a supramaximal current.
NOTE: When the ElectroSensor is used, a reference level for the stimulation responses
is determined after the search.
For adults, the supramaximal current is usually between 35 and 55 mA. The current is
displayed in the digit field during the search for supramaximal current. It is also
displayed in the NMT Setup menu directly after the current selection.
NMT
Supramax search
TOF%
Count
30mA
Defasciculating doses of nondepolarizing neuromuscular blocking agents

(precurarisation) do not normally affect the supramaximal current or the reference
value.
Supramaximal current may not be found if the patient is already relaxed. If the
supramaximal current is not found or if the response is too weak for searching a
supramaximal current, the current is set to 70 mA.
If the monitor is unable to find the supramaximal stimulation current, the fault is
usually in the electrode placement—the nerve is outside the dense current flow or both
the ulnar and median nerves are stimulated. Progressively more muscle activity is
detected as the increasing stimulation current activates new motor units.
18-6
Increasing pulse width

To help find the supramaximal current, you can increase the pulse width to increase
the effect of the stimulation:
NMT 1. Press the NMT key.
NMT Setup 2. Select NMT Setup.

3. Select Pulse Width and 300 µs.
Current S(70MA)
Pulse Width 200µs 4. To start a new measurement,
Stim. Beep Volume 0 100 µs
select Start-up in the NMT menu.
Previous Menu 200 µs
300 µs
Change stimulation pulse

width: 100, 200 or 300 µs.
Determining response reference level

The supramaximal current search is followed by determination of a response reference
level.
The monitor delivers four stimuli of supramaximal current at 1-second intervals. A
mean of four stimulation responses is calculated and is determined as a 100%
reference level.
• With the ElectroSensor, this reference is used to calculate the T1% (T1/Tref *100),
the ratio of the first twitch’s response to the determined reference level.
• With the MechanoSensor, the reference is used only for scaling the bar graph.
Each stimulation response is displayed as a bar in the digit field. If the bars are not
similar, the responses are not repeatable and the reference level will not be accepted.
NMT
Setting reference
TOF%
Count
52mA
If the patient is paralyzed at the time of start-up, it does not make the measurement
impossible or the results useless. When nondepolarizing blocking agents are used, the
responses will fade and the reference value is rejected, however, values other than T1%
are available.
If the block is depolarizing at start-up, T1% should not be used because the reference
level is incorrect.
18-7
Changing the stimulus mode

NOTE: To ensure a correct reference value, the stimulus mode should be changed
before monitoring starts.
To change the stimulus mode:
NMT
2. Select Stimulus Mode.
Start-up
3. Select the stimulus mode (TOF, DBS, or ST).
Continue TOF
Stimulus Mode TOF DBS
Cycle Time 20 sec ST
Tetanic/PTC
Recovery Note OFF
NMT Setup
Parameters Menu
Change stimulus mode:

TOF, DBS (3,3) or Single
Twitch.
Train of Four (TOF) stimulation

Train of Four (TOF), the factory default setting, is recommended for most cases.
During Train of Four stimulation, four stimulation pulses are generated at 0.5-second
intervals. The response is measured after each stimulus and the ratio of the fourth to
the first response of the TOF sequence is calculated, resulting in TOF%.
NMT If you use the ElectroSensor, T1% is displayed below the

TOF% 31 stimulation pulse bars, and a scale is included if the
Count 4 reference is successfully found. Scale markers represent
0 20 sec T1% 71 0%, 25%, 50%, 75% and 100% reference values.
NMT When no reference is available, no T1% is displayed and

TOF% 30 the displayed bars are not scaled.
Count 4
0 20 sec
NMT When relaxation deepens, the TOF% declines until the

TOF% fourth response disappears and no TOF% is calculated.
Count 2
0 20 sec T1% 9
18-8
When no TOF% is available, the degree of neuromuscular block is estimated from the
number of responses, or Counts. The Count tells how many responses have been
detected to the 4 stimuli. The fewer responses detected, the deeper the relaxation.
Number of responses Neuromuscular Muscle Power

(Count) Block (% of Control)
1 95% 5%
2 90% 10%
3 85% 15%
4 75% 25%
Perioperatively, this can be seen in the trends where the bars represent the TOF%.
NMT 120 20 NMT

Ratio% 80 PTC
Count
T1% 40
0 0
Figure 18-8. Perioperative stimulus response
Adequate clinical recovery from competitive block is normally reached when the
TOF% is over 70.
Double Burst Stimulation (DBS)

Double Burst Stimulation (DBS) enables better visual observation of fading responses. It
is practical when the MechanoSensor cannot be used with infants, for example.
DBS includes two separate bursts where each burst consists of three pulses directly
after each other, at 50 Hz frequency. The response ratio of the second to the first burst
is calculated, resulting in DBS%. DBS% is equivalent to TOF%.
NMT
DBS% 31
Count 2
0 20 sec T1% 56
Single Twitch (ST) stimulation

In single twitch stimulation, one pulse is generated and its response is measured. Single
Twitch is practical when using depolarizing relaxants, since TOF% does not give
additional information about the state of the patient.
NMT
SINGLE TW.
Count 1
T1% 34
18-9
Changing the cycle time

Check that the desired cycle time is selected.
To change the cycle time:
NMT 2. Select Cycle Time.
Start-up 3. Select the time interval.
Continue Manual NOTE: The TOF and DBS cycle times are as
Stimulus Mode TOF 10 sec shown. The ST cycle times are 1, 10, and 20
Cycle Time 20 sec 12 sec seconds.
Tetanic/PTC 15 sec
Recovery Note OFF 20 sec
NMT Setup 1 min
Parameters Menu 5 min
15 min
Set time interval for

NMT measurements.
Changing the stimulus current

Check that the correct stimulus current strength is set. The current is either
supramaximal (automatic start-up search) or manually selected between 10 and 70 mA.
Smaller currents may be desirable for children.
To change the stimulus current:
NMT
2. Select NMT Setup.
NMT Setup
3. Select Current and choose the current.
Current S(70MA)
Pulse Width 200µs Supra
Stim. Beep Volume 0 70 mA
Previous Menu 65 mA
60 mA
55 mA
50 mA
45 mA
40 mA
–More–
Select supramaximal or
manual (10 mA – 70 mA) current.
18-10
Enabling recovery note

The Recovery Note alarms when the count reaches the set value. It indicates that the
patient is responding more clearly to the stimuli and the neuromuscular block is
decreasing. The note can be used, for example, to help maintain a certain relaxation level.
To make the note operative and set the limit for the alarming count number:
NMT
2. Select Recovery Note.
Start-up
3. Select the count limit for activating the
Continue 1Count note.
Stimulus Mode TOF 2Count When the note is activated, you will hear a
Cycle Time 20 sec 3Count note sound and a beep. The “Block recovery”
Tetanic/PTC 4Count message is displayed.
Recovery Note 3Count OFF
NMT Setup
Parameters Menu
Set count number that

activates ‘Block recovery’
note.
Activation principle
Activation of the note depends on the Count number set as the recovery note and the
cycle time.
When the cycle time is less than one minute, the monitor requires that the Count is
below the Count limit in two successive measurements before the Recovery Note is
enabled. Then, to give the note, the monitor requires that the number of Counts
exceeds the limit, or is the same as the limit, twice in one minute. The note disappears
when two measurements are below the limit again.
If the cycle time is one minute or more, or if the measurement is done manually, the
monitor requires that at least one Count is below the chosen limit before the note is
enabled. Then, to give the note, the monitor requires one Count to exceed or to be the
same as the Count limit. The note disappears when one measurement is below the limit
again.
Stopping and restarting

• To discontinue the NMT measurement, press the NMT key and select Stop.
• To continue with same patient, press the NMT key and select Continue.
Do not select Start-up if you want to preserve the current and reference values.
18-11
Measuring deep relaxation with PTC

When neuromuscular block deepens, different parameters are needed to measure the
response. At first, when the response to the fourth TOF stimulation pulse disappears, or
the first twitch is very weak, the TOF% is not available and only the number of
detected counts can be observed.
Relaxation Meter
100 TOF% 20 4 Count 0 10 PTC 0
Light Deep
When stimulation pulses no longer give any stimulation response, the Count is not
available either. To monitor the relaxation level, you can start tetanic stimulation and
estimate the relaxation level from the Post Tetanic Count (PTC).
Tetanic stimulation is a continuous, 5-second stimulation. The stimulation makes the
muscle more responsive. After the tetanic stimulation, single-twitch stimulations are
generated. The number of detected responses to the stimulations is counted and
expressed as PTC. The fewer responses detected, the deeper the relaxation.
For example, when the patient is relaxed with pancuronium, the TOF response will
return in about 5 minutes when PTC is 8, and in 15 minutes when PTC is 5. These
values are general guidelines and may differ from case to case.
NMT
Measurement OFF
TOF% PTC 6
Count
T1%
If the responses do not fade away, a maximum of 20 responses are counted and >20 is
displayed.
After tetanic stimulation, NMT measurements are stopped for one minute. After this
the monitor continues with the previously selected cycle automatically.
18-12
Regional block stimulation (Plexus stimulation)

Regional block stimulation is used for locating a nerve.
Regional block requires its own adapter cable. When the regional block adapter cable
is connected, the Regional Block menu can be selected from the NMT menu. Once the
cable is connected, the digit field displays only the stimulation current value.
The monitor delivers single stimulation pulses at a selected rate until manually
stopped. The responses to these stimulations are observable visually, the monitor does
not measure them. You adjust the current manually.
To manually adjust the current:
1. Set up the regional block cable, adapter, and needle as shown below.
Figure 18-9. Sensor cable, regional block adapter, and needle with syringe
2. Connect the cable to the NMT connector on the monitor.

4. Select Cycle Time and choose the cycle time.
5. Select Regional Block to open the Regional Block menu.
6. Select Run.
The monitor is automatically in single twitch mode.
When the needle approaches the motor nerve, reduce the current so that the
response stays small. The closer the needle is to the nerve, the lower the current
that is needed to give a response.
NMT
Regional Block
Current
2.0 mA
Note that the pulse width is 40 µs and somewhat higher currents may be needed
when compared to other similar systems. However, shorter pulse width is less
painful to the patient.
7. To stop the stimulation, select Stop in the Regional Block menu.
18-13
Measurement limitations and artifacts

Stimulation artifact
If electrodes are placed incorrectly, the wrong nerves are stimulated. Consequently, the
wrong muscles are stimulated and the measuring electrodes are improperly placed to
measure the stimulation response.
When multiple nerves are stimulated, the measured response may be affected by the
electrical activity of other muscles.
If the stimulation electrodes are placed very close to the palm of the hand, the muscles
are stimulated directly by the stimulation pulses.
If the current is too strong, the muscles may be stimulated directly by the current.
Movement artifact
All movements of the hand are measured as a response to the stimulation. Therefore,
moving or touching the patient during a measurement may cause incorrect results. If
possible, immobilize the hand during NMT measurements.
Electrosurgery
The measurement results may be incorrect during electrosurgery.
Verifying reliability
The reliability of the response can be estimated by looking at the bar graph or the NMT
trend.
The bars of the graph should be in a smoothly descending order from left to right, and
the NMT trend should indicate that the T1% has remained steady. If this is not the
case, the newest response is unreliable. Relaxation level does not usually decrease
greatly in one minute even with short-acting relaxants.
To verify the observations, start a new measurement manually right after completing
the previous measurement. Sometimes the selected cycle time has been so long (five
minutes, for example) that the relaxation level has changed considerably between the
measurements.
18-14

This section describes other adjustable features related to NMT measurement. A
Selecting NMT trend

If you want the NMT trend in a trend field or you want to change the NMT trend page
number, do the following:
1. Press the ComWheel and select Monitor
Graphical Trends Setup from the Main Menu.
Page 4 2. Select Install/Service and enter the
Field 1 ECG1 –More– password.
Field 2 P1+HR NMT 3. Select Trends & Snapshot.
Field 3 Sp+Ple Event1 4. Select Graphical Trends.
Field 4 T1+T2 Event2
5. Select the page you wish.
Field 5 NMT Event3
6. Select the field and choose NMT.
Field 6 OFF Event4
Previous Menu Event5
Event6
Event7
–More–
Neuromuscular transmission
graphical trends:
T1%, Ratio%, Count and PTC.
18-15
18-16

Cardiocap 5 Manual Usuario

Uploaded by

Copyright:

Available Formats

Cardiocap 5 Manual Usuario

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Cardiocap 5 Manual Usuario

Uploaded by

Copyright:

Available Formats

Cardiocap™/5 Anesthesia

User’s Reference Manual

Document Number 6050-0006-347

Responsibility of the manufacturer

Part I – Setup and General Use

Part II – Measurement Parameters

Chapter 1. Monitor Description

Cardiocap/5 model and options for Anesthesia software............... 1-2

Parts of the monitor.............................................................. 1-3

Symbols ............................................................................ 1-6

Safety precautions ............................................................... 1-8

Invasive blood pressure.......................................................................................................................1-12

Cardiocap/5 model and options for Anesthesia software

Hemodynamic model with airway gas measurement (F-MXG)

Data collection and management options

Parts of the monitor

Figure 1-1. Cardiocap/5 monitor (F-MXG)

(1) Power On/Standby key

Patient connectors panel

NIBP ECG SpO2 P1 T1

Figure 1-2. Patient connectors (F-MXG)

(1) Spirometry (N-XV option)

Connector for Datex-Ohmeda standard pulse oximetry

Connector for Datex-Ohmeda enhanced pulse oximetry

Connector for Nellcor® compatible pulse oximetry

Figure 1-3. Cardiocap/5 rear panel (F-MXG)

(1) Built-in handle

Rear panel connections

Data card (green) and/or the Menu card (white) is inserted.

Charge Battery charging.

Type BF applied part (IEC 60601-1). Defibrillator-proof protection against

Equipotentiality. Monitor can be connected to potential equalization

Delayed standby function

The operating time that remains is updated every minute.

Electrical shock hazard

ECG, Impedance respiration, Invasive blood pressure

ECG, Impedance respiration, NMT

Invasive blood pressure

Patients with pacemakers or arrhythmia

Airway gas measurement

Invasive blood pressure

Invasive blood pressure

Pulse oximetry, standard

Default alarm limits

Sensor emitter wavelength ranges

Pulse oximetry, Datex-Ohmeda enhanced (N-XOSAT option)

Default alarm limits

Sensor emitter wavelength ranges

Pulse oximetry, Nellcor compatible (N-XNSAT option)

Default alarm limits

Sensor emitter wavelength ranges

Respiration rate (RR)

Carbon Dioxide (CO2), Oxygen (O2), and Nitrous Oxide (N2O)

Anesthetic Agent (AA)

Measurement D-lite flow sensor Pedi-lite flow sensor

Regional block mode

Chapter 2. Monitoring Basics

Remote control ................................................................... 2-3

Using menus....................................................................... 2-4