Mindray DPM 1 Návod k obsluze

Central Monitoring SystemOperator’s Manual

2 FOR YOUR NOTES

9-6  Selecting waveforms to be saved By clicking the “Wave Save” button, you can select waveforms to be saved for each patient as desired followi

9-7 Showing/Hiding Parameter Click the “Numeric Data” or “Hide Numerics” button, the non-compressed waveform area will respectively display the patie

9-8 Within the time bar, there is a black line indicating the time moment to which the current cursor corresponds. While moving the cursor along th

9-9  Waveform Time Display Area In this area, waveform start time and end time are respectively shown at leftmost and rightmost; the current curs

9-10  Selecting Sweep Speed By clicking the “Sweep Speed” button, you can set the width of waveforms displayed in the waveform area. Available op

9-11 9.1.4 C.O. Review 9.1.4.1 Overview Clicking the “C.O. Review” tab will enter a tab sheet, through which you can view up to 720 C.O. measuremen

9-12 9.1.5 Event Review 9.1.5.1 Overview Clicking the “Event Review” tab will enter the following tab sheet, through which you can view all event p

9-13 9.1.5.2 Operation In the “Event Review” window, you can:  Select event type and alarm priority  Sequence the event list  Lock and unlock

9-14 Making Selection You can select single, multiple or all events in event list:  Select one event: Click one event you wish to select.  Sele

9-15 Export to EMR Select one event from event list, and then click “Export to EMR” button. The event related data can be exported to other systems

3 Contents 1 Safety...

9-16 9.1.6.2 Operation In the ST review window, you can:  View ST segment  Set reference ST segment  Select reference ST segment  Delete re

9-17 Setting Trend Parameter You can click the “Trend Parameter” drop-down list to select two different trend parameters and “Zoom” drop-down list

9-18 9.2.1 All Patients 9.2.1.1 Overview In the “All patients” tab sheet, you can view discharged patients’ data of all CMSs on the network. Brief

9-19 Deleting Discharged Patient 1. In the “Delete or not” column, select the check box corresponding to the patient that you want to delete. 2. C

9-20 FOR YOUR NOTES

10-1 10 Calculation NOTE z If the version of currently used CMS system software is lower than 3.0, some of calculation results will be deleted or

10-2 Calculate From the “Name” drop-down list below, you can select one to calculate its amount, liquid volume, concentration, etc.  Drug A 

10-3 WARNING z Be sure to input correct parameter values. The user must verify the correctness of the calculations displayed on the screen before

10-4 10.2 Hemodynamics Calculation Clicking the “Hemo Calcs” tab will enter the tab sheet. The “Calculated Results List” shows the time correspond

10-5 Save Results The CMS is capable of saving 100 calculations for each patient. To save calculations, you can click the “Save Results” button aft

4 5 Patient Management... 5-1 5.1 Admitting Pati

10-6 Calculate 1. Input parameter values needed into the “Input Item” area. 2. Pressure unit, Hb unit and Oxygen content unit can be changed by s

10-7 10.4 Ventilation Calculation Clicking the “Ventilation Calc.” tab will enter the tab sheet. The “Calculated Results List” shows the time co

10-8 NOTE z If you continue to perform the “Save Results” operation when the number of calculations exceeds 100, the system will delete the earlie

10-9 Calculate 1. Input parameter values needed into the “Input Item” area. 2. Click the “Calc” button. The calculations of other parameters will

10-10 FOR YOUR NOTES

11-1 11 Record, Print and Save as 11.1 Record As shown in the figure below, the CMS can be equipped with a thermal recorder, which, with a separat

11-2  Patient Information  Drug Calculations  Hemodynamics Calculations  Oxygenation Calculations  Ventilation Calculations  Renal Calc

11-3 Installing Procedure To install recorder paper, follow the steps shown in Figure 11-3 through Figure 11-8: 1. Open the recorder door, and ope

11-4 11.1.2 Recorder Operations Recording Patient Information 1. Enter the “Patient Mgmt.” tab sheet. 2. Make sure that the patient information is

11-5 Recording Normal Waveforms 1. Enter the “Waveform Review” tab sheet. 2. Click the “Full Size” button. 3. Click the “Record” button. 4. Sele

5 7.4.10 Show/Hide Alarm High/Low Limits ... 7-7 7.4.11 Show/Hide Dynamic Short Trend ..

11-6 Recording CCO Hemodynamic Parameters 1. Enter the “ViewBed” tab sheet. 2. Select and then click CCO parameter area. 3. Select the “CCO” tab

11-7 11.1.3 Recording Control By clicking “System Setup” then “Recording Control”, you can enter a tab sheet. In this tab sheet, the current tasks

11-8 11.2 Print 11.2.1 Printing Support The CMS can be connected with a local printer or network printer to print out reports. With a separate powe

11-9  ST segment waveform  Real-time report  12-lead ECG report  Multi-lead ECG report  EEG report  ICG Hemodynamic Parameters  CCO He

11-10 Printing Oxygenation Calculations 1. Enter the “Oxygenation Calc.” tab sheet. 2. Perform oxygenation calculation per part 10.3 Oxygenation

11-11 Printing Normal Waveforms 1. Click the “Waveform Review” tab sheet. If compressed waves are displayed, click the “Full Size” button in the l

11-12 Printing Event Table 1. Enter the “Event Review” tab sheet. 2. Click the icon on the “Print” button under the eventalarm list and select “

11-13 Printing in Real-time 1. Enter the “ViewBed” tab sheet. 2. Click the “Print” button. 3. Select the desired waveforms from the pop-up dia

11-14 Printing ICG Hemodynamic Parameters 1. Enter the “ViewBed” tab sheet. 2. Select and then click ICG parameter area. 3. Select the “ICG” tab

11-15 11.2.4 Printing Control By clicking “System Setup” then “Printing Control”, you can select local printer or network printer from the printer

6 10.1 Drug Calculation ... 10-1 10.2 Hemodynam

11-16 11.3 Save as The CMS can save the following items as html files:  Graphic trends  Tabular trends  Waveform review  C.O. Review  Eve

11-17 Graphic Trends 1. Enter the “Trend Review” tab sheet. 2. If tabular is currently displayed on the screen, click the “Graphic” button. 3. C

11-18 C.O. Review 1. Enter the “C.O. Review” tab sheet. 2. Select the C.O. measurements to be saved per part 9.1.4 C.O. Review 3. Click the “Sav

11-19 Hemodynamics Calculation 1. Enter the “Hemo Calcs” tab sheet. 2. Perform hemodynamics calculation per 10.2 Hemodynamics Calculation. 3. Cli

11-20 FOR YOUR NOTES

12-1 12 System Setup 12.1 General Setup Clicking the “System Setup” will access a tab sheet. The CMS has three levels of setup:  Low level:

12-2 Set Unit You can set unit for each parameter of the following modules as required: Module Parameter Options Defaults IBP IBP mmHg, kPa, cmH2

12-3 12.2 Admin Setup Click the “Admin Setup” button in the “General Setup” tab sheet. The Input Password dialog box will pop up. After inputting t

12-4 12.2.2 Display Setup You can set screen size, number of main screen /display layout, multibed view window, and auxiliary window. Screen Size

12-5 Multibed Display Select/deselect the check box before “Measurement Units” to show/hide parameter units on the multibed screen. Select/desel

7 13.4.3 Authorization... 13-5 13.5 Viewing Remote CMS

12-6 12.2.3 Alarm Click “Alarm” to open a dialog box. Turn off Alarm Sound Refer to Section 8.11 CMS Audio Alarm Off. Switch on/off Alarm Off R

12-7 Select Stored Waveforms In the “Alarm” tab sheet, you can select the relevant waves stored when alarms occurred to the specific parameter. 1.

12-8 12.2.5 Monitor List Clicking the “Monitor List” will enter a tab sheet, which lists all the monitors in the LAN including the monitors admitte

12-9 12.2.6 Log Clicking the “Log” tab will enter a tab sheet, which records the operating status of the CMS providing the convenience for the serv

12-10 12.2.7 Telemetry If your CMS is connected with telemetry monitors, select the “Telemetry” tab, you can set the following items in an opened t

12-11 Frequency Setup Select frequency range: 1. You can select the appropriate frequency segment from “Freq Segment”. The minimum “Start Freq” an

12-12 12.2.8 Other Clicking the “Other” tab will enter a tab sheet. In this tab sheet, you can turn on or off the following options:  Password n

12-13 Change User Password 1. Click the “Change User Password” button. The dialog box will be displayed. 2. Input old password and new password b

12-14  Automatically change time 1. Click “Change Time” button, and the dialog box will be displayed. 2. Set “Time Synchronization” to “On”. 3.

12-15 Gateway Communication Setting Gateway communication setting menu provides three (3) tabs which are Network Setup, Authorization Setup and Ser

8 FOR YOUR NOTES

12-16 NOTE z The "Obtain Patient Information" button is available on the patient management screen only when“ADT Query”is set to “Enable”

12-17 Remote Control Settings Remote Control Settings menu is used to set up alarm paused, silence, alarm latched, privacy mode and night mode. 

12-18 FOR YOUR NOTES

13-1 13 Remote CMS 13.1 Overview In the event that there are multiple CMSs in a LAN, the CMS can view a single patient connected to the target CMS

13-2 13.2.1 Beds List The beds list displays the information about all CMSs and networked bedside monitors (target monitors) in the same network se

13-3 13.2.4 Alarm Icon Area This area displays icons for alarm pause , alarm off , alarm audio off , alarm audio paused or alarm silenced ,moni

13-4 13.4 Network Setup and Authorization 13.4.1 IP Address Setup To implement the Remote CMS function between CMSs, each CMS needs to be equipped

13-5 Select “System Setup” → “Admin Setup” → “Other” → “Gateway Communication Setting” → “Network Setup” and set as follows: 1. Select network car

13-6 Figure 13-2 VPN Networking When the VPN network is set up, you can directly connect one of the network interface cards of the CMS with LAN p

14-1 14 Database Backup and Recovery 14.1 Overview The CMS provides database backup and recovery. The CMS will shut off automatically during dat

1-1 1 Safety 1.1 Safety Information The safety statements presented in this chapter refer to the basic safety information that the operator of the

14-2 14.2 Backup Database 14.2.1 Select Operation Type When you run the “Database Backup and Recovery” program, a dialog will pop up for you to s

14-3 14.3 Recover Database CAUTION z The recovered database will overwrite the current one. Make sure whether you need to backup the current da

14-4 14.4 Rebuild Database After the “Database Backup and Recovery” program starts up, the dialog box will appear. Select “Rebuild Database”. NOTE

15-1 15 System Help 15.1 Overview The CMS features a webpage-like on-line help so that you can obtain a better understanding of the system. Click

15-2 FOR YOUR NOTES

A-1 A Technical Specifications A.1 Requirements The computer of the CMS should be highly reliable and stable. The commercial computer we recommend

A-2 A.2 Recorder Size 210×100×100 mm Weight 1 kg Type Thermal recorder Record rate: 25 mm/s, 50 mm/s Interface RS232 interface Width of the record

A-3 A.6 Calculation Drug calculation 75 calculations for single patient Hemodynamics calculation 100 calculations for single patient Oxygenation

A-4 FOR YOUR NOTES

B-1 B Central Monitoring System Alarms The CMS alarms displayed in the system alarm area on the upper screen are shown in the table below. Alarms

1-2 1.1.1 Dangers There are no dangers that refer to the product in general. Specific “Danger” statements may be given in the respective sections o

B-2 Alarms Level Cause and solution time. Wait until it cools down. Recorder Self-check Error Med Recorder Self-check Error: CPU Med Recorder Se

C-1 C Units, Symbols and Terms C.1 Units BPM beats per minute ℃ centigrade cc cubic centimeter cm centimeter cmH2O cmH2O dB decibel ℉ Fahrenheit g gr

C-2 RPM breath per minute s second V volt W Watt C.2 Symbols - minus % percent & and / per, divide, or ~ to + Plus < Less than = Equal

C-3 ABBREVIATION DEFINITIONS BC Burst count BIS bispectral index CCI Continuous Cardiac Index Cdyn Dynamic compliance CE Conformité Européenne CFI C

C-4 ABBREVIATION DEFINITIONS EtN2O end-tidal nitrous oxide EtO2 end-tidal oxygen EVLW Extravascular Lung Water ELWI Extravascular Lung Water Index

C-5 ABBREVIATION DEFINITIONS ICP intracranial pressure ICU Intensive Care Unit ID identification I:E Inspiratory time:Expiratory time ratio IEC In

C-6 ABBREVIATION DEFINITIONS pCVP Central Venous Pressure PEEP Positive end-expiratory pressure PEEP/CPAP PEEP/CPAP PEEPi Intrinsic positive end-exp

C-7 ABBREVIATION DEFINITIONS SvO2 mixed venous oxygen saturation ScvO2 central venous oxygen saturation SVR Systemic Vascular Resistance SVRI Sys

C-8 ABBREVIATION DEFINITIONS VTsigh Sigh tidal volume WOB work of breathing WOBimp Imposed work of breathing

1-3 1.1.3 Cautions CAUTION z Federal Law (USA) restricts this device to sale by or on the order of a physician.z Hospitals without stable power s

P/N: 046-001291-00(5.0)Mindray DS USA, Inc.800 MacArthur Blvd.Mahwah, New Jersey 07430USATel 1.800.288.2121Tel 1.201.995.8000www.mindray.com

1-4 CAUTION z If Windows® XP® Professional Embedded operating system is installed, please do not use the system until you have read the end user li

1-5 1.2 Equipment Symbols NOTE z Some symbols may not appear on all equipment. ATTENTION: Consult accompanying documents (this manual). CAUTI

1-6 Sound output port Sound input port Microphone port TYPE B APPLIED PART Manufacture date Serial number The following definition of the WEE

2-1 2 The Basics 2.1 Intended Use The CMS network transfers information between DPM Central Station and other networked devices. It also allows inf

2-2 2.3 Contraindications None. 2.4 Functions The CMS comprises powerful system software and high-performance computer components. It constructs a

2-3  Provides comprehensive help information, prompts and operational guide.  Provides 1280×1024 high display resolution.  Provides two wavef

2-4 2.5 Components The CMS consists of system software, computer (optional), hardware dongle, network devices (optional), recorder (optional), prin

2-5 2.6 Networking Mode The typical networking diagram of a single CMS is shown below: Figure 2-2 Central Monitoring Network  Wire n

2-6 2.7 Controls 2.7.1 Mouse The mouse is the primary means of user interaction with the CMS. Following are two basic ways to operate the mouse:

2-7 2.7.2 Keyboard The keyboard can be used to enter characters into text entry fields. To enter characters into a text entry field, position the m

I © Copyright 2010-2011 Mindray DS USA, Inc. All rights reserved. For this Operator’s Manual, the issue date is 2011-11. WARNING z Federal Law (

2-8 Radio Buttons Radio buttons can be used to select one of a group of mutually exclusive options:  ○ indicates unselected  ⊙ indicates sele

2-9 List Box The list box contains a list of options from which the user can select one or more. If there are too many options to be displayed in

2-10 FOR YOUR NOTES

3-1 3 Installation and Maintenance 3.1 Unpacking and Inspection Be careful to remove the host, displays and other components from their packaging

3-2 3.2 Installation WARNING z The CMS should be installed by manufacturer designated personnel. The copyright of the CMS software is solely owned

3-3 3.2.2 Power Requirements Each component of the CMS must be powered by the specified power source. To protect the hospital personnel from elect

3-4 Receiver 1. Connect the input port of remote equipment (such as a display or a LCD TV) with the VGA interface of OUTPUT1 or OUTPUT2 of receive

3-5 3.3 Starting the System Follow this procedure to start your system: 1. Perform safety checks before starting your system. For details, refer

3-6 3.4 Shutting down the System It is important to shut down the system properly. Follow this simple procedure to properly shut down your system.

3-7 3.5 Maintenance WARNING z Failure on the part of the responsible hospital or institution employing the use of the CMS to implement a satisfac

II Intellectual Property Statement Mindray DS USA, Inc. (hereinafter called Mindray DS) owns the intellectual property rights to this product and th

3-8 3.5.2 General Cleaning WARNING z Be sure to shut down the system and disconnect all power cords from the outlet before cleaning the equipment

3-9 To avoid damage to the equipment, follow these rules: CAUTION z Failure to follow these rules may melt, distort, or dull the finish of the ca

3-10 FOR YOUR NOTES

4-1 4 Display 4.1 Overview The central monitoring system can support single-, dual- and multi- screen display modes. The main screen and auxiliary

4-2 NOTE z In single-screen mode, maximum 16 monitors can be viewed simultaneously. If monitors connected to a CMS are more than 16 but less than

4-3 System icons include: No. Icon name Icon Description 1 Alarm List Show the alarms of all being monitored patients within the specified time ra

4-4 4.2.2 Auxiliary Screen in Single-Screen Mode Figure 4-2 Auxiliary Screen in Single-Screen Mode In single-screen mode, you can enter the auxili

4-5 4.3 Dual-Screen Mode As to the CMS which supports dual-screen mode, two displays can be connected to the host, and the two displays are respe

4-6  One Main Screen As shown below, if the number of main screen is configured to 1, the primary display on the left always shows main screen an

4-7 4.4 Multi-Screen Mode As to the CMS which supports tri-screen or quad-screen mode, three or four displays can be connected to the host. One dis

III Manufacturer’s Responsibility All information contained in this manual is believed to be correct. Mindray DS shall not be liable for errors cont

4-8 FOR YOUR NOTES

5-1 5 Patient Management The CMS enables you to manage patients by:  Admitting patient  Obtaining patient information  Patient information s

5-2 5.1.1 Admitting Patient through CMS When a monitor which has not admitted a patient is connected to the network, you can admit a patient either

5-3 The monitoring status and corresponding details are shown in the following table. Monitoring status Details The monitor is in this CMS monitor

5-4 NOTE z If you directly click on the Admit Patient button before inputting patient information, the patient information will be blank. In this

5-5 5.2 Obtaining Patient Information Obtaining patient information means to obtain patient information from the HIS system through Gateway and dis

5-6 5.3 Patient Information Synchronization When the CMS is associated with HIS system, the CMS will automatically synchronize and update the patie

5-7 5.4.2 Inconsistent Patient Information between Monitor and CMS If patient information is modified when the monitor is disconnected from the CMS

5-8  Procedure 2 (applied to both spot patients and non-spot patients): 1. Click the patient window for a spot patient or the block in the last

5-9 5.8 Transferring a Patient In the process of monitoring, a patient may be transferred from one bed (source bed) to another (destination bed). I

IV Warranty THIS WARRANTY IS EXCLUSIVE AND IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY OR FITN

5-10 NOTE z Transferring patient and combining with destination bed patient data may cause some patient data loss if the system time is inconsiste

6-1 6 Multibed Screen 6.1 Overview Each screen of the CMS can display up to 16 patient windows. In single-screen mode, you can view 16 patients on

6-2 6.2 Patient Window 6.2.1 Non-Spot patient window The non-spot patient window shows information including bed number and status for each monitor

6-3 6.2.2 Spot Patient Windows In the process of monitoring, the spot patient window may stay in one of the following statuses:  “No Patient Ad

6-4 6.2.3 Patient Window in Monitoring Status In the monitoring status, a patient window displays real-time patient data transmitted from the mon

6-5 6.2.3.2 Drop-down Menu Button Clicking this button will open a drop-down menu, in which you can perform these operations:  Monitor Silence:

6-6  Night Mode: Open the “Multibed” menu, select and set current bed or all beds to Night Mode, and choose whether to stop NIBP measuring.  ST

6-7 6.2.3.4 Technical Alarm and Patient Information Area The Technical Alarm and Patient Information Area displays:  The technical alarms and mes

6-8 6.2.3.7 Parameter Area This area is to display parameter values transmitted from the monitor. The icon beside the parameter indicates that al

6-9 Icon name Icon Description Received Signal Strength This icon tells the received signal strength for corresponding channel. With the receiv

V Exemptions Mindray DS 's obligation or liability under this warranty does not include any transportation or other charges or liability for di

6-10 NOTE z When a patient is discharged, the settings in “Waveform Selection and Order” are saved. The waveforms will be shown as per the same co

7-1 7 Viewbed 7.1 Overview The CMS allows you to view a single patient through the “ViewBed” screen, in which you will have an enlarged view of th

7-2 7.2 ViewBed Screen 1. Patient information area 2. Alarm sound icons 3. Telemetry icons 4. Technical alarm area 5. Physiological alarm

7-3 7.2.1 Button Area Icon Name Description Alarm Silence Used to enter alarm silence status. Audio Paused Used to enter or exit audio paused s

7-4 7.2.3 Parameter Area This area is to display parameter values transmitted from the monitor. Each parameter module occupies a rectangular area,

7-5 7.4 Basic Operations 7.4.1 Alarm Setup Clicking the button will enter the “Alarm Setup” tab sheet, in which you can set parameter alarms, ar

7-6 7.4.6 STANDBY The STANDBY icon is applicable to the telemetry transmitter only. Clicking this icon will have the current patient to enter th

7-7 7.4.9 Freeze/Unfreeze Waveforms By clicking the button, you can freeze all dynamic waveforms in the waveform area. In this area, freeze t

7-8 7.4.11 Show/Hide Dynamic Short Trend Clicking the button will show or hide dynamic short trends for each physiological parameter. For detail

7-9 7.4.14 Print Printing in Real-time Click the button, the “Print Setup” dialog box will pop up. In this dialog box, you can select the wavefo

VI Company Contact Manufacturer: Mindray DS USA, Inc. Address: 800 MacArthur Blvd.Mahwah, New Jersey 07430 USA Tel: 1.800.288.2121 1.201.995

7-10 7.4.15 Show/Hide Multi-lead ECG Click the button to turn on multi-lead ECG waveform display as shown below: Figure 7-3 Multi-lead ECG In

7-11 Click the button to turn on 12-lead ECG waveform display when the bedside monitor enters full-screen 12-lead screen, as shown below. Figure

7-12 7.4.18 Show/Hide BIS Expand View You can click button to open BIS Expand View. In BIS Expand View, you can select to view EEG waveforms, BI

7-13 7.4.20 Display ST Segments Display real-time ST segments In the ECG parameter setup menu, select “Display ST Segments”. In the viewbed window,

7-14 Display ST-segments on the multi-lead ECG screen If multi-lead ECG screen is accessed, corresponding ST segments are displayed after the lead

8-1 8 Alarm Control 8.1 Alarm Structure Alarms, triggered by a vital sign that appears abnormal or by technical problems of the monitor, are sent

8-2 8.2.1 Audible Alarms This system has three choices of alarm tones and patterns: ISO, Mode 1 and Mode 2. For each pattern, the alarm tones ident

8-3 8.2.3 Alarm Messages The CMS alerts the users by giving alarm messages in the physiological or technical alarm area. Before the alarm messages,

8-4 In the “General Setup” tab, you can set high alarm volume. High alarm volume can be set equal to or louder than the alarm volume. The choices a

8-5 8.4.2 Alarm Setup Tab Sheet Clicking the button in the “ViewBed” screen will enter the “Alarm Setup” tab sheet, in which you can set paramet

1 Preface Manual Purpose This manual provides the instructions necessary to operate the DPM Central Station in accordance with its function and int

8-6 8.4.2.3 Setting Arrh. Threshold The threshold of PVCs high limit, tachy and others can be set in “Arrh. Threshold Setup” sheet. 8.4.2.4 Others

8-7 As for the monitor’s alarm silenced status and the classification of technical alarms, please refer to the monitor’s Operator’s Manual. The al

8-8 8.8 Silencing the Monitors For the monitors supporting bidirectional control of monitor silence, you can enter the status of Monitor Silence of

8-9 8.10 CMS System Silence CMS system silence only silences the CMS system sounds. Alarms from the monitors will not be affected. The CMS’ system

8-10 8.11 CMS Audio Alarm Off CMS Alarm Audio Off only switches off the audible alarms from CMS. Alarms from the monitors will not be affected.

9-1 9 Review 9.1 Online Review Online review is to review the dynamic short trends, C.O. measurements, waveforms, trends, NIBP measurements and al

9-2 9.1.2 Trend Review 9.1.2.1 Overview Clicking the “Trend Review” tab will enter a tab sheet, through which you can store and review up to 240 h

9-3 Viewing Parameter Values at a Certain Time Clicking at a place in the graphic, you can position the cursor at that place and view parameter val

9-4 9.1.3 Waveform Review The CMS can store 240 hours’ waveforms of all patients. 9.1.3.1 Overview In the Waveform Review window, you can review

9-5  Time Scale Displays the time moment to which one-minute waveform of each line in the compressed waveform area corresponds. In the single scr