Multi-Parameter Veterinary Monitor: Shenzhen Comen Medical Instruments Co., LTD

Multi-parameter Veterinary monitor
C80
User Manual
Shenzhen Comen Medical Instruments Co., Ltd.
Downloaded from www.Manualslib.com manuals search engine

Copyright
Version: A
Time: 2012 /09
Part No. 046-000333-00
Statements
Our Company makes no warranty of any kind with regard to this material, including(but not
limited to) the implied warranties of merchantability and fitness for a particular purpose. Our
Company assumes no responsibility for any errors that may appear in this document, or for
incidental or consequential damage caused by the providing, performance and using of this
manual.
This manual includes the proprietary information which is protected by the copyright law. All
rights reserved, any part of this manual can not be copied or photocopied by any form or method
without the consent of the Our Company.
Responsibility of the Manufacturer

Our Company only considerers itself responsible for the safety, reliability and performance of the
instrument under the following situations, as:
♦ Assembly operations, extensions, re-adjustments, improvements and repairs are all

conducted by the personnel authorized by Our Company
♦ The related electrical equipment complies with the national standards

♦ Theinstrument is used in accordance with the instruction for use.
Note: This device is not intended for home use.
Warning :
This device is not intended for treatment.

Note: Nowadays, Our Company will provide the circuit diagram conditionally if the user requests
and in addition list to instruct the calibration methods and other information so as to help the user
to repair the parts which have been classified by the Our Company that the user can repair with
appropriate and qualified personnel.
Guide to Labels in the Manual
Warning :
The information you should know for how to avoid the damage that the patients and

medical staff may suffer.
Caution :
You should know the information for how to avoid the damage the equipment may
suffer.
Note: The important information you should know.
II

Contents
Chapter1 General Information ............................................................................................... 1
1.1 General Information .................................................................................................. 2
1.2 Button Functions and Basic Operations .................................................................... 3
1.3 Screen display ........................................................................................................... 4
1.4 External Socket ......................................................................................................... 9
1.4.1 Left Panel .......................................................................................................... 9
1.4.2 Right Panel ........................................................................................................ 9
1.4.3 Rear Panel ....................................................................................................... 10
1.5 Built-in charge battery............................................................................................. 11
Chapter2 Monitor Assembly ................................................................................................. 12
2.1 Open Package and Check ........................................................................................ 12
2.2 Connect with AC Cable ........................................................................................... 12
2.3 Power on ................................................................................................................. 13
2.4 Connect with Sensor ............................................................................................... 13
2.5 Check Recorder ....................................................................................................... 13
Chapter3 System Menu ......................................................................................................... 14
3.1 PATIENT MANAGE .............................................................................................. 14
3.2 Survey setup ............................................................................................................ 16
3.3 SELECTION ........................................................................................................... 16
3.3.1 ALARM Volume ............................................................................................. 16
3.3.2 HEART BEAT VOLUME ............................................................................... 17
3.3.3 KEY VOL (Keyboard Vol ) ............................................................................. 17
3.3.4 LCD LIGHT（LCD Brightness) .................................................................... 17
3.4 MONITOR SETUP (Monitor Setting) .................................................................... 17
3.4.1 ALARM SETUP ............................................................................................. 18
3.4.2 RECORD (Record output setting)................................................................... 18
3.4.3 TIME SETUP (System Time Setting) ............................................................. 19
3.4.4 3.4.4 NURSE CALL SETUP .......................................................................... 19
3.4.5 MODULE SETUP .......................................................................................... 19
3.5 WORK INTERFACE SELECTION ....................................................................... 20
3.6 TREND SCREEN ................................................................................................... 20
3.7 TREND TABLE (TREND Figure).......................................................................... 21
3.8 NIBP RECALL ....................................................................................................... 22
3.9 Reviewing alarm ..................................................................................................... 23
3.10 WAVE RECALL ..................................................................................................... 25
3.11 INFO (Monitoring Information).............................................................................. 25
3.12 DRUG CALCULATION & TITRATION LIST ..................................................... 26
3.13 Maintenance ............................................................................................................ 26
3.14 DEMO (Password: 5188) ........................................................................................ 26
3.15 SCR LOCK(screen lock)......................................................................................... 27
Chapter4 System Work Interface ......................................................................................... 28
4.1 Work Interface Selection ......................................................................................... 28
III

4.1.1 STANDARD ................................................................................................... 28
4.1.2 LIST FACE ..................................................................................................... 28
4.1.3 TREND SCREEN ........................................................................................... 29
4.1.4 OxyCRG SCREEN ......................................................................................... 30
4.1.5 BIG FONT INTERFACE ................................................................................ 31
4.1.6 7-CH MULTI-LEADS DISPLAY ................................................................... 32
4.1.7 ANESTHESIA-GAS SCREEN (optional) ...................................................... 33
Chapter5 Recording ............................................................................................................... 34
5.1 General Information on the Recorder...................................................................... 34
5.2 Record Type ............................................................................................................ 34
5.2.1 Real-time record .............................................................................................. 34
5.2.2 Frozen waveform record ................................................................................. 35
5.2.3 The contents of the real time recording ........................................................... 35
5.3 Operation and Status Information of Recorder ....................................................... 35
5.3.1 Requirements on record paper......................................................................... 35
5.3.2 Normal service ................................................................................................ 35
5.3.3 Insufficient paper ............................................................................................ 35
5.3.4 Paper loading procedures ................................................................................ 36
5.3.5 Solution to paper jam ...................................................................................... 36
Chapter6 Trend ...................................................................................................................... 37
6.1 TREND GRAPH (TREND Diagram) ..................................................................... 37
6.1.1 Select trend diagrams for various parameters to be displayed: ....................... 38
6.1.2 Select 1-hour or 120-hour TREND diagrams:................................................. 38
6.1.3 Observe TREND diagrams of later or earlier duration: .................................. 38
6.1.4 Change the display zoom ................................................................................ 38
6.1.5 Obtain the TREND data at certain time in the current TREND diagram ........ 38
6.1.6 Operation sample ............................................................................................ 39
6.2 TREND TABLE (TREND Figure).......................................................................... 39
6.2.1 Select TREND Figures in various resolutions................................................. 40
6.2.2 Observe earlier or later TREND curves .......................................................... 41
6.2.3 Observe TREND data of various parameters .................................................. 41
6.2.4 Operation sample ............................................................................................ 41
6.3 NIBP RECALL ....................................................................................................... 41
Chapter7 Drug Calculation & Titration List ....................................................................... 43
7.1 DRUG CALC .......................................................................................................... 43
7.2 TITRATION ............................................................................................................ 45
Chapter8 Alarm...................................................................................................................... 47
8.1 Alarm Type.............................................................................................................. 47
8.2 Alarm Level ............................................................................................................ 47
8.3 Alarm Mode ............................................................................................................ 48
8.4 Lighting Alarm ........................................................................................................ 48
8.5 Sound Alarm ........................................................................................................... 48
8.6 Alarm Information .................................................................................................. 49
8.7 Alarm Parameter Flashing....................................................................................... 49
IV

8.8 Icon of Alarm Status................................................................................................ 49
8.9 Setting the upper and lower limits of alarm ............................................................ 50
Chapter9 Patient Safety ......................................................................................................... 51
9.1 Environment ............................................................................................................ 51
9.2 Power Source .......................................................................................................... 51
9.3 Monitor earthing ..................................................................................................... 52
9.4 Equal-potential earthing .......................................................................................... 52
9.5 Condensation ........................................................................................................... 52
9.6 Explanations on Symbols Used in the Monitor ....................................................... 53
Chapter10 Maintenance & cleaning ....................................................................................... 54
10.1 Maintenance check .................................................................................................. 54
10.2 Cleaning and Sterilization ....................................................................................... 54
10.2.1 Note on Cleaning and Sterilization ................................................................. 54
10.2.2 Cleaning .......................................................................................................... 55
10.2.3 Sterilization ..................................................................................................... 55
Chapter11 ECG Monitoring .................................................................................................... 57
11.1 Definition of ECG Monitoring ................................................................................ 57
11.2 Attentions during ECG Monitoring......................................................................... 57
11.3 Monitoring Procedures ............................................................................................ 58
11.3.1 Preparation ...................................................................................................... 58
11.3.2 Install ECG leads............................................................................................. 59
11.3.3 ECG lead connection recommended for surgery patients ............................... 60
11.3.4 Use the 5-lead ECG device. ............................................................................ 61
11.4 ECG Hot Key .......................................................................................................... 61
11.5 ECG Menu .............................................................................................................. 63
11.5.1 ECG setting in parameter area ........................................................................ 63
11.5.2 ECG setting in waveform area ........................................................................ 64
11.5.3 ECG setting in measurements ......................................................................... 66
11.5.4 About ST Monitoring ...................................................................................... 67
11.5.5 Arrhythmia Analysis ....................................................................................... 71
11.6 ECG Alarms & Reminders ...................................................................................... 75
Chapter12 RESP Measurement .............................................................................................. 78
12.1 Measure RESP ........................................................................................................ 78
12.1.1 How to measure RESP .................................................................................... 78
12.1.2 Setting of RESP monitoring ............................................................................ 78
12.2 RESP Setting in parameter area .............................................................................. 79
12.3 RESP setting in waveform area ............................................................................... 81
12.4 RESP setting in measurements ................................................................................ 81
12.5 RESP alarm information and prompt information .................................................. 82
12.6 Maintenance & Cleaning......................................................................................... 83
Chapter13 SpO2 Monitoring................................................................................................... 84
13.1 Definition of SpO2 Monitoring ............................................................................... 84
13.1.1 Principle for Measurement of SpO2 Volume Recording Parameter ................ 84
13.1.2 BOS/Pulse Monitoring .................................................................................... 84

13.2 Precautions in SpO2/Pulse Monitoring ................................................................... 85
13.3 Monitoring Procedures ............................................................................................ 86
13.4 Measurement restriction .......................................................................................... 87
13.5 SpO2 Setting in the parameter area ......................................................................... 88
13.6 SPO2 setting in waveform area ............................................................................... 89
13.7 SPO2 setting in measurements ................................................................................ 89
13.8 Alarms & Reminders............................................................................................... 90
13.9 Maintenance & Cleaning......................................................................................... 92
13.9.1 Cleaning: ......................................................................................................... 93
Chapter14 NIBP Monitoring ................................................................................................... 94
14.1 General Information ................................................................................................ 94
14.2 NIBP Monitoring..................................................................................................... 94
14.2.1 NlBP Measurement ......................................................................................... 94
14.2.2 Operational guide ............................................................................................ 97
14.2.3 Measurement restriction .................................................................................. 98
14.2.4 NIBP Parameter Setting & Adjustment ........................................................... 99
14.3 NIBP setting in parameter area ............................................................................... 99
14.4 NIBP setting in measurements .............................................................................. 101
14.5 NIBP Pressure Calibration .................................................................................... 102
14.6 Gas leakage detection ............................................................................................ 103
14.7 NIBPAlarms & Reminders .................................................................................... 104
14.8 NIBP alarm information ........................................................................................ 107
14.9 Maintenance & Cleaning....................................................................................... 107
14.9.1 Recyclable blood pressure cuff ..................................................................... 107
14.9.2 One-time blood pressure cuff ........................................................................ 108
Chapter15 TEMP Monitoring ............................................................................................... 109
15.1 TEMP Monitoring ................................................................................................. 109
15.1.1 TEMP measurement setting .......................................................................... 109
15.2 TEMP setting in parameter area ............................................................................ 110
15.3 TEMP setting in measurements ............................................................................. 111
15.4 Alarm information and prompt information .......................................................... 111
15.5 Maintenance & Cleaning....................................................................................... 112
Chapter16 CO2 Monitoring .................................................................................................. 114
16.1 General .................................................................................................................. 114
16.2 Measuring Principle and Working Process............................................................ 115
16.3 Operating Instruction for CO2 Connection............................................................ 115
16.4 CO2 Measurement Procedures .............................................................................. 118
16.4.1 Measuring Procedure of RESPIRONICS Branded Mainstream and Sidestream
Modules 118
16.4.2 Measuring Procedure of PHASEIN Branded Sidestream and Mainstream
Analyzers ...................................................................................................................... 121
16.5 CO2 Settings in Parameter Area............................................................................ 123
16.6 CO2 Settings in Waveform Area ........................................................................... 125
16.7 CO2 Settings in Measurement Setup ..................................................................... 125
VI

16.8 Discharging Waste Gases ...................................................................................... 126
16.9 Maintenance and Cleaning of RESPIRONICS Branded Mainstream and Sdestream
Modules 127
16.9.1 Common Cleaning ........................................................................................ 127
16.9.2 Airway Adapter for Cleaning Reusable Mainstream Sensor ......................... 127
16.9.3 Method for Sterilizing Reusable Adapter ...................................................... 127
16.9.4 Sterilization Times for Reusable Airway Adapter ......................................... 128
16.9.5 Zeroing .......................................................................................................... 128
16.10 PHASEIN Branded Mainstream and Sidestream Analyzer Related Information . 128
16.10.1 Zeroing .................................................................................................. 128
16.10.2 CO2 Module Lighting Information ........................................................ 129
16.10.3 Others .................................................................................................... 129
Chapter17 IBP Monitoring .................................................................................................... 130
17.1 16.1 General information ...................................................................................... 130
17.2 Considerations of IBP monitoring ......................................................................... 130
17.3 Monitoring procedure............................................................................................ 131
17.4 IBP Menu .............................................................................................................. 132
17.4.1 IBP<1,2>setup in the parameter area ............................................................ 132
17.4.2 IBP<1,2>setup in the waveform area ............................................................ 135
17.4.3 IBP<1,2>setup in the measurement setup ..................................................... 136
17.5 Zero calibration of sensor: .................................................................................... 137
17.6 Mercury manometer calibration procedures: ........................................................ 138
17.7 Alarm information and prompt information .......................................................... 140
17.7.1 Alarm information ......................................................................................... 140
17.8 Maintenance and Cleaning .................................................................................... 140
Chapter18 Measurement of Anesthetic Gases ..................................................................... 143
18.1 Overview ............................................................................................................... 143
18.2 Measurement Principle and Work Process ............................................................ 143
18.3 AG Display ........................................................................................................... 144
18.4 MAC Value............................................................................................................ 145
18.5 Preparations for Measurement .............................................................................. 146
18.6 AG Setup ............................................................................................................... 147
18.6.1 CO2 Settings ................................................................................................. 147
18.6.2 O2 Settings .................................................................................................... 149
18.6.3 N2O Settings ................................................................................................. 151
18.6.4 AG AA Settings ............................................................................................. 152
18.7 Aderse effects on performance .............................................................................. 154
18.8 Safety Alarm Information ..................................................................................... 155
18.8.1 ISA Sidestream Gas Analyzer Safety Warning Information.......................... 155
18.8.2 ISA Mainstream Gas Analyzer Safety Warning Information ........................ 157
18.9 Airway Obstruction ............................................................................................... 159
18.10 Discharging Waste Gases ...................................................................................... 160
18.11 Consumables ......................................................................................................... 160
18.12 Safety Symbol Information ................................................................................... 160
VII

18.13 Patents and Trademarks......................................................................................... 162
18.14 Maintenance .......................................................................................................... 162
18.15 Cleaning the Analyzer ........................................................................................... 163
Appendix I. Accessories ................................................................................................... 164
Appendix II. Specification ................................................................................................. 166
Appendix III. Description of System Alarm Prompt ........................................................ 174
VIII

Chapter1 General Information
For information about the monitor, please read the General Information on the Monitor chapter.
For introduction on various information displayed on screen, please read the Screen Display
chapter.
For operational methods, please read the Button Functions and Basic Operations chapter.
For locations of various interfaces, please read the External Interfaces chapter.
For notices of using the monitor with power supply from a battery, please read the Built-in
Chargeable Battery chapter.
Warning
This monitor is to monitor clinical patients, only for doctors and nurses’ use.
Warning
Don’t open cover of the equipment to avoid possible risks in electric shock. Any
maintenance or upgrading on the monitor must be conducted by service personnel
trained and authorized by Our Company.
Warning
Don’t use this monitor where there are flammables such as anesthetic agent, so as to
prevent from explosion.
Warning
Users before starting use should check whether the equipment and its accessories can
work properly and safety.
Warning
Please make sufficient alarming setting for each patient in order to prevent from
delayed therapy and make sure there is voice effect during alarming.
Warning
Don’t use mobile phones around the monitor. Mobile phones will generate strong
emission fields and disturb the monitor.
Warning
During defibrillation don’t touch patients, tables and the machine.

1

Warning
Equipments inter-connected with the monitor should form an equal-potential body (as
protective effective earthing).
Warning
Users (doctors or nurses) should ensure safety of patients under monitoring, when the
monitor is used together with electrosurgical equipments.
1.1 General Information

Transport and Storage:
Temperature: -20℃～+40℃
Humidity: ≤80%
Atmospheric Pressure: Pressure: 50kPa～106kPa
Working:
Temperature: 5℃～+40℃
Humidity: ≤80%
Atmospheric Pressure: 86kPa～106kPa
Voltage:
a.c.100V~240V 50Hz/60Hz
FUSE T 1.6A
The portable Veterinary Monitor is of rich functions, applicable for bedside monitoring on
Veterinary, such as cat, dog, the small animals.
This monitor can monitor main parameters including ECG, RESP, SpO2, NIBP, Double TEMP,
IBP, EtCO2 and Anesthesia Gas. It integrates parameter measurement modules, display and record
output to build such a solid and light monitor. Its replaceable built-in battery makes convenience
for patient movement and it will clearly display 7 waveforms and all the monitoring parameter
information on the high-resolution interface.
Notice:
IBP , CO2 and Anesthesia Gas are optional.
From left to right they are in turn:
(1) ALARM INDICATOR; (2)Waveform area; (3) ON/OFF button ; (4)Function button; (5)Knob;
(6)MENU; (7)Parameter area; (8)Information area. The Knob has three working methods as
turning left, turning right and pressing to confirm parameters are mainly applied to the operation
of menu.
2

The outlet of the recorder is located on the left side of monitor and AC power line sockets are on
the rear panel of the monitor.
(1)
(8)
(2)
(7)
(3) (6)
(5)
(4)
Figure 1-1 Multi-parameter Patient Monitor
This monitor has rich functions, able to provide various functions such as visual/audio alarming,
TREND storage & output, NIBP measurement save and review, medicine calculation, ST analysis,
pulse analysis, heart rate turbulence analysis, etc.
This monitor has a friendly operation interface, able to provide all functions with the keys and
buttons on the front panel, refer to Function Keys part for details.
1.2 Button Functions and Basic Operations

The monitor can be operated through use of the buttons and knobs. Here are the functions of the
buttons as follows:
(SILENCE button): Press this button and the alarm will be silence for 3
minutes (this item can be set in the “Alarm Setting” menu). Press this button
over 1 second and the alarm sound can be shielded. In the information area
appears sign. Repress this button again to pause alarm, resume heart beat
sound and cancel some technical alarm (ECG off, SPO2 off), and the sign
disappears.

(FREEZE button): Press this button and all waveforms on the screen can be
frozen in the normal mode. Press this button once again and the frozen
waveforms can be freed.
(PRINT button): Press this button to start a real-time recording. The recording
length is determined according to the “real-time recording time” in the
“Recorder” submenu of “Setting” menu. Press this button once again in the
recording process and the recording will stop at once. Each interval of pressing
this button should be greater than 2 seconds and the frequency should not be
excessively high.
（To start/stop NIBP measurement）, press to inflate the cuff to start a blood
pressure measurement. When measuring, press to stop the measurement and
deflate the cuff.
(MENU button): Press this button to have the main menu pop up when the
interface is in the state of non-window setting.
(ON/OFF button): Press this button to control the startup and shutdown of the
monitor.
a.c. INDICATOR
Work INDICATOR
JOG-DIAL JOG-DIAL to select and change the settings. Operation can be performed by
turning it clockwise, counterclockwise or pressing it down. JOG-DIAL is
mainly used in menu and window operation
1.3 Screen display

This monitor has a color LED screen, able to concurrently display collected patient
parameters, waveforms, and alarming information provided by the monitor, bed marks, clocks,
monitor status and other reminder information.
The main screen is divided into 4 sub-areas, i.e., Information Area ①, Waveform Area ②,
Parameter Area ③ and Menu Area④ (As shown in Figure 0-2)

Information Area
Waveform
Parameter
Area
Area
Menu Area
Figure 1-2 Main screen display
Information Area (①):

Prompt message in the information area appears and disappears together with the reported state. In
accordance with the content, it is divided into:
1. Network setup: Cursor stops in sign, press to enter system setup.
Network Bed No.: refer to IP address for monitor, The IP is 200.200.200.X,（X is
Network Bed No.:, from 1 to 100）
Caution
Connection state of CMS (central monitoring system) : when displaying , no

connection; when displaying , connection.
Network Bed No. should not conflict with other monitors, or there will be unnecessary problems
for the monitor.
If any problem happens because of confliction, unplug network wire, restart the monitor, reset the
Network Bed No. and connect the network wire again.
2. Patient Information: press to enter the Patient Information menu when cursor is in bed No.,
name or patient group area.
“Bed No.”: Refer to the bed number of the patient being monitored, this area will be
blank if there is no input.
Name: Patient name, this area will be blank if there is no input.
5

Sex: Male and Female.
Weight(kg): patient’s weight
Patient Type: neonatal, pediatric, adult
Update patient: Replaced with new patients, once the update, delete the monitoring data
on a patient
3. Time setup: set up local time
time: display system time
4. Technical alarm: display technical alarm, such as ECG lead off.
5. Physical alarm: display physical alarm, such as T2 too low.
6. Battery: display capacity of batter.
Full capacity
Not full capacity
Low capacity
Very low capacity, need to charge soon.
7. Volume setup: setup alarm volume, heart beat volume, key volume.
Alarm volume: there are five Alarm Vol levels, 1, 2, 3, 4 and OFF, where "OFF" level
means the alarm sound is closed.
Alarm volume on, alarm level 4
Alarm volume off
Caution
Visual alarm and alarm status

Alarm light winks or shines when there is an alarm. The colour of light means the alarm
level. Refer to alarm function chapter for details.
Waveform Area (②)

There are four waveforms in the waveform area, which are respectively from up to down:
two-channel ECG waveform, SpO2 volume graphic waveform and respiratory waveform
(possibly from ECG module).
The name of selected waveform is displayed on the upper left part. For details, please refer to
chapter of ECG Monitoring. Each ECG waveform still shows the gain of this channel and the
filtering method of ECG waveform. A 1-mv rod is on the left of ECG waveform.
When you choose/touch each waveform, submenu of waveform will be pop up, which always
occupies most of space of waveform area, so that some waveforms are invisible. The original
image will come back after the menu exit.
Waveforms are refreshed at the set speed. For adjustment on waveform refresh speed, refer to the

chapter of each Parameter Setting.
Parameter Area(③)：
Parameters can display at the fixed position (as shown in ①~12of
○ the following picture), which
are separately:
②
① ③
④
⑤
○
8
○9
○
10
○
11
Figure 1-3 Main Screen
ECG
—Heart Rate or Pulse Rate（①,unit：bpm）
—pacer detection (②PACE)
—ST-segment of channel 1 and channel 2 (③, unit: mv)
— PVCs times (④ Unit: times/minute)
NIBP
— None-Invisive Blood Pressure
(From left to right) Systolic, Diastolic, Mean (⑤, Unit: mmHg or kPa)
SpO2
—SpO2（⑥,unit：%）

—Pulse Rate（unit：bpm）
IBP (optional)
— Invisive Blood Pressure
(From left to right) Systolic, Diastolic, Mean (⑦, Unit: mmHg or kPa)
TEMP
—TEMP
—Temperature（⑧,unit: ℃ or℉）
CO2 (optional)
—end-tidal CO2 (⑨, Unit: mmHg or kPa)
—inspiratory CO2 (⑩, Unit: mmHg or kPa)
—Air Way Respiration Rate (AWRR)（○

11 ,unit：bpm）
RESP
—Respiration Rate（,unit：bpm）
The above monitored results will show in the parameter area.
The parameters are refreshed once per second, but NIBP value, once per measurement.
Users can select the monitoring parameters and the main screen will display the relative content.
Menu Area(④)
1. PATIENT: patient information configuration. Refer to chapter of Patient Informatio for details.
2. ALARM SETUP: set up alarm type
ALARM RECORD TIME: in case of physiological alarm, the system can record the
information before and after the alarm time. The system can give three kinds of time, i.e., 8
seconds, 16 seconds. The seconds in the options are the sum of seconds before and after the
alarm time. For example, 8 seconds mean the information within 4 seconds before the alarm
time and within 4 seconds after such a time.
ALM PAUSE TIME (Alarm pause time)：“1 minute”, “2 minutes” or “3 minutes”
ALAM LIMIT (Display alarm limits)：”ON” and”OFF”
ALM LATER :Disabled ,5s,10s,15s,20s. Select "Disable", when an alarm occurs, the
instrument that occurs immediately alarm; When Select "five seconds", alarm occurs only
when the parameters continue to exceed the the alarm upper or lower limit of 5 seconds
instrument, other settings and so on. The purpose of this feature is to reduce the instant false
alarms, allow doctors to more accurately grasp the situation
3. SURVEY SETUP: ECG, RESP, SpO2, NIBP and TEMP setup, refer to each chapter for details
4. SCREEN CHANGE: STANDARD, LIST FACE, TREND SCREEN, oxyCRG SCREEN, BIG
FONT, AND 7CH MULTI-LEADS DISPLAY. For details,please refer to chapters for each

parameter.
5. NIBP STARTt: press this button to start/stop NIBP measurement.
6. FROZEN: the screen freezes when press this button, turn the knob to review all the waveform
stored for the last 4 minutes.
7. TREND GRAPH, TREND TABLE (TREND Figure), NIBP RECALL: refer to chapter 3 for
details.
8. PRINT: press this button to record waveforms and patient information.
9. SCR LOCK: In order to avoid non-operators misuse Monitor, the instrument has a touch
screen lock function. Click on the "lock screen" button to lock the touch screen in the main
interface. For To unlock the the continuous point lived unlock the screen "option for three seconds,
you can unlock the screen is locked
1.4 External Socket
1.4.1 Left Panel
Recorder is optional
1. Open the recorder door.
2. Take away the no-paper rod
3. Fix the new paper correctly, tip of paper out from the
head of printer.
4. 3mm paper must out of recorder door, close the door.
5. Press PRINT to check if the paper fixed well or not.
If no printing, prease re-fix the paper.
Fig 1-4 Recorder
1.4.2 Right Panel
On the right side of the monitor are sockets for each transducer

① ECG1 ○
6
①
② NELLCORSPO2 ○
7
②
③ ECG2 ○
8
④ IBP1 （optional） ③
⑤ Hidden NIBP ④ ○
9
⑥ TEMP1 ⑤ ○
10
⑦ TEMP2
⑧ CO2（optional）
⑨ IBP2（optional）
⑩ ICG or Anesthesia Gas（optional） Fig 1-5
This symbol means “be careful”; refer to this manual for details.
This symbol means this application part is of CF type, designed with special protection
from electric shock (especially provided with F-type floating insulation apparatus for permissible
leakage current) and suitable for the defibrillation process.
Other symbols will be introduced in the Patient Safety chapter.
this symbol means: BF type
means the equipotential grounding terminal.
A.C. indicator
work indicator
Power-up
Switch-on/off
1.4.3 Rear Panel
There are the following soclets in the rear panel:
10

①
④
②
○
1 ○
2 ○
3 ○
4 ○
5 ○
6 ○
7
Fig 1-7 rear panel socket
Fig 1-6 ③ Panel

Rear
Handle 2.Fan 3.rear panel socket（Fig 1-7 ○
1 Fuse-holder,○
2 Power socket,○
3 Equipotential
socket,○
4 Nurse call socket,○
5 Network socket,○
6 Channel socket,○
7 VGA socket,4.Speaker
Warning
This network port can only be connected with CARL NOVEL’s central monitoring
system.
Warning
All the simulated or digital equipments connected with this monitor must be certified
under the designated IEC standards (such as IEC 60950 Data Processing Equipment
Standard and IEC 60601-1 Medical Equipment Standard). And all configurations must
comply with effective versions of IEC 60601-1-1 system standards. Persons in charge of
connecting additional equipments with the input/ output signal terminals should
configure the medical system and be responsible for compliance of the system to IEC
60601-1-1 standard. For any enquiries, please contact the supplier.
Warning
Patient cable interface, network interface and other interfaces connected to different
equipments, the leakage current should not exceed the limit.
1.5 Built-in charge battery

The multi-parameter monitor has a built-in charge battery. When connected with AC power, the
battery will charge automatically until it is full. On the right side of the screen, there is a “ ”, it
means charging state. Its yellow part means the quantity of the battery. If this monitor has no
built-in battery, the battery state will display “ ”, it means no battery or defective battery.
11

Chapter2 Monitor Assembly
Caution
For normal work of the monitor, before use please read this chapter and the Patient
Safety chapter and assemble in accordance with the requirements.
2.1 Open Package and Check

Carefully pick up the monitor and accessories from the package box, and properly keep the
package materials for future transport or storage. Please check the accessories with the package
checklist.
Check whether there is any mechanical damage;
Check all the exposed cables and plug in some accessories for test.
Any problems should be immediately raised to the Sales Department of our Company or our
agents.
2.2 Connect with AC Cable

Procedures to connect with AC power cables:
Make sure the AC supply complies with the following specification: 100-250VAC，50/60Hz
Use the power cables provided with the monitor together. Plug in the power cable into power
supply interface of the monitor, while insert the other end of this cable to a 3-phase earthing power
socket.
Caution
Connect the power cable with the sockets special for hospital use.
If deemed necessary, connect with an equal-potential earthing cable. Refer to the equal-potential
earthing part in the Patient Safety chapter.
Caution
In case configured with a battery, the equipment after transport or storage must have
the battery taken for charging. Thus in case of direct booting without connection with
AC power supply, the equipment may not work properly due to insufficient power. With
AC power supply connected, the battery will be charged no matter the monitor is
12

booted or not.
2.3 Power on
The logo displays when the power is on, and appears the processing screen. After the 3~5 seconds
checking process, the system enters the monitoring main screen and the users can start operations.
Caution
In case of any fatal errors found during the self-detection process, the system will
alarm.
Caution
Check all the available monitoring functions and make sure they work properly.
Caution
If a battery is configured, users must charge the battery after each time of use so as to
ensure sufficient power storage.
Caution
If any monitoring functions are found with damage or there are any error reminders,
don’t use this monitor to monitor patients and quickly contact with the biomedical
engineers of your hospital or maintenance engineers of our Company
Caution
Reboot the equipment at least 1 minute after shut down.
2.4 Connect with Sensor

Connect the required sensor between the monitor and the monitoring position of a patient.
Caution
For correct connection methods and relevant requirements of various sensors, please
refer to Chapters 10-15.
2.5 Check Recorder

If there is recorder in monitor, check the paper. If there is no paper, see reference related in chapter 1.
13

Chapter3 System Menu
The monitor system setting is more flexible. Monitoring, waveform speed, volume and output, all
can be setup by user. Press the “ ” button or use turn-knob to choose main menu, popping up
MAIN MENU.
Fig 3-1 Main Menu

MAIN MENU including: PATIENT MANAGE, SURVEY SETUP, SELECTION, MONITOR
SETUP, FACE SELECT, TREND GRAPH, TREND TABLE, NIBP RECALL, ALM RECALL ,
WAVE RECALL ,INFO, DRUG CALC, MAINTAIN, DEMO.
3.1 PATIENT MANAGE
Caution
For deleting the patient’s current data, please refer to the “UPDATE PATIENT” in
this chapter.
Select the “PATIENT MANAGE” item under the system menu, and then pop up the following
menu:
14

Fig 3-2 Patient Manage
Users can set the following content:
1. Bed NO. 0-999 for option, for example, 666
2. Name input patient name to the popping up menu
Lock Shift Del Clr Enter
Caps Lock Caps shift delete clear enter

（permanent）（one-off）
3. SEX Patient gender( female, male)
4. PAT TYPE PATIENT TYPE (big，small)
5. Weight(kg) 0~200, for example, 100
Caution
PACE: The default setting is OFF after you restart the monitor.
In this menu, user can select the “UPDATE PATIENT” and select “CONFIRM TO UPDATE
PATIENT” to update patient information.
Warning
Patient type changed, the alarm parameters such as heart beat and NBP may vary,
usually make sure the limits are suitable for the patient.
Pacer detection must be on for pacing patients. If falsely setting OFF, the monitor would
miktake pacing pulse as QRS, and not alarm for heatbeat stop
15

3.2 Survey setup
Select the “Survey setup” item under the system menu, Survey setup include: ECG setup, SPO2
setup, NIBP setup, RESP setup, TEMP setup, CO2 setup, IBP(1,2) setup pop up the following
menu (next chapter would be detail introduce to the setup function):
Fig 3-3 Survey setup
3.3 SELECTION
Select the “SELECTION” in the “MENU MENU” and sub-menu following with Figure below,
including
Fig 3-4 Selection Setup
3.3.1 ALARM Volume
In the system there are five levels of Alarm Vol: OFF, 1~4.
16

"OFF" level means the alarm sound is closed.
WARINING
Where the alarm volume of the system is set at OFF, the monitor will not give alarm
sound in case of alarm, so you should use this function carefully.
3.3.2 HEART BEAT VOLUME
In the “SYSTEM MENU” select the “SELECTION”. Pitch on the “BEAT VOL ” with the cursor
and turn the knob to select the volume from such five options as “OFF”, “1”,“2”、“3” and “4”.
3.3.3 KEY VOL (Keyboard Vol )
Pitch on the “KEY VOL ” with the cursor and select the volume from such five options as “OFF”,
“1”,“2”、“3” and “4”.
3.3.4 LCD LIGHT（LCD Brightness)
In the system there are five Brightness level, i.e. “1~5”, where “5” means the maximum
brightness.
3.4 MONITOR SETUP (Monitor Setting)

Select MONITOR SETUP in MAIN MENU, sub-menu following with figure below, including
Fig 3-5 Monitor Setup

17

3.4.1 ALARM SETUP
Alarm Setup has the following options:

ALM REC TIME (Alarm Record Time):
In case of physiological alarm, the system can record the information before and after the alarm
time. The system can give three kinds of time, i.e., 4 seconds, 8 seconds, 16 seconds. The seconds
in the options are the sum of seconds before and after the alarm time. For example, 8 seconds
mean the information within 4 seconds before the alarm time and within 4 seconds after such a
time.
ALM PAUSE TIME (Alarm pause time)：“1 minute”, “2 minutes” or “3 minutes”
ALM LIMIT (Display alarm limits)：”ON” and”OFF”
ALM LATER: Disabled ,5s,10s,15s,20s. Select "Disable".
when an alarm occurs, the instrument that occurs immediately alarm; When Select "five seconds",
alarm occurs only when the parameters continue to exceed the the alarm upper or lower limit of 5
seconds instrument, other settings and so on. The purpose of this feature is to reduce the instant
false alarms, allow doctors to more accurately grasp the situation.
3.4.2 RECORD (Record output setting)
Options for record output:

REC WAVE1/ REC WAVE2: can not change
REC RATE: 25.0/50.0 mm/s, record speed
REC GRID: ON/OFF
RT REC TIME: 3S/5S/8S/CONTINUAL (real-time record time)
CONTINUAL means after pressing PRINT BUTTON , monitor will keep printing
parameters and waveform, until press to stop
Caution
The recorder is a component for option.
Caution
Where two similar waveforms are selected, the system will automatically adjust the
other one into a different one.
18

3.4.3 TIME SETUP (System Time Setting)
"TIME SETUP" with options below:

Setup year, month, day, hours, minutes and seconds.
Pitch on the content required for correction.
3.4.4 3.4.4 NURSE CALL SETUP
Options in nurse call setting:

ALM ON/OFF: ON/OFF
ALM LEV(Alarm lever): high, middle, low
3.4.5 MODULE SETUP
Options in module setup:

ECG and SpO2 are not optional.
TEMP: ON/OFF. When it is ON, machine can monitor TEMP, when it is OFF, machine can
not monitor TEMP, and no parameter area of TEMP in main interface.
RESP: ON/OFF. When it is ON, machine can monitor RESP, when it is OFF, machine can not
monitor REST, and no parameter area of RESP in main interface.
NIBP: ON/OFF. When it is ON, machine can monitor NIBP, when it is OFF, machine can not
monitor NIBP, and no parameter area of NIBP in main interface.
IBP<1,2>(optional): ON/OFF. When it is ON, machine can monitor IBP<1,2>, when it is OFF,
machine can not monitor IBP<1,2>, and no parameter area of NIBP in main interface.
CO2(optional): ON/OFF. When it is ON, machine can monitor CO2, when it is OFF, machine
can not monitor CO2, and no parameter area of CO2 in main interface.
AG(optional): ON/OFF. When it is ON, machine can monitor AG, when it is OFF, machine
can not monitor AG , and no parameter area of NIBP in main interface.
Caution
When CO2 module is set to "On", RESP option is the system default to "Off".
Caution
When the temperature module manufacturers setting temperature module is locked,

this menu "TEMP" is not option.
Caution
19

Factory software program determines the option module switch settings when CO2
(CO2 mainstream and sidestream module work), no AG the options appear AG ,
CO2-free options, in short, both only appear single, and will not appear in this menu
3.5 WORK INTERFACE SELECTION

In the System Menu, select the “FACE SELECT” to enter the dialog box in the following Figure.
Here there are such seven options as “STANDARD”, “LIST FACE” “TREND SCREEN”,
“oxyCRG SCREEN” , “BIG FONT” , “7CH MULTI-LEADS DISPLAY” and AG SCREEN.
Fig 3-6 Work Interface
Caution
z " 7CH MULTI-LEADS DISPLAY " of the measurement setup "by the" lead type
"decision, when the lead type is set to" 5 lead ", this menu is “7CH
MULTI-LEADS DISPLAY”.
z When the lead type is set to "3 lead", it not have the menu.
z When the instrument function with AG anesthetic gas, module switch is set to
"On", this menu will have “AG SCERRN”
3.6 TREND SCREEN

Trend gragh for the previous 1 hour can be diplayed in the resolution of one data per one second
or one data per five seconds.
20

Trend gragh for the previous 120 hour can be diplayed in the resolution of one data per minute,
per five minutes or per ten minutes.
Users can select the TREND Diagram Review item under the System menu so as to pop up the
following window:
Fig 3-7 Trend Graph

Parameter selection: HR、RR、SPO2、PR、TEMP、NIBP、IBP1、IBP2、CO2、INS、AWRR.Y-axis
means measurement value, X-axis means measurement time. “Ð” is cursor for trend graph, The
measurement values it points to display at the bottome of the graph, corresponding time at the
upper end of the graph: 2012-09-17 12：33：29。
Vertical axis is for measured values and horizontal axis for measurement time. The “ ” symbol is
the cursor for TREND diagrams, and the measured value at the position it arrows is displayed
below the TREND diagram while its corresponding time is displayed above the TREND diagram.
3.7 TREND TABLE (TREND Figure)

TREND Figure data over the previous 120 hours can be displayed in the following resolutions: 1
minute, 5 minutes, 10 minutes, 30 minutes and 60 minutes.
Select “TREND TABLE” under the system menu to pop up the following TREND Figure:
21

Fig 3-8 Trend Table
Time corresponding to various groups of TREND data is displayed at the left column, with dates
braced. What are listed is the cases that have once been marked, which corresponds to the time of
the marked cases. Parameters in the TREND Figures can be categorized into the following 9
groups:
HR,
ST1, ST2
RR,
T1，T2，TD
SPO2, PR
NIBP （（S/ D/M）DATE
IBP1（S/D/M）
IBP2（S/ D/M）
CO2 INS AWRR
NIBP TREND data has its own characteristics; besides of measured values, below each
“measurement point” there is time for this NIBP measurement.
3.8 NIBP RECALL
22

The monitor can display the latest 2000 NIBP measurement data in the NIBP review function.
After users select the NIBP Data Review item under the System menu, the windows will display
the latest 10 NIBP measurement results and measurement time, as shown in the following:
Fig 3-9 NIBP Recall

Data is sorted in time sequence, from early to late, and each screen can display 10 times of
measurement data, while users can select “ ” or “ ” to view later or earlier data. Maximally
2000 measurement results can be displayed, and when the measure times are over 2000, only the
latest 2000 will be displayed.
3.9 Reviewing alarm

When parameter alarm occured ,the monitor would be memory the alarm parameter data. Enter
the “main menu” selected “ALM RECALL-condition” could be recheck the patient status in
“RECALL EVENT”：
23

Fig 3-10 Alarm Recall condition
1. Setup up the “recall event” from start time/date to end time/date
2. Would be re-check the alarm status in “RECALL EVENT” menu , the events include
“ALL , ECG ,SPO2 , NIBP , IBP , CO2 , RESP , TEMP” status.
3. Optional “ALM-RECALL_Condition” window , would be recall the alarm parameter
and waveform ，following with figure below:
Fig 3-11 Recall event
24

3.10 WAVE RECALL
In “main menu” selected the “WALL RECALL-Condition”could be recall the parts information or
all information within memory data , following with figure below
Fig 3-12 WAVE RECALL-Condition

Setup the review types of the recall events and times , enter in “WAVE RECALL-Condition”
selected “WAVE RECALL ” would be display the window , following with figure below:
Fig 3-13 WAVE RECALL
3.11 INFO (Monitoring Information)

In the “MAIN MENU” select the “INFO” to look through the version information of the software
and hardware.
25

Fig 3-14 Monitoring Information
3.12 DRUG CALCULATION & TITRATION LIST

The portable-type multi-parameter monitor can provide the computation for 15 kinds of medicines
as well as the Titration List Display Function, and output the content of Titration list on the
recorder.
3.13 Maintenance
In the “MAIN MENU” select the “MAINTENANCE”, submenu pop out:
Password: 5188
a) Language：you can select CHINESE(SIMP) or ENGLISH
b) VGA size：12.1 `TFT
c) Wave Mode: Color or mono
d) Wave type: SpO2 waveform and RESP waveform has two type to select: LINE and
FILL
e) Exporting Data：Data including alarm data, NIBP list data and trend table data. The
monitor export data provides two options: CSV (* csv) file export and TXT (* txt) file
export. Based on the need to export data format
f) Screen Adjust: switch on touch screen as monitor indicated.
g) Factory default: you can into the menu “default” ,if you select “YES” , adopt factory
default big configuration ,the previous configure will be lost.
3.14 DEMO (Password: 5188)

In the “System Menu” select the “Demo” to have the “Input Demo Password” dialog box pop up.
26

Input the correct password and the system will enter the waveform demonstration state.
Demo Waveform means the simulated one set by the manufacturer for showing the monitor
performance and helping users with training.
In the practical clinical l use it is prohibited to use such a function because it will make the
medical personnel misthink they are the monitored patient’s waveforms and parameters so as to
affect patient monitoring and delay treatment. So this menu is set with the password.
3.15 SCR LOCK(screen lock)
Screen Lock: In order to avoid non-operators misuse Monitor, the instrument has a touch screen
lock function. Click on the "SCR LOCK" button to lock the touch screen in the main interface.
For To unlock the screen , continuous point lived “ SCR UNLOCK” option for three seconds, you
can unlock the screen is locked.
27

Chapter4 System Work Interface
4.1 Work Interface Selection

In the Main Menu, select the “FACE SELECT” to enter the dialog box in the following Figure.
Here there are such seven interfaces to choose:
STANDARD, LIST FACE, TREND SCREEN, oxyCRG SCREEN, BIG FONT, 7CH
MULTI-LEADS DISPLAY, and Anesthesia-gas screen.
4.1.1 STANDARD
In the “FACE SELECT” menu, select the “STANDARD” to enter the standard work interface. The
Standard interface provides us the parameter waveforms under monitoring and displays the
parameters in the parameter area, as shown in the following picture:
Fig 4-1 Standard Interface
4.1.2 LIST FACE
In the “FACE SELECT” menu, select the “LIST FACE” to enter the LIST FACE work interface.
28

Fig 4-2 List interface
4.1.3 TREND SCREEN
Enter the “FACE SELECT” and select the “TREND SCREEN” in the Work Interface Selection
menu to enter such an interface.
29

Fig 4-3 Trend Sreen Interface
Location of trend diagrams
TREND diagrams is located at right side of waveforms, with the same colors to the corresponding
parameters.
TREND length
Dynamic trend length is 2 hours; in a trend diagram, the right side of the horizontal axis is 0 hour,
and the left side is 2 hours.
End of trend concurrence interface
Out of the “Interface Selection” options, select any other work interface to end the trend
concurrence interface.
4.1.4 OxyCRG SCREEN
In the Work Interface Selection menu, select the “oxyCRG Screen” to enter the oxyCRG work
interface.
30

Fig 4-4OxyCRG Screen
TREND Diagram in oxyCRG Interface
OxyCRG Dynamic Interface is consist of compressed respiratory wave and RR.
OxyCRG Trend Length Selection
Two hot key at the below part of dynamic interface: TIME and TYPE
TREND Diagram for “1 minute” and “2 minute” can be selected through the trend time
buttons.
Compressed Respiratory Wave and RR
“The function of “Respiratory Rate/Compressed Respiratory Wave” means the operator
can select the “PR Trend” or “Compressed Respiratory Wave” as needed, under which
the displayed content occupies the same position. Select the “PR Trend” and this
position will show the TREND Diagram of the respiratory rate; select the “Compressed
Respiratory Wave” and this position will show the respiratory wave after compression.
In the Work Interface Selection menu, select other work interface to end the OxyCRG work
interface.
4.1.5 BIG FONT INTERFACE
In the Work Interface Selection menu, select the “BIG FONT” to enter the big font interface.
31

Fig 4-5 Big Font Interface
4.1.6 7-CH MULTI-LEADS DISPLAY
In the Work Interface Selection menu, select “7-CH MULTI-LEADS SCREEN” to enter the
MULTI-LEADS SCREEN interface. Users could observe seven ECG channels in this screen,
including II, I, III, AVR, AVL, AVF
32

Fig 4-6 6-CHANNEL ECG DISPLAY
4.1.7 ANESTHESIA-GAS SCREEN (optional)
In the Work Interface Selection menu, select “ANESTHESIA-GAS SCREEN” to enter the
anesthesia-gas interface:
Fig 4-8 Anesthesia-gas screen
33

Chapter5 Recording
In the Main Menu, select the “MONITOR SETUP”, then to RECORD menu
5.1 General Information on the Recorder

The recorder used with this monitor is a heat-sensitive array recorder, with print width of 50mm.
Recorder capability
1. Outputted waveforms run at 25mm /sec or 50mm / sec
2. Maximally record two waveforms
3. Grid output function is optional
4. English output
5. Real-time record time and waveforms are selected by users through menus
6. Automatic record interval is selected by users through menus, while waveforms are
identical to real-time records
5.2 Record Type

This monitor generates slip records of the following types:
Real-time continuous record;
Real-time 3, 5, 8-second record;
Automatic alarm record;
5.2.1 Real-time record
Start recording waveforms from the moment you press the button.
Real-time continuous record for 8-second defaulted by machine system (normally only for two
waveforms) or set by users through menu. Please refer to relevant chapters for details.
Caution
During output process, the next parameter alarming output will be outputted after
completion of the current output.
34

5.2.2 Frozen waveform record
In case waveforms are frozen, the system can output the designated waveforms on the screen and
in such a way record those unusual waveforms captured by freezing.
5.2.3 The contents of the real time recording
Record time
Record type :real-time print ,alarm trigger print ,frozen print
ECG lead,1mV ruler, and gain
Paper speed : 25mm /sec. or 50mm / sec
Time
Bed number
HR ,RR
ST1,ST2
T1,T2
SPO2,PR
NIBP
5.3 Operation and Status Information of Recorder
5.3.1 Requirements on record paper
Only qualified heat-sensitive record paper can be used, otherwise there may be failure or quality
reduction in record, or damage to the heat-sensitive head.
5.3.2 Normal service
Do not pull out paper when the recorder is working.

Do not use recorder without record paper.
5.3.3 Insufficient paper
Don’t boot the recorder when there is a reminder of “add paper to the recorder” in the information
area. Please load qualified heat-sensitive record paper.
35

5.3.4 Paper loading procedures
Open the recorder door;

Pull up the slide switch at the left rod of the recorder;
Load new paper exactly following the paper inlet, with the print side toward the
heat-sensitive head;
Slightly pull the paper exposed from the other side, and align the paper properly;
Pull back the slide switch at the left rod of the recorder;
Remove the paper from the paper outlet of the recorder;
Close the recorder door.
Caution
Paper loading must be done softly so as to avoid heat on the heat sensitive head. Unless
during paper loading or trouble shooting, the recorder door must be kept open.
5.3.5 Solution to paper jam
When the running voice of the recorder sounds improper or paper outputs improperly, users
should open the recorder door to check whether there is paper jam. Procedures to clear paper jam:
Cut the recorder paper at the paper outlet side;
Pull up the slide switch at the left rod of the recorder;
Pull out the recorder paper from the bottom;
Re-load paper.
36

Chapter6 Trend
It can store 120 hours trend data, 2000 NIBP and 500 alarm events and support recording.
Observation methods are provided in this chapter.
6.1 TREND GRAPH (TREND Diagram)

TREND diagram for the latest 1 hour can be displayed one data per second or one data per five
seconds;
TREND diagram for latest 120 hours can be displayed one data per minute, per 5 minutes, or per
10 minutes.
Select “TREND GRAPH” in the “MAIN MENU” to pop up the following TREND figure:
Fig 6-1 Trend Graph

Vertical axis is for measured values and horizontal axis for measurement time. The “ ” symbol is
the cursor for TREND diagrams, and the measured value at the position it arrows is displayed
below the TREND diagram while its corresponding time is displayed above the TREND diagram.
37

6.1.1 Select trend diagrams for various parameters to be displayed:
Use the cursor to select the Parameter Selection option and revise the displayed contents. Upon
display of the expected parameter, press the knob, then the TREND diagram for this parameter
will be displayed in the window.
6.1.2 Select 1-hour or 120-hour TREND diagrams:
Use the cursor to select the Resolution option, then select 1 seconds or 5 seconds if you want to
observe 1-hour TREND, or select 1 minute, 5 minutes or 10 minutes if you want to observe
96-hour TREND.
6.1.3 Observe TREND diagrams of later or earlier duration:
Press the “ or ” button or rotate the knob clockwise or anticlockwise so as to observe later
or earlier TREND curves.
6.1.4 Change the display zoom
Use the “ or ” button to change displayed size of the vertical axis, while displayed size of
the TREND curves will follow to change. Values higher than the biggest axis value will be
represented by the biggest axis value.
6.1.5 Obtain the TREND data at certain time in the current
TREND diagram
Select “Cursor” and rotate the knob to “ ” or “ ” control movement of the cursor;
with the cursor moves, its arrowed time also changes, and the parameter value at such time will be
displayed below the horizontal axis. If there is a “ ” indication in the right side of the window,
when the cursor moves onto this indication the TREND diagram will automatically page down to
display later TREND curves; and if there is a “ ” indication in the left side of the window, when
the cursor moves onto this indication the TREND diagram will automatically page up to display
earlier TREND curves.
38

6.1.6 Operation sample
Observe the NIBP TREND diagram within the latest 1 hour:

Press the TREND button on the control panel to pop up the Main menu;
Select the TREND Diagram Review option in the menu;
1. Select the parameter: rotate the knob in the Parameter Selection item until “NIBP” is
shown in the dropdown box;
2. Select 1 or 5 seconds in the Resolution item;
3. Press the “ or ” button or rotate the knob, while observing changes in the
TREND diagram time and TREND curves;
4. Stop at the period to be carefully observed; in case the vertical axis is out of proper size,
for example, some TREND values exceed the highest value of the current vertical
axis, select “Adjust amplitude” to adjust;
5. If users want to know the measured value at certain time, just select “move cursor” and
move the cursor to where they wants, then time will be displayed above the curve and
measured values below the curve;
6. If users need output the TREND diagrams to the recorder, just select the “record” button
so as to let the recorder output NIBP TREND of the current review window;
7. Press “ ” to exit observation on TREND diagram.
6.2 TREND TABLE (TREND Figure)

TREND Figure data over the previous 120 hours can be displayed in the following resolutions: 1
minute, 5 minutes, 10 minutes, 30 minutes and 60 minutes.
Select “TREND TABLE” under the “Main Menu” to pop up the following TREND figure:
39

Fig 6-2 Trend Table
Time corresponding to various groups of TREND data is displayed at the left column, with dates
braced. What are listed is the cases that have once been marked, which corresponds to the time of
the marked cases. Parameters in the TREND Figures can be categorized into the following 9
groups:
HR,
ST1, ST2
RR,
T1，T2，TD
SPO2, PR
NIBP （S/D/M）DATE
IBP1（S/ D/M）
IBP2（S/ D/M）
CO2, INS, AWRR
NIBP TREND data has its own characteristics; besides of measured values, below each
“measurement point” there is time for this NIBP measurement.
6.2.1 Select TREND Figures in various resolutions
Use the cursor to select a resolution and use the knob to change options so as to change the time
40

interval for TREND data.
6.2.2 Observe earlier or later TREND curves
Press “ or ” button or rotate the knob clockwise or anticlockwise so as to observe later or

earlier TREND curves.
6.2.3 Observe TREND data of various parameters
Press “ or ” button and select one group of parameters out of 6 available groups.
6.2.4 Operation sample
To observe a NIBP TREND Figure:

Press the TREND button on the control panel to pop up the Main menu;
Select the TREND Figure Review option in the menu;
1. Press “ or ” button or rotate the knob to select the NIBP （S/D/M ）DATE;
2. Select the resolution: click the left item and select the expected data interval;
3. Press “ or ” button or rotate the knob, while observing NIBP TREND data over various
time;
4. Press “ ” to exit observation on TREND table.
6.3 NIBP RECALL

The monitor can record the latest 2000 NIBP datas. After select the NIBP RECALL in MAIN
MENU, the window will display 10 groups of NIBP records as follows:
41

Fig 6-3 NIBP RECALL
Data is sorted in time sequence, from early to late, and each screen can display 10 times of
measurement data, while users can Press “ or ” button to view later or earlier data.
Maximally 2000 measurement results can be displayed, and when the measure times are over
2000, only the latest 2000 will be displayed.
42

Chapter7 Drug Calculation & Titration
List
The portable-type multi-parameter monitor can provide the computation for 15 kinds of medicines
as well as the Titration List Display Function, and output the content of Titration list on the
recorder.
7.1 DRUG CALC

Medicines able to be calculated under this system are: aminophylline, dobutamine, dopamine,
epinephrine, heparin, isuprel, lidocaine, nipride, nitroglycerin and pitocin. Besides, there are Drag
A, Drag B, Drag C, Drag D and Drag E provided to flexibly replace any medicine.
Users can select “Drug Calculation” under the MAIN MENU to pop up the following window:
Figure7-1 Drug Calculation

The following formulae are used for medicine dosage calculation:
Medicine contents = Total medicine volume / Liquid volume
Infusion speed = Medicine dosage / Medicine contents
Continued time = Total medicine volume / Medicine dosage
43

Medicine dosage = Infusion speed × Medicine contents
Operation method:
In the medicine calculation window, operators should firstly select names of the medicines to be
calculated, and then confirm patient weight, and input other known values. Subsequently,
operators move the cursor to the various calculation items in the calculation formulae, press the
knob and rotate it, so as to select the calculation value. After the calculation value is selected,
value of the items to be calculated will be displayed at the corresponding position. Values for each
calculation item have their limits, if the calculated results exceed such limits, the system will
display “---.--”.
Caution
Under this medicine calculation function, other menu items are available for input only
after operators input patient weight and medicine names. The values firstly given in the
system are only a random group of initial values, and operators should not take such
values as calculation standard, instead, should re-input a group of values suitable for
the current patient, based on the comments by doctors.
Caution
Each kind of medicine is subject with fixed units or unit series, and operators must
select proper unit based on comments by doctors. Under the same unit series,
numbering system of the units will be automatically adjusted with the current input
values, and when the input value exceed out of expression of the relevant unit, the
system will display “---”.
Caution
After operators input a certain value, the system will give a clear reminder in the menu,
reminding operators to check correctness of the inputted value; only inputted values are
guaranteed to be correct, the calculated values will be reliable and safe.
Caution
In case of newborns, dropping speed and volume of an infusion drop make no sense.
Caution
The system gives a reminder for each inputted value, asking operators to confirm.
Operators must be serious with every such reminder, as only valid and correct inputs
can get reliable calculation results.
Select medicine type: move the cursor onto “Medicine name”, rotate the knob and select one from
aminophylline, dobutamine, dopamine, epinephrine, heparin, isuprel, lidocaine, nipride,
nitroglycerin, pitocin, Medicine A, Medicine B, Medicine C, Medicine D and Medicine E,
44

altogether 15 types. At one time, only one type of medicine can be selected for calculation.
Caution
The above introduced A, B, C, D, and E are not actual medicine names but only codes
for medicines. Units for these five types of medicines are fixed, and operators can select
proper units based on general practice of medicines. The expression rules of their units
are as follows:
Medicines A, B, and C are fixed under the “mg” unit series, including g, mg, and mcg; Medicine
D is fixed under the “unit” unit series, including unit, k unit, and m unit; and Medicine E is fixed
under the “mEq” unit.
Patient weight: When entering the medicine calculation window, operators should firstly or
secondly input patient weight, which will be taken as independent information for calculation of
medicine contents.
Caution
This function of medicine calculation is only to provide a medicine calculator, while

values in the list should not be related with the patient under monitoring. Thus the
patient weight under this menu is different from the patient weight in the system; when
the system refresh with a new patient, values in this menu will not be affected.
7.2 TITRATION
7.2.1.1 Enter the Titration list:
In the “Drug Calculation” menu, pitch on the “Titration” to enter the Titration list interface.
The Titration list interface for medicines is shown in the following Figure:
45

Figure7-2 Titration List
The specific operations are as follows:
In the Titration list, move the cursor to the “Reference Item” with the knob first, and then press the
knob to select the required item. “Dosage” and “Injection Speed” are two options.
Move the cursor to the “Step Length” and press the knob to select the step length in the range of
1~10.
Move the cursor to the “Dosage Type” and press the knob to select the dosage unit.
Move the cursor to the “ or ” button and press and turn the knob to check the previous and
next pages of the list.
Move the cursor to the”Record” and press the knob to output the Titration list data on the current
display interface.
Move the cursor to the” ” and press the knob to return to the “Medicine Calculation” menu.
46

Chapter8 Alarm
8.1 Alarm Type

The monitor can give an alarm of three types: physiological alarm, technical alarm and prompt
message.
(1) Physiological alarm
Physiological alarm is usually caused by a certain physiological parameter of the patient

which exceeds the set upper/lower limit scope or by the physiological abnormality of the
patient. The alarm message of the physiological alarm will appear in the physiological alarm
area above the screen.
(2) Technical alarm
The technical alarm is also referred to as a system error message, indicating the alarm is
caused by a misoperation or system malfunction thereby causing improper operation of a
system function or distortion of monitored results. The alarm message of the technical alarm
will appear in the technical alarm area above the screen.
(3) Prompt message
Strictly speaking, prompt message does not belong to the domain of alarm. It is to display the
information relative to the system conditions themselves, which have nothing to do with the
patient’s vital sign.Prompt message will appear in the prompt message area.
8.2 Alarm Level

The monitor can give an alarm in three volume levels: high, medium and low, based on the
severity.
(1) High level alarm:
The patient is in a critical condition, endangering the patient’s life, emergent attention
required.
(2) Medium level alarm:
47

The patient’s vital signs are abnormal, relevant measures and treatment are immediately
required.
(3) Low level alarm :
The patient’s vital signs are abnormal,and relevant measures and treatment may be required.
All alarm levels for technical alarms and some physiological alarms have be set before the
monitors are delivered:, the users are not allowed to change them. but a certain degree of
physiological alarm can be modified.
8.3 Alarm Mode

When giving an alarm, the monitor will prompt the users in both sound and visual modes:
Lighting Alarm
Sound Alarm
Alarm
parameter’s flashing
In which light signal, sound signal and prompting message are differentiated with different alarm
levels.
8.4 Lighting Alarm
When giving an alarm, the alarm indicating lamp will show alarms in different levels with color
and flashing frequency.
High level alarm red with flash frequency of 2 per second.
Medium level alarm yellow with flash frequency of one every two seconds.
Low level alarm yellow without flash but with a continuous light.
8.5 Sound Alarm
The sound alarm is set to prompt the alarm in different levels of severity with different sounds.
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High level alarm: Do-Do-Do--Do-Do
Medium level alarm: Do-Do-Do
Low level alarm: Do
8.6 Alarm Information

Prompting message means the related information will appear on the physiological alarm area or
technical alarm area of the monitor when the alarm is active. The system will show different alarm
levels in different background colors:
High level alarm: Red
Medium level alarm: Yellow
Low level alarm: Yellow
Levels of the prompt message in the front of the alarm will be distinguished with the following
symbols:
High level alarm: ***
Medium level alarm: **
Low level alarm: *
8.7 Alarm Parameter Flashing
When a parameter is alarming, the parameter will flash once every second.
8.8 Icon of Alarm Status
Besides the alarm modes mentioned above, the following alarm icons will appear on the screen to
indicate different alarm conditions.
: indicating alarm muted.
: indicating shut off of a parameter alarm.
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8.9 Setting the upper and lower limits of alarm
Take ECG for example:
a) Select ECG in the parameter area;
b) In the popped-out menu ECG Setting, select the HR ALM SETUP;
c) Set the upper and lower limits of HIGH LIMIT as 120bpm and 50bpm respectively;
d) Set the upper and lower limits of MID LIMIT as 110bpm and 60bpm respectively
e) Set the upper and lower limits of LOW LIMIT as 100bpm and 70bpm respectively
f) Upon completion of setting, press the key “ ” to exit.
Warning
When setting the upper and lower limits of alarm, decide whether the patient you are
monitoring is an big or small animal, and the limit should be set according to clinical
requirements.If the set limit value exceeds the alarm limit, it will easily lead to alarm
system failure.
50

Chapter9 Patient Safety
The portable monitor is designed to meet the international safety requirements IEC60601-1,
EN60601-2-27 and EN60601-2-30 formulated for medical electric equipments. It’s furnished with
floating inputted defibrillation resistance and surgery electric knife protection. If correct electrodes
(referring to the ECG and RESP chapters) are installed following supervision of the manufacturer,
screen display will be recovered within 10 seconds after defibrillation.
This symbol means the application part is of IEC 60601-1 type CF equipment, and designed with
special electric shock resistant apparatus (especially with an F-type floating insulation apparatus
for permissible leakage current), especially recommended for use during defibrillation period.
Warning
During defibrillation period don’t touch the relevant patients, beds or equipments.
9.1 Environment
Users should follow the following guides to ensure absolute safety of electricity installation. For
an environment where the portable monitor is located, users should reasonably avoid vibration,
dusts, corrosive or explosive gases, extreme temperature and moisture. In case installed inside a
chamber, the front side must be given sufficient space for convenient operations, and while the
chamber door is open, the rear side must be given sufficient space for easy repair. Besides, must
make sure of air flow inside the chamber.
The monitor, when working in an ambient temperature between 0℃～40℃, can meet the
technical indexes, otherwise may have equipment accuracy affected or parts or circuits damaged.
Moreover, there should be at least 2 inch (5 cm) of space reserved surrounding the monitor to
ensure air flow.
9.2 Power Source

Please refer to the Product Specification chapter.
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9.3 Monitor earthing
To protect patients and medical staffs, the portable monitor must has its cover connected with the
earth; for such reason the monitor is equipped with a dismountable 3-line cable, which should be
plugged into a matching 3-line socket and further connected with the earth through the ground line
of the power supply cable. In case of no 3-line socket, please consult with the electricity staffs of
your hospital.
Warning
Don’t connect the 3-line cable of this monitor with a 2-line socket.
Connect the ground line with the equal-potential earthing terminal of the monitor. If unaware
whether a certain equipment combination is risky in terms of equipment specification, for example,
whether gathered leakage current is dangerous, users should consult with relevant manufacturers
or specialists, so as to make sure the necessary safety of the relevant equipment will not be
damaged by the proposed combination.
9.4 Equal-potential earthing

First level protection on the equipment has been contained in the house protective earthing system
through earthing of the power socket. For heart or head internal check, this portable monitor must
be individually connected with an equal-potential earthing system. One side of the equal-potential
cable (potential balanced cable) should be connected with the equal-potential earthing terminal on
the rear panel of the monitor, while the other side connected with one interface of the
equal-potential system. In case of any damage to the protective earthing system, the
equal-potential earthing system will take the safety function of protecting the earthing cable. Heart
or head checks should be conducted within houses for medical use installed with protective
earthing systems. Before each time of use, users should check whether the equipment is under
good work status and pay attention the cable connecting patients and the equipment must be free
from electrolytes pollution.
Warning
If the protective earthing system is instable, the monitor should be applied with internal
power supply.
9.5 Condensation
52

During work period the equipment must be made sure of no condensation. When the equipment is
shifted from one room to another room, condensation may be formed as the equipment is exposed
in moistured atmosphere and different temperature.
Warning
If the monitor is used where there are flammable anesthetic agents, there may be
explosion.
9.6 Explanations on Symbols Used in the Monitor

See reference in external interface in chapter 1.
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Chapter10 Maintenance & cleaning
10.1 Maintenance check

Before monitoring patients, you shall:
♦ Check whether there is any physical damage;
♦ Check all the disclosed leads, plugs, and accessories;
♦ Check all the functions to be used to monitor the patients and ensure the equipment
works well; if any phenomenon is observed with the possibility of damaged
functions, the Monitor shall not be used onto the patients and please contact the
biochemical engineers of your hospital or the maintenance engineers of our
company.
♦ Comprehensive checks, including safety checks, must be conducted by qualified
personnel once per 6-12 months and after each time of repair.
Warning
if any hospital or agency responsible for using the Monitor fails to implement a set of
satisfying maintenance plan, unusual functional failure may be resulted to the Monitor
and may threaten the people’s health.
10.2 Cleaning and Sterilization
10.2.1 Note on Cleaning and Sterilization
Attention
z The monitor and accessory surface can be cleaned with hospital-grade ethanol and
dried in air or with soft, clean cloth.For protecting the environment, disposable
accessories should be recycled or disposed of properly.
Caution
z Do not autoclave the sensor.
54

z Do not soak the sensor in liquids.
z If the sensor or cable is damaged or has signs of deterioration, do not use again.
10.2.2 Cleaning
The Monitor must be kept dust-free. Regular cleaning of the monitor shell and screen is strongly
recommended. More cleaning is needed in the environmental polluted or sandstorm areas. Before
cleaning the monitor or the sensor, please consult with customer service or understand the hospital
equipment cleaning regulation.
(a) Cleaning agents are listed below:
Diluted Ammonia Water
Diluted Sodium Hypochlorite(Bleaching agent)
Diluted Soapy Water
Hydrogen Peroxide 3%
Alcohol 70%
Isopropanol 70%
(b) Before cleaning the monitor:
a) Make sure that the equipment is switched off and disconnected from the power line.
b) Use soft cotton ball to adsorb a small amount of cleaning agents and clean the screen.
c) Use soft cloth to adsorb a small amount of cleaning agents and clean the monitor shell.
d) If necessary, use a soft dry cloth to wipe away the excess cleaning agents.
e) Dry the monitor in air.
10.2.3 Sterilization
To avoid damage to the monitor, sterilization is recommended only when stipulated as necessary
in the Hospital Maintenance Schedule. Monitor facilities should be washed first.
Recommended sterilization material: Ethyl alcohol 70%, Isopropanol 70%,Glutaraldehyde 2%.
55

Caution
z Do not use ETO gas to disinfect the monitor.
z Use a moistened cloth to wipe up any agent remaining on the monitor
z Try to use low-content liquids or dilute liquids following the instructions of

manufacturers.
z Don’t let any liquid enter the cover and don’t immerse any part of the equipment into
any liquids.
z Don’t remain any cleaning liquid on the equipment surface.
z Don’t pour liquids onto the equipment during the disinfection process.
56

Chapter11 ECG Monitoring
11.1 Definition of ECG Monitoring

ECG monitoring describes continuous waveforms of cardiac activities of patients so as to
accurately assess the current psychological status of the patients. Thus proper connection of ECG
cables must be ensured in order to obtain correct measurement values. This portable monitor
concurrently can display 2 waveforms under normal work status.
A patient cable consists of two parts:
Wire connecting the monitor;
Leads connecting patients
With a 3-lead facility for monitoring, ECG can obtain two waveforms from two different
leads. Users can use the knob, in the left side of the ECG waveforms on the screen, to
directly select the lead to be monitored.
Displayed monitoring parameters include HR, ST segment measurement value and
arrhythmia.
All the above parameters can be taken as alarm parameters.
Caution
In the ex-factory setting of the monitor the ECG waveform displays at the position of
the first two waveforms in the waveform area.
11.2 Attentions during ECG Monitoring
Warning
Don’t touch patients, tables or the equipment during defibrillation.
Warning
The ECG cable used for ECG signal monitoring by this portable monitor must be
provided by our Company.
Warning
When connecting electrodes or patient cables, users should ensure there is no

connection with other electric conductive parts or the ground, and more importantly,
57

ensure all the ECG electrodes including neutral electrodes are attached with patient
bodies instead of touching with electric conductive parts or the ground.
Caution
Disturbance from non-earthing equipments around a patient or ESU disturbance may

affect waveforms to function improperly.
Where this monitor is operated according to the conditions specified in the EN60601-1-2
(anti-radiation ability: 3V/M) and the electric-field strength above 1V/M may give rise
to the measurement mistakes under various frequencies, it is suggested that the
electroradiant equipment should not be used in the place next to the
ECG/Respirometer.
11.3 Monitoring Procedures
11.3.1 Preparation
Take patient skin preparation before installation of electrodes:

1. Skin is bad conductor, thus to ensure good touch between electrodes and skin it’s very
important to well prepare patient skin.
2. When necessary, remove body hair surrounding the electrode positions.
3. Clean thoroughly the skin with soap and water (don’t use ethyl ether or pure alcohol, as they
will increase skin resistance)
4. Drily sweep the skin so as to increase capillary blood flow as remove skin scraps and oil.
5. Install spring clamp or snap before installation of electrodes
6. Put the electrodes on patient body; in case the electrodes contain no conductive paste, coat
the conductive paste before installation.
7. Confirm power supply.
Warning
Daily check whether the ECG electrode plates stimulate skin; in case of any
sensitiveness phenomenon, change the electrodes or positions every 24 hours.
Caution
To protect the environment, used electrode must be recycled or properly treated.
Warning
Before monitoring check whether the leads work properly. After users plug out the
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ECG cables, screen will display the error information of “Sensor disconnected” and
activate voice alarming.
11.3.2 Install ECG leads
Caution
The following table lists the lead names under the European and US standards (leads
are represented in R, L, N, F and C under the European standard and in RA, LA, RL,
LL, and V under the US standard
US standard European standard
Lead name Color Lead name Color
RA White R Red
LA Black L Yellow
LL Red F Green
RL Green N Black
V Brown C White
Three-lead ECG electrodes position (Fig 10-1):
Fig 10-1(1) 3-leads monitoring
59

Note: the sign name and color of the elec tro de is American standard, what inside the
square brackets
[-] are European standard.
white electrode (RA) — Right foreleg

■ black electrode (LA)— Left foreleg
■ green electrode (RL)— Right hind leg.
■ red electrode (LL)—Left hind leg.
■brown electrode (V) — Fourth intercostal space.
Fig10-2 5-leads ECG Electrodes position
Caution
For patient safety, all the leads must be connected with patient body.
11.3.3 ECG lead connection recommended for surgery patients
Warning
When using ES equipments, users should put ECG electrodes at middle of the ES
earthing plate and ES knives to prevent from burns. Cables of ES equipments can not
be wrapped with ECG cables together.
Positioning of ECG leads is up to operation types, for example, for chest operation, electrodes can
be put on breast sides or back. Inside operation rooms using surgery electric knives, sometimes
artificial discrepancy may affect ECG waveforms; to reduce such artificial discrepancy, users may
put the electrodes at the left and right shoulders, near left and right abdomen, with breast lead at
left to the middle breast. No electrodes should be put on left arm; otherwise the ECG waveforms
60

will be very small.
Warning
During use of ES equipments, don’t put electrodes near the earthing plate of such
equipments, otherwise ECG signals will be much disturbed.
11.3.4 Use the 5-lead ECG device.
Users may based on their requirements arrange leads at each channel. Lead names for each
channel are displayed at left to the corresponding waveforms, and users can directly select them
for revision. Users can select proper leads from I, II, III, AVR, AVL, AVF, and V for the channels,
as shown in Fig. 0-5. In case a user selects the same leads, the monitor will automatically adjust to
different lead.
Characteristics of a good signal:

High and narrow, without incisura
High R-wave, fully above or below the baseline
Pacing signal no higher than R-wave
T-wave lower than 1/3 of R-wave
P-wave significantly lower than T-wave
To obtain 1mV of calibrated ECG waveform, users should conduct ECG calibration, in such case
the screen will display” Don’t monitor patients during calibration.
T
P
Q S
Fig 10-5 Standard ECG waveform
11.4 ECG Hot Key
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○
2 ○
3
○
1
○
4
Fig 10-4 ECG Hot Key
○
1 Name of the First ECG Lead:
ECG using 5-lead, the selectable leads include I, II, III, aVR, aVL, aVF and V;
ECG using 3-lead, the selectable leads include I, II and III. (For neonate)
The leads on the ECG waveform should not have the same name, otherwise the
system will automatically change the similar name into another.
○
2 The 1st-ECG Waveform Gain: used to adjust the amplitude of ECG waveform.
The gain of each calculation channel can be selected, which has such columns as
×0.25, ×0.5, ×1 and ×2 as well as auto mode. Auto mode means that the monitor can
automatically adjust the gain. On the right side of each ECG waveform there is a 1-mv rod
of which height and amplitude are proportional.
Caution
The input signal being too strong, the wave crest may be truncated. At this time users
can manually change the gain column of ECG waveform by reference to the actual
waveform for fear of incompleteness of waveform.
62

○
3 Filtering Mode: The cleaner or precise waveform can be obtained through filtering.
There are three filtering modes for option. The unfiltered ECG waveform is shown in
the diagnostic mode; the monitoring mode will possibly lead to the artifact filtering;
the operation mode used in the surgery can reduce the artifact and interference from
the electrosurgery unit. The filtering mode can be used in two channels and displayed
on the upper part of the first ECG waveform.
Warning
Only in the diagnostic mode can the system provide the real signal that has not been
treated. In the filtering modes such as “Monitoring” and “Operation”, the ECG
waveform will abnormally occur to the different extents. At this time the system can
only provide the basic ECG status, and will produce greater influence on the analysis
result of ST Segment. The analysis result of ARR may partially be affected in the
operating mode, so it is suggested that efforts are made to monitor patients in the
diagnostic mode when the interference is small.
○
4 the waveform of the ECG lead
○
5 The Name of 2nd-ECG Waveform Gain: for details, please refer to ○
1
Caution
The detected pacing signal displays on the upper part of the ECG waveform in the
waveform area, which is expressed as “ ”.
11.5 ECG Menu
11.5.1 ECG setting in parameter area
Use turn knob and move cursor on the main screen to the ECG hot keys in the parameter area,
then press the knob to pop up the ECG Setting menu:
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Fig 10-5 ECG Setup
Alarm ON/OFF: Select “ON” to give alarm prompt and storage when the heart rate alarm
happens. will be prompted beside ECG.
Alarm record: Users can select “On” to print HR alarms when they happen
ST ALM ON/OFF: Select "ON” in the event of ST1 or ST1 overrun alarm prompt and
storage, select the "OFFs not an alarm, and ST1 next have " ” pompt.
PVCs ALM ON/OFF: Select "ON” in the event of PVCs or PVCs overrun alarm prompt and
storage, select the "OFFs not an alarm, and PVCs next have " ” pompt.
HR ALM SETUP: setup heart rate hight limit ,middle limit ,low limit of the upper and lower
limits .
Alarms will happen once the HR values exceed the upper or lower limit.
Adjustable ranges for HR alarm upper & lower limits are as follows:
Name Adjustment step

Highest upper limit Lowest lower limit
length
Big /small 350 15 1
Caution
Users should set the alarm upper & lower limits based on the clinical conditions of
every patient. Setting of the HR alarm upper limit is very important, and users should
not set it too high but consider fluctuation factors. The set HR alarm upper limit should
not be over 20 beats/ minutes than patient HR.
11.5.2 ECG setting in waveform area
Turn the knob to waveform area,press the knob to enter ECG waveform setting
64

Fig 10-6 ECG Setup
Lead Name：
ECG using 5-lead, the selectable leads include I, II, III, aVR, aVL, aVF and V;
ECG using 3-lead, the selectable leads include I, II and III.
Gain: used to adjust the amplitude of ECG waveform. The gain of each calculation
channel can be selected, which has such columns as ×0.25, ×0.5, ×1 and ×2 as well as auto
mode. Auto mode means that the monitor can automatically adjust the gain. On the right
side of each ECG waveform there is a 1-mv rod of which height and amplitude are
proportional.
Sweep: ECG Waveform scanning wave has four levels for option, such as 6.25, 12.5,
25.0 and 50.0mm/s.
Filtering Mode: The cleaner or precise waveform can be obtained through filtering.
There are three filtering modes for option. The unfiltered ECG waveform is shown in the
diagnostic mode; the monitoring mode will possibly lead to the artifact filtering; the
operation mode used in the surgery can reduce the artifact and interference from the
electrosurgery unit. The filtering mode can be used in two channels and displayed on the
upper part of the first ECG waveform.
Wave Color: green, cyan, red, yellow, white, blue, violet.
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11.5.3 ECG setting in measurements
Fig 10-7 ECG Setting menu
1. When the heart rate alarm happens. Select “OFF” will be prompted beside ECG.
2. Alarm record: Users can select “On” to print HR alarms when they happen
3. Lead type: 5-lead or 3-lead
4. HR CHANNEL(Selection of HR calculation channel)
“Channel 1” means the HR is calculated according to the first ECG waveform data.
“Channel 2” means the HR is calculated according to the second ECG waveform data.
“Auto” means the monitor will automatically select the channel of calculating HR.
5. HR FROM(HR Source)
Users can select to check HR through ECG or PLETH (blood-oxygen volume
recording waveform); if users select “Automatic”, the monitor will decide HR source
based on signal quality; if users select “All”, the monitor will concurrently display HR
and PR. In case PLETH is taken as the HR source, the PULSE reminder will be
displayed together with pulse voice.
In case PLETH is taken as HR source, no alarm judgment on HR but alarm judgment
on PR will be conducted. In case “All” is selected, PR measurement values will be
displayed in the right to SpO2 on the main screen, and HR & PR make alarms at the
same time. Pulse voice will give priority to HR, as long as there is HR data, voice
reminder will be there; only when there is no HR data, voice reminder will be subject
66

with PR.
6. FILTER,SWEEP ,WAVE COLOR : See this chapter “ECG Settings” parameter area
corresponding
7. NOTCH: When set to ON, it is a method of inhibiting the method and apparatus of the
power frequency common mode interference, for bioelectric signals measurement
system including a common mode interference signal extraction circuit and a drive
circuit connected to the circuit; particular, the apparatus furtherincludes a phase
compensation processing means for receiving from the subject organisms of
biological signals and the driver circuit to provide the amplified signal, the output is
sent to a feedback signal by measuring biometric.
8. HR ALM SETUP: setup heart rate hight limit ,middle limit ,low limit of the upper and
lower limits .
9. ST AMALYSIS : ST Segment Analysis Select this item and enter the “ST Segment
Analysis” menu.
10. ARR ANALYSIS: ARR Analysis Select this item and enter the “ARR Analysis”
menu.
11. ECG CAL : When the ECG calibration, you can not monitor the patient . Tip: in the
middle of the screen of the instrument calibration can not monitor the patient . Stop
the calibration is required to return to the “ECG Setup” select to “stop ECG
calibration” menus .
12. DEFAULT : Select "default configuration" dialog box, the user can choose "No" or
“Yes" to be “the default configuration” or “original configuration will be set”
11.5.4 About ST Monitoring
The monitor performs ST segment analysis on normal and atrially paced beats and calculates ST
segment elevations and depressions. This information can be displayed in the form of ST numerics
and snippets on the monitor.
All available leads can be monitored continuously. The ECG waveform does not need to be
displayed on the Screen for ST segment analysis.
Warning
This monitor provides ST level change information; the clinical significance of the ST
level change information should be determined by a physician.
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11.5.4.1 Setting of ST Segment Analysis Menu
ST Segment Analysis: this switch is mainly used to set the state of ST Segment Analysis. Only
when the switch is ON, ST Segment Analysis can proceed.
Alarm Switch: Where “ON” is selected, the alarm prompt and saving will proceed when ST
analysis result is alarmed; where “OFF” is selected, alarming will not happen, but will be
prompted beside ST in the screen parameter area. ST Alarm will be triggered only when its
measured value exceeds ST Alarm Upper Limit or ST Alarm Lower Limit.
Alarm Level: used to set the ST Alarm Level according to three options such as “High”, “Middle”
and “Low”.
Alarm Record: when it is set at “ON”, the system will start the recorder for alarm record.
Alarm Upper Limit: used to set the alarm upper limit of ST Segment, of which maximum upper
limit is 2.0 and of which minimum upper limit must be more than -1.6 of the set lower limit.
Alarm Lower Limit: used to set the alarm lower limit of ST Segment, of which minimum lower
limit is 1.8 and of which maximum lower limit must be lower than -2 of the set upper limit.
The adjustable range for upper limit and lower limit of alarm as follows:
Max. Upper Limit Min. Lower Limit Single Adjustable Quantity
ST 2.0mv -2.0mv 0.1mv
Determine the ST Segment AP (Analysis Point): Select this option to enter the “Determine the ST
Segment AP” window and set the values at ISO and ST.
ISO (BP: base point): set the baseline point. Power on time is ste at 96 ms.
ST (SP: starting point): set the measuring point. Power on time is set at 128ms.
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Fig10-8 Determine the ST Segment AP
ISO and ST are two measuring points of ST Segment, which are adjustable.
R wave crest point is the reference point in setting of ST measuring point (as shown in the
following figure):
R Wave
P T
} ST Value
BP: ISO Q }
S
-78 ms ST Measuring Point
Initial Value +109 ms
+109 ms
Fig 10-9 ST Analysis Point
ST measured value of each HB composite waveform is the vertical distance between this
waveform and the crossing of two measuring points.
Caution
Where obvious changes happen to the patient’s HR or ECG Waveform, it is necessary

69

to adjust the ST measuring point in the following methods.
Method of Adjusting ISO and ST
Adjust the values by turning the knob.
Setting the measuring point of ST Segment, please open the “Determine Analysis Point” window
and the window will show QRS wave-group module (if the channel is not opened, “ST Analysis
Switch OFF” will be prompted). The location for high-brightness line in the window can be
adjusted. Select the ISO or ST first, and then turn the knob both leftward and rightward to move
such a line in parallel so as to determine the reference point or measuring point.
Caution
The abnormal QRS wave group will not be taken into consideration when ST segment is
analyzed.
Alarms & Reminders used in ST Segment Analysis.
Caution
The alarm limits for two measured values of ST SEGMENT are coincident. The alarm
limit of each channel can’t be set alone.
The alarm record switch in the related menu being opened, the physical alarm caused by the
parameter alarm super-limit will make the recorder automatically output the alarm parameter
values and related measured waveforms.
For the physical alarm, technical alarm and noticed information possible to happen in the ST
Segment Measurement, please see the following table.
Physical alarms:
Prompt Causes Alarm Levels
Messages
ST1 too The measured value for ST Segment of Channel 1 is higher than the Selectable by
high set alarm upper limit. users
ST1 too low The measured value for ST Segment of Channel 1 is lower than the Selectable by
set alarm lower limit. users
ST2 too The measured value for ST Segment of Channel 2 is higher than the Selectable by
high set alarm upper limit. users
ST2 too low The measured value for ST Segment of Channel 2 is lower than the Selectable by
set alarm lower limit. users
Technical alarms
Prompt Alarm
Causes Solutions
Message Level
ST Alarm
Function Stop use of ST SEGMENT alarm and advise the
Limit is High
safety failure biomedicine engineer or our company’s servicemen.
wrong.
70

Prompt Message (including general alarm message):
Prompt Alarm
Causes
Messages Level
ST1 measurement The measured value for ST Segment of Channel 1 exceeds the measured
High
out of scope range.
ST2 measurement The measured value for ST Segment of Channel 2 exceeds the measured
High
out of scope range.
11.5.5 Arrhythmia Analysis
Press SURVEY in main interface, one submenu pop up; choose ECG SETUP, Arrhythmia analysis
information inside
Arrhythmia analysis is used in clinically monitoring the ECG of baby and adult patients, detecting
the HR change and PVB, saving the arrhythmia events and producing alarm messages. Besides, it
can be used to monitor the patients with or without the pacemaker. The qualified personnel can
evaluate the patient’s status (such as HR, PVCS (PVB), frequency, rhythm and abnormal HB)
according to arrhythmia analysis and make a diagnosis and give treatment. In addition to detect
the ECG change, arrhythmia analysis can monitor patients and give a suitable alarm.
The functional default of arrhythmia monitoring in the system is the off state.
Users can start this function as needed.
Arrhythmia monitoring can arouse the doctor’s attention to the patient’s cardiac rhythm and give
an alarm through test and classification of arrhythmia and HB abnormality.
This monitor can perform 13 kinds of arrhythmia analysis.
In arrhythmia analysis, the system will save the latest 60 alarm events (the single-channel ECG
waveform four seconds before and after alarm). The operator can edit the arrhythmia events
through this menu.
11.5.5.1 Arrhythmia Analysis Menu
In the “ECG Setting” menu, select the “Arrhythmia Analysis” to enter the submenu.
(1) ARR ANAL(Arrhythmia Analysis): During monitoring it can be set at “ON” and during
default, “OFF”
(2) ALM ON/OFF(Alarm Switch): Select the “ON” and the alarm prompt and saving will
proceed; select the “OFF” and PVCs alarm won’t start, but prompting do beside
PVCs in the screen parameter area.
(3) ALM LEV(Alarm Level): There are such three options as “high”, “middle” and “low”.
71

“High” means the most serious PVCs alarm.
(4) ALM REC(Alarm Record): Select the “ON” and the recorder will output during PVCs
alarm.
(5) ALM HI(Alarm Upper Limit): PVCs alarm is based upon the set alarm upper limit. The
alarm will happen when PVCs exceeds the upper limit.
The adjustable range for upper limit and lower limit of alarm as follows:
Name Max. Upper Limit Min. Lower Limit Single Adjustable Quantity
PVCs 10 1 1
PVCs Alarm Message and Prompt Message:

When the alarm record switch in the related menu is turned on, the physical alarm arising out of
that the parameters exceeds the alarm limit will make the recorder automatically output the alarm
parameter values and related waveforms.
The physical alarm and technical alarm that may happen in PVCs parameter measurement are
listed in the following table.
Physical alarms:
Prompt Causes Alarm Level
Message
PVCs too high PVCs measured value is above the set alarm upper limit. Selectable by users
Technical alarms
prompt message Causes Alarm Solutions
Level
PVCs alarm Function Stop use of PVCs alarm and advise the biomedicine
High
limit is wrong. safety failure engineer or our company’s servicemen.
(6) ARR ALARM(ARR alarm setup): Set the Arrhythmia Alarm
① ARR TYPE : ASYSRTOLE、VFIB/VTAC、R ON T、VT>2、COUPLET、PVC、

BIGEMINY、TRIGEMINY、TACHY、BRADY、PNC、PNP、MISSED BEATS.
② ALM ON/OFF :ON ,OFF
③ ALM LEV :HIGH ,MED, LOW
④ ALM REC :ON/OFF
⑤ ARR ALM QUICK SETUP : The alarm fully open, the alarm fully closed, the record
fully open, to record fully closed, the alarm level. The user can select the alarm fully
open various arrhythmia alarm is set to "On", select "Alarm full off various arrhythmia
alarm set to" Off ". Similarly, the record fully open "alarm record switch can be all set
to" On ", the The record fully closed alarm record switch can be all set to" Off ".
(7) ARR RECALL (Arrhythmia Recall): Select this option and you can view and edit the
72

patient’s arrhythmia information.
The latest saved arrhythmia events are listed in the window (one page can show 10 events
and at most 6 pages can display).
Fig 10-11 Arrhythmia Review
The latest saved arrhythmia events are listed in the window (one page can show 10 events and at
most 6 pages can display).
Press “ ”&“ ”: to observe the list of arrhythmia events in other pages.
Cursor Movement: to move the cursor to select the arrhythmia events in the list.
Waveform: press this button and the window will show the waveforms, occurrence time
and parameters of the selected arrhythmia events .
Arrhythmia Waveform Review Window:
Press “ ”&“ ”: to observe waveforms of other arrhythmia events.
Movable Waveform: to observe all waveforms of arrhythmia events in 8 seconds.
Waveform: to output the arrhythmia event waveform through the recorder.
Quit: to return to the window of arrhythmia event list.
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Fig 10-12 Arrhythmia Waveform Review Window
Caution
In the event that the number of arrhythmia event is more than 200, the monitor will
retain the latest instead of the earliest. As for the monitor with the power-fail saving
function, it can save 200 arrhythmia events with power-fail.
Arrhythmia Alarm
In case of arrhythmia, the system will give an alarm sound. If “Alarm Switch” is ON, the system
will give an alarm sound and the indicator light; if “Alarm Record Switch” is ON, the alarm
record will be outputted (ECG waveform of channels analyzed 4 seconds before and after
alarming).
The alarm or prompt message related to arrhythmia analysis is as shown in the following table.
Physical alarms:
Applied
Prompt Alarm
Patient Conditions
Message Level
Type
Selectabl
Asystole Full No QRS waveforms successivefully for 4 seconds
e by users
F Wave successively for 4 seconds or the continuous
ventricular beats are greater than the number upper limit of Selectabl
VFIB/VTAC No pacing
serial ventricular beats (≥5pcs), of which R-R time is smaller e by users
than 600ms.
The number of serial PVS greater than or equal to 3 and Selectabl
Multiple PVS No pacing
smaller than 5. e by users
Selectabl
Two PVS No pacing Two continuous PVS
e by users
Selectabl
PVS bigeminy No pacing PVS bigeminy
e by users
Selectabl
PVS trigeminy No pacing PVS trigeminy
e by users
74

HR<100, RR interval < 1/3of average interval, after which
Selectabl
R ON T No pacing there is a compensation interval of which length is 1.25 x R-R
e by users
mean (next R waveform is moved up to the previous T wave.)
Selectabl
Single PVS No pacing Single PVS not belonging to the above types
e by users
Successively 5 QRS waveforms and RR mean smaller than Selectabl
Tachycardia Full
0.5s e by users
Selectabl
Bradycardia Full Successively 5 QRS waveforms and RR mean greater than 1.5s
e by users
Where HR is smaller than 100times/minute, HB is not detected
MB(Missed in the 1.75 times of time for RR mean; or where HR is greater Selectabl
No pacing
Beat) than 100times/minute, pulsation is not detected within 1 e by users
second.
In the 1.75 times of time for RR mean there are no QRS
Pacemaker Selectabl
Pacing waveform and pacing pulse (only for the patient with the
doesn’t work. e by users
pacemaker).
Pacemaker
In case of pacing pulse there is no QRS wave in the 1.75 times Selectabl
doesn’t capture Pacing
of time for RR mean (only for the patient with the pacemaker). e by users
pacing.
Applied Patient Type: “Full” means the arrhythmia analysis that can be given to the patient with
the pacemaker as well as that to the patient without the pacemaker.
“Non-pacing”: means the arrhythmia analysis that can be given to the patient without the
pacemaker.
“Pacing”: means the arrhythmia analysis that can be given to the patient with the pacemaker.
Prompt Message:
Prompt Cause Alarm
Message Level
ARR Learning QRS wave template necessary in ARR analysis is forming. No Alarm
Caution
Arrhythmia name displays in the alarm message area.
11.6 ECG Alarms & Reminders

Alarming information
Possibly happened alarms during ECG measurement are classified into physical alarms and
technical alarms, while during the same process there may be various reminders. The visual and
audio appearance of the monitor upon happening of such alarms or reminders, are as described in
the Alarming chapter. On the display screen, physical alarms and general reminders are displayed
75

in the alarming area, while technical alarms and those reminders unable to activate alarms are
displayed in the information area. In this chapter all the descriptions on alarming applies out of the
arrhythmia and ST segment analysis parts.
When the alarming record function under relevant menu is turned on, those physical alarms
activated because parameters exceed alarming limits may activate the recorder to automatically
output alarming parameter values and the relevant measurement waveforms.
The following classified table lists various possible alarms during such measurement process.
Physical alarms:
Reminders Causes Alarming levels
ECG signal
Fail to detect patient ECG signals High
over-weak
HR measurement values higher the set alarming
HR over-high User customized
limit
HR measurement values lower the set alarming
HR over-low User customized
limit
Technical alarms:
Alarming
Reminders Causes Solution
levels
ECG lead disconnected
ECG V-lead disconnected or ECG electrodes drop
ECG C-lead disconnected off from patient Make sure electrodes,
ECG LL-lead disconnected or body or ECG cables Low leads and cables are all
ECG L-lead disconnected drop off from the connected properly
ECG RA-lead disconnected or monitor
ECG R-lead disconnected
ECG module initialization error
ECG module initialization error 1
Stop using the
ECG module initialization error 2 measurement function
ECG module initialization error 3 Failure in ECG provided from the ECG
ECG module initialization error 4 measurement High module and inform
ECG module initialization error 5 module biochemical engineers or
ECG module initialization error 6 our maintenance
ECG module initialization error 7 personnel
ECG module initialization error 8
ECG measurement
ECG module communication module failure or
High Ditto
stopped communication
failure
Casual Ditto if the failure
ECG module communication error High
communication continues
76

error
Stop using HR alarming

Function / safety and inform biochemical
HR alarming limit error High
error engineers or our
maintenance personnel
Keep patients silent,
ECG measurement
electrode connection
ECG over-disturbance signals are heavily Low
reliable, and AC supply
disturbed
earthing well
Reminders (including general alarming information):
HR measurement out of HR measurement values out of High
scope measurement scope
77

Chapter12 RESP Measurement
12.1 Measure RESP
12.1.1 How to measure RESP
This monitor measures RESP values from the breast impedance values at two electrodes;
impedance change between such electrodes (due to breast activities) will generate a RESP
waveform on the screen.
12.1.2 Setting of RESP monitoring
For RESP monitoring, no additional electrodes are required, but how to install electrode is critical.
For some patients, especially with clinical condition that negative breast internal pressure will be
generated if their breast is horizontal expanded. In that case, users should put the two RESP
electrodes respectively at middle line of the right axilla and left side to the breast, where there are
largest activities during respiration, so as to obtain the best RESP wave.
Caution
RESP monitoring is not applicable for patients with active activities otherwise may
generate wrong alarms.
RESP monitoring checks:
Take patient skin preparation before installation of electrodes;
Install spring clamp or snap for electrodes, and follow the later-introduced method to
install electrodes on patient body;
Turn on power supply for the monitor system.
Install electrodes for RESP monitoring
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Fig 11-1 Install electrodes
■ white electrode (RA) — Right foreleg

■ black electrode (LA)— Left foreleg
■ green electrode (RL)— Right hind leg.
■ red electrode (LL)—Left hind leg.
■brown electrode (V) — Fourth intercostal space.
Caution
Install the white and red electrodes in a diagonal line so as to obtain the best RESP wave.
Need keep the liver and heart area out of the line formed by such electrodes, so as to
avoid artificial discrepancy generated from heart cover or pulsatile blood, which is very
important for newborns.
12.2 RESP Setting in parameter area

Users can rotate the knob and move the cursor to the RESP hotkey on the parameter area of the
main screen, then press the knob to enter the RESP Setting menu.
79

Fig 11-2 RESP Setup
1. ALM ON/OFF(Alarm Switch): select the “ON” and the alarm prompt and saving will
proceed during RR alarm; select the “OFF” and “ ” will be prompted beside RESP in the
screen parameter area.
2. ALM LEV(Alarm levels): High, MED or Low to be selected, and High for the most serious
alarm.
3. ALM REC(Alarm record): If users select “On”, upon RESP alarming, the recorder will
output the alarm.
4. ALM HI(Alarm high): used to be set with the upper limit for RR alarm.
5. ALM LO(Alarm low): used to be set with the alarm lower limit.
RESP alarming takes the set upper & lower limits as standard, and once the RESP values exceed
such limits there will be alarms.
Adjustable range of RESP alarm upper & lower limits:

RR Max upper limit Min lower limit Adjusted amount per time
BIG
7～120bpm 6～119bpm 1
SMALL
7～150bpm 6～149bpm 1
Choke alarm: Users can set the time to judge patient choke; 10-40 seconds are optional, each
rotation of knob will increase/ decrease 5 seconds.
80

12.3 RESP setting in waveform area
Fig 11-3 RESP Setup
GAIN(Waveform amplitude): Users can set enlarged display of RESP waveforms under five
optional enlargement rates: ×0.25, ×0.5, ×1, × 2 and ×4.
SWEEP(Waveform speed): Three optional speeds, 6.25mm/s, 12.5mm/s and 25.0mm/s
WAVE COLOR: green, cyan, red, yellow, white, blue, violet.
WAVE TYPE : LINE or FILL
12.4 RESP setting in measurements

81

Fig 11-4 RESP Alarm Setup
1. ALM ON/OFF: see reference in RESP Setting menu

2. ALM LEV: see reference in RESP Setting menu
3. ALM REC see reference in RESP Setting menu
4. SWEEP: Waveform speed, Three optional speeds, 6.25mm/s, 12.5mm/s and 25.0mm/s
5. WAVE COLOR: green, cyan, red, yellow, white, blue, violet
6. RR Gain: Users can set enlarged display of RESP waveforms under four optional
enlargement rates: 0.25, 0.5, 1.0, 2.0 and 4.0.
7. APNEA ALM :Set the time dignosing a patient suffocation .NO , 1s ,2s ,5s ,10s ,15s ,20s,
25s ,30s ,35s ,40s.
6. ALM HI: used to be set with the upper limit for RR alarm.
8. ALM LO: used to be set with the alarm lower limit.

9. DEFAULT: Select this option to enter "default configuration" dialog box, select the "Yes",
that is, using the default default configuration, the original configuration will be overwritten,
select "No" to abandon the current operation, the system remains the original configuration
unchanged
12.5 RESP alarm information and prompt information

The physiological alarm, technical alarm and prompt message which may occur in the RESP
measurement are listed below:
Physiological alarms:
Prompt information Cause Alarm level
82

RESP measurements higher than the set
RR too high User-selectable
alarm upper limit
RESP measurements lower than the set

RR too low User-selectable
alarm upper limit
Breathing not detectable within a specific

Apnea High
time interval
Table 12-2
Technical alarm:
Prompt Alarm
Cause Countermeasure
information level
Stop using RESP alarm function, notice

RESP alarm limit Functional safety
High biomedical engineer or maintenance personnel
fault failure
of Our company.
Table 12-3
Prompt information (including the general alarm information):
Prompt information Cause Alarm level
RR measurements beyond measurement

RR beyond measurement range High
range
Table 12-4
12.6 Maintenance & Cleaning
Please see Chapter 10 maintenance, cleaning and disinfection
83

Chapter13 SpO2 Monitoring
13.1 Definition of SpO2 Monitoring

The SpO2 volume recording parameter is used to measure arterial SpO2, i.e., percentage of
oxyhemoglobin. For example, if there are 97% of hemoglobin molecules combining with oxygen
out of the arterial red blood cells, the blood will be described as SpO2 97％, and the SpO2 reading
on the monitor will be 97％. SpO2 values thus can show the percentage of oxygen-attached
hemoglobin molecules (will form oxyhemoglobin), meanwhile, SpO2 volume recording
parameters can also provide the PR signals and volume recording waves.
13.1.1 Principle for Measurement of SpO2 Volume Recording
Parameter
BOS (blood oxygen saturation) is measured and determined in the method of pulse oximetry,
which is a method of measuring and determining the oxyhemoglobin saturation continuously and
without any hurt, mainly used to measure and determine how many rays from the light source of
the sensor penetrate the patient’s tissue (such as fingers or ears) and reach another receiver.
As for the wave length measurable by the sensor, generally the red LED is 660nm and the infrared
LED, 940nm. The maximum selectable output power of LED is 4mW.
The number of penetrated rays rests with many factors where most are constant, but one of these
factors means the arterial flow changes through time because it is pulsant. The arterialized blood’s
BOS can be obtained through measurement of absorbed rays during pulsation. A “volume
recording” waveform and PR signal can be given through detection of pulsation.
“SpO2” value and “Volume Recording” waveform can display on the main screen.
Warning
Where there is carboxyhemoglobin, ferrihemoglobin ordye dilution chemicals, SpO2

value will have a deviation.
13.1.2 BOS/Pulse Monitoring
Warning
84

The cable for the equipment of electrosurgery can’t be twisted together with the sensor
cable.
Warning
Please don’t place the senor on the limb with arterial duct or vein injection syringe.
Caution
Please don’t place SpO2 detector and cover on the same limb for measurement of blood
pressure, because in the course of measuring blood pressure the vascular obstruction
will affect the BOS reading.
13.2 Precautions in SpO2/Pulse Monitoring
Caution
Guarantee the nail can shut out the light.

The detector cable should be fixed on the back of hand.
Caution
SpO2 value always displays at the fixed place.

Only in the following cases PR will appear:
♦ In ECG menu, set “HR Source” as SPO2 or all.
♦ In ECG menu, set “HR Source” as “AUTO” and there is no ECG signal at this time.
Caution
SpO2 waveform and pulse are out of proportion.
Warning
Prior to monitoring, the first inspection should be given to whether the sensor cable is
normal. SpO2 sensor cable being pulled out of the jack, the screen will display the
“Sensor Off” mistaken information, and trigger the sound alarm.
Warning
Where the sensor packing or the sensor has the sign of damage, please don’t use this
SpO2 sensor, but return it to the manufacturer.
Warning
Continuous and overlong monitoring may increase the undesirable dangers that skin
features change, such as extraordinary sensitivity, reddening, blistering or pressure
85

necrosis, which are especially easy to happen to the newborns or the patients with
perfusion disorder or immature skin. In such a case special attention should be given to
aiming the correct beam path at detection of sensor position according to the change of
skin quality. Regular inspection should also be given to the laid-on position of sensor
and the change of such a position when the skin quality goes worse. It is possible to
require for the more frequent inspection due to different patient status.
13.3 Monitoring Procedures

(1) he oxygen probe clip open in the left and right sides of the clip installed infrared LED sensor
(see Figure 13-1-A);
(2) open the monitor;
(3) to one end of the sensor cable connector insertion the SpO2 module's SpO2 hole;
(4) the best placement of the probe position is the animal's tongue, the probe can be placed in the
intermediate position of the tongue of the animal. Other places, such as the toes and ears are
also available for placement. We recommend to the probe clip clamped the animal tongue to
oxygen guardianship, (see Figure 13-1-B):
Figure 13-1 placement of senseor
Attention
When the accurate positioning between the test site and the probe fails, it may result in
wrong readings of blood-oxygen saturation, and even stop monitoring because of the
failure of the search for the pulse wave. In this case you should re-position the two.
Excessive movement of measured sites may affect the accuracy of the measurement,
therefore, you should calm the patient or replace sites in order to reduce the impact of
86

excessive movement.
Warning
In a long and continuous monitoring process, check the condition of the peripheral
circulation and skin under measuring every 2 hours or so, and if negative conditions
happen, timely change the site under measurement.
In a long and continuous monitoring process, it is advisable to check periodically the
positioning of the probe to avoid inaccurate measurement due to changing in the
positioning from moving or other factors.
13.4 Measurement restriction

Measurement restriction
During operation, the following factors may affect accuracy of SpO2 measurement:
High-frequency electric disturbance, such as disturbance generated from the system itself or
electrosurgery equipments connected with the system;
A photo-oximeter and SPO2 sensor are used during MRI process, as the inductive current may
cause burns;
Intravenous Dye;
Frequent movement by patient;
Light radiation from outside;
Improper installation of the sensor or improper touching position with objects;
Improper sensor temperature (ideal temperature should be 28℃-42℃);
The sensor is put onto body with blood pressure cuff, arterial duct or vein tube;
Contents of non-functional Hb such as COHb and MetHb;
SPO2 over low;
Bad microvascular perfusion at the test position;
Shock, anemia, low temperature and application of vessel shrinking medicines, which all can
reduce the arterial blood flow to a non-measurable level;
Measurement is also up to absorption of lights with special wavelengths by oxyhemoglobin and
deoxygenated hemoglobin. Existence of other materials that absorbs the same wavelengths, such
as carbonated hemoglobin, hemoglobin, methylene blue and indi carmine, will make artificial or
low SPO2 values.
SPO2 sensor introduced in the accessory is recommended.
87

13.5 SpO2 Setting in the parameter area
Users can rotate the knob and move the cursor onto the SPO2 hotkey in the parameter area, then
press the knob to enter the SpO2 Setting menu.
Fig 12-7 SPO2 Setup
Warning
Setting the SpO2 alarm upper limit to be 100% means to release the upper limit.
However, high SpO2 level will make early-born infants infected with retrolental
fibroplasias, thus the SpO2 alarm upper limit must be carefully selected based on
common acknowledged clinical practice.
ALM ON/OFF(Alarm Switch): Where “ON” is selected, the alarm prompt and saving will
proceed when SpO2 (BOS) is alarmed; where “OFF” is selected, alarming will not happen,
but will be prompted beside SpO2 in the screen parameter area.

ALM LEV(Alarm level): used to set alarm levels and, during SpO2 alarming, for alarm
reminder and saving. Options include “High”, “Middle”, and “Low”; “High” for the most
serious alarm.
ALM REC(Alarm record): If “On” is selected, the recorder will output during SpO2
alarming.
SPO2 ALM SETUP: setup SPO2 hight limit ,middle limit ,low limit of the upper and lower
limits .
PR ALM SETUP: setup pulse rate hight limit ,middle limit ,low limit of the upper and lower
limits .
If the monitor SPO2 is NELLCOR ,the “SPO2 ALM SETUP” and “PR ALM STEUP” , according
to the set upper/lower limit, alarm will happen when SpO2 is higher than upper limit or lower than
lower limit.
88

SpO2 & PR adjustable limits:
Parameter Max upper limit Min lower limit Adjustable amount
each time
SpO2 100% 0 1
PR 300bpm 15 bpm 1
13.6 SPO2 setting in waveform area

press the knob to enter the SpO2 Setting menu.
Fig 12-8 SPO2 Setting
SWEEP: Waveform Speed, the scanning speed of SpO2 volume recording waveform is provided
with 12.5 and 25.0mm/s for option.
Waveform Colour: green, cyan, red, yellow, white, blue, violet.
WAVE TYPE:LINE or FILL
13.7 SPO2 setting in measurements
In the menu bar, select the “SURVEY SETUP”, select the "SPO2 SETUP” , see below
89

Figure 13-4 SPO2 setup
ALM ON/OFF: see the content of this chapter parameter area the SPO2 set the “ALM
ON/OFF”
ALM LEV: see the content of this chapter parameter area the SPO2 set " ALM LEV ".
ALM REC: see this chapter parameter area the SPO2 set “ALM REC”.
SWEEP: see this chapter waveform area the SPO2 set "SWEEP”.
WAVE COLOR:.see this chapter waveform area the SPO2 set "WAVE COLOR”
BRAIN ALARM(intelligent alarm): 10, 25, 50, 100 seconds, disable, for example, intelligent
alarm range is set to 50, then when NELLCOR oximeter alarm limit 97, and the lower limit is
90, and the measured oxygen value is 99, then from exceeding the alarm limit commences
consecutive exceeds the alarm limit of 25 seconds as soon as they sound and light alarm at
the same time the oxygen values next to the circle and draw back to square one. The
intelligent alarm to reduce false alarms, allow doctors to more accurate and timely master
oxygen changes. (This feature is only effective NELLCOR oxygen)
SPO2 ALM SETUP: see the content of this chapter parameter area the SPO2 set alarm
settings.
PR ALM SETUP: see the content of this chapter parameter area the SPO2 set alarm settings.
If the oxygen probe in the machine NELLCOR probe "SPO2 alarm settings, PR (pulse rate) alarm
settings set upper and lower limits of the alarm limit.
DEFAULT: Select this option to enter the the SPO2 default configuration dialog box, the user can
choose "yes" or "no" to "will be the default configuration" or "original configuration will be set.
13.8 Alarms & Reminders
90

Sp02 alarm information
When the alarm record function under certain menus is on, those physical alarms caused because
relevant parameters exceed the specified alarm limits will automatically output alarm parameter
values and relevant measurement waveforms.
Possible physical alarms, technical alarms and reminders during Sp02 module measurement are as
listed here:
Physical alarms:

SPO2 over-high SpO2 measurement value higher than the set User defined
upper limit
SpO2 over-low SpO2 measurement value lower than the set User defined
lower limit
PR over-high PR measurement value higher than the set User defined
upper limit
PR over-low PR measurement value lower than the set User defined
lower limit
Technical alarms
Reminders Causes Alar

m
Remedial Measures
Level
s
Ensure the sensor is fixed on the
SpO2 sensor drops down
SPO2 Sensor patient’s finger or other locus and
from the patient or Low
disconnected that the monitor is normally
monitor.
connected with the cable.
SPO2 module
initialization wrong
SPO2 module
initialization wrong 1
SPO2 module Stop use of SpO2 module
initialization wrong 2 measurement function and advise
SpO2 module wrong High
SPO2 module the biomedicine engineer or User
initialization wrong 3 Service Dept.
SPO2 module
SPO2 module
91

SPO2 module
SPO2 module
SPO2 module
Stop use of SpO2 module
SPO2 module SpO2 module wrong or measurement function and advise
High
communication stop communication mistaken the biomedicine engineer or User
Service Dept.
SPO2 module
communication wrong
measurement function and advise
SPO2 alarm limit wrong Function/safety faulty High
the biomedicine engineer or User
Service Dept.
measurement function and advise
PR alarm limit wrong Function/safety faulty High
the biomedicine engineer or User
Service Dept.
Prompt Message (including general warnings):
Reminders Causes Alarm Levels

SPO2 Measurement out of
SpO2 measured value is out of range High
scope
PR Measurement out of
PR measured value is out of range High
scope
Seek pulses SpO2 module seeks pulse. No alarm
Pulse not found SpO2 module can’t find SpO2 signal. High
Warning
Users must turn off the equipment and shut down the AC power supply before cleaning
the monitor or the connected sensor.
Caution
Please don’t sterilize the senor with pressure.

Please don’t soak the sensor in the liquid.
92

Use of the senor or cable is prohibited if they are damaged or degenerated.
13.9.1 Cleaning:
Having cleansed the surface of the sensor with the cotton ball or cotton cloth soaked with medical
alcohol, dry it with the dry cloth. The luminotron and receiver of the sensor can be cleaned in the
same method. The cable can be cleaned and sterilized with 3% of hydrogen peroxide or 70% of
isopropyl alcohol. Active reagent can also be used for this purpose. However, the joint can’t be
soaked in the above solution.
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Chapter14 NIBP Monitoring
14.1 General Information

NIBP measurement can be performed in the oscillation method;
It can be used in big cuff and small cuff( decided to use based on the animal's limbs cuff type);
Measurement mode: manual, automatic and continuous measurement. Each mode can show NS,
NM and ND.
♦ “Manual” mode: measurement can only be done once.
♦ “Auto” mode: measurement can be repeated. The interval time can be set as
1/2/3/4/5/10/15/30/60/90/120/180/240/480 minutes.
♦ “Continuous” mode: measurement can continuously be done within 5 minutes.
Warning
Don’t apply NIBP measurement onto a patient with sickle cell disease or any skin
damage or expected to have skin damage.
For patients with serious DIC, users should decide whether to apply NIBP measurement
based on clinical assessment, as there may have blood tumor at the touching area
between body and cuff.
In case of measurement on infants and newborns, users must ensure to select the correct
mode setting (refers to Patient Information Menu setting). A wrong mode may threaten
patient safety, as adult blood pressure levels are too high to be applied on infants and
newborns.
14.2 NIBP Monitoring
14.2.1 NlBP Measurement
Warning
Before measurement, users must make sure the selected monitoring mode is applicable
for the patients (adult, infant or newborn).
Don’t install a cuff on a body part with vein duct or other tubes. During cuff pumping,
slow infusion or infusion blocking may cause damage to the surrounding body area.
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Warning
The pumping pipe connecting blood pressure cuff and the monitor must be smooth,
without any entanglement.
1. Insert the pumping pipe into the interface of a blood pressure cuff and turn on the
power supply.
2. In accordance with the following method (Pic 14-1), tie the blood pressure cuff on
upper arm of upper leg of a patient.
3. Confirm the cuff is fully vented
4. Select a cuff in proper size for the annimal, and make sure the mark is just along
the proper vein and cuff tie the body non-toughly, otherwise remote body part may
have color change or even ischaemia.
5. Confirm correctness of the monitoring mode (as displayed on the information area);
if requiring to change the monitoring mode, users need go to the “Patient manage”
item under the Main menu and change “Patient Type”.
6. Select the measurement mode under the NIBP menu. Refer to the following
Operational Guide for details
7. Press the NIBP START button “ ”on the front panel to start pressure
measurement.
Figure14-1 Use of a Cuff
z The instrument must ensure that the blood pressure cuff is completely deflated, to
maintain a balance on the cat's left knee, and try to get the cat away from the noise and
bright location. The forelimb is better to place the blood pressure cuff position, feeling
nervous cat, blood pressure cuff, may be better placed in the tail.
z select noninvasive blood pressure measurement the sternum lateral or back to the dog,
although not with the big dogs is a bit difficult. If so, let the dog to sit up, take
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measurements from palm measurement. Such as palm and the front of the tibia or the
tail of the other parts of the dog, if the hair is very thick it will affect the measurement,
the necessary hair cut
z Check the cuff edges are between the “<->” marks; otherwise users should change with
a more proper cuff.
z Connect the cuff with a pumping pipe. Make sure the body part used for pressure
measurement is at the same horizontal level with patient heart, and if failing to realize
this, users should apply the following correction method to correct the measurement
results
• In case horizontal level of cuff is higher than that of heart, add 0.75mmHg
(0.10kPa) onto the displayed value for each cm difference.
• In case horizontal level of cuff is lower than that of heart, deduct 0.75mmHg
(0.10kPa) onto the displayed value for each cm difference.
Caution
Cuff width should be 40% of arm perimeter (50% in case of newborns) or 2/3 of upper
arm length. Width of the pumping part of a cuff should be as long as to surround
50%~80% of the arm. Cuffs in improper size will generate wrong readings. In case of
size problem with a cuff, users should change it with a bigger one so as to reduce
mistakes.
Cuff type：
Animal type Use standard
elephant Neo #5
horse Neo #4
dog Neo #3
cat Neo #2
mouse Neo #1
Animal cuff size：

Arm
Cuff name Cuff length Cuff width Tube length
circumference
measurements
Pet blood pressure cuff 1# 3 ～ 5.5 cm 12.2cm 2.6 cm
Pet blood pressure cuff 2# 4 ～ 8 cm 15.4 cm 3.2 cm 2m
Pet blood pressure cuff 3# 6 ～ 11 cm 18.7 cm 4.2 cm
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Pet blood pressure cuff 4# 18 ～ 26 cm 10.6 cm 10.6 cm
Pet blood pressure cuff 5# 46 ～ 66 cm 21 cm 21 cm
14.2.2 Operational guide
1. Conduct one time of Automatic measurement

Enter the “NIBP Setting” menu, select a proper time interval at the “Time Interval” item, and press
the “START/STOP” button on the front panel. Then the system will start automatic pumping
measurement in the specified time interval.
Warning
If NIBP measurement under the Automatic mode lasts too long, body touching with the
cuff may have allergic purpuras, ischemia and neural injury. During monitoring on
patients, users should often check color, warmness and sensitiveness of remote body
parts. Once any abnormal phenomenon is found, users should put the cuff at another
location or immediately stop measuring blood pressure.
2. Stop automatic measurement
At any moment during the automatic measurement process, press the START/STOP button will
stop the automatic measurement.
3. Conduct one time of manual measurement
z Enter the “NIBP Setting” menu, select the “Time Interval” item and set its value
as ”Manual”, then press the START/STOP button on the front panel so as to start
manual measurement.
z During spare time of an automatic measurement, press the START/STOP button
will start a manual measurement; then if users press the START/STOP button again,
the manual measurement will stop and the automatic measurement will continue.
4. Conduct a manual measurement during automatic measurement process
Just press the START/STOP button on the control panel.
5. Stop a manual measurement
Re-press the START/STOP button on the control panel.
6. Conduct a continuous measurement
Enter the “NIBP Setting” menu and select the “Continuous” item to start a continuous
measurement, which will always last 10 minutes.
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Warning
If NIBP measurement under the Automatic mode lasts too long, body touching with the
cuff may have allergic purpuras, ischemia and neural injury. During monitoring on
patients, users should often check color, warmness and sensitiveness of remote body
parts. Once any abnormal phenomenon is found, users should put the cuff at another
location or immediately stop measuring blood pressure.
7. Stop continuous measurement
At any moment during the continuous measurement process, press the START/STOP button will
stop the continuous measurement.
Caution
In case of suspecting reading accuracy, users should take possible methods to check life
signs of patients before checking the monitor,
Warning
In case any liquid is sprayed onto the equipment or its accessories, especially when the
liquid may enter the tube or monitor, please contact with the maintenance department
of your hospital.
14.2.3 Measurement restriction
Vibration measurement has its restriction subject with patient conditions. This measurement
method looks for regular pulse waves generated from arterial pressure, so when patient conditions
make this wave detection method hard to work, measured values are no more reliable and
measurement time last longer. Users must understand the following cases will disturb the
measurement method, making measured press unreliable or measurement time extended. In such
cases, patient conditions disable measurement to be continued.
Patient movement
In case a patient is moving, shaking or convulsing, measurement will be unreliable or
even impossible; as such scenarios will disturb detection of arterial pulse and extend
measurement time.
Arrhythmia
In case a patient shows irregular heartbeats resulted from arrhythmia, measurement will
be unreliable or even impossible, while measurement time will also be extended.
Heart-lung machine
If a patient is connected with an artificial heart-lung machine, measurement can’t be
realized.
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Pressure change
Within certain time if the patient blood pressure immediately changes while users are
analyzing arterial pulse so as to obtain measurement values, measurement will be
unreliable or even impossible.
Serious shock
In case a patient is under serious shock or extreme low temperature, measurement will be
unreliable as reduction in blood flowing peripherally will result reduction in arterial
pulse.
HR limits
In case of HR lower than 40bpm or higher than 240bpm, no blood pressure measurement
can be done.
14.2.4 NIBP Parameter Setting & Adjustment
NIBP measurement results and relevant information are laid on screen as follows:
Measurement Time
BP Unit
Measured Value
Measuring Mode Patient type

Prompt Area
Fig 13-3 NIBP measurement results
14.3 NIBP setting in parameter area

Rotate the knob, move the cursor onto the NIBP hotkey in the parameter area, and then press the
knob to enter the NIBP Setting menu.
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Fig 13-4 NIBP Setup
ALM ON/OFF(Alarm switch): Where “ON” is selected, the alarm prompt and
saving will proceed when the pressure is alarmed; where “OFF” is selected,
alarming will not happen, but will be prompted beside NIBP in the screen
parameter area.
ALM REC(Alarm record): Users can select “On” to output through recorder when
blood pressure alarms happen
Measure mode:big or small
INTERVAL: MANUAL and auto(1min, 2min , 3min, 4min,

5min ,10min ,15min ,30 min ,60min ,90min ,120min ,180 min ,240 min ,480min)
DISP COLOR(Display color): green, cyan, red, yellow, white, blue, violet.
NIBP SYS / NIBP MEA / NIBP DIA ALM STEUP: set the valve of NS ,NM ,ND
high limit ,middle limit ,low limit.
NS, ND, NM upper/lower limits
Big：
NS upper limi：42-270 mmHg lower limit：40-268 mmHg
ND upper limi：12-210 mmHg lower limit：10-208 mmHg
NM upper limi：22-230 mmHg lower limit：20-228 mmHg
Small：
NS upper limi：42-200 mmHg lower limit：40-198 mmHg
ND upper limi：12-150 mmHg lower limit：10-148 mmHg
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NM upper limi：22-165 mmHg lower limit： 20-163 mmHg
14.4 NIBP setting in measurements

press the knob to enter the NIBP Setting menu.
Fig 13-5 NIBP Setup
ALM ON/OFF: Where “ON” is selected, the alarm prompt and saving will proceed when the
pressure is alarmed; where “OFF” is selected, alarming will not happen, but will be
prompted beside NIBP in the screen parameter area.
ALM REC: Users can select “On” to output through recorder when blood pressure alarms
happen
Unit: mmHg/kPa
MEASURE MODE:big or small
INTERVAL: Time interval (Unit: minute) for automatic measurement: 1, 2, 3, 4, 5, 10, 15,
30, 60, 90, 120, 180, 240, 480 minutes, Manual, and Continuous. After users select an
interval, there will be a display of “Please press the ‘START/STOP’ button” in the NIBP
reminder area, then users just press the button to start pumping for the first time of automatic
measurement. To end the automatic measurement and return to the manual mode, users need
only select “Manual” during the measurement interval.
DISP Colour: green, cyan, red, yellow, white, blue, violet.
NIBP SYS / NIBP MEA / NIBP DIA ALM STEUP: set the valve of NS ,NM ,ND high
limit ,middle limit ,low limit.
RESET : reset of measuring status of blood pressure pump. Press the reset button, the inflated
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value of blood pressure pump will recover the initial settings. When blood pressure pump is
not working properly but the monitor does not question why, this is the recommended key.
Because it allows self checking of blood pressure pumps, allowing automatic recovery of
pump exception due to some accident.
CONTINAL : After select continuous measurement, the menu will disappear automatically
and continuous measurement starts immediately; If you want to stop it, press the key of blood
pressure measurement on the shell.
CALIBRATE : (pressure calibration)
For calibration of NIBP pressure, it should be carried out at least every two years or when do
you think the value is not accurate.
PENUMATIC (Leak detection):For detecting the closed conditions of NIBP gas path
DEFAULT: Select this item to enter "NIBP default settings" dialog box, the user can choose
"no" or "Yes" to exit or select "the default configuration is to be used, the original
configuration will be overwritten."
14.5 NIBP Pressure Calibration

The manufacturer recommends to use pressure meter or mercurial sphygmomanometer with
calibrated precision higher than 1mmHg for calibration. Users can select the Calibration item to
start calibration, while this item turns to be “Stop calibration”; if at such moment press the button,
the system will stop calibration.
Warning
Calibration for NIBP measurement should be done every two years (or conducted
following the maintenance plan of your hospital). Please follow the following details to
check its performance.
14.5.1.1 Calibration procedures of a pressure sensor:
Use a metal container of 500ml±5％ to replace cuff. Connect a calibrated standard pressure meter
with inaccuracy less than 0.8mmHg, T-interface ball pump and the pumping tube into the NIBP
holes on the module. Set the monitor to be under “Standard” mode, then take the ball pumps to
pump the metal container to be 0, 50 ad 200mmHg; in such cases values of standard pressure
meter and press values indicated on the monitor will differ within 3mmHg, otherwise please
contact with our Maintenance engineers.
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Standard
pressure meter
Gas pipe
Metal vessel
Round pump
Fig 13-6 Connection for NIBP calibration
14.6 Gas leakage detection

This button is used to detect gas leakage from the NIBP measurement pump. Users, after
connecting with a NIBP cuff, can use this button to start NIBP pumping process so as to observe
whether the NIBP gas route is sealed well. If such a gas leakage test gives a good result, the
system will make no reminder, otherwise there will be the corresponding error reminder in the
NIBP information area.
Default Setting
Users can select this item to enter the “NIBP Default Setting” dialogue box, then further select
“Manufacturer Default” or “User Default”. After making a selection, the system will eject a dialog
box for confirmation of selection by users.
Warning
This gas leakage test, different from as described in the EN 1060-1 Standard, is only for
users to simply detect gas leakage during NIBP pumping process. In case the system
shows there is NIBP gas leakage, please contact with our maintenance engineers.
14.6.1.1 Gas leakage detection process:
Properly connect the cuff with the NIBP hole of the monitor.
Wrap the cuff onto a column body in proper size.
Enter the “NIBP Setting” menu
Rotate the knob, move the cursor onto the “Gas Leakage Detection” item, then press the knob.
There will be a reminder of “Gas leakage detection in progress” at bottom of the NIBP parameter
area of the screen, meaning the system has started executing gas leakage detection
The system automatically pumps to the pressure of 180mmHg.
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In about 20 seconds, the system will automatically open the air bleeder, indicating completion of
gas leakage measurement.
No reminder information displaying on the NIBP parameter area doesn’t mean no gas leakage
within the system. Display of “Pump leaking…” means there is possible gas leakage with the gas
route, in such case operators should check whether there is any loose connection, and after making
sure of no more loose connection re-do the gas leakage detection; if the error reminder is still
displayed, please contact with the manufacturer for repair
Cylinder
Gas pipe
Cuff
Fig 13-7 Connection for NIBP Gas Leakage Detection
14.7 NIBPAlarms & Reminders

Provided that the alarming record function under relevant menu is turned on, those physical
alarms activated because parameters exceed alarming limits may activate the recorder to
automatically output alarming parameter values and the relevant measurement waveforms.The
following table lists various possible alarms during NIBP measurement process.
Physical alarms:
NS over-high Measured NIBP systolic pressure higher than specified User defined
alarming upper limit
NS over-low Measured NIBP systolic pressure lower than specified User defined
alarming lower limit
ND over-high Measured diastolic pressure higher than specified alarming User defined
upper limit
ND over-low Measured diastolic pressure lower than specified alarming User defined
lower limit
NM over-high Measured average pressure higher than specified alarming User defined
upper limit
NM over-low Measured average pressure lower than specified alarming User defined
lower limit
Technical alarms 1 (displayed in the monitor information area):
Reminders Causes Alarming Solution
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levels
Function/ Stop using the NIBP module alarming
NS alarming limit
safety High function and inform biochemical engineers
error
failure or our maintenance team
NM alarming limit
error
ND alarming limit
error
Technical alarms 2 (displayed in the reminder area below NIBP values):
Alarming
Reminders Causes Solution
levels
Stop using the NIBP measurement
NIBP self-detection Sensor or other
High function and inform biochemical
error hardware failure
engineers or our maintenance team
Communication
If the failure continues, stop using the
NIBP failure with
NIBP measurement function and inform
communication NIBP High
biochemical engineers or our maintenance
error measurement
team
module
Cuff isn’t
Cuff loose or out of properly
Low Wrap the cuff properly
connection wrapped or no
cuff
Damage with Check and change the part with leakage,
Gas leakage with
cuff, pipe or Low and if necessary also inform biochemical
cuff pumping pipe
connector engineers or our maintenance team
Fail to obtain
Check whether there is pipe wrapping; if
stable pressure
the problem continuous, inform
Air pressure error value, e.g., Low
biochemical engineers or our maintenance
because of pipe
team
wrapping
Cuff too loose
Apply other methods to measure blood
Signal too weak or patient pulse Low
pressure
too weak
Reset the NIBP measurement module;
Measurement
and if the problem continuous, stop using
Pressure out of scope exceeding
High the NIBP measurement module and
scope specified upper
inform biochemical engineers or our
limit
maintenance team
Arm movement Big signal noise Low Make sure the patient is silent, without
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or irregular PR movement
due to arm
movement
Pressure Re-measure. If the problem continuous,
Overpressure exceeding stop using the NIBP measurement module
High
protection specified upper and inform biochemical engineers or our
limit maintenance team
Significant
Signal saturation Low Stop the patient from movement
movement
Check and change the part(s) with
Leakage during leakage, and if necessary, inform
Pump leakage Low
the leakage test biochemical engineers or our maintenance
team
Blood pressure Stop using the NIBP measurement
NIBP system failure pump system High function and inform biochemical
running failure engineers or our maintenance team
Current cuff
Wrong cuff type type not suitable Low Select proper cuff
for patient
Measurement
time over 120
Measurement time seconds (for Re-measure or apply other measurement
High
out adults) or 90 methods
seconds (for
newborns)
Module reset
NIBP reset error High Re-use the reset function
improperly
During
measurement
the system can Check the cuff and re-measure while
Measurement error not execute High making sure the patient is silent during
measurement monitoring
analysis or
calculation
Reminders (displayed in the reminder area below NIBP values):

Manual measurement… Manual measurement in process
Continuous measurement… Continuous measurement in process
Automatic measurement… Automatic measurement in process
Please press START After you select the measurement time No alarm
interval
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Measurement stopped During measurement users press the START
button to stop measurement
Calibration… Calibration in process
Calibration stopped Calibration completed
Gas leakage detection… Gas leakage detection in process
Gas leakage detection stopped Gas leakage detection is stopped
Module reset… Reset after NIBP module is loaded
Manual reset… NIBP reset (activated by users) in process
Fail to reset Fail to reset
14.8 NIBP alarm information

Provided that the alarming record function under relevant menu is turned on, those physical
alarms activated because parameters exceed alarming limits may activate the recorder to
automatically output alarming parameter values and the relevant measurement waveforms. The
following table lists various possible alarms during NIBP measurement process.
Warning
Don’t compress the rubber pipe on a cuff.

Keep water or cleaning liquids out of the connector socket in the front of the monitor,
otherwise the equipment may be damaged.
During monitor cleaning, users need only sweep the outer surface of the connector
socket instead of its inner surface.
In case a recyclable cuff is disconnected with the monitor or being cleaned, users should
locate the cover cap above the rubber pipe so as to prevent any liquids from entering
the rubber pipe and being absorbed into the module.
14.9.1 Recyclable blood pressure cuff
Normally cuff may be disinfected within a hot air cabinet under the high pressure, gas or radiation
disinfection methods or sterilized by immersion into decontamination solutions. But users must
take away the rubber bag when applying such methods. Cuff can not be dry washed but machine
washed or hand washed only, and hand wash can extend service life of cuff. Before cleaning, users
should take away the rubber bag and put back after cleaning and cuff drying.
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Fig 13-8 Change the tape inside cuff
To put the rubber bag back into the cuff, users should put the rubber bag near the cuff opening side,
making the rubber pipe aligned with the long opening of the cuff, then vertically roll the rubber
bag and insert it into the long opening, hold on the rubber pipe and cuff, and then shake the whole
cuff until the rubber gag is positioned exactly. Insert the rubber pipe into the cuff, letting it go
through the hole liner and extend out.
14.9.2 One-time blood pressure cuff
Cuffs for one-time use can only be used for one patient. Don’t use the same cuff with different
patients. Don’t take one-time cuffs for disinfection or high-pressure vapor sterilization. However,
users can use soap to clean one-time cuffs for infection control purpose.
Caution
To protect the environment, one-time blood cuffs after use must be recycled or properly
treated.
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Chapter15 TEMP Monitoring
15.1 TEMP Monitoring

The monitor has two TEMP measuring channels. The temperature data can be measured with the
TEMP detector. Teperature is not a standard configuration for the neonatal monitor.
15.1.1 TEMP measurement setting
For one-time TEMP detectors, users must insert the TEMP cables into slots and then connect the
detectors with such cables; for reusable TEMP detectors, users can directly insert them into slots.
Closely paste TEMP detectors with patient body.
Turn on the system power supply.
Warning
Before monitoring users should check status of detector cables by plugging out the
TEMP detector cable from the hole, then the screen will display the error information
“T sensor disconnected” and make voice alarming.
Caution
A one-time TEM detector can only be used once.
Warning
Be careful to use or store TEMP detector and cables; spare detectors and cables should
be wrapped into loose rolls. Tough wires inside the detector and cables, if any, may
cause mechanical injury.
Warning
Calibration of a TEMP detector must be done for every two years or comply with your
hospital’s specified schedule. When requiring calibration, please contact the
manufacturer.
Caution
During monitoring process a TEMP detector will self-detect once per hour; such
self-detection last for 2 seconds and will not affect normal work of the TESP monitor.
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15.2 TEMP setting in parameter area
Users can use the knob to move the cursor onto the TEMP hotkey in the parameter area and press
the knob to enter the TEMP Setting menu.
Fig 14-1 TEMP setting
Alarm Switch: Select “ON” and the alarm prompt and saving will proceed when TEMP
is alarmed; select “OFF” and no alarm will happen, but will be prompted beside
TEMP in the screen parameter area.

Alarming levels: High, Middle or Low to be selected by users to set alarming levels.
Alarm Record: it is mainly used in starting/closing the output function of TEMP alarm
record. If “On” is selected, the present TEMP alarm will be outputted through the recorder.
Disp Color: green, cyan, red, yellow, white, blue, violet.
T1\T2\TD ALM HI/LO: Temperature alarm is set high limit and low limit alarm when
the temperature exceeds the high limit or below the lower limit
Adjustable range of TEMP alarm upper & lower limits:
Parameters Max upper limit Min lower limit Adjusted amount

per time
TEMP 0.1～50℃ 0～49.9℃ 0.1
TEMP unit: ℃ or ℉
Default Setting: Please refer to the “ECGDefault Setting” in the “ECG/TEMPMonitoring”.
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15.3 TEMP setting in measurements
Fig 14-2 TEMP setting
Alarm Switch: Select “ON” and the alarm prompt and saving will proceed when TEMP is
alarmed; select “OFF” and no alarm will happen, but will be prompted beside TEMP in
the screen parameter area.
Alarming levels: High, Middle or Low to be selected by users to set alarming levels.
Alarm Record: it is mainly used in starting/closing the output function of TEMP alarm record.
If “On” is selected, the present TEMP alarm will be outputted through the recorder.
TEMP unit: ℃ or ℉
Disp Color: green, cyan, red, yellow, white, blue, violet.
T1\T2\TD ALM HI/LO: Temperature alarm is set high limit and low limit alarm when the
temperature exceeds the high limit or below the lower limit.
Default Setting: Please refer to the “ECG Default Setting” in the “ECG/TEMP Monitoring”.
15.4 Alarm information and prompt information

In case the alarm record function under relevant menus is enabled, those physical alarms caused
111

because relevant parameters exceed relevant alarming limits will activate the recorder to
automatically output alarming parameter values and relevant measurement waveforms. The
physical alarms, technical alarms and reminders possible happening during TEMP measurement
are listed as follows:
Physical alarms:

T over-high TEMP measurement value higher than the set upper limit User defined
T over-low TEMP measurement value lower than the set lower limit User defined
Technical alarms
Reminders Causes Alarming Solutions

levels
Sensor TEMP cable disconnected Low Make sure the cable is reliably
disconnected from the monitor connected
Alarming limit Function/ safety failure High Stop using the TEMP alarm function
error and inform biochemical engineers or
our maintenance personnel
Reminders:

TEMP Measurement TEMP measurement value out of High
out of scope measurement scope
Warning
Users must turn off the equipment and shut down the AC power supply before cleaning
the monitor or the connected sensor.
This monitor is compatible with YSI400 series TEMP detectors, whose cleaning procedures are as
follows:
Reusable TEMP detectors:
Heating onto a TEMP detector can not be over 100oC (212.F), as such detector can only
undertake 80oC (176.F) --100oC (212.F) within short period.
Detectors can not be vapor disinfected.
Only cleaning agents with alcohol can be used for disinfection.
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During use of straight detectors, users should cover them with protective adhesive.
When cleaning detectors, users should use one hand to hold on one end and the other hand
to downward hold wet lint-free cloth to wash detectors towards the connector direction.
Caution
If you are using a one-time TEMP detector, this detector is allowed to be re-disinfected
or reused.
Caution
To protect the environment, one-time TEMP detectors should be recycled or properly

treated.
113

Chapter16 CO2 Monitoring
16.1 General
The contents of this section are just the descriptions of the ways of measurement by sidestream
and mainstream CO2 modules, which are different from the working mode of CO2 measured in an
anesthetic gas (AG). Please note their differences.
This instrument measures the CO2 pressure of the patient's air circuit, can measure the content of
end-of-respiration CO2 (EtCO2), the content of minimum CO2 intake (Ins CO2), and the airway
respiration rate (AWRR), and display the CO2 pressure waveform.
Monitors using the way of CO2 measurement are divided into sidestream monitors and mainstream
monitors.
In the side-stream measurement mode, the respiratory gases through patient airways are
sampled with a constant sampling flows and analyzed by remote CO2 sensors built in the
measurement system.
In the mainstream measurement mode, CO2 sensors are mounted on an airway joint that is
directly inserted into the respiratory system of a patient.
CO2 measurement provides:
• CO2 waveform.
• End-of-respiration CO2 (EtCO2): CO2 value measured at the end of respiration.
• Minimum CO2 intake (Ins CO2): The minimum value measured during respiration.
• Airway Respiration Rate (AWRR): respiration rate per minute derived from CO2 waveform.
Warning
The bumping and shaking of the CO2 module should be avoided whenever possible.
Attention
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Do not use this instrument where combustible anesthetic gases are present in the
environment.
Attention
This instrument can be operated only by professionals who are occupationally trained
and familiar with this manual.
In the “Monitor Settings” main menu, select “Module Switch Settings”, set the CO2 switch to On,
as shown in the figure below:
Figure 16-1 CO2 Waveform and Parameter Display
16.2 Measuring Principle and Working Process

The CO2 measuring principle is mainly based on the characteristic that CO2 can absorb the
infrared rays having a wavelength of 4. 3um. The measuring method works as follows: Gaseous
CO2 is introduced to a measuring chamber of which one side is irradiated by infrared rays, and
sensors are employed to measure the attenuation degrees of received infrared rays at the other side
of the measuring chamber, and the attenuation degree is directly proportional to the CO2
concentrations.
The comparison expression for the conversion between CO2 partial pressure and CO2
concentration is:
CO2 Partial Pressure (mmHg)= CO2 Concentration (%)¡ÁPamp (Ambient Pressure)
For example: 5% CO2 = 38mmHg at 760mmHg
5% CO2 = 35mmHg at 700mmHg
CO2 Module: adopting Autorun instruction measurement mode, and the waveform is sampled
once in every 31 milliseconds.
16.3 Operating Instruction for CO2 Connection

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(1) The schematic of connection of the mainstream module produced by the RESPIRONICS
company is shown in the figure below:
Figure 16-2 Mainstream Mode CO2 Connection
(2) The schematic of connection of the sidestream module produced by the RESPIRONICS
Figure 16-3 Sidestream Mode CO2 Connection Schematic
(3) The schematic of connection of the ISA™ sidestream analyzer produced by the PHASEIN
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Sampling tube
Figure 16-4 ISA™ Sidestream Analyzer (ISA CO2) CO2 Connection Schematic
(4) The schematic of connection of the IRMA™ mainstream analyzer produced by the
PHASEIN company is shown in the figure below:
Figure 16-5 IRMA™ Mainstream Analyzer (IRMA CO 2) CO2 Connection Schematic
The monitoring equipment produced by this company supports CO2 measurement by using a
sidestream or mainstream module produced by the IRONICES company, or an ISA™ sidestream
analyzer (ISA CO2 (CO2) CAT. NO. 800101) produced by the PHASEIN company.
Attention
When an ISA™ sidestream analyzer (ISA CO2 (CO2) CAT. NO. 800101) produced by the
PHASEIN company is used for monitoring CO2, please refer to the contents of the section
titled “17.6 Measuring Procedure and Before-Using Checking” for the measuring procedure,
and change the procedure for setting the AG module menu to CO2 menu setting.
Warning
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Before use, please check airway joints. Do not use when visible damage or breaks are
found on the airway adapter.
Warning
When CO2 is not used, it must be turned off, otherwise the CO2 module will be in a
working condition all the time
16.4 CO2 Measurement Procedures

Based on different CO2 modules used, determine if it is necessary to set such menu items as
“Oxygen Compensation”, “Balancing Gas”, “Altitude” and “Atmospheric Pressure” etc for the
instrument. When an ISA™ sidestream analyzer (ISA CO2 (CO2) CAT. NO. 800101) produced by
the PHASEIN company is used, if there are no such settings as altitude and atmospheric pressure
etc, it means that such functions have been carried by the module itself, need not to be set
manually. Please refer to the instruction manual coming with the module.
If you need the CO2 alarm message function, you can set this function in “CO2 Settings”.
16.4.1 Measuring Procedure of RESPIRONICS Branded
Mainstream and Sidestream Modules
The RESPIRONICS branded sidestream analyzer operating procedure is roughly the same as the
mainstream analyzer operating procedure; please refer to the sidestream analyzer operating
procedure for the mainstream analyzer operating procedure.
(1) Start the host monitoring equipment (if a minihost is used, please start the minihost
monitoring equipment at the same time).
(2) Or insert the CO2 plug-in module into the host monitoring equipment; the indicator of the
CO2 plug-in module will illuminate, which means that the module has been successfully
connected to the host monitoring equipment; otherwise, please reinsert the CO2 plug-in
module.
(3) Make connections according to the CO2 module type or Figure 15-4 or Figure 15-5, and
connect the CO2 module interface cable to the CO2 interface of the CO2 plug-in module or
the minihost.
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(4) Enter into the conventional screen of the host monitoring equipment, select [Exchange
Waveform] to call out the “CO2” waveform and parameters which you want to monitor, such
as [CO2] (this step can be skipped if the screen has already displayed the “CO2” waveform
and parameters).
(5) When the CO2 module is connected to the monitor, its module working mode is in the
“Measurement” state; however, in order to make sure that it is in the correct working state,
please do enter into the [CO2 Settings] menu to set its “Working Mode” to the [Measurement]
mode.
(6) Set [CO2 Switch] to [On].
(7) In the [CO2 Settings] menu, set [Oxygen Compensation] to 21 (usually, although it is 21 in
this menu, in order to make sure that its datum is in an activated state, the customer still
needs to reselect it);
(8) In the [CO2 Settings] menu, select an appropriate [Balancing Gas]: Indoor air, laughing gas
or helium (usually if there is no unused laughing gas or helium indoors, you can just select
indoor air);
(9) In the [CO2 Settings] menu, select a correct [Altitude]: 0～5029. 2m, instrument default: 0m;
mainly refer to the following table for its standard:
Air Pressure Conversion Table – End-of-Respiration CO2 Data Read By Basing the Standard on
Altitude
Sea-Level Elevation Atmospheric Pressure 5%CO2
Inch m mmHg ETCO2 mmHg
Sea Level (0) Sea Level (0) 760 38
500 152. 4 745 37
750 228. 6 738 37
1, 000 304. 8 731 37
1, 500 457. 2 717 36
2, 000 609. 6 704 35
2, 500 762 690 35
3, 000 914. 9 677 34
3, 500 1066. 8 665 33
4, 000 1219. 2 652 33
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4, 500 1371. 6 640 32
5, 000 1524 628 31
5, 500 1676. 4 616 31
6, 000 1828. 8 604 30
6, 500 1981. 2 593 30
7, 000 2133. 6 581 29
7, 500 2286 570 29
8, 000 2438. 4 560 28
8, 500 2590. 8 549 27
9, 000 2743. 2 539 27
10, 000 3048 518 26
10, 500 3200. 4 509 25
11, 000 3352. 8 499 25
11, 500 3505. 2 490 24
12, 000 3657. 6 480 24
12, 500 3810 471 24
13, 000 3962. 4 462 23
13, 500 4114. 8 454 23
14, 000 4267. 2 445 22
14, 500 4419. 6 437 22
15, 000 4572 428 21
15, 500 4724. 4 420 21
16, 000 4876. 8 412 21
16, 500 5029. 2 405 20
16, 800 5120. 6 400 20
Table 16-1
Note: It is assumed that the atmospheric pressure is 760mmHg and the ambient temperature is 0℃
at the sea level. Calculation of Atmospheric Pressure: the sea-level based ambient temperature is
assumed as 0℃. Refer to the above Table.
Warning
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By setting sea-level elevation, the monitor is not automatically changed with air pressure
compensations. Correct sea-level elevation must be set before the first use of CO2
Measurement Program. Improper setting of sea-level elevation will result in incorrect CO2
readings. A 5% CO2 deviation is generally generated corresponding to difference of each
1000m height.
(10) In the [CO2 Settings] menu, select a correct [Atmospheric Pressure]: 405～760mmHg, the
instrument default is 760 mmHg; when CO2 value is on the high side or on the low side,
select an appropriate atmospheric pressure based on the local condition by referring to the
table above (since the atmospheric pressure and the altitude are corresponding, the
atmospheric pressure can be adjusted only by setting the altitude. )
(11) In the [CO2 Settings] menu, select [Zeroing]; after zeroing, the following prompt is displayed
at the lower right corner of the screen: Zeroing…Please Wait for 30s; you can start measuring
CO2 only after the prompt disappears.
16.4.2 Measuring Procedure of PHASEIN Branded Sidestream and
Mainstream Analyzers
The PHASEIN branded sidestream analyzer operating procedure is roughly the same as the
mainstream analyzer operating procedure; please refer to the sidestream analyzer operating
procedure for the mainstream analyzer operating procedure.
16.4.2.1 Measurement Steps
If you want to set the host monitoring equipment in order to start gas analysis, please execute the
following procedure:
a) Start the host monitoring equipment (if a minihost is used, please start the minihost
monitoring equipment at the same time).
b) Or insert the CO2 plug-in module into the host monitoring equipment; the indicator of the
CO2 plug-in module will illuminate, which means that the module has been successfully
connected to the host monitoring equipment; otherwise, please reinsert the CO2 plug-in
module.
c) Connect the Nomoline sampling tube to the input interface of the ISA analyzer (CO2 module)
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d) Connect the interface cable of the ISA analyzer to the CO2 interface of the CO2 plug-in
module or the minihost.
e) Enter into the conventional screen of the host monitoring equipment, select [Exchange
Waveform] to call out the “CO2” waveform and parameters which you want to monitor, such
as [CO2] (this step can be skipped if the screen has already displayed the “CO2” waveform
and parameters).
f) When the CO2 module is connected to the monitor, its module working mode is in the
“Measurement” state; however, in order to make sure that it is in the correct working state,
please do enter into the [CO2 Settings] menu to set its “Working Mode” to the [Measurement]
mode.
g) Set [CO2 Switch] to [On].
h) Set appropriate [Oxygen Compensation], [Laughing Gas Compensation].
i) To connect the outlet of the sample gas to the discharge system, or to make the gas to flow
back to the patient’s circuit.
j) If it is green LED indication, ISA Analyzer is available.
k) To carry out inspection before use according to the statement in the “Inspection Prior to Use
(2)”.
l) If the inspection is normal, start to monitor the Anaesthetic Gas.
16.4.2.2 Check before use
Before connecting the Nomoline sampling pipe to the breathing circuit, carry out the following
steps:
a) Connect the sampling tube to the gas entrance interface (LEGI) of the ISA CO2 module.
b) Check whether the green light of LEGI is steadily on or not（The indication system is
normal. ）.
c) Exhale to the sampling tube, check if a valid CO2 waveform and value are displayed on the
host monitoring equipment.
d) Use the finger tip to block up the sampling pipe, and hold on for 10 minutes.
e) Examine whether there is obstruction warning and if the LEGI shows a red flashing light.
f) Under proper circumstances：Carry out enclosure check on the patient’s circuit that is linked
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with the sampling pipe.
Attention
If the interface shows the prompt of ‘no connection to the oxygen sensor’, please reinstall the
oxygen sensor.
Attention
The end of the gas circuit adapter which connects the gas sampling pipe should point
upward so as to prevent the condensing water drops entering the gas sampling pipe and
blocking it up.
Warning
z Hang the external CO2 analyzer onto the CO2 bracket on the rear casing of the
instrument; prevent the dropping damage of the CO2 module.
z Unless HME is used to protect the IRMA probe, the state indicating LED should face
upward all the time during IRMA probe placement.
z Do not pull the cable of ISA By-flow Gas Analyzer.
z Do not operate the ISA By-flow Gas Analyzer in the environment beyond the designated
working temperature.
z Make sure all connections are firm and reliable. Any leakage will result in the inclusion
of ambient air in the patients respiratory gas, which leads to a wrong reading.
16.5 CO2 Settings in Parameter Area

Rotate the rotary shuttle button to move the cursor on the display interface to the CO2 hotkey in
the parameter area, and then press the rotary shuttle button to enter the menu “CO2 Settings”.
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Figure 16-6 CO2 Settings
ALM ON/OFF(Alarm Switch): select “On" to enable CO2 alarms, or select “Off" to
disable CO2 alarms with the icon “ ” appearing beside “CO2” in the parameter area on
the screen.
ALM REC(Alarm Record): select “On” to enable the recorder output when there is any
CO2 alarm.
SWEEP(Alarm Speed): 12.5mm/s~25.0mm/s.
WAVE COLOR(Waveform Color): Green, Cyan, Red, Yellow, White, Blue, or Purple
Unit: mmHg/kpa.
CO2 ON(CO2 Switch): On or Off; select "On" to monitor the CO2.
O2 COMPEN(Oxygen Compensation): 5~100.
BALAN GAS(Balance Gas): Indoor Air, Laughing Gas, or Helium.
ALTITUDE: 120~4920 mmHg (adjustable based on the geographical location).
BARO PRE(Atmospheric Pressure): 400~850 mmHg (adjustable based on the
geographical location: either Altitude or Atmospheric Pressure, not both).
INS ALM HI(Upper Limit of INS Alarm): adjust the upper limit of INS alarm; if the
measured INS value exceeds the upper limit, there will be an alarm and prompting.
APNEA ALM(apnea alarm):No ,1s ,2s ,5s ,10s ,15s ,20s ,25s ,30s ,35s ,40s.
CO2 ALM SETUP: Used for to adjust CO2 the upper and lower limits of the range of
the high limit, middle limit and lower limit alarm . When the alarm limit CO2
measurement value is greater than or less than the alarm limit , the instrument alarm and
prompt .
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AWRR ALM SETUP: Used for to adjust AWRR the upper and lower limits of the range
of the high limit, middle limit and lower limit alarm . When the alarm limit CO2
measurement value is greater than or less than the alarm limit , the instrument alarm and
prompt
ZERO CAL: zero before monitoring the CO2, in order to obtain a more accurate
measured value.
DEFAULT : override the original settings.
16.6 CO2 Settings in Waveform Area

Rotate the shuttle button to move the cursor on the display interface to the CO2 hotkey in the
waveform area, and then press the shuttle button to enter the menu “CO2 Settings” as below:
SWEEP: 12.5mm/s~25.0mm/s.
WAVE COLOR: Green, Cyan, Red, Yellow, White, Blue, or Purple.
WAVE TYPE: Line or Fill.
16.7 CO2 Settings in Measurement Setup

Select “CO2 SETUP” in the menu “SURVEY SETUP " or rotate the shuttle button to move the
cursor to CO2 hotkey in the parameter area on the main screen, and then press the shuttle button to
enter the menu “CO2 SETUP” as below:
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Note: Refer to the section “CO2 Settings in Parameter Area” for the specific options of the menu
“CO2 Settings” in “Measurement Setup”.
Warning
This monitor does not provide auto atmospheric pressure compensation. Please set a
correct altitude before the first use of the CO2 for measuring. Any wrong altitude could
result in an inaccurate CO2 reading: a reading error of 5% for each altitude deviation
of 1000m.
16.8 Discharging Waste Gases

When nitrous oxide and/or an anesthetic gas is used, you should prevent these gases from
polluting the operating room. Usually the gas discharging outlet should be connected to (via the
gas discharging pipe connected to the sample gas outlet of the host equipment):
A discharging system (used for discharging collected gases) or the patient circuit (used for the
back flowing of collected gases).
Warning
Anesthetics: When an anesthetic which is being used or a patient who recently used an
anesthetic is measured, the gas discharging hole on the module must be connected to a waste
gas processing system or the patient circuit (on the anesthesia machine or the respirator), so
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as to prevent medical personnel from inhaling the anesthetic.
16.9 Maintenance and Cleaning of RESPIRONICS Branded
Mainstream and Sdestream Modules
16.9.1 Common Cleaning
Clean with cloth, optionally dipped with 70% isopropanol, aqueous solution containing 10%
sodium hypochlorite (bleacher), sterilizing spray cleaner (such as Steris Coverage Spray HB),
ammonia water or mild soap water. Before cleaning, wash the cloth with rinse water and then
wring out and air-dry the washed cloth. Make sure that sensor windows are clean and are air-dried
before being used repeatedly.
16.9.2 Airway Adapter for Cleaning Reusable Mainstream Sensor
Rinse it with warm soapy water first and soak it in liquid sterilizing fluid, such as 70%
isopropanol, aqueous solution containing 10% sodium hypochlorite (bleacher), 2. 4%
glutaraldehyde solvent, e. g. Cidex Plus or Steris System 1 or ammonia water. Wash it with clean
water completely.
16.9.3 Method for Sterilizing Reusable Adapter
Autoclave Sterilizer-operable only to adult-used adapters.
Ethylene oxide (ETO)- Sterilizing for 1. 5h.
Soaking in Cidex Plus for 10h.
Soaking in Perasafe for 10h.
U. S. Steris System 1pasteurizer.
Before adapters are reused, please make sure that the windows are dried without any residuals and
that adapters stand intact during operation or cleaning/sterilization.
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16.9.4 Sterilization Times for Reusable Airway Adapter
The reusable airway adapters can be reused 100 times if the above sterilization method is used.
16.9.5 Zeroing
Please zero before monitoring CO2; zeroing is to eliminate the effect of baseline drifting on the
results during measurement, thus ensuring the correctness of measured results.
Usually, the module will zero itself automatically when necessary. The user can zero the module
manually when the user considers it necessary: Select [CO2] in the parameter area, in the [CO2
Settings] menu popping up, select [Zeroing] to zero the CO2 module. During zeroing, make sure
that the patient circuit is exposed to the ambient air (21% oxygen and 0% CO2) for approximately
30 seconds; when the 30s zeroing prompt on the screen ends, it means zeroing is completed.
16.10 PHASEIN Branded Mainstream and Sidestream Analyzer
Related Information
16.10.1 Zeroing
An infrared gas analyzer needs to determine the zero reference level for CO2 measurement. This
zeroing standard is called as “zeroing” here.
Automatic Zeroing
The ISA sidestream gas analyzer execute zeroing automatically by switching the gas sample from
the respiration circuit to the ambient air. To execute automatic zeroing once every 24 hours, the
ISA sidestream gas analyzer takes less than 3 seconds. If the ISA sidestream gas analyzer is
equipped with an oxygen sensor, automatic zeroing also includes the indoor air calibration of the
oxygen sensor.
Manual Zeroing
Select [CO2] in the parameter area, in the [CO2 Settings] menu popping up, select [Zeroing] to
zero the CO2 module. During zeroing, make sure that the patient circuit is exposed to the ambient
air (21% oxygen and 0% CO2) for approximately 30 seconds; when this menu is in a non default
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(settable) condition, zeroing can be executed.
Warning
Since successful zeroing requires that the gas analyzer exists in the ambient air (21% oxygen
and 0% CO2), you should make sure that the ISA is placed at a well ventilated position.
Before and after executing the zeroing procedure, avoid breathing in the vicinity of the ISA
sidestream gas analyzer.
16.10.2 CO2 Module Lighting Information
Overview of States Indicated by LEGI:
Indicating Signal State
Not blinking green light The system is normal
Blinking green light Zeroing
Not blinking red light Sensor Error
Blinking red light Checking the sampling tube
16.10.3 Others
The operating methods for CO2 analyzers and AG analyzers produced by the PHASEIN company
are identical. Therefore, for such contents as “adverse effects on performance, safety warning
messages, airway obstruction, consumables, safety symbol information, patent and trademark,
analyzer maintenance and cleaning” with respect to the CO2 analyzer described in this section, the
user can refer to relevant contents in Chapter 18, Anesthetic Gas Measurement.
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Chapter17 IBP Monitoring
17.1 16.1 General information

This chapter mainly introduces invasive blood pressure (IBP) monitoring methods and contents
relevant to maintenance and cleaning of accessories.
STAR8000H portable-type multi-parameter monitor can be directly used for measuring vascular
pressures (diastolic pressure, systolic pressure and mean blood pressure). The following
waveforms can be displayed:
Waveform Name Definition
ART arterial pressure
PA pulmonary arterial pressure
CVP central venous pressure
RAP right atrial pressure
LAP left atrial pressure
ICP intracranial pressure
Remark: IBP monitoring part is an optional component.
17.2 Considerations of IBP monitoring
Warning
The chosen accessory, if applied, should confirm to safety requirements of medical

equipment.
Warning
In connection and application, accessories should be avoided from contacting metal

parts connected with electric apparatus.
Warning
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Users, when connecting the monitor with a high-frequency surgical instrument, should
avoid the sensor and cable of the monitor from contacting the high-frequency surgical
instrument so as to prevent patients from being burnt in case of electricity leakage.
Warning
The disposable pressure sensor should not be reused.
Caution
Only the pressure sensor specified in the Manual can be used.

The specified sensor has shock-proof function (with resistance to leakage current) and can prevent
influence of cardiac defivrillators. It can be used in surgeries. When the patient is in the
defibrillation period, the pressure wave may exhibit temporary disorders; but after defibrillation,
the monitor will work normally and the operation mode and user configuration of it won’t be
affected.
Warning
Before monitoring, the sensor should be examined for normality assurance. If the sensor
is pulled out of the jack, an error-warning message, “IBP sensor detached”, will appear
on the screen and alarm sounds will be sent out.
Caution
Sensors, new or used, should be regularly calibrated according to hospital practice.
Warning
If liquid (not solution applied to the pressure pipe and the sensor) is splashed on the
instrument or accessories, especially when the liquid may enter the sensor or the
monitor, place contact with the maintenance department of your hospital.
17.3 Monitoring procedure

Measurement preparation:
1. Insert cables into corresponding sockets and check to ensure the monitor has been
plugged in.
2. Have the pressure pipe and the sensor prepared. Fill the system full with
physiological saline solution to make sure no bubble exists therein.
3. Connect the patient catheter to the pressure pipe and make sure that there is no air
in the catheter and the pressure pipe or the sensor.
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Warning
If bubbles are found in the pressure pipe or the sensor, flush the system with the
perfusion liquid.
1. Position the sensor on the same level as the heart, approximately on the
midaxiallary line
2. Confirm correct ruler names have been chosen. See the following section for
details.
3. Do zero-adjustment of the sensor. See the following section for details.
Fig 16-1 IBP Monitoring
17.4 IBP Menu
17.4.1 IBP<1,2>setup in the parameter area
Rotate the knob and move the cursor to the IBP hotkey in the parameter area of the screen.
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Fig 17-2 IBP Parameter Setting Menu
Settings can be done on the following items:

z ALM ON/OFF(Alarm switch): Where “ON” is selected, the alarm prompt and
saving will proceed when the IBP (invasive blood pressure) is alarmed; where
“OFF” is selected, alarming will not happen, but will be prompted beside IBP
in the screen parameter area.
z ALM LEV(Alarmlevels): Optional levels are “High”, “Middle” and “Low”.
z ALM REC(Alarm record): select “On” to enable the recorder output when there is
any IBP alarm.
z ALARM SETUP: When the alarm measurement value is greater than or less than
the alarm limit , the instrument alarm and prompt .
CH1: ART, PA, CVP, RAP, LAP ,LAP ,ICP ,P1,P2 limit Hi setup:
SYS: Upper SYS alarm limit: used for setting the upper alarm limit
MEA: Upper MEA alarm limit:used for setting the upper alarm limit
DIA: Upper DIA alarm limit: used for setting the upper alarm limit
CH1: ART, PA, CVP, RAP, LAP ,LAP ,ICP ,P1,P2 limit Lo setup:
SYS: Lower SYS alarm limit: used for setting the lower alarm limit
MEA: Lower MEA alarm limit:used for setting the lower alarm limit
DIA: Lower DIA alarm limit: used for setting the lower alarm limit
CH2: ART, PA, CVP, RAP, LAP ,LAP ,ICP ,P1,P2 limit Hi setup:
SYS: Upper SYS alarm limit: used for setting the upper alarm limit
MEA: Upper MEA alarm limit:used for setting the upper alarm limit
DIA: Upper DIA alarm limit: used for setting the upper alarm limit
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CH2: ART, PA, CVP, RAP, LAP ,LAP ,ICP ,P1,P2 limit Lo setup:
SYS: Lower SYS alarm limit: used for setting the lower alarm limit
MEA: Lower MEA alarm limit:used for setting the lower alarm limit
DIA: Lower DIA alarm limit: used for setting the lower alarm limit
Caution
Users should guarantee that zero calibration has been done on the sensor before the
measurement; otherwise the instrument has no effective zero value, which may lead to
inaccuracy of measured data.
Once the measured data exceed the alarm limits, the alarm will be triggered.
IBP alarm limits:
Adjustable
Pressure Scale Name Max Upper Limit Min Lower Limit
Single-Step Length
(mmHg) (mmHg)
（mmHg）
ART 300 0 1
PA 120 -6 1
CVP 40 -10 1
RAP 40 -10 1
LAP 40 -10 1
ICP 40 -10 1
z SCALE AGJUST : The IBP waveform area provides scales for waveforms. Two
dash line of each IBP waveform, from the upper to the lower, respectively
represents the upper-limit scale and the lower-limit scale of the waveform. Values
of the two scales may be set. The detailed setting method is introduced in the
current menu.
CH1:ATR ,PA ,CVP ,RAP ,LAP ,ICP ,P1 ,P2 Setup:
• Upper scale: The pressure value represented by the upper scale limit. The
choice range is the measurement range of the current pressure.
• Lower scale: The pressure value represented by the lower scale limit. The
• Mean scale: he pressure value represented by the middle scale limit. The
CH2:ATR ,PA ,CVP ,RAP ,LAP ,ICP ,P1 ,P2 Setup:
• Upper scale: The pressure value represented by the upper scale limit. The
• Lower scale: The pressure value represented by the lower scale limit. The
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• Mean scale: he pressure value represented by the middle scale limit. The
Caution
The upper scale limit value should not be lower than the lower limit value.
Caution
The lower scale limit value should not be higher than the upper limit value.
Caution
The lower pressure limit, the upper pressure limit, the reference scale and the waveform
are displayed simultaneously on the screen so that users can observe waveform changes
after the scales are adjusted.
z CH1/CH2 ZERO: the IBP1 and IBP2 module into the socket, the need for invasive
pressure zeroing.
17.4.2 IBP<1,2>setup in the waveform area
Rotate the knob and move the cursor to the IBP hotkey in the waveform area of the screen.

z CH Press Setup:eight options including ART, PA, CVP, RAP, LAP,ICP ,P1 and P2 are
provided.
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z SWEEP:12.5mm/s,25mm/s
z FILTER: smooth, normal ,no filter
z WAVE COLOR:green ,cyan , red ,yellow ,white ,blue , purple
z WAVE TYPE:line,fill
17.4.3 IBP<1,2>setup in the measurement setup
Select the “Module Setup” option in the “monitor setup” menu and set the CO2 on-off to be on.
The following figure (the present figure is in demonstrating mode) will come out:
Press the knob to enter the “IBP selection” menu.

IBP<1,2>SETUP:
z ALM ON/OFF: see this chapter parameter area IBP <1,2> setup the ALM ON/OFF.
z ALM LEV: see this chapter parameter area IBP <1,2> setup the ALM LEV
z ALM REC: see this chapter parameter area IBP <1,2> setup the ALM REC
z SWEEP: see this chapter waveform area IBP <1,2> setup the SWEEP
z WAVE COLOR: see this chapter waveform area IBP <1,2> setup the WAVE
COLOR.
z UNIT : mmHg,kPa,cmH2O
z FILTER: see this chapter waveform area IBP <1,2> setup the FILTER.
z CH Press Setup: see this chapter waceform area IBP <1,2> setup the CH Press
Setup
z ALARM SETUP: see this chapter parameter area IBP <1,2> setup the ALARM
SETUP
z SCALE AGJUST see this chapter parameter area IBP <1,2> setup the SCALE
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AGJUST
z DEFAULT: checked into the IBP <1,2> Default Settings dialog box, select "No" to
abandon the current operation, the system remains the original configuration
unchanged, select "Yes", and will be using the default settings,the original
configuration will be overwritten.
IBP PRESSURE ZERO
z CH1 ZERO: the IBP1 and IBP2 module into the socket, the need for invasive
pressure zeroing.
z CH2 ZERO: the IBP1 and IBP2 module into the socket, the need for invasive
pressure zeroing.
CAL(calibration)
z CH1 CAL VALUE: Adjustable from 80 to 300 values.
z CH2 CAL VALUE: Adjustable from 80 to 300 values.
z CH1 ADJUST
z CH2 ADJUST
Warning
When setting alarm limits, users should confirm the item to be set.
17.5 Zero calibration of sensor:

Press the “IBP zero calibration” key with the rotary knob and the system will begin zero
calibration.
Zero calibration consideration:
Before zero calibration, close the three-way stop cock at the patient side.
Before zero calibration, the sensor should communicate with the atmosphere.
The sensor must be positioned at the same level with the heart, approximately on the
midaxillary line.
Zero calibration should be done before monitoring start and at lease once per day (zero
calibration must be done each time after the cable is plugged or pulled.)
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blood pressure gauge
Fig 16-5 Connection layout of IBP pressure calibration
Calibration of the mercury manometer should be done when a new sensor is being
started to use or at the specified cycle in the hospital practice.
The purpose of calibration is to ensure the system to provide accurate measured results.
Before calibration of the mercury manometer, pressure zero calibration should be done.
If the procedure is to be carried out by yourself, you should have the following devices.
z standard blood pressure gauge
z three-way stop cock
z pipeline with a length of about 25cm
17.6 Mercury manometer calibration procedures:
Warning
The following operation should never be done when a patient is being monitored.
① Close the three-way stop cock which is opened to the atmosphere for zero calibration.
② Connect the pipeline with the blood pressure gauge.
③ Confirm that connection to the patient has been off.
④ Connect a three-way stop cock with the three-way joint that hasn’t been connected to
the patient catheter (when the patient is being monitored). Connect a syringe to one end
of the three-way stop cock and connect the blood pressure gauge and the pipeline with
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the other end.
⑤ Open the end open to the blood pressure gauge.
⑥ Select the channel to be calibrated in the pressure calibration menu and adjust the
pressure values of the channel to be calibrated.
⑦ Charge gas to raise the scale of the mercury column to the set pressure value in the
menu.
⑧ Repeatedly adjust until values in the menu equal to pressure values in the blood
pressure gauge.
⑨ Press once the calibration button in the calibration menu to command the instrument to
begin calibration.
⑩ Wait until the calibration ends. Make corresponding countermeasures to be taken
according to prompt information.
⑪ Detach the pipeline of the blood pressure gauge and the added three-way stop cock
after completion of the calibration.
The IBP waveform area provides scales for waveforms. Two dash line of each IBP waveform,
from the upper to the lower, respectively represents the upper-limit scale and the lower-limit scale
of the waveform. Values of the two scales may be set. The detailed setting method is introduced in
the current menu.
z IBP pressure scale name: ART, RA, CVP, RAP, LAP and ICP are available for
selection in the hotkey area of the IBP menu;
z Upper scale: The pressure value represented by the upper scale limit. The choice
range is the measurement range of the current pressure.
Caution
The upper scale limit value should not be lower than the lower limit value.
z Lower scale: The pressure value represented by the lower scale limit. The choice
range is the measurement range of the current pressure.
Caution
The lower scale limit value should not be higher than the upper limit value.
Caution
The lower pressure limit, the upper pressure limit, the reference scale and the waveform
are displayed simultaneously on the screen so that users can observe waveform changes
after the scales are adjusted.
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17.7 Alarm information and prompt information
17.7.1 Alarm information
When alarm record switches in related menus are turned on, physiological alarms given when
parameters exceeds alarm limits will trigger the recorder to automatically output alarmed
parameters and related measured waveforms.
Possible physiological alarms, technical alarms and prompt messages in IBP module measurement
are listed in the following tables:
Physiological alarms：
PROMPT CAUSE ALARM

MESSAGE LEVEL
IS too high Measured SP value is higher than the set upper User Optional
alarm limit.
IS too low Measured SP value is lower than the set lower User Optional
alarm limit.
ID too high Measured DP value is higher than the set upper User Optional
alarm limit.
ID too low Measured DP value is lower than the set lower User Optional
alarm limit.
IM too high Measured MP value is higher than the set upper User Optional
alarm limit.
IM too low Measured MP value is lower than the set lower User Optional
alarm limit.
Technical alarms:
PROMPT CAUSE ALARM SOLUTION

MESSAGE LEVEL
IBP lead detached IBP cable is Low Make sure the cable is connected
detached from the reliably.
monitor
IBP module IBP measurement High Suspend the IBP measurement function
initialization module has faults and inform biomedical engineers or
wrong maintenance workers.
17.8 Maintenance and Cleaning
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Warning
Please turn off the monitor and disconnect the AC power supply before cleaning the
monitor or sensor.
When the operations of pressure monitor is finished, please remove the airway and cap from the
sensor and clean the film of the sensor with water. You can use the soapy solution or any of the
following detergents to clean the sensor and cable.
Cetylcide
Wavicide-01
Wescodyne
Glutaraldehyde
Lysol
Vesphene
Do not immerse the connector in any liquid. After cleaning, do not put it away until the sensor is
completely dry. It is normal that the cable fades slightly or has a stronger adhesiveness on the
surface. If it is necessary to remove the residue of adhesive tape from the sensor, please use the
double-sided adhesive scavenger. Be careful to use the cable, in order to minimize the damage.
Please do not use such strong solvents as acetone, alcohol, ammonia water or chloroform, as they
could damage the vinyl cable as time goes on.
Caution
No one-off sensor or cap is allowed to be re-disinfected or reused.
Caution
For the purpose of environmental protection, please recycle or dispose of the one-off
sensor or cap in a proper way.
Disinfection
Disinfection by Chemical Liquid
Follow the above steps to remove the visible dirt. Select an effective chemical disinfectant
applicable to the equipments in the operation room, like buffered glutaraldehyde (glutaraldehyde
or preservative). Do not use any quadrivalent cationic detergent, like benzalkonium chloride. To
disinfect the whole instrument, please remove the cap, immerse the sensor (except the electrical
connector) in the disinfectant for the recommended time, and then use the sterile water or
physiological saline to rinse out all components (except the electrical connector) of the sensor. Do
not put the sensor away until it is completely dry.
Disinfection by Gas
For a complete sterility, a gas disinfectant is necessary:
141

Follow the above steps to remove the visible dirt. In order to restrict the ethylene glycol,
please make sure the sensor is completely dry when you use the ethylene oxide gas
disinfectant.
Please follow the operating instructions provided by the manufacturer of the gas
disinfectant.
Warning
The disinfectant temperature should not be higher than 70℃(150℉), or the plastics
inside the pressure sensor could deform or melt.
142

Chapter18 Measurement of Anesthetic Gases
18.1 Overview
Anesthetic gas (AG) is used to measure the anesthetic gases and breathing gases for the patients
under anesthesia. This module provides the end-tidal value (et) and inhalation value (in) of the
following gases:
CO2 —— measure EtCO2 (maximum exhalation value – measured in respiration).

N2O —— laughing gas.
O2 —— optional.
AwRR —— respiration per minute (rpm)
The system can display four waveforms for an anesthetic gas at a time, including CO2 waveform,
O2 waveform, N2O waveform, and anesthetic agent gas waveform. By default, the CO2
waveform is displayed.
The system can display such parameters as CO2, N2O, O2, and AA (the anesthetic agent being
monitored: DES, ISO, ENF, SEV, or HAL), including both the inhalation and exhalation value,
and also display the MAC (minimum alveolar concentration), BAL (balance gas), and AwRR.
Names of Parameters:
CO2: carbon dioxide.
N2O: nitrous oxide (laughing gas).
O2: oxygen.
AwRR: airway respiration rate (respiration per minute: rpm).
Halothame: HAL.
Isoflurane: ISO.
Enflurane: ENF.
Sevoflurane: SEV.
Desflurane: DES.
Caution
Only the waveform and value of a single anesthetic agent are displayed at a time.
18.2 Measurement Principle and Work Process

143

Measurement Principle for Anesthetic Gases:
Measure the AG concentration based on the AG ability of absorbing infrared rays. All gases
to be measured by the AG module should be able to absorb infrared rays, and each gas has its own
absorption characteristics. The gas is transmitted to a sampling room and passed through by the
infrared rays of a specific frequency band selected by an infrared ray filter. When you measure
more than one gas, there will be more than one infrared ray filter. The higher the gas concentration
within the given volume is, the more infrared rays will be absorbed and the smaller transmission
amount of infrared rays will pass through the gas. You can work out the gas concentration by
measuring the transmission amount of infrared rays.
Measurement Principle for Oxygen:
Since oxygen can not absorb infrared rays, you can measure the oxygen concentration based
on its paramagnetic characteristics. Inside the sensor of oxygen module, there are two crystal balls
filled with nitrogen hung in symmetrical magnetic fields with the help of a torsion device. In case
of different oxygen concentrations, the crystal balls will have different deviations under the action
of magnetic fields and there will be different moments acting on the torsion device. You can work
out the oxygen concentration by measuring the moment.
18.3 AG Display
Select “Module Switch” from “Monitor Setup” in the main menu to set the AG module as “On",
and then return to the main menu to select “AG Interface” from “Work Interface”. See the figure
below:
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Fig. 17-1 AG Display Interface
The AG module can display all the measured waveforms and parameters on the screen of the
monitor, including:
z CO2, O2, N2O, and AA waveform;
z AWRR: airway respiration rate;
z MAC: minimum alveolar concentration;
z CO2, O2, N2O, and AA end-tidal (Et) value and inhalation (Fi) value.
“AA” stands for one of such five anesthetic gases as Des, Iso, Enf, Sev, or Hal.
18.4 MAC Value

As a basic index reflecting the depth of inhalation anesthesia, MAC (minimum alveolar
concentration) is defined by the standard ISO21647 as the alveolar concentration of an
inhalational anesthetic agent in balanced state in the absence of any other anesthetic agent, which
can prevent the body movements of 50% patients under a standard surgical stimulation.
Below are the 1MAC values for inhalational anesthetic agents:
Anesthetic DES ISO ENF SEV HAL N2O
Agent
1MAC 7.3%* 1.15% 1.7% 2.1% 0.77% 105%**
*: This figure comes from a 25-year-old patient.

**: This 1MAC value for N2O is only obtained in a high-pressure chamber.
145

Caution
The above data of a 40-year-old healthy male patient comes from ISO21647 and is
published by FDA.
In practice, such factors as age and weight may influence the effect of inhalational
anesthetic agent.
Below is the formula to calculate the MAC value in the presence of one or more anesthetic
agents:
“N” stands for the number of all anesthetic agents (including N2O) detected by the AG module;
“EtAgenti” stands for the end-tidal concentration of each inhalational anesthetic agent; and
“AgentVoli” stands for the 1MAC value of each inhalational anesthetic agent.
For example, if the AG module finds that the end-tidal gas for the patient contains 4% DES,
0.5% HAL and 50% N2O, the MAC value will be:
Caution
The above formula is applicable to adults.
18.5 Preparations for Measurement

1. Select a water tank appropriate for the patient type and install it onto the holder.
2. Connect one end of the gas sampling tube to the water tank.
3. Use the airway adapter to connect the other end of the gas sampling tube to the
patient.
4. Connect a waste gas exhaust tube to the exhaust port on the AG module so as to
discharge the sample gas into the waste gas treatment system.
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Fig. 17-2 Connection Diagram for Preparations
5. Select “Measurement Setup” from the main menu or menu bar to enter “AG CO2”
and “AG N2O”, and set the operation mode as “Measure” to enable AG.
Caution
The end of the airway adapter connected to gas sampling tube should face up, in order
to prevent condensed water drops entering and blocking the gas sampling tube.
The water tank is used to collect the condensed water drops from the sampling airway
and prevent them entering the module. Please pour the water in the water tank when it
reaches a certain amount, or the airway could be blocked.
The water tank contains filtering materials to prevent the bacteria, moisture or
patient’s secretions entering the module. After a long-time use, the dusts or other
external objects will reduce the air permeability of the filtering materials, which could
block the airway if serious. In this case, please replace the water tank. It is better to
replace the water tank every other month.
Warning
The water tank for adults is not applicable to any newborn patient, or it could hurt the
patient.
Make sure all connections are secure and reliable. Any leakage could cause reading
errors since the breathing gas for the patient is mixed with the ambient air.
18.6 AG Setup
18.6.1 CO2 Settings
1. CO2 Settings in Parameter Area
In the AG interface, rotate the shuttle button to move the cursor on the display interface to the
147

CO2 hotkey in the parameter area, and then press the shuttle button to enter the menu “CO2
Settings”.
Fig. 17-3 CO2 Settings

ALM ON/OFF(Alarm Switch): select “On" to enable CO2 alarms, or select “Off" to
disable CO2 alarms with the icon “ ” appearing beside “CO2” in the parameter area on
the screen.
Pressure Unit: mmHg, kpa.
Oxygen Compensation: High ,Med ,Low
N2O Compensation: On or Off.
APNEA ALM: No ,1s ,2s ,5s, 10s ,15s,20s ,25s ,30s ,35s ,40s
ET ALM SETUP :set high alarm limit ,middle alarm limit ,low alarm limit. if the
measured ET value exceeds the limit, there will be an alarm and prompting
FI ALM SETUP : set high alarm limit ,middle alarm limit ,low alarm limit. if the
AWRR ALM SETUP : set high alarm limit ,middle alarm limit ,low alarm limit. if the
DEFAULT: select “Yes” to enable the default settings to override the original settings.
2. CO2 Settings in Waveform Area
In the AG interface, rotate the shuttle button to move the cursor on the display interface to
the CO2 hotkey in the waveform area, and then press the shuttle button to enter the menu
“AG CO2” as below:
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Fig. 17-4 AG CO2 Settings
Waveform Speed: 12.5mm/s or 25.0mm/s.
Waveform Color: Green, Cyan, Red, Yellow, White, Blue, or Purple.
Gain: ×1, ×2, or ×4, to adjust the wave amplitude of the CO2 waveform.
3. CO2 Settings in Measurement Setup
“Measurement Setup" in the menu bar or enter “Measurement Setup" in the main menu to select
“AG Setup” and “AG CO2”, and then press the shuttle button to enter the menu “AG CO2”. Refer
to the section “AG CO2 Settings in Parameter Area” for the specific options of the menu “AG
CO2” in “Measurement Setup”.
18.6.2 O2 Settings
1. O2 Settings in Parameter Area
In the AG interface, rotate the shuttle button to move the cursor on the display interface to the O2
hotkey in the parameter area, and then press the shuttle button to enter the menu “O2 Settings”.
Fig. 17-5 O2 Settings

149

ALM ON/OFF: select “On" to enable O2 alarms, or select “Off" to disable O2 alarms
with the icon “ ” appearing beside “O2” in the parameter area on the screen.
ALM LEV: High, Medium, or Low; “High” is most serious.

Oxygen Compensation: HIGH ,MED ,LOW.
2. O2 Settings in Waveform Area
In the AG interface, rotate the shuttle button to move the cursor on the display interface to the O2
hotkey in the waveform area, and then press the shuttle button to enter the menu “AG O2” as
below:
Fig. 17-6 AG O2 Settings

Gain: ×1, ×2, or ×4, to adjust the wave amplitude of the O2 waveform.
3. O2 Settings in Measurement Setup
“AG Setup” and “AG O2”, and then press the shuttle button to enter the menu “AG O2”. Refer to
the section “O2 Settings in Parameter Area” for the specific options of the menu “AG O2” in
“Measurement Setup”.
150

18.6.3 N2O Settings
1. N2O Settings in Parameter Area
N2O hotkey in the parameter area, and then press the shuttle button to enter the menu “Laughing
Gas Settings”.
Fig. 17-7 Laughing Gas Settings

ALM ON/OFF: select “On" to enable N2O alarms, or select “Off" to disable N2O
alarms with the icon “ ” appearing beside “N2O” in the parameter area on the screen.

measured ET value exceeds the limit, there will be an alarm and prompting.
2. N2O Settings in Waveform Area
N2O hotkey in the waveform area, and then press the shuttle button to enter the menu “AG N2O”
as below:
151

Fig. 17-8 N2O Settings

Gain: ×1, ×2, or ×4, to adjust the wave amplitude of the N2O waveform.
3. N2O Settings in Measurement Setup
“AG Setup” and “AG N2O”, and then press the shuttle button to enter the menu “AG N2O”. Refer
to the section “N2O Settings in Parameter Area” for the specific options of the menu “AG N2O”
in “Measurement Setup”.
18.6.4 AG AA Settings
1. AG AA Settings in Parameter Area
hotkey “AG AA” in the parameter area, and then press the shuttle button to enter the menu “AG
AA”.
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Fig. 17-9 AG Settings
ALM ON/OFF
2. AGAA Settings in Waveform Area
hotkey “AG X” in the waveform area, and then press the shuttle button to enter the menu “AG
AA” as below:
Fig. 17-10 AG AA Settings

Gain: ×1, ×2, or ×4, to adjust the wave amplitude of the AG AA waveform.
3. AG X Settings in Measurement Setup
153

“AG Setup” and “AG AA”, and then press the shuttle button to enter the menu “AG AA”. Refer to
the section “AG AA Settings in Parameter Area” for the specific options of the menu “AG AA” in
“Measurement Setup”.
18.7 Aderse effects on performance

(1) The following circumstances can cause known adverse effects on indicated performance:
z Quantitative effects of humidity or condensation.
z Quantitative effects of atmospheric pressure.
z Disturbing gases or water vapor.
z Other disturbing sources.
(2) Gas measurement unit
Volume percentage is used as the unit of concentration of a reported gas. Concentration is

defined below:
The total pressure of a mixed gas is measured by the cup pressure sensor in the ISA gas
analyzer.
If you want to convert it into another unit, you can the actual atmospheric pressure sent by
the ISA sidestream analyzer; for example:
CO2 (mmHg) = (CO2) x (atmospheric pressure (kPa) from the ISA) x (750 / 100)。
For example: 5.0 vol% CO2 @ 101.3 kPa 0.05 x 101.3 x 750 / 100 = 38 mmHg
(3) Effects of Moisture
The partial pressure and volume percentage of CO2, N2O, oxygen or an anesthetic gas depend
on the content of water vapor in the measured gas. Oxygen measurement will be calibrated;
at the actual ambient temperature and humidity level, 20.8 vol%, in stead of the actual partial
154

pressure, will be displayed. 20.8 vol% of oxygen corresponds to the actual oxygen
concentration of indoor air (the water concentration is 0.7 vol%) (for example: at 1013 hPa,
corresponding to 25°C and 23% RH). The actual partial pressure at the current humidity level
will be displayed all the time when CO2, N2O, oxygen and anesthetic gases (all the gases
measured the infrared cell) are measured.
In the pulmonary alveoli of a patient, the water vapor in breathing gases become saturated at
the body temperature.
After breathing gases is collected and sent into the sampling tube, their temperature gets near
to the ambient temperature before they enter into the ISA sidestream gas analyzer. After
Nomoline has removed all the condensed water, water molecules will not enter into the ISA
sidestream gas analyzer. The relative humidity of all the gases collected is approximately
95%.
If you need the CO2 value under BTPS, you can use the following equation:
Et CO2 = Et CO2 value [vol %] sent by the ISA
Pamb = Atmospheric pressure [kPa] sent by the ISA
3.8 = Typical partial pressure [kPa] of water vapor condensed between the patient’s circuit
and the ISA
Et CO2 (BTPS) = Et CO2 gas concentration [vol%] under BTPS
It is assumed that standard oxygen of indoor air has been used at a humidity level of 0.7 vol%
H2O
18.8 Safety Alarm Information
18.8.1 ISA Sidestream Gas Analyzer Safety Warning Information
Warning
155

z The ISA sidestream gas analyzer is designed to be used by authorized or trained
medical personnel.
z Only Nomoline sampling tubes produced by PHASEIN can be used.
z The ISA sidestream gas analyzer shall not be used in an inflammable anesthetic
gas.
z You should earnestly neaten the sampling tube in order to reduce the risk of it
wrapping or reining the patient.
z Do not repeatedly use a disposable sampling tube.
z Do not lift the ISA/host equipment by grasping the sampling tube; otherwise it may
break away from the ISA/host equipment, which may result in that the ISA/host
equipment falls onto the patient.
z Used disposable sampling tubes should be disposed according to local medical

waste stipulations.
z Do not use a sampling tube configured for a big animal on a small animal;
otherwise the invalid cavity in the patient circuit will increase.
z Do not use a sampling tube configured for a small animal on a big animal;
otherwise it will result in a too big flowing resistance.
z Do not use the ISA sidestream gas analyzer together with a quantitative spraying
agent or spray; otherwise it may result in the clogging of the germ filter.
z Check if the flowing speed of the gas sample is too high for the given patient type.
z Since successful zeroing requires that the gas analyzer exists in the ambient air
(21% oxygen and 0% CO2), you should make sure that the ISA is placed at a well
ventilated position. Before and after executing the zeroing procedure, avoid
breathing in the vicinity of the ISA sidestream gas analyzer.
z The Nomoline sampling tube and its interface are not germ free devices. In order
to prevent the sampling tube from causing damages, please never carry out high
pressure sterilization on any part of the sampling tube.
z Never disinfect the ISA sidestream gas analyzer or soak it into a liquid.
z Mobile and radio frequency communication equipment will affect measurement.

Make sure that the ISA gas analyzer is used in the electromagnetic environment
designated in this operating instruction manual.
z The ISA gas analyzer can only be used as a piece of auxiliary equipment for patent
156

evaluation. It must be used together with other vital sign and symptom evaluation
equipment.
z If the input interface of the sampling tube starts showing red blinking, or a
Nomoline clogging message is displayed on the host, the sampling tube should be
replaced.
z It is not allowed to alter this equipment without the manufacturer’s authorization.

If this equipment is altered, appropriate checking and testing must be conducted in
order to make sure that it can be safely operated over a long period of time.
z The ISA gas analyzer is not designed for being used in a MRI environment.
z During MRI scanning, the host equipment must be placed outside the MRI room.
z Using high frequency electrosurgical equipment in the vicinity of the ISA/host

equipment may produce interference, which will result into incorrect
measurements.
z Do not use the external natural heat dissipation function of the ISA equipment.
z Do not apply a negative pressure (such as using a syringe) onto the Nomoline to
remove condensed water.
z If the positive or negative pressure in the patient circuit is too high, it may affect
the sample’s flowing speed.
z If the discharging or sucking pressure is too high, it may affect the sample’s
flowing speed.
z The discharged gas should be discharged into the patient circuit, or into a
discharging system.
z If the collected gas sample needs to supply air for respiration, a germ filter should
be used at the discharging side all the time.
z When placing the ISA gas analyzer, try not to place it at a position where the
analyzer might fall onto the patient's body.
18.8.2 ISA Mainstream Gas Analyzer Safety Warning Information
Warning
z Do not use an IRMA airway adapter configured for big animal on a small animal,
157

since the adapter will add 6ml of invalid cavity to the patient circuit.
z If the airway adapter has water drops/condensation, it should be replaced.
z Use an IRMA airway adapter made by PHASEIN.
z Do not use an IRMA small airway adapter on a big animal; otherwise it will result
in a too big flowing resistance.
z When an energized part is contacted, sufficient protection should be provided to

the host equipment.
z Only an adapter cable approved by PHASEIN AB can be used.
z A warning must be implemented in the host equipment, displayed during

demonstrative data displaying.
z The host equipment should be equipped with an appropriate alarm system to

remind the user of circumstances which may cause death or serious damages to the
patient’s health.
z Every corresponding alarm message in IRMA state abstract fields must be

implemented in the host equipment.
z The IRMA probe is not designed to be contactable to the patient.
z Incorrect probe zeroing will result in false gas readings.
z The IRMA probe is designed for being used by authorized or trained medical
personnel.
z The IRMA probe is not designed shall not be used in an inflammable anesthetic
gas.
z A disposable IRMA airway adapter shall not be used repeatedly. Repeatedly using
a disposable adapter will cause cross infection.
z Used disposable airway adapters should be disposed according to local medical

waste stipulations.
z Only oxygen sensors made by PHASEIN can be used. Oxygen exhausted oxygen
sensors should be disposed according to local battery disposal stipulations.
z Never try to open the oxygen sensor device. The oxygen sensor in the IRMA probe
is a disposable product, containing corrosive electrolytes and lead.
z The IRMA probe is designed only as an auxiliary means for patient evaluation. It
must be used together with other vital sign and symptom evaluation equipment.
158

z Never place the IRMA airway adapter somewhere between the trachea catheter
and the elbow; otherwise it may result in the adapter window being clogged by the
patient’s secretions and operating errors.
z In order to prevent secretions and moisture from aggregating at the window and
the oxygen sensor port, always place the IRMA probe at a vertical position and let
the LED face upwards.
z Never use the IRMA airway adapter together with a quantitative spraying agent or
spray; otherwise it may affect the light traveling of the airway adapter window.
z If an IRMA OR (without the automatic anesthetic gas identification function) user

select a wrong anesthetic gas, it will result in false anesthetic gas readings.
z If the IRMA OR (without the automatic anesthetic gas identification function) is

applied to a mixed gas containing several anesthetic gases, it will result in false
anesthetic gas readings.
z Mobile and radio frequency communication equipment will affect measurement.

You should make sure that the IRMA probe is used in the electromagnetic
environment designated in this operating instruction manual.
z Never disinfect the IRMA probe or soak it into a liquid.
z The IRMA oxygen cell and the IRMA airway adapter are not germ free devices.
Never carry out high pressure sterilization on the equipment; otherwise it will
result in equipment damage.
z Even if an IRMA probe has not been used, do not install an oxygen exhausted
oxygen cell on the probe.
z Do not stretch the sensor cable.
z Do not run this equipment beyond the temperature environment designated by this
operating instruction manual.
(USA): According to the federal law, this product can only be sold by doctors or based on
prescriptions.
18.9 Airway Obstruction

When the anesthetic gas airway is obstructed, on the screen there will be such a prompt message
as “The anesthetic gas airway is obstructed”; under such a circumstance, replace the Nomoline
159

sampling tube.
Warning
Do not use the ISA gas analyzer together with a quantitative spraying agent or
pulverization treatment; otherwise it may result in the clogging of the germ filter.
18.10 Discharging Waste Gases

When nitrous oxide and/or an anesthetic gas is used, you should prevent these gases from
polluting the operating room. Usually the gas discharging outlet should be connected to (via the
gas discharging pipe connected to the sample gas outlet of the host equipment):
A discharging system (used for discharging collected gases) or the patient circuit (used for the
back flowing of collected gases).
Warning
Anesthetics: When an anesthetic which is being used or a patient who recently used an
anesthetic is measured, the gas discharging hole on the module must be connected to a
waste gas processing system or the patient circuit (on the anesthesia machine or the
respirator), so as to prevent medical personnel from inhaling the anesthetic.
18.11 Consumables
The Nomoline sampling tube cannot be used repeatedly.
Replace the Nomoline sampling tube every two weeks or when “The sampling tube is clogged” is
displayed (based on whichever comes first).
18.12 Safety Symbol Information

Reminding Symbol Text, Color Code and
Description
Symbol Description Text Format
“Warning” refers to a dangerous situation which may

Warning: Supplementary text. cause personal injury or death. A warning symbol
should be in conformity with: ISO 7010-W001.
160

Operation Instructions Please refer to operation instructions
ISA operating instructions Please refer to ISA operating instructions
Catalog number
Serial number
Lot No.:
Effective period: The equipment can no longer be run after the date
[YYYY-MM-DD] nearby the symbol.
Temperature limitation
Pressure limitation
Humidity limitation
No repeated usage
Waste electronic and electrical Electrical and electrical equipment which should be
equipment (WEEE) directives reclaimed in accordance with 2002/96/EC directives
Containing Pb
Applicable to IRMAXL oxygen

sensors
In conformity with 93/42/EEC medical equipment

European Union directives when connected to medical equipment
0413 approved by PHASEIN AB
Waterproof rating Waterproof performance indicated by IP classification
Provide protection for tools and short wire ends

Level of protection from water
(>1mm).
inflow and solid foreign objects
Provide protection for water spraying towards all
indicated by IP classification
directions.
Warning (USA): According to the federal law, this

Sold based on prescriptions product can only be sold by practicing medical
personnel or based on prescriptions.
Recommended storage
Applicable to IRMA XL oxygen sensors
temperature
Below room temperature (23°C), the maximum

Limited temperature rise
surface temperature of the probe is:
161

- IRMA CO2, 41°C/106°F
- IRMA OR，45°C/113°F
- IRMA AX+，50°C/122°F
Carbon dioxide ISA equipment measures CO2 only
Multi-gas (AX+ or OR+) ISA equipment can measure multiple gases设
PHASEIN Sigma multi-gas technology is applied in

Sigma multi-gas technology
the product
Gas inlet
Gas outlet (discharge)
Illustration of the connection of Nomoline to the

{Patient circuit connection
patient circuit
Connected to ISA Illustration of the connection of Nomoline to ISA
Non germ free, no containing This product is not a germ free device, does not
latex contain latex.
18.13 Patents and Trademarks

(1) Patent Statement
PHASEIN AB owns the following patents for relevant products described in this operating
instruction manual: SE519766; SE519779; SE523461; SE524086. Other patents are being
applied.
(2) Trademark
PHASEIN IRMA™, PHASEIN ISA™, PHASEIN XTP™, Sigma Multigas Technology™,

LEGI™, Nomoline™, IRMA EZ Integrator™, PHASEIN GasMaster™ and ISA
MaintenanceMaster™ are trademarks of PHASEIN AB.
Tygothane® is a registered trademark of Saint-Gobain Performance Plastics Corporation.
18.14 Maintenance
The user should verify gas readings regularly; If finding any problem, please contact an engineer
162

of the manufacturer for maintenance.
18.15 Cleaning the Analyzer

The “Plug in and measure” ISA sidestream gas analyzer should be cleaned regularly. Use ethanol
or isopropyl alcohol with a maximum concentration of 70% and a wet rag to clean the analyzer..
In order to prevent the cleaning liquid and dust from entering into the ISA gas analyzer from the
LEGI interface, the Nomoline sampling tube should be connected all the time during analyzer
cleaning.
Before cleaning the IRMA probe, take off the disposable IRMA airway adapter.
Warning
z The Nomoline sampling tube is not a germ free device. In order to prevent the
sampling tube from causing damages, please never carry out high pressure
sterilization on any part of the sampling tube.
z Never sterilize the ISA sidestream gas analyzer and the IRMA probe or soak them
into a liquid.
z The IRMA oxygen sensor and the IRMA airway adapter are not germ free devices.
Never carry out high pressure sterilization on the equipment; otherwise it will
result in equipment damage.
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Appendix I. Accessories
Please use the accessories below for this patient monitor, as recommended by the manufacturer:
Warning
Only use our cardiac electric cable and other accessories, or the instrument may be
damaged or has poor performance and safety.
Standard accessories：
No Code Name Quantity
1 040-000148-00 Ground wire 1PCS
Veterinary clamp ECG 5-leads

2 040-000061-00 1PCS
cable
3 040-000339-00 Veterinary simulation SPO2 probe 1PCS
1PCS
4 040-000343-00 Veterinary cuff #1
1PCS
5 040-000344-00 Veterinary cuff #2
Veterinary cuff #3 1PCS

6 040-000345-00

7 040-000346-00

8 040-000347-00
9 040-000328-00 BP catheter (2m) 1PCS
Swappable batteries（14.8V 1PCS

10 022-000065-00
4000mAH）
1PCS
11 040-000121-00 Veterinary TEMP probe-B1
12 220V power cord 1PCS
Optional accessories:
1 040-000007-00 50mm×20m paper reocrd 1roll

Veterinary clamp ECG 3-leads cable 1PCS
2 040-000337-00
98ME01AA605 REV:A.1
164

NELLCOR blood oxygen extension wire / 1PCS
3 009-000466-00
DOC-10
Blood oxygen probe/ Veterinary /NELLCOR 1PCS
4 040-000076-00
VETSAT® V-SAT D-YS
5 040-000012-00 Invasive blood pressure cable 2 PCS
6 040-000013-00 Invasive blood pressure sensor 2 PCS
7 099-000005-00 CO2 module REF:1015928 1 PCS

Airway adapter used for a single patient
8 040-000021-00 1 PCS
REF:6063-00
Airway adapter used for a single neonate
9 040-000022-00 1 PCS
REF:6312-00
10 040-000023-00 Cable fixing casing REF:8751-00 5 PCS
11 099-000004-00 CO2 module REF:1022054 1 PCS

Airway adapter (with a dehumidification tube)
12 040-000024-00 1 PCS
(adults/children) REF:3473ADU-00
13 040-000025-00 Module fixing clipREF:1027730 1 PCS
PHASEIN IRMA™ CO2 analyzer / IRMA CO2 1PCS
14 099-000006-00
CAT.NO.200101
PHASEIN IRMA™ Airway adapter 1PCS
15 040-000216-00
CAT.NO.106220
16 040-000193-00 Anesthesia module extension wire accessory 1PCS
17 099-000007-00 PHASEIN ISA™CO2 module /CAT.NO.800101 1PCS
PHASEIN ISA NOMOLINE sampling tube / 1PCS

18 040-000017-00
CAT.NO.108210
19 041-000129-00 Anesthesia module linked REF: 100845 1PCS
20 041-000130-00 Modura bracket REF: 100840 1PCS
21 099-000003-00 ISA™ AX+ anesthesia module/ CAT.NO.800601 1 PCS
22 040-000017-00 NOMOLINE 采样管/ CAT.NO.108210 5 PCS
165

Appendix II. Specification
Monitor type
Name Type
belongs to Class I, Type CF application part, Type BF application
part anti-defibrillator devices with internal power supply Among
classified by electric shock
which except for the cardiac electrophysiologic detecting part, which
protection
belongs to Type CF application part, other detecting part belong to
Type BF application part
IEC 60601-1; IEC 60601-2-27 and GB 9706.25;
Safety standards IEC 60601-1-2 and YY 0505; IEC 60601-2-30 and YY 0667;
IEC 60601-2-49 and YY 0668; YY 91079.
anti-leakage extent Common seal apparatus, without anti-leakage character
Disinfection / sterilization
Refer to Chapter 10 -16for details
methods
work mode Continuous
2. Monitor Specifications
(1) Size and weight
Name Specifications
Size: 344.5mm×291 mm×165mm
Size and weight
Weight: 4. 5kg
(2) Environment requirement

Name Specifications
Environment temperature range 5℃～40℃
Relative humidity range ≤80%
Working
Atmospheric pressure range 86kPa～106kPa
environment
Power frequency 50Hz/60Hz
Input 70VA
Transport: Must avoid severe shock ,vibration, rain and snow during transport
Packed monitors must be stored in well ventilated rooms with -10℃～+40℃
Storage
temperature, relative humidity no more than 80%, and without corrosive gases
(3) Displayer specification

Name Specifications
display 12.1 inches color LCD displayer
166

display information Maximum7 waveforms display
Resolution 800×600
(4) Battery
Name Specifications
Battery Specifications 12V Lithium Battery
In fully-charged normal-using conditions, battery can continuously
Working time
work for at least 4 hours.
(5)Record
Name Specifications
width of chart paper 50mm
valid width of recorder 48 mm
Paper speed 25/50 mm/s
settings of realtime record 3 sec,5 sec, 8 sec, connection

tracing waveform 2 channels
alarm trigger record yes
(6) ECG Specification

Name Specifications
big: 15～350bpm;
Range and accuracy of heart rate
small: 15～350bpm
detection
±1% or ±1bpm (both maximum)
big: Upper limit of alarm 21bpm～350bpm
lower limit of alarm 15bpm～344pm
Upper and lower limits and error
small: Upper limit of alarm 21bpm～350bpm
of alarm
lower limit of alarm 15bpm～344bpm
Error of alarm should be setting value±1bpm
Heart rate alarm occurring time ＜12s
Monitoring mode: 0.5～40Hz;
cardiac electrophysiology
Diagnostic mode: 0.05～130Hz;
channel bandwidth
Surgical mode: 1～20Hz.
Lead selection Standard 3,5
Lead mode Five lead (R, L, F, N, C or RA, LA, LL, RL, V)
Lead mode 3 leads ( R, L, F or RA, LA, LL)
Lead fashion I, II, III
Electrode disconnection Automatic detection display
167

Indication
Scanning speed 12.5、25、50mm/s
Gain selection ×1/4、×1/2 、×1、×2、×4
Cardiac Electrophysiology
≤30μVP-P.
Noise level
≤0.1μA
Input loop current
Input impedance ≥5MΩ
common mode rejection ≥105dB
ratio(CMRR)
Monitoring, surgical mode: ≥0.3s;
Time constant
Diagnosis mode: ≥3.2s.
protection for defibrillator
Recovery time no more than 5s after resetting
discharge
Heart rate algorithm

When testing according to YY 1079 Part 4.1.2.1c，heart rate device will
Tall T wave inhibit all QRS wave groups whose amplitudes are below
Inhibition 1.0mV,100ms ,and T wave whose intervals are 180ms and Q-T intervals
350ms
According to the requirement of YY 1079 Part 4.1.2.1 d，average heart
rate is calculated with following methods : if the last successive RR
Average heart rate intervals are over 1200ms，get the average of the 4 closest RR intervals to
calculate heart rate；otherwise，get the 12 closest RR intervals，remove
the max and min，then calculate the average of them
According to the requirement of YY 1079 Part 4.1.2.1 e，after 20 sec of a
Heart rate calculation stabilizing period, the heart rate value is displayed as:
accuracy and figure 3 a) (coupled rhythm) 80±1bpm;
response to figure 3 b) (slowly varying coupled rhythm) 60±1bpm;
arrhythmia figure 3 c) (quickly varying coupled rhythm) 120±1bpm;
figure 3 d) (Two-way contraction) 90±2bpm。
Time of response to According to the requirement of YY 1079 Part 4.1.2.1 f, heart rate rise
heart rate variation from 80 to 120bpm: in less than 10s；from 80 to 40bpm: in less than 10s。
According to the requirement of YY 1079 Part 4.1.2.1 g，waveform:
figure 4 a) 1-range: 10s；
Time of initiation of figure 4 a) 0.5-range: 10s;
alarm of tachycardia figure 4 a) 2-range: 10s;
figure 4 b) 1- range: 10s;
figure 4 b) 0.5- range: 10s;
168

figure 4 b) 2- range: 10s.
(7)SpO2 specification
Name Specifications
Detection range and 0～300bpm , accuracy ±1bpm
accuracy
Display Resolution 1%
Detection accuracy Within range of 90%～100%，measurement error should be±1% (No
state of motion);
Within range of 70%～90%, measurement error should be±2% (No
state of motion).
Upper and lower limit NELLCOR: Upper limit of alarm: 1%～100%
of alarm preset and Lower limit of alarm: 0%～99%
accuracy Error of alarm should be setting value±1%
Simulate: Upper limit of alarm: 3%～100%
Lower limit of alarm: 0%～99%
Error of alarm should be setting value±1%
PR range and accuracy Comen

range：20 - 254bpm
accuracy：± 3 bpm
　 Masimo
range：25 - 240 bpm
accuracy：± 3 bpm (no movement)
± 5 bpm(no movement)
　 Nellcor
range：20 - 300bpm
accuracy：20 - 250 bpm： ± 3 bpm
（8）NIBP specification
Name Specifications
Measuring
Automatic oscillation
mode
Systolic blood pressure 40-270mmHg
Measurement
Measurement Diastolic blood
range and 10-210mmHg
range for big pressure
accuracy
Mean blood pressure 20-230mmHg
169

Systolic blood pressure 40-200mmHg
Measurement
diastolic pressure 10-150mmHg
range for small
Mean blood pressure 20-165mmHg
±5mmHg, when non-invasive BP exceeds the above
Accuracy range, the monitor can still display normally, but
without accuracy
Range and Scope: should be 0mmHg～300mmHg。
accuracy of
accuracy should be±3mmHg
static pressure
Range and Big mode 300mmHg
tolerance of Small mode 150mmHg
overvoltage
protection tolerance ±3mmHg
Systolic blood Upper limit 46-270mmHg

pressure Lower limit 40-264mmHg
Big Mean blood Upper limit 26-230mmHg
diastolic Upper limit 16-210mmHg
Range and pressure Lower limit 10-204mmHg
error of alarm Systolic blood Upper limit 46-200mmHg
preset pressure Lower limit 40-194mmHg
Small Mean blood Upper limit26-165mmHg
diastolic Upper limit 16-150mmHg
Error ±0.1kPa or±1mmHg (Both maximum)
NIBP
measurement 2000 NIBP measurementdata
recall
（9）TEMP specification
Name Specifications
Detection range 0℃～50℃
Measurement range and
Measurement
accuracy ±0.1℃
error
Alarm setting Upper limit of alarm should be 0.1℃～50.0℃
Alarm setting and
range Lower limit of alarm should be 0℃～49.9℃
accuracy
Alarm error ±0.1℃
Display Resolution 0.1°C
170

（10）Respiration specification
Name Specifications
Way Thoracic impedance method
Big 6bpm-120bpm
Respiration rate Measuring range
Small 6bpm-150bpm
detection and accuracy
Accuracy ±1bpm
Upper limit not
8bpm-120bpm
narrower than
Big
Lower limit not
6bpm-118bpm
Accuracy and error of narrower than
preset alarm of Upper limit not
8pm-150bpm
respiration rate narrower than
Small
Lower limit not
6bpm-148bpm
narrower than
Error ±1bpm
Range and error of
Scope: 10s～40s，and no alarm
suffocation alarm
（11）CO2 specification
Name Specifications
CO2’s range of
0mmHg～150mmHg, And air pressure is supplied by the mainframe.
measurement
CO2’s resolution 1mmHg or 0.1kPa or 0.1%
Gain ×0 .25 、×0.5、×1、×2、×4
Unit mmHg、KPa
±2mmHg between 0mmHg ～40mmHg ;
±5% between 41mmHg ～70mmHg;
CO2’s accuracy
±8% between 71mmHg ～100mmHg;
±10% between 101mmHg～150mmHg
Atmospheric
400～850mmHg/0～ 5029.2 M
pressure/altidude
O2 compensation 5～100 mmHg
Range of alarm set and 0~ 150mmHg/0～20 KPa；
error of alarm set ±1mmHg/±0.1 KPa。
Wave speed 2.5mm/s、25 mm/s
Equilibrium gas N2O,indoor air ,Helium
171

（12）IBP Specifications
Name Specifications
Number of IBP channel 2 channels
Artery pressure(ART), pulmonary artery pressure(PA), central vein
Names of channel
pressure(CVP), right atrial pressure(RAP), left atrial pressure(LAP),
pressure
intracranial pressure(ICP), plus pressure(P1,P2).
ART 0～40kPa（0～300mmHg）
PA -0.8～16kPa(-6～120 mmHg)
CVP -1.3～5.3kPa(-10～40mmHg)
Range and accuracy of
RAP -1.3～5.3kPa(-10～40mmHg）
measurement
LAP -1.3～5.3kPa(-10～40mmHg)
ICP -1.3～5.3kPa (-10～40mmHg)
P1，P2 -1.3～40kPa(-10～300mmHg)
error of IPB’s alarm set ±0.1 or ±1mmHg of the set value
sensitivity: 5μV/V/mmHg
pressure sensor
range of impedance: 300～3000Ω
（13） AG Specifications
Name Specifications
AG measurement feature of infrared radiation absorption
CO2：1mmHg
AG resolution
awRR：1rpm
CO2 , O2, N2O and one of five anesthetics (Enflurane, isoflurane,
AG gas
sevoflurane, halothane, desflurane)
Alarm
range accura-cy
specification step
upper limit (lower limit ＋
2)~76mmHg
EtCo2 1mmHg ±1mmHg
lower limit 0~ (upper limit －
2)mmHg
2)~76mmHg
range and accuracy of FiCo2 1mmHg ±1mmHg
AG alarm set
2)mmHg
2)~100rpm
AwRR 1rpm ±1rpm
2)rpm
upper limit (lower limit ＋2)
EtO2 20~100% 1% ±1%
lower limit 18~ (upper limit
172

－2)%

2)~100%
FiO2 1% ±1%
lower limit 18~ (upper limit
－2)%
20~100%
EtN2O 1% ±1%
2)%
20~100%
FiN2O 1% ±1%
2)%
EtHal/EtEnf/EtI 0.2) ~25%
0.1% ±0.1%
So/EtSev/EtDes lower limit 0~ (upper limit －
0.2)%
FiHal/FiEnf/FiI
0.2) ~25%
So/FiSev/FiDes 0.1% ±0.1%
v
0.2)%
173

Appendix III. Description of System
Alarm Prompt
PROMPT MESSAGE CAUSES SOLUTIONS
XX is higher than the upper limit value
"XX is too high " Check whether the alarm limit values are
of alarm limit.
suitable, and the current status of the
XX is lower than the lower limit value
"XX is too low" patient.
of alarm limit.
XX means all parameter values in such systems as HR, ST1, ST2, RR, SPO2, IBP and NIBP.
The patient's ECG signal is too small, Check whether the electrode and lead
"ECG signal is too weak " so the system can’t do ECG signal cable are connected correctly, and the
analysis. current status of the patient.
The patient's pulse signal is too small,
Check the connection of the sensor, and
"Pulse is not found " so the system can’t do pulse signal
the current status of the patient.
analysis.
The patient's RESP signal is too small,
Check the connection of the lead cable,
"RESP apnea" so the system can’t do RESP signal
and the current status of the patient.
analysis.
Check the current status of the patient,
The patient suffers from arrhythmia of a
"ASYSTOLE " and whether the electrode and lead cable
systole.
are connected correctly.
The patient suffers from arrhythmia of
"VFIB/VTAC " and whether the electrode and lead cable
VFIB/VTAC.
"COUPLET (two PVS)" and whether the electrode and lead cable
two PVS.
"BIGEMINY (PVS bigeminy)" and whether the electrode and lead cable
PVS bigeminy.
"TRIGEMINY (PVS trigeminy)" and whether the electrode and lead cable
PVS trigeminy.
"R ON T" and whether the electrode and lead cable
R ON T.
"PVC (single PVS)" and whether the electrode and lead cable
single PVS bigeminy.
"TACHY (tachycardia)" The patient suffers from tachycardia.
and whether the electrode and lead cable
174

"BRADY (bradycardia)" The patient suffers from bradycardia. and whether the electrode and lead cable
"VT>2 (multiple PVS)" and whether the electrode and lead cable
multiple PVS.
"MISSED BEATS" and whether the electrode and lead cable
missed beat.
Check the connection of the pacemaker,
the current status of the patient, and
"PNP (Pacemaker not paced)" The pacemaker doesn’t pace.
whether the electrode and lead cable are
connected correctly.
"PNC (Packer not captured)" No pacemaker signal is captured. and whether the electrode and lead cable
"ECG lead disconnected" ECG lead cable is not joined well. Check the connection of ECG lead cable.
Check the connection of ECG V-lead
"ECG V lead disconnected" ECG V-lead cable is not joined well.
cable.
Check the connection of ECG LL-lead
"ECG LL lead disconnected" ECG LL-lead cable is not joined well.
cable.
Check the connection of ECG LA-lead
"ECG LA lead disconnected" ECG LA-lead cable is not joined well.
cable.
Check the connection of ECG RA-lead
"ECG RA lead disconnected" ECG RA-lead cable is not joined well.
cable.
Check the connection of ECG C-lead
"ECG C lead disconnected" ECG C-lead cable is not joined well.
cable.
Check the connection of ECG F-lead
"ECG F lead disconnected" ECG F-lead cable is not joined well.
cable.
Check the connection of ECG L-lead
"ECG L lead disconnected" ECG L-lead cable is not joined well.
cable.
Check the connection of ECG R-lead
"ECG R lead disconnected" ECG R-lead cable is not joined well.
cable.
"SPO2 sensors fall off " SPO2 sensor is not joined well. Check the connection of SPO2 sensor.
SPO2 sensor is not joined well, or the Check the connection of SPO2 sensor
"Searching pulse"
patient moves his arms. and the current status of the patient.
"TEMP sensors fall off " TEMP sensor is not joined well. Check the connection of TEMP sensor.
"IBP lead disconnected" IBP sensor is not joined well. Check the connection of IBP sensor.
"IBP needs zeroing" IBP needs zeroing before measurement. Zero pressure for IBP.
175

Check the connection of ECG R-lead
Stronger interference signal appear in
"ECG interference too strong " cable, the current status of the patient and
ECG signal.
whether more actions happen.
"XX module initialization wrong Error X appears when XX module is
X" initialized.
Restart the monitor for trial. If errors still
"XX module communication XX module can’t communicate with the
exist, please contact the manufacturer for
stop" main system normally.
maintenance.
"XX module communication XX module can’t communicate with the
wrong " main system normally.
XX means all parameter modules in the system such as ECG module, NIBP module, SPO2 module, IBP module and etc.
The alarm limit of XX parameter is Contact the manufacturer for
"XX alarm limit wrong "
changed accidently. maintenance.
The measured value of XX parameter
Contact the manufacturer for
"XX measurement out of scope " goes out of the range of measurement
maintenance.
by the system.
XX means the names of all parameters in the system, such as HR, ST1, ST2, RR, SPO2, IBP, NIBP and etc.
If the system time is 2000-1-1, the Reset the system time. After resetting,
"The real-time clock needs
system will remind users that this time please restart the monitor for fear of
resetting.”
is wrong. unnecessary time error being saved.
"The real-time clock doesn’t No button batteries exist in the system
Increase or change the button battery.
exist " or the batteries have no charge.
"System failure: software"
" System failure: cmos full"
" System failure: cmos err"
" System failure: fpga"
" System failure 2"
" System failure 3"
" System failure 4"
" System failure 5"
" System failure 6"
" System failure 7"
" System failure 8"
" System failure 9"
" System failure 10"
Please check whether the keys are held
on to artificially or other articles. If no
"Keyboard unusable "; The keys on the keyboard are unusable. abnormal pressing is found, please
contact the manufacturer for
maintenance.
"Communication with keyboard Please contact the manufacturer for
The keyboard fails, so it is unusable.
wrong "; maintenance.
176

"Key wrong ";
" Keyboard wrong 1";
" Keyboard wrong 2";
"Network initialization wrong
(G.)"
" Network initialization wrong
(Ram)"
(Reg)" Something wrong happens to the
Please contact the manufacturer for
" Network initialization wrong network of the system so the system
maintenance.
(Mii)" can’t start network function.
(Loop)"
" Network wrong (Run1)"
"5V voltage too high"
"5V voltage too low"
"Power system wrong 3"
" Power system wrong 4"
Please contact the manufacturer for
"12V voltage too high " Something wrong happens to the power
maintenance if such a prompt appears
"12V voltage too low " supply of the system.
frequently.
"3.3V12V voltage too high "
"3.3V voltage too low "
" Button battery voltage too Something wrong happens to the button
high" battery. Please replace the battery. If the fault still
The button battery is short of charge or exists, please contact the manufacturer
"Button battery voltage too low.
it is not fixed or the connection of for maintenance.
Please change it."
button battery is loose.
In the recorder-setting menu, start the

record-deletion function that can make
The system fails in connection with the the upper machine and the lower machine
"Recorder self-check wrong "
recorder module in self-check. reconnected. If the fault still exists,
please contact the manufacturer for
maintenance.
"Recorder voltage too high" Please contact the manufacturer for
The recorder module voltage fails.
" Recorder voltage too low" maintenance.
177

After the recorder is fully cooled, do the
Maybe the continuous recording time is record output. If the fault still exists,
"Recorder head too hot "
too long. please contact the manufacturer for
maintenance.
"The position of the recorder The paper-pressing handle of the Depress the paper-pressing handle of the
head wrong " recorder doesn’t work. recorder.
"Recorder short of paper " There is no record paper in the recorder. Install the record paper.
Place the recorder correct first and then
"Recorder having paper jam " The recorder has a paper jam.
start recording.
"Recorder communication wrong In the record setting menu, start the
" record-deletion function that can make
The recorder communication is not the upper machine and the lower machine
"The serial port of recorder normal. reconnected. If the fault still exists,
wrong in communication” please contact the manufacturer for
maintenance.
"The paper position of recorder The paper is not placed correctly in the Re-place the corder paper rolls at the
wrong " recorder. correct location.
In the record setting menu, start the
record-deletion function that can make
the upper machine and the lower machine
"Recorder unusable " The recorder can’t be communicated.
reconnected. If the fault still exists,
maintenance.
"NIBP initialization wrong " Select the resetting function in NIBP

NIBP initialization is wrong. menu. If the error persists, please contact
"NIBP self-check wrong "
the manufacturer for maintenance.
Please do measurement again after
checking the air path of NIBP and
Abnormal resetting happens when NIBP
"NIBP resetting wrong " whether there is air jam. If the error
is measured.
persists, please contact the manufacturer
for maintenance.
Select the resetting function in NIBP
Something wrong happens to the NIBP
"NIBP communication wrong " menu. If the error persists, please contact
communication.
the manufacturer for maintenance.
"Cuff too loose or not joined " NIBP cuff is not joined well. Please reconnect the NIBP cuff.
Please check the connection of all parts
NIBP cuff is not joined well, or the air or replace a cuff. If the error persists,
"Cuff gas tube leaked "
path is leaked. . please contact the manufacturer for
maintenance.
Something wrong happens to the Please check the connection of all parts
measuring curve so that the system can or replace a cuff. If the error persists,
"Air pressure wrong"
do measurement, analysis and please contact the manufacturer for
calculation. maintenance.
178

After inspecting whether patient type is
Something wrong happens to the
set correctly, please check the connection
measuring curve so that the system can
"Signal too weak " of all parts or replace a cuff. If the error
do measurement, analysis and
calculation.
for maintenance.
Something wrong happens to the Please check the connection of all parts
measuring curve so that the system can or replace a cuff. If the error persists,
"Pressure out of scope "
do measurement, analysis and please contact the manufacturer for
calculation. maintenance.
checking the connection of all parts and
"Arms movement " The patient’s arm moves. the patient's condition. If the error
for maintenance.
checking whether the air path is smooth
Maybe the air path has once been
"Overpressure protection " and the patient’s condition. If the error
folded.
for maintenance.
"Signal saturated " the patient's condition. If the error
calculation.
for maintenance.
"Measurement time-out " the patient's condition. If the error
calculation.
for maintenance.
After inspecting whether patient type is
set correctly, Please check the connection
Maybe the cuff doesn’t accord with the
"Cuff type wrong " of all parts or replace a cuff. If the error
set patient type.
for maintenance.
Please check the connection of all parts
or replace a cuff. If the error persists,
"Pump with air leakage " NIBP air path is leaked.
maintenance.
"NIBP measurement failure " the patient's condition. If the error
calculation.
for maintenance.
"NIBP system failure " Something wrong happens to the Please do measurement again after
179

measuring curve so that the system can checking the connection of all parts and
do measurement, analysis and the patient's condition. If the error
calculation. persists, please contact the manufacturer
for maintenance.
180

Shenzhen Comen Medical Instrument Co., Ltd.
www.szcomen.com
Floor 7, Block 5, 4th Industrial Area of Nanyou, Nanshan District, Shenzhen, China
Tel: +86-755-26408879 Fax: +86-755-26401232

Multi-Parameter Veterinary Monitor: Shenzhen Comen Medical Instruments Co., LTD

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Multi-parameter Veterinary monitor

Shenzhen Comen Medical Instruments Co., Ltd.

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Responsibility of the Manufacturer

♦ Assembly operations, extensions, re-adjustments, improvements and repairs are all

♦ The related electrical equipment complies with the national standards

This device is not intended for treatment.

Guide to Labels in the Manual

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During defibrillation don’t touch patients, tables and the machine.

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1.1 General Information

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Figure 1-1 Multi-parameter Patient Monitor

1.2 Button Functions and Basic Operations

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1.3 Screen display

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Figure 1-2 Main screen display

Information Area (①):

Connection state of CMS (central monitoring system) : when displaying , no

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Visual alarm and alarm status

Waveform Area (②)

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Figure 1-3 Main Screen

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—Air Way Respiration Rate (AWRR)（○

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1.4 External Socket

1.4.1 Left Panel

Fig 1-4 Recorder

1.4.2 Right Panel

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⑩ ICG or Anesthesia Gas（optional） Fig 1-5

1.4.3 Rear Panel

There are the following soclets in the rear panel:

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Fig 1-7 rear panel socket

Fig 1-6 ③ Panel

1.5 Built-in charge battery

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2.1 Open Package and Check

2.2 Connect with AC Cable

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Reboot the equipment at least 1 minute after shut down.

2.4 Connect with Sensor

2.5 Check Recorder

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Fig 3-1 Main Menu

3.1 PATIENT MANAGE

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