Philips MP60/70/80/90 Manuel d'utilisateur Page 129
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- Table des matières
- DEPANNAGE
- MARQUE LIVRES
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Understanding the Arrhythmia Display 6 ECG, Arrhythmia, and ST Monitoring
109
Intermittent Bundle Branch Block
Bundle branch and the other fascicular blocks create a challenge for the arrhythmia algorithm. If the
QRS during the block changes considerably from the learned normal, the blocked beat may be
incorrectly classified as ventricular, causing false PVC alarms. You should always select a lead where the
bundle branch block beats have an R-wave that is as narrow as possible to minimize incorrect calls.
Ventricular beats should look different from these ‘normal beats’. Instead of trying to select two leads
with a narrow R-wave, it may be easier to just select one lead and use single lead arrhythmia
monitoring. Extra vigilance is required by the clinician for this type of patient.
Understanding the Arrhythmia Display
Your monitor screen may look slightly different from the illustration.
Viewing Arrhythmia Waves
♦ To review arrhythmia beat labels, in the Setup Arrhythmia menu, select Annotate Arrhy.
The wave showing the primary ECG lead will be delayed by six seconds and shown on a grey
background. Beat labels will be annotated above the ECG wave and
Delayed will be written
beside it.
♦ To return to the normal ECG primary lead display, select Annotate Arrhy again.
Arrhythmia Beat Labels
Arrhythmia beat labels tell you how the monitor is classifying beats.
N = Normal
V = Ventricular Ectopic
S = Supra-ventricular Premature
P = Paced
' = Pacer spike
L = Learning patient's ECG
A = Artifact (noisy episode)
? = Insufficient information to classify beats
I = Inoperative condition (e.g., LEADS OFF)
M = Pause or missed beat
PP
P
Delayed
1mV
II
M
PVC Numeric
HR Numeric
Delayed arrhythmia wave
Beat label
Rhythm status message
Pair PVCs
Ectopic status message
Paced Rhythm
75
HR
2
PVC
Pace pulse marks
- IntelliVue Patient Monitor 1
- *M8000-9001G* 2
- Table Of Contents 3
- 2 What’s New? 35 4
- 3 Alarms 41 5
- 4 Patient Alarms and INOPs 53 5
- 5 Managing Patients 77 5
- 7 Monitoring Pulse Rate 127 8
- 9 Monitoring SpO 9
- 10 Monitoring NBP 143 9
- 11 Monitoring Temperature 149 9
- 16 Monitoring tcGas 195 12
- 17 Monitoring SvO 12
- 18 Monitoring EEG 207 12
- 19 Monitoring BIS 215 13
- 20 Trends 223 13
- 21 Calculations 233 14
- 23 Event Surveillance 241 14
- 24 Recording 257 15
- 27 VueLink Modules 281 16
- 28 Using Timers 285 16
- 29 Respiratory Loops 289 17
- 30 Care and Cleaning 293 17
- 31 Using the Batteries 297 17
- 33 Accessories 309 18
- Basic Operation 21
- IntelliVue MP20/MP30 22
- IntelliVue MP40/MP50 24
- IntelliVue MP60/MP70 25
- IntelliVue MP80/MP90 26
- D80 Intelligent Display 27
- Remote Alarm Device 27
- Related Products 28
- Measurement Modules 29
- Operating and Navigating 34
- Selecting Screen Elements 35
- Using the Setup Menu 35
- Using the Touchscreen 35
- Using the SpeedPoint 36
- Using the Navigation Point 37
- Using a Mouse or Trackball 37
- Using Keys 37
- SmartKeys 38
- Hardkeys 39
- Pop-Up Keys 39
- Using the On-Screen Keyboard 40
- Operating Modes 41
- Understanding Screens 42
- Using Additional Displays 43
- Understanding Profiles 44
- Swapping a Complete Profile 45
- Understanding Settings 46
- Changing Wave Speeds 47
- Freezing Waves 48
- Using Labels 49
- Resolving Label Conflicts 50
- Changing Monitor Settings 51
- Getting Started 52
- Disconnecting from Power 53
- Networked Monitoring 53
- Using Remote Applications 53
- Remote Application Popup Keys 54
- What’s New? 55
- What’s New in Release C.0? 56
- What’s New in Release B.1? 57
- What’s New in Release B.0? 58
- What’s New in Release A.2? 59
- Visual Alarm Indicators 62
- Audible Alarm Indicators 62
- Acknowledging Alarms 64
- To Pause All Alarms 65
- To Switch All Alarms Off 65
- Alarm Limits 66
- Viewing All Alarm Limits 67
- Changing Alarm Limits 68
- Documenting Alarm Limits 69
- Reviewing Alarms 70
- Understanding Alarm Messages 71
- Latching Alarms 71
- Testing Alarms 72
- Alarm Behavior at On/Off 72
- Patient Alarms and INOPs 73
- , anesthetic agent, and 79
- (M4605A) 79
- CO2 OCCLUSION is 85
- Lead Setup 87
- Setup SVR menu 94
- Setup TCGas menu 94
- ∆Temp> CHK SOURCES 95
- ∆Temp> CHK UNITS 95
- °C, or greater than 45°C.] 95
- Managing Patients 97
- Quick Admitting a Patient 98
- Editing Patient Information 99
- Discharging a Patient 99
- Transferring Patients 100
- Data Upload from an MMS 101
- Care Groups 104
- Bed 12 Bed 13 105
- Other Patients SmartKey, if 106
- Viewing the Other Bed Window 107
- Care Group Alarms 108
- Telemetry Data Overview 109
- Suspending Telemetry Alarms 110
- Using Standby 110
- ECG, Arrhythmia, and ST 111
- Monitoring 111
- Checking Paced Status 112
- Understanding the ECG Display 113
- Monitoring Paced Patients 113
- Paced is set to Yes: 114
- About ECG Leads 116
- ECG Lead Fallback 117
- ECG Lead Placements 117
- Standard 3-Lead Placement 118
- Standard 5-Lead Placement 118
- Chest Electrode Placement 119
- 10-Lead Placement 120
- Conventional 12-Lead ECG 120
- Labelling 12-Lead ECG Reports 121
- Capture 12-Lead 122
- EASI ECG Lead Placement 122
- Using ECG Alarms 125
- ECG Safety Information 125
- About Arrhythmia Monitoring 127
- Aberrantly-Conducted Beats 128
- Viewing Arrhythmia Waves 129
- Arrhythmia Beat Labels 129
- Arrhythmia Status Messages 130
- Arrhythmia Relearning 131
- Arrhythmia Alarms 132
- What is a Timeout Period? 134
- Resetting the Timeout Period 134
- Arrhythmia Alarm Chaining 135
- but ≤ 12 136
- About ST Monitoring 137
- Switching ST On and Off 137
- Understanding the ST Display 138
- Updating ST Baseline Snippets 139
- Recording ST Segments 139
- ST Alarms 142
- Viewing ST Maps 142
- Trend View 143
- Viewing an ST Map 144
- Printing an ST Map Report 145
- Monitoring Pulse Rate 147
- Switching Pulse On and Off 148
- Using Pulse Alarms 148
- Extreme Alarm Limits 149
- QRS Tone 149
- Monitoring Respiration Rate 151
- Changing Resp Detection Modes 152
- Manual Detection Mode 153
- Using Resp Alarms 154
- Resp Safety Information 154
- Monitoring SpO 157
- Connecting SpO 158
- Measuring SpO 158
- Assessing a Suspicious SpO 159
- Reading 159
- Understanding SpO 160
- Pleth Wave 160
- Setup menu, select First SpO 162
- Second SpO 162
- Monitoring NBP 163
- Preparing to Measure NBP 164
- Choosing the NBP Alarm Source 167
- Assisting Venous Puncture 167
- Calibrating NBP 167
- Monitoring Temperature 169
- Calculating Temp Difference 170
- Monitoring Invasive Pressure 171
- Extended Pressure Label Set 172
- Zeroing ICP (or IC1/IC2) 173
- Using the Zero Hardkey 173
- Troubleshooting the Zero 174
- Optimizing the Waveform 175
- Editing the Wedge 179
- (module M1006B 180
- Monitoring Cardiac Output 181
- Hemodynamic Parameters 182
- Entering the HemoCalc Window 184
- Save C.O. and Cal CCO 187
- Save C.O. & Cal CCO 187
- Thermodilution Method 188
- Documenting C.O. Measurements 189
- C.O. Injectate Guidelines 190
- C.O./CCO Curve Alert Messages 191
- C.O./CCO Prompt Messages 192
- C.O./CCO Warning Messages 193
- C.O./CCO Safety Information 193
- Monitoring Carbon Dioxide 195
- Start Zero 197
- Zero done at <date 197
- Start Zero Cal 198
- Using the Mainstream CO 199
- Extension (M3016A) 199
- Calibrating the Transducer 200
- Attaching and Removing the CO 200
- Transducer 200
- Using the Microstream CO 201
- Extension (M3015A) 201
- Suppressing Zero Calibration 203
- Adjusting the CO 203
- Wave Scale 203
- Setting up CO 203
- Corrections 203
- 14 Monitoring Carbon Dioxide 205
- Monitoring Airway Flow 207
- Volume and Pressure 207
- Attaching the Flow Sensor 208
- Pediatric/adult sensor 209
- Zero Calibration 210
- Automatic Purging 210
- Manual Purging 211
- Gas Compensation 211
- Setting up Spirometry 212
- and the Inspired Agents 213
- Monitoring tcGas 215
- Using the tcGas Site Timer 216
- New/Dried Out Transducers 218
- Storing tcGas Transducers 218
- Calibration Failure 220
- Applying the tcGas Transducer 221
- Finishing tcGas Monitoring 222
- TcGas Corrections 222
- Monitoring SvO 223
- Preparing to Monitor SvO 224
- Inserting the Catheter 225
- Calculating Oxygen Extraction 226
- Monitoring EEG 227
- EEG Monitoring Setup 228
- Changing the Impedance Limit 229
- Impedance Indicators 230
- Changing EEG Settings 232
- EEG Reports 233
- EEG Safety Information 234
- Monitoring BIS 235
- BIS Monitoring Setup 236
- Monitoring BIS using the BISx 237
- BIS Cyclic Impedance Check 238
- BIS Window 239
- BIS Safety Information 241
- Viewing Trends 243
- Viewing Graphic Trends 244
- Viewing Vital Signs Trends 244
- Setting Up Trends 245
- Making Segment Settings 246
- Trend Groups 247
- Trend Interval 247
- Trend Priority 247
- Trend Parameter Scales 247
- Documenting Trends 248
- Trends Databases 249
- Screen Trends 249
- Setting the Screen Trend Time 250
- Tabular View 251
- Horizon View 252
- Setting the Horizon 252
- Calculations 253
- Calculations Windows 254
- Calculations Pop-Up Keys 254
- Reviewing Calculations 255
- Performing Calculations 255
- Automatic Value Substitution 256
- Automatic Unit Conversion 256
- Manual Unit Conversion 256
- BSA Formula 256
- Documenting Calculations 257
- High Resolution Trend 259
- Hi-Res Trend Wave Recordings 260
- Event Surveillance 261
- Event Groups 262
- Event Episodes 262
- Events Pop-Up Keys 263
- Event Triggers 264
- Event Retriggering 265
- Event Notification 265
- Triggering Events Manually 266
- The Events Database 267
- Viewing Events 267
- Counting Combi-Events 268
- Event Summary Window 269
- Event Review Window 269
- Event Episode Window 270
- Annotating Events 271
- Documenting Events 271
- Documenting an Event Episode 272
- Event Recordings 272
- Event Reports 273
- Event Review Reports 274
- Event Episode Reports 275
- Event Summary Reports 275
- Recording 277
- Quickstarting Recordings 278
- Overview of Recording Types 279
- All ECG Waves Recordings 280
- Changing ECG Wave Gain 281
- Recording Priorities 282
- Sample Recording Strip 282
- Recorded Waveforms 283
- Maintaining Recording Strips 283
- Reloading Paper 284
- Recorder Status Messages 285
- Printing Patient Reports 287
- Stopping Reports Printouts 288
- Setting Up Reports 288
- Setting Up Auto Reports 289
- Checking Printer Settings 290
- Printing a Test Report 291
- Dashed Lines on Reports 291
- Printer Status Messages 292
- Sample Report Printouts 292
- Alarm Limits Report 293
- Realtime Report 294
- Cardiac Output Report 295
- ECG Reports 296
- Other Reports 296
- Using the Drug Calculator 297
- Performing Drug Calculations 298
- Drug Calculator 299
- Lidocaine 299
- Patient Category 299
- Charting Infusion Progress 300
- Using the Titration Table 300
- Documenting Drug Calculations 300
- VueLink Modules 301
- Using VueLink Screens 303
- Switching VueLink On and Off 303
- Using Timers 305
- Timer Setup Pop-up Keys 306
- Setting Up Timers 306
- Run Time 307
- Timer Counting Direction 307
- Main Screen Timer Pop-up Keys 308
- Respiratory Loops 309
- Capturing and Deleting Loops 310
- Showing/Hiding Loops 310
- Changing Loops Display Size 311
- Using the Loops Cursor 311
- Changing Loops Type 311
- Setting Up Source Device 311
- Documenting Loops 312
- Care and Cleaning 313
- Cleaning 314
- Disinfecting 314
- Sterilizing 315
- Using the Batteries 317
- 3:40 hrs 318
- Checking Battery Charge 320
- Replacing Batteries 321
- Display Brightness Setting 322
- Charging Batteries 322
- Conditioning Batteries 322
- Unequally-Charged Batteries 322
- Battery Safety Information 323
- Maintenance and 325
- Troubleshooting 325
- Disposing of the Monitor 327
- Accessories 329
- 5-Electrode Cable Sets 330
- 10-Electrode Cable Sets 330
- 3-Electrode One Piece Cables 330
- 5-Electrode One Piece Cables 330
- NBP Accessories 331
- Invasive Pressure Accessories 333
- 33 Accessories SpO 334
- Temperature Accessories 338
- Description Part No 340
- Microstream CO 341
- Spirometry Accessories 341
- EEG Accessories 342
- BIS Accessories 342
- Recorder Accessories 344
- Intended Use 345
- Indication for Use 345
- Manufacturer’s Information 346
- Trademark Acknowledgement 347
- Connectors 349
- MP20/MP30 350
- MP40/MP50 351
- MP60/MP70 352
- MP80/MP90 354
- Altitude Setting 356
- Monitor Safety Specifications 356
- Physical Specifications 357
- Environmental Specifications 359
- MP20/MP30/ 361
- Display Specifications 366
- Measurement Specifications 368
- Respiration 370
- Performance Specifications 372
- Adult: 165 ±15 mmHg 373
- Pedi: 130 ±15 mmHg 373
- Neo: 100 ±15 mmHg 373
- Invasive Pressure and Pulse 374
- Spirometry 379
- Safety and Performance Tests 385
- Electromagnetic Immunity 386
- Fast Transients/Bursts 388
- Restart time 388
- Default Settings Appendix 389
- Alarm Default Settings 390
- On Off Off 392
- Pulse Default Settings 393
- Respiration Default Settings 394
- Default Settings 394
- NBP Default Settings 395
- Temperature Default Settings 395
- Spirometry Default Settings 398
- EEG Default Settings 400
- BIS Default Settings 400
- VueLink Default Settings 401
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