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COROMETR 115 FETAL MO
OPERATOR'S MANUAL
1
CONTENTS
INTRODUCTION ........................................... 1
SAFETY ................................................... 2
CONTROLS AND INDICATORS ............................. 5
Front Panel Controls ........................................ 5 Front Panel Connectors ...................................... 7
........................................ Front Panel Displays 7 T i e and Date Set Pushbuttons ............................... 8
........................................ Strip Chart Recorder 9 ................................................. Rear Panel 10
Rear Panel Connectors ...................................... 10
OPERATION ............................................... 12
Selecting Monitoring Modes .................................. 12 Fetal Heart Rate Monitoring ....................... : ......... 12
............................................. Uterine Activity 12 Preparing Monitor For Use .................................. 13 Mounting Strain Gauge ...................................... 14 Chart Paper Installation ..................................... 16 Monitor Self Test Routines ................................... 18 Application of Monitor to Patient ............................. 19
FHR Recording . Ultrasound ............................... 19 ................................... F,H R Recording . Phono 22
FHR Rmrding . Internal Direct FECG ...................... 25 Uterine Activity Recording . Tocodynamometer ............... 27 Uterine Activity Recording . Catheter and Strain Gauge ........ 29 Flushing and Calibration of the Strain Gauge ................. 31
Dual Heart Rate Monitoring .................................. 35 ...................................... Alphanumeric Messages 38
..................................... SET TIME AND DATE 40
CARE AND CLEANING .................................... 43
...................................... TROUBLESHOOTING 46
SPECIFICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACCESSORIES 50
Features -
* Quiet, easy-to-load recorder with high-resolution dot matrix printhead. Prints out continuous trends and alphanumeric data on one strip chart in single or dual heart rate modes.
* Automatic mode selection. The desired monitoring mode is selected simply by inserting the appropriate transducer plug into the front panel connector.
* Easy-to-use durable transducer connectors.
* All functions controlled by pushbuttons-including audio volume, UA reference, time/date set, and paper advance.
* Cleaner more accurate traces with fewer "dropouts" using ultrasound or phono because of patented autocor- relation processing.
* U.S. Patent No. 3,982,528
Section 1 INTRODUCTION
The CorometricsB Model 115 Fetal Monitor is capable of monitoring two heart rates (maternal and fetal or twins) and maternal uterine contractions. Simultaneous trends of
' beat-to-beat heart rate and uterine activity (UA) are plotted continuously on the built-in dual channel strip chart recorder. Fetal heart rate (FHR) and UA are displayed continuously on the front-panel numeric display. The Model 115 is capable of monitoring heart rate and uterine activity using the following external or internal clinical methods.
External Monitoring Modes
1) Continuous-Wave Doppler Ultrasound: A transducer placed on the abdomen is used to direct an ultrasonic beam toward the fetal heart and to sense Doppler-shied echoes created by moving cardiac structures. A patented autocorrelation process is used to determine the timing of successive cardiac cycles.
2) Phono: An acoustically sensitive transducer placed on the maternal abdomen senses fetal heart -sounds which are used to compute the fetal heart rate. The patented autocorrelation processing is also used in the Phono Mode to improve measurement accuracy.
3) Tocodynamometer: Relative Pressure within the uterus is measured using a tocotransducer strapped to the abdomen in the area of the uterine fundus. The readings are recorded on the strip chart paper in a relative scale from 0 to 100.
Internal Monitoring Modes
1) Direct Fetal ECG: FECG waveforms are obtained via a spiral electrode attached to the fetal presenting part. FHR is computed on a beat-to-beat basis using the time interval between R-wave peaks. The instantaneous FHR pattern is printed on the strip chart paper and the FHR appears on the numeric display.
2) Intrauterine Catheter and Strain Gauge: Amniotic fluid pressure is measured using a transcervical intrauterine catheter and externally mounted strain gauge. Pressure trends are plotted over the range of 0 to 100 rnrnHg.
Maternal Monitoring Mode
MECG waveforms are obtained via electrodes placed on the maternal chest and abdomen. MHR is computed on a beat-to-beat basis using the time interval between R-wave peaks. The instantaneous MHR pattern is printed on the strip chart paper and the MHR appears on the numeric display.
Section 2
SAFETY
GENERAL USE AND POWER PRECAUTIONS
IMPORTANT: Read this manual before operating the monitor. Keep this manual available for future reference and orientation of new personnel.
Refer to supplementary "Guide to Fetal Heart Rate Monitoring" for limitations of internal and external monitoring techniques.
This monitor is ordinarily shipped with provisions to operate from a hospital grade three-wire 117-volt electrical outlet. The monitor can be changed to operate from other types of outlets and voltages with appropriate modifications performed by personnel authorized by Corometrics Medical Systems, Inc.
Do not defeat the three-wire grounding feature in the power cord by means of adapters, plug modifications or other methods. A dangerous shock hazard to both patient
' and operator may result.
Monitors should be plugged into the same circuit as other equipment in use on the same patient. Your hospital engineering staff should identify outlets that are on the same circuit in patient areas.
This equipment is not designed for use in an explosive atmosphere, in the presence of flammable anaesthetics, or inside an oxygen tent. Use under these conditions may present an explosion hazard.
LEAKAGE CURRENT
Corometrics monitors are equipped with isolated inputs (ECG) and isolated transducers (Phono , ultrasound, strain gauge, and tocodynamometer). Leakcase current is limited to a few microamperes even if full power-line vcltage is applied to the patient leads. However, for maximum patient safety, the following procedures are recommended.
Keep equipment clean and free of transducer gel, electrode cream, and other substances.
Do not operate if unit is wet because of spills or condensation. Condensation could occur if a monitor is moved from building to building such as from a cold environment to a warm and humid location.
DIRECT MEASURING PRECAUTIONS
Because the tip of the spiral electrode is designed to penetrate the fetal epidermis, the possibility of trauma, hemorrhage and infection exists.
Direct monitoring should be used only under aseptic conditions.
Membranes must be ruptured prior to the introduction of either the spiral electrode or the intrauterine catheter.
When inserting an intrauterine catheter, do not force the catheter guide or catheter since it is possible to perforate the uterus.
Contraindications: The electrode should NOT be applied to the fetal face, fontanels or genitalia or when it is not possible to identify the portion of the fetal body where- application is contemplated. Direct monitoring should NOT be used when placenta previa or bleeding from the uterine cavity is present; when genital infections (e.g., herpes, Group B streptococcus, gonorrhea) or other infections exist. - -
Section 3
Section 3
CONTROLS AND INDICATORS
FRONT PANEL CONTROLS
Volume
Two pushbuttons used to change the volume of sound emitted by the rear-panel speaker. Depressing the button with the arrow pointing up causes the volume to increase. Depressing the button with the arrow pointing down causes the volume to decrease. Volume control has no effect on the processing used to compute heart rate.
UA Reference
Pushbutton which sets the pressure reference level on the UA recorder channel at 0-mmHg for the strain gauge or at 10 for the tocodynamometer. To activate, depress and hold for 1 second.
Test
Pushbutton used to initiate a monitor self-test routine. To activate, depress and hold for 1 second.
Mark
,Depressing the Mark button causes an arrow-shaped mark to be printed on heart rate channel of the strip chart paper-
Record
Depressing pushbutton activates the recorder, provided paper has been installed. Once the recorder is activated, - - - * s
depressing Record again turns it off.
An amber light next to the Record pushbutton will be on when the recorder is activated and off when the recorder is deactivated or if paper has run out. It will flash when the end of the paper is approaching. When the recorder is out of paper, the recorder will automatically stop and cannot be restarted until chart paper is inserted.
Paper Advance
Pressure on pushbutton causes the recorder to advance chart paper at the speed of 25 crnlminute for as long as the pushbutton is depressed. The recorder will print the monitoring modes, time, date and chart speed informa- tion 20 seconds after the pushbutton is released, if the recorder is activated.
Power
Pushbutton switch that turns the monitor on and off. A green light next to the Power pushbutton is illuminated when the Power switch is activated.
Automatic ~aseline 'Zeroing" in External UA Monitoring Mode.
If pressure falls below 0, automatic UA reference wiU occur and new baseline reference is set at 0. The center margin for the strip chart will automatically be annotated with "UA REF".
FRONT PANEL DISPLAYS
Heart Rate Display
Heart rate in beats-per-minute will be displayed in the left portion of the window.
Heartbeat Indicator
A heart-shaped symbol flashes with each detected valid heartbeat.
Uterine Activity Display
Uterine activity values displayed in the right portion of the window will represent mmHg for internal uterine ac- tivity monitoring and relative units for the external monitoring (Tm).
FRONTPANELCONNECTORS
Ochre colored 12-pin connector mechanically keyed to accept only the Model 115's phono or ultrasound transducer plugs. The input connector is electrically keyed to recognize which transducer plug has been inserted.
ECG
Gray colored 12-pin connector which is mechanically and electrically keyed to accept only the ECG transducer . plugs.
UA rg.
White 12-pin connector which is mechaniay keyed to accept either the tocotransducer or strain gauge. The con- nector is electrically keyed to recognize which transducer plug has been inserted.
Section 3
TIME AND DATE SET PUSHBUTTONS
Three pushbuttons located under the lip of the front panel. Only active when the rear panel -/DATE SET switch is in the ENABLE postion. The function of each pushbutton is indicated by a title or an arrow located im- mediately above the row of pushbuttons.
SELECT T/D
Successive depression of SELECT T/D permits selection of the time or date parameter to be changed.
(Upwards Pointing Arrow)
Activation of the "increase value" pushbutton increases the value of the selected timeldate parameter. Continuous activation of the pushbutton causes the front panel display to cycle from the lowest value of the selected parameter to its highest possible value and then to "wrap around" to the lowest value.
(Downwards Pointing Arrow)
Activation of the "decrease value" pushbutton is similar to "increase value" except that decreasing of the selected parameters occurs.
STRIP CHART RECORDER
The dual-channel strip chart recorder is located on the right side of the front panel. The lever on the left side of the recorder opens the paper drawer.
Heart Rate Channel
The heart rate channel is located on the left side of the recorder.
Uterine Activity Channel
The uterine activity channel is located on the right side of the recorder.
Alphanumeric Print-Out
When the recorder is activated, time, date, modes of monitoring and paper speed are printed automatically on the margin between the fetal and uterine activity channels. Various messages relating to functions and parameter changes wil be printed as the latter occur. In addition, if the optional 2115 keypad or 2116 keyboard is being used, messages keyed in by the operator appear in this margin.
C W W f ElCS FETnl U O V ~ T O ~ M O M < 2 7 % ZIMSERIES c c a w n a l c s UEOI(PL SVSTEY uc DATA ~ m m SYSTEM
ECG ARTIFACT ELlMlNlTlON
@ CHART SPEED ECG l -8Ddb l
1 CM MlN 3 CM MIN
TIME OATE SET
DISABLE [IID ENABLE
1 50 AMF CAUTlON A COROLAN
SLOW BLOW FUSE
6 isi W T I M I ELECTRIC SHOCK HAZARD DO NOT REMOVE COVER OR BACK REFER SER n c E ONLY TO QUIUF~ED PERSONNEL WARNING TO REWCE FIRE HAZARD REPLACE
111111111 FUSES AS MARKED
117 VOLTS €4 HZ 1CU WATT5 J t02
CONNECT TO COROMETRICS SERIES 400 MONITORS ONLY
REAR PANEL
ECG ARTIFACT ELIMINATION
A two position slide switch is locked in place by means of a plate and two screws. In order to change the switch position, the plate must be removed, the switch changed a d the plate reversed to lock it in the new position.
In the ON position, any new HEART RATE value which differs by more than +25 BPM from the previously calculated heart rate will not be printed.
In the OFF position, all HEART RATE values will be printed without regard to previous rates. This switch affects o n l ~ the direct ECG mode.
CHART SPEED
Chart paper speed may be set at 1 or 3 cdrnin. (1 or 2 cmlmin.) with this switch.
TIMEIDATE SET
The ENABLE position is used when setting the time and date. The DISABLE position is used at all other times.
REAR PANEL CONNECTORS
ECG (+80dB)
Permits recording of Direct FECG signals on an external recorder. Output level is compatible with standard adult ECG recorders.
Connector for optional Corometrics 21 15 Keypad or 21 16 Keyboard. b
w
NOTE: Data Entry Keypad should be plugged into J103 connector prior to turning on the monitor's power.
LEG PLATE TESTER
Connector from internal ECG simulator used to test 115 leg plate.
REMOTE MARK
Connector for remote event marker.
HEADSET
Connector for Corometrics headset. Insertion of the headset into this connector will inhibit sounds from speaker.
Connector for use with Corometrics Model 400 Central System Monitors.
GROUND LUG
POTENTIAL EQUALIZATION POINT
Terminal which can be used to provide an additional ground for the monitor.
AC-linecord connector.
MONITOR FUSE HOLDERS
FlOl
Fuseholder for 1.50-ampere SLOW-BLOW fuse.
SPARE
Fuseholder containing spare fuse.
5108 (optional)
COROLAN/RS-232C Input/Output Connector
NOTE: If your Model 115 has an option for connection to a data communications system, the connector for this option is located on the rear panel and is labeled (5108). It is also identified by the symbol (A).
Do not attempt to connect a cable to this connector without contacting your Biomedical Engineering Department or Corornetrics Service. This is to insure the connection complies with leakage-current requirements of one of the following applicable standards: Underwriters Laboratories U.L. 544, Canadian Standards Association CSA 22.2 No. 125, or International Electrotechnical Commission IEC 60 1 - 1 .
The maximum nondestructive voltage that may be applied to the rear panel connectors is 0 volts.
Section 4 OPERATION
SELECTING MONITORING MODES UTERIh'E ACTIVITY
The Corometrics Model 115 Fetal Monitor can monitor the Internal Method: fetal heart rate in three modes and the uterine activity in two modes. For maternal heart rate monitoring see page Intrauterine Pressure Catheter and Strain Gauge 35.
A catheter inserted transcervically into the uterine cavity FETAL HEART RATE MONITORING transmits intrauterine pressure to the strain gauge. This
pressure is recorded in mrnHg. The membranes must be Internal Method: ruptured in order to use this method.
Fetal ECG External Method:
This method uses an electrode attached directly to the fetal Tocodynamometer presenting part and connected to a leg plate on the maternal thigh. The heart rate is computed based upon the A tocotransducer placed on the maternal abdomen will
- ' interval between successive R-Wave peaks of the fetal record changes in abdominal tension. The resulting tracings : ECG. This provides the most accurate FHR patterns. The will reflect uterine contractions. .$
membranes must be ruptured and the cervix dilated to t utilize this technique. Uterine Activity Display
External Methods:
Ultrasound
An ultrasound transducer placed on the maternal abdomen senses heart motion utilizing the Doppler principle. The rate is determined using the patented autocorrelation processing to determine the time interval between successive heart beats.
Phono
Phonocardiography utilizes a sensitive transducer similar to a microphone to pick up heart sounds. The patented autocorrelation processing is used to compute cardiac intervals. Both the mother and baby need to be relatively inactive to utilize this method; therefore, this technique is most useful during the antepartum period or early labor.
Fetal Heart Rate Displays
The fetal heart rate is displayed in several ways. A heart beat indicator (amber backlit heart symbol) flashes for each detected valid heart beat after the circuits have settled. It does not flash for event triggers which are rejected by the monitor's editing. A three digit amber numeric display indicates FHR in beats per minute. This display will be blanked (except during 3 second warm up and TEST) if no front panel FHR connector is inserted into the monitor. FHR trends will be plotted on the fetal channel of the strip chart. There is a few seconds delay from printing until the tracing appears on the moving chart paper. The rear panel speaker will emit an audible tone for each detected heart beat.
Uterine activity will be continuously plotted on the UA channel of the strip chart paper. Pressure will be plotted on a scale of 0- 100 mmHg for internal pressure and 0-100 relative units for toco signals. If the recorder is turned on, the message "TOCO" or "IUP" will be printed 20 seconds after connector insertion. Pressure exceeding 100 mmHg will be printed as a straight line at 100 mmHg. The uterine activity numeric values on the front panel dis- play represent changes in pressure in either mmHg or relative units. Depression of the UA reference pushbutton for one second will reset the display to 0 mmHg (strain gauge) or 10 (toco). Pushbutton should be activated for internal monitoring when the strain gauge is open to air and activated for external monitoring (toco) between contractions. If the relative pressure is greater than 100, 3 a " + " sign will flash continuously. Should the pressure s
value exceed the monitoring range when the UA reference button is depressed - i.e. damaged toco or belt too tight - the display will continuously flash " + 199". The message "BASELINE PRESSURE OFF SCALE" will be printed on the lower portion of the recorder's UA channel after 20 seconds of baseline pressure less than 0 mmHg (or relative units).
P R E P m N G MOMTOR FOR USE
1) Plug power cord into rear panel connector (J101) and into a hospital grade grounded electrical wall outlet.
2) Select a method of monitoring the fetus using either FECG, ultrasound, or phono. Connect the appropriate transducer plug to the corresponding colorcoded connector on the front panel of the monitor.
3) Select a method of monitoring uterine activity using either the tocotransducer or the strain gauge. Connect appropriate color-coded plug to the UA connector.
MOUNTING THE STWIN GAUGE
A) Place the rod of the strain gauge mount through holes of the strain gauge clip.
B) Attach the strain gauge mount to the side of the monitor by placing the lip of the top bracket into the groove between the chassis and top cover of the monitor. Place the bottom bracket in the groove irm the bottom of the monitor.
C ) Tighten thumb screw enough to seat mount firmly.
D) Gently snap the strain gauge into the plastic clip.
E) Plug adapter end of nector on monitor.
cable into color-coded UA con-
4) Set chart speed with slide switch on rear panel (3 cm/min is the generally accepted standard in the United States).
5) Depress Power pushbutton on front panel.
When the power is first turned on, the following will occur:
A) The green "Power On" indicator will be lit.
B) The front panel heart rate numeric display will read, "888" for three seconds.
C) The front panel UA display will read " + 188" for three seconds.
D) All other front panel displays will light for three seconds.
After the three second test period, the monitor will be ready to receive and display the FNR and UA signals by the chosen modes.
6) Insure an adequate supply of paper is in the recorder. The recorder will automatically stop when paper runs out.
CAUTION: Use only recorder paper designed for use in the Model 115 Monitor (Corometrics Catalog Number 4305AAO). Attempts to use paper suitable for other recorders can damage the recorder's print head. (Cor- ometrics Catalog Number 4303AAO is designed for other Corometrics monitors and should not be used in the Model 115). Use of such papers may void the warranty.
CHART SPEED EGG (+80db)
Section 4
CHART PAPER INSTALLATION
To install chart paper, follow these steps:
A) Depress the lever at the left of the recorder to the paper drawer.
open
B) Hold the paper so that the black squares are on the top of the pack and appear at the right.
C) Fan pack of Z-fold paper on all sides to loosen folds and insure proper feed of paper through recorder.
ir ..,. e.<. <<.& ,$.S i a: -..- ii. ;&,
. .,J<., .'=re
:Lkq, -* . .-. ", .- - i.. I. .& -.*. ,jT -f
!.,
<,g r ,.. %,
;" '... ,.*. --,+- .?Z,<
.>E :?"x q.; .<@$ 242, ?g, @? ;;g <>,;*' .&& . --
D) UnfoId the paper from the bottom of the pack so that it extends towards you.
E) Place the pack in the drawer so that the black squares are up and the paper extends out the bottom of the pack and over the roller.
F) Close the door.
Section 4
7) Press P a p s Advance to move paper enough to write patient identification.
8) Depress the Record pushbutton to activate recorder: amber light next to the pushbutton will stay on continuously and the paper will begin to advance at the preset speed.
the
MOPdsFOR SELF TEST RO S
The Model 115 contains test routines which check the calibration and internal circuitry of the monitor. It is recommended practice to initiate the self test feature at the beginning of each monitoring period so the results will be documented on the patient's strip chart. These routines are initiated by depressing the front panel Test pushbutton. Paper must be installed in the recorder. If the recorder is off, the test routine will turn it on and then turn it off after the tests are complete. If the recorder is running, the tests will be performed, printed out, and the recorder will remain on. The chart recorder will print the message" TEST " and " ALL DOTS PRINTED ? "Then, the routines listed in Table 1 will be printed.
18
TABLE 1
TEST, ROUTINE
LAMP TEST
RECORDER TEST
COUNTING TEST
DESCRIPTION
All indicators illuminate for the duration of the test with the heart rate display "888" and UA Display reading "+188" during recorder test.
The software energizes all the elements in the print head which should appear as a continuous Sine of dots across the paper. A sin'Iulated trend of 30, 120, and 24.0 or 50-120-210 BPM will be printed Out on the heart rate channel and a simulated pressure trend at 0, 50, and 100 m a g will be printed out on the UA
(the values will also be printed out numerically in the enter margin of the strip chart).
After recorder test, software generates a 120 BPM heart rate signal and displays the rate on the numeric display and on the strip chart.
UTERINE ACTIVITY TEST The monitor adds 50 mmHg to present pressure level; displays this value on the UA display and prifits this value on the recorder paper. (NOTE: If no transducer is plugged intc the UA connector, no trace will be printed.)
At the completion of the self test routine, the monitor is ready for patient use.
APPLICATION O F MONITOR T O PATIENT
F'HR RECORDING-ULTRASOUND
(Monitor should be prepared as described on page 13)
EQUIPMENT NEEDED:
A) Fetoscope
B) Ultrasound transducer
C) Ultrasound strap (Disposable or reusable)
D) Ultrasonic coupling gel
E) Headset (optional)
PROCEDURE
1) Explain procedure to patient.
2) Place strap under patient.
3) Determine position of the fetus using Le~pold's maneuvers.
4) Determine the area from which the strongest fetal heart tones are heard using the fetoscope (this will usually be though the fetal back). Avoid the maternal aorta.
Section 4
5) Connect the ultrasound transducer plug to the UA connector on the front panel.
6) Insert a corner of the strap through one slot on the transducer and pull it through several inches.
7) Apply a small amount of ultrasonic coupling gel to the transducer face.
8) Place the transducer face down on the maternal ab- domen where the strongest heart tones were auscultated.
9) Depress Power pushbutton if power is off.
11) SOU
Adjust volume on front panel of monitor.
Reposition transducer as necessary until clearest heaft ~nd is heard through headset or speaker.
12) Insert the other end of the strap through the remain- ing slot in the transducer and adjust to a comfortable fit. Three to five seconds after a clear heart sound is heard, the heart shaped indicator will flash synchronously with the sound, indicating signal acceptance and recording.
13) Activate the recorder and insure that a tracing appears on the heart rate channel. Check the maternal pulse to document recording FHR.
NOTE: Temporary loss of signal will cause the heart light to stop flashing. If sound is still clear, allow 3 to 5 seconds for light to resume flashing. As labor progresses, fetal movement or maternal movement which results in loss of sound for an extended period may require repositioning the transducer.
(Monitor should be prepared as described on page 13 .)
EQUIPMENT NEEDED:
A) Fetoscope
B) Phonotransducer
C) PatienUTransducer Interface Ring
D) Headset (optional)
PROCEDURE
1) Explain procedure to the patient.
2) Use a fetoscope to determine the location of the clearest fetal heart sounds. Take care to avoid placenta, cord, and other abdominal sounds.
3) Be certain abdomen is dry and clean. Do NOT use coupling gels or EKG paste.
4) Peel backing from the patientltransducer interface ring using the tab.
CAUTION: Do not place the phonotransducer-with its - patient-contact side on a hard surface. The microphone (shielded by the housing on the patient side) can be easily damaged.
5 ) Apply the adhesive surface of the ring to the face of the phonou-ansducer.
6) Place the phonotransducer, face down, on the maternal abdomen over the area of clearest fetal heart sounds. Preferably, hold the transducer in place using the interface ring by itself. If this is not possible, the transducer cable may be taped in place.
NOTE: Maternal or fetal movement can affect signal quality and the transducer may need to be repositioned. Avoid sources of noise such as straps, gowns, or sheets which may come in contact with the transducer.
7) Depress the Power pushbutton if power is off. Allow 20 to 30 seconds for the monitor circuits to stabilize. Also, any time the transducer is moved, allow 20 to 30 seconds for the circuits to re-stabilize.
8) Adjust volume with front panel pushbuttons. Once acceptable fetal heart sounds are obtained, the computed heart rate will appear on the front panel display and the amber heartbeat symbol will flash synchronously with the audible fetal heartbeats.
9) Depress the front panel Record pushbutton to activate the recorder and insure that a tracing appears.
Section 4 1 r
FHR RECORDING-INTERNAL DIRECT F@CG
(Monitor should be prepared as described on page 13.)
EQUIPMENT NEEDED:
A) Leg plate
B) Leg plate strap (Disposable or reusable)
C) EKG Sol
D) Spiral Electrode
PROCEDURE
1) Explain procedure to patient.
2) Attach strap to leg plate by inserting the plastic clip into hinge holes on one end of the leg plate, keeping Velcro side facing you.
3) Apply EKG Sol to the contact surface of the leg plate and place it on the thigh of the patient.
4) Pass the leg plate strap around and under the patient's thigh and then through the slot in the leg plate. Fold the strap back onto itself so that the Velcro adheres.
NOTE: Instructions for using the disposable straps are printed on the package.
5 ) Apply spiral electrode to fetal presenting part according to standard procedure.
6) Attach the spiral electrode wires to the corresponding . , a
push posts of the leg plate, GREEN wire to push post labeled green and RED wire to push post labeled red. Connect the leg plate cable to the front panel ECG connector.
7) Depress Power pushbutton if power is off.
8) Depress the Record pushbutton and insure a trace appears on the heart-rate channel.
9) An adequate ECG signal is indicated by an acceptable continuous trace recorded on the strip chart.
NOTE: An artifact elimination switch is located on the rear panel. In the ON position, the monitor will not print any new FHR value which differs by more than 2 25 BPM from the previously calculated heart value. The printing inhibition functions on a beat-to-beat basis by comparing the last calculated rate against the newly calculated rate. The rate used for comparison purposes is always the previous rate regardless of whether this rate passed the previous ? 25 BPM test. In the OFF position it causes all direct ECG rates to be plotted by the recorder without regard to their deviation from previous rates. The effect of this function change is that sudden heart changes (such as certain arrhythmias, accelerations or decelerations) as well as artifactual changes (as when the electrode is disturbed or loosely connected) will be recorded when the switch is in the OFF position. They will not be recorded when the switch is in the O N position; instead, gaps in the tracing will occur. This slide switch only affects the direct mode. All other FHR modes always have the printing inhibition enabled automatically.
UTERINE ACTIVITY RECORDING- TOCODYNAMOMETER
(Monitor should be prepared as discussed on page 13.)
EQUIPMENT NEEDED:
A) Tocotransducer
B) Strap (reusable or disposable)
PROCEDURE
1) Explain monitoring procedure to patient.
2) Place strap under patient.
3) Insert a comer of the strap through one slot of the tocotransducer and pull through several inches.
I 1
4) Connect the transducer cable to the front panel UA connector. Depress the Power and Record pushbuttons if off.
5) Depress the UA Reference pushbutton for one (1) second (count "one, one thousand").
6) Position tocotransducer on the maternal abdomen over the uterine fundus or where there is the least maternal tissue and the contractions are most strongly palpated.
7) Lnsert the other end of the strap into the remaining slot and tighten to hold transducer securely in place. Digital display andlor recorder should read at least 35, between contractions.
8) When the uterus is relaxed, depress the UA Reference pushbutton again for one (1) second. This will set the UA baseline to 10. The Model 115 is now ready to begin monitoring uterine activity.
Automatic Baseline "Zeroing" In External UA Monitoring Mode
If pressure falls below 0, automatic UA reference will m u r and new baseline reference is set at 0. The center margin for the strip chart will automatically be annotated with "UA REF".
Section 4
UTERINE ACTIVITY RECORDING-CATHETER AND STRAIN GAUGE
(Monitor should be prepared as described on page 13.)
EQUIPMENT NEEDED:
A) Sterile strain gauge and bracket
B) Intrauterine kit, the kit contains the following:
catheter with needle adapter catheter guide 3-way stopcock 20 cc plastic syringe
C) hjectable sterile distilled water
D) 18 gauge 1 % " sterile needle
E) Sterile pressure relief valve (PRV)
F) Sterile dome
NOTE: Sterile disposable domes or nonsterile reusable domes are available.
PROCEDURE
1) Explain procedure to patient.
2) Place dome, with O-ring in place, on top of strain gauge. (Disposable domes do not have O-rings.) Tighten collar.
3) Attach pressure relief valve (PRV) to the upright fitting on the strain gauge dome.
4) Adjust the height of the strain gauge until it is level with the maternal xiphoid.
5 ) Open intrauterine kit and place contents on a small sterile field maintaining sterile technique.
6) Following sterile technique. remove stopcock from sterile field and attach to angle fitting on dome.
7) Pressure catheter should be inserted into the uterine cavity by standard technique. Reminder: catheter must be filled with sterile water before insertion.
8) Tape catheter to patient's thigh to avoid accidental removal of catheter.
. 9) After catheter has been inserted, attach the end with the needle adapter to the male fitting on the 3-way stopcock.
10) Attach syringe filled with sterile distilled water (not saline) to the remab-ing fitting on the stopcock.
FLUSHING AND CALIBRATING OF THE STRAIN GAUGE
1) Rotate stopcock lever so that the OFF arrow points toward the strain gauge dome. (This connects the syringe to the catheter.)
Section 4
2) Inject 5 ml (cc) of sterile distilled water into the catheter- . to remove any air bubbles or debris that may have collected during insertion of catheter.
3) Rotate stopcock lever so that the OFF arrow points toward the catheter. (This connects the syringe to the strain gauge dome.)
4) Lift and hold up the pressure relief valve cap by the handle. Inject water through the strain gauge dome with cap held open until all air bubbles are removed. Release PRV handle. Connect the strain gauge connector to the UA front panel connector.
Section 4
5) Depress the Bower pushbutton on the front of the monitor, if it is deactivated.
6) Depress the Record pushbutton.
7) Remove syringe. (This will open the dome to air.)
8) Depress UA Reference pushbutton for 1 second. This will cause the recorder to start printing at 0 on the strip chart paper.
9) Replace syringe and turn the OFF lever on the stopcock toward the syringe. This will reopen the connection from the patient to the strain gauge and the recording will be intrauterine pressure in rnrnHg.
NOTE: The strain gauge must be recalibrated under the following circumstances:
a) When the monitor is first turned on, the circuits in the strain gauge require at least ten minutes to stabilize thermally.
b) If a negative value (i.e. "- 15") appears on the front panel UA display, be sure the strain gauge has been positioned at the height of the maternal xiphoid. (If recalibration fails to remedy the condition, refer to troubleshooting section.)
DUAL HEART RATE MONITORING
INTRODUCTION
The Corometrics Model 115 Fetal Monitor is capable of monitoring two heart rates as well as maternal uterine contractions. This will allow maternal and fetal heart rates or the heart rates of twins to be simultaneously monitored using ECG (maternal or fetal) and either ultrasound or phono. Under these circumstances, simultaneous trends of two heart rates and the uterine activity are plotted on the strip chart recorder and the heart rate derived from either ultrasound or phono is displayed on the front panel HR numeric display. The monitor will automatically print the specific operating mode(s) with reference trace(s) at start up, with transducer changes and every 10 minutes (see Table 1).
APPLICATION OF MONITOR TO PATIENT
MATERNAL AND FETAL MONITORING
EQUIPMENT NEEDED:
A) Fetoscope B) Ultrasound transducer or Phonotransducer C) Ultrasound coupling gel or patient/transducer interface
f ig D) Abdominal strap (disposable or reusable) E) Headset (optional) F) 3 disposable ECG electrodes G) Maternal ECG cable H) Alcohol swabs I) Garment clip
PROCEDURE:
1) Explain procedure to patient.
2) Plug the ultrasound transducer or the phono transducer into the PHONO/ULTRASOUND connector on the front panel and the maternal ECG cable into the ECG connector. Apply the selected transducer for recording Fetal Heart Rate (FHR) as previously described.
3) Cleanse electrode sites with alcohol swab and allow to dry.
4) Gently abrade the skin at the electrode site with the built in rough pad affixed to the electrode protective cover.
Section 4
5) Remove the protective cover and apply the electrodes as illustrated. Do not press down on the center, secure by pressing on the paper edges.
6) Connect the cable clips to the electrodes. Insure there is no tension on the wires. Secure the cable to the bed sheet or gown with the garment clip. Allow a few minutes for the electrodes to stabilize.
7) Apply tocotransducer as previously described.
8) Activate the recorder and ensure that the tracings appear and are properly annotated. '
MONITORING OF TWINS
EQUIPMENT NEEDED:
A) Fetoscope B) Ultrasound transducer or phonotransducer C ) Ultrasound coupling gel or patientltransducer interface
ring D) Abdominal strap (disposable or reusable) E) Headset (optional) F) Spiral Electrode G) Leg plate H) Leg plate strap (disposable or reusable) I) EKG solution
PROCEDURE:
1) Explain procedure to patient.
2) Apply the spiral electrode to the fetal presenting part according to standard procedure.
3) Attach the spiral electrode wires to the leg plate.
Section 4
4) Plug-the ultrasound transducer or the phono transducer into the PHONO/ULTRASOUND connector on the front panel and the leg plate cable into the ECG connector. Apply the selected transducer for recording the second fetal heart rate externally to the matemal'abdomen as previously described.
5) Attach the selected method of recording uterine activity.
6) Activate the recorder and insure that two different tracings appear and are properly annotated.
NOTE: Tracing illustrates single FHR monitoring (normal density trace) with ultrasound at start-up. When direct FECG monitoring commences with the presenting twin, the ultrasound trace switches to heavy density and the FECG trace appears in normal density. Automatic annotations occur at startup, when modes are added or switched, and with the time at the 10-minute interval.
The following chart summarizes the functions of the 115 Fetal Monitor. See Table 1
k
NOTE: If NOT using dual HR monitoring never plug tuio HR transducers in at the same time.*
MODE OF MONITORING
MATERNAUFETAL
1) MECG& US
2) MECG & PHONO
TWINS:
1) FECG& US
2) FECG& PHONO
FECG ALONE*
US ALONE*
PHONO ALONE'
MECG ALONE*
. - ",
TRACING
US - ~ 4 MECG j l _
PHONO W MECG i~ i
US % FECG - - e
PHONO -A4 FECG
FECG -.I.
Us
PHONO --,\/,
MECG -
TABLE 1
HR DISPLAY
US
PHONO
US
PHONO
FECG
US
PHONO
MECG
AUDIO
HEART SOUNDS
US
PHONO
US
PHONO
-
US
PHONO
BEEPS
MECG
MECG
FECG
FECG
FECG
-
-
MECG
HEARTBEAT lND,CATOR 0
US
PHONO
US
PHONO
FECG
US
PHONO
MECG
CENTRAL STATION
FHR DISPLAY
US
PHONO
US
PHONO
FECG
US
PHONO
MECG
Section 4
ALPHAhTUMERIC MESSAGES
Alphanumeric messages will be printed in the center margin of the Model 115 chart paper, Up to four lines of data can be printed, with the messages falling into three categories:
A) Messages printed automatically each time the recorder is activated.
. B) Messages printed in response to certah conditions.
C) Messages keyed in by the operator via the optional 2 1 15 or 21 16 keyboard-(refer to the Model 2 1 15 and/or Model 21 16 Operator's Manual for a complete listing of these messages).
TABLE 2
The parameter and mode status messages generated by the 115 are listed below in TABLE 2. The recorder must be activated before any trend curves or messages will be displayed (except during monitor self test).
MESSAGE FORMAT HOW ACTIVATED
FECG Insertion of leg plate into ECG connector.
MECG
Insertion of the US transducer into the PHONOIUS connector.
Insertion of maternal patient cable into ECG connector.
PHONO Insertion of phonotransducer into PHONOIUS connector.
TOCO Insertion of tocotransducer into UA connector.
Insertion of strain gauge into UA COMeCtOT.
CARD10 INOP No les plate or FHR transducer is plugged into the fiont panel connectors or 20 seconds after all plugs are removed.
UA INOP No tocodynamometer or strain gauge plugged into the UA connector or 20 seconds after either transducer is removed.
COMMENTS
Printed each time the recorder is activated, when the mode is changed and after paper advance.
Same as above.
Same as above.
Same as above.
Same as above.
Same as above.
Printed each time the recorder is activated, after paper advance and after connector removal.
Same as CARDIO INOP.
TABLE 2
MESSAGE FORMAT HOW ACTIVATED COMMENTS -
x CMIMIN Recorder activation or change in recorder (Chart Paper) speed during operation or after paper x = l or 3 advance.
U.A. REF Depressing front-panel UA Reference pushbutton with tocodynamometer or strain gauge plugged into UA connector.
Recorder activation and every ten minutes Time printed in 24 hour format. The on the ten minute mark. printing of the time will be inhibited if
other mode or status message is being printed at the ten minute mark.
15 SEPT 83 Printed only at time of recorder activation Not printed if clock battery has (Day, Month, Year) and after paper advance. . discharged sin& last monitor usage.
BASELINE Printed automatically when the uterine ' Printed on lower portion of UA scale. PRESSURE OFF pressure drops below the established SCALE pressure baseline for more than 20
seconds.
SET TIMEIDATE Printed on recorder activation if the Time will be printed in hours and internal battery .has discharged since minutes lapsed since monitor activation previous monitor usage. Also printed at rather than real time (until the timeldate the ten minute mark until the clock is is reset). reset.
TEST Printed when front-panel TEST pushbutton is depressed.
ALL DOTS PRINTED? Printed during recorder test to alert the user to look for a continuous unbroken line
TELEMETRY
of recorder dots.
Printed when the Model 315 Telemetry System is turned on and the connectors are plugged into the UA and ECG connectors.
Section 5
SET THME/DATE
The clock will only need to be set prior to initial operation. A maintenance free rechargeabie battery keeps the clock running even when the monitor is unplugged. If the monitor has been unplugged for an extended period of time (approximately 5 weeks) the battery may discharge. This will be indicated by the message "SET TIMEIDATE" when the recorder is turned on. This message and lapsed time will be printed every 10 minutes. The message will be discontinued and real time will begin to be printed after the clock has been reset. The three pushbuttons beneath the lower lip of the front panel which are used to set the time and date are only functional when the "TIMEIDATE SET" switch on the rear panel is in the ENABLE position. All monitoring functions are nonfunctional when the timeldate set switch is in the ENABLE position. To set the time and date turn the monitor ON. lace the TIMEIDATE SET switch located
-CHART SPEED
TIME/DATE SET
The clock uses a 24 hour format, with each unit of the time and date having its own code and range value as follows:
UNIT OF TIME CODE RANGE
Minutes 5 00-59 Hours 6 00-23 Day 7 01-31 Month 8 01-12 Year 9 00-99
NOTE: If the battery discharges, all ranges will start with "00" during the resetting period.
TO SET MTPdlJTES
Depress the SELECT T/D (left) pushbutton until the numeral "5" (the code for minutes) appears on the left of the numeric display. Any two numbers between the range of 00-59 will appear to the right of the code (5).
To increase the minutes to the colrrect setting, depress the I pushbutton with the upwards-pointing arrow (middle $ 3 pushbutton). The two numerals on the right of the "5" will increase to the desired setting. I
NOTE: ?The numeric increments or decrements are one per second for the first 3 seconds the switch is activated. After 5 seconds the rate is increased to 3 counts per second until the switch is released.
, I; f
TO SET B[O
NOTE: The internal clock is a 24 hour clock. 'One minute past midnight will be printed as 00:01 on the recorder, and 1 minute to midnight will be printed as 2359.
Depress the SELECT T/D (left) pushbutton until the numqral "6" (the-code for hours) appears on fhe left of the numeric display. Any two numbers between the range of 08-23 will appear to the right of the code (6). '
Depress either the middle or the right pushbutton to either increase or decrease the two numerals located on the right to the desired setting. ,
TO SET DAY
Depress the SELECT T/D (left) pushbutton until the numeral "7" (the code for day) appears on the left of the numeric display. Any two numbers between the range of 01-31 will appear on the right of the code (7).
Depress either the middle or the right pushbuttons to either increase or decrease the numeric value located on the right to the desired setting.
TO SET MBhm
Depress the SELECT TID (left) pushbutton until the numeral "8" (the code for month) appears on the left of the numeric display. Any two numbers between the range of 01-12 wil l appear on the right of the code (8).
Depress either the middle or the right pushbutton to either increase or decrease the numeric value located on the right to the desired setting.
- - numeric display. Any two numbers between the range of 00-99 will appear on the right of the code (9).
Depress either the middle or the right pushbutton to either increase or decrease the numeric values located on the right to the desired value.
Recheck the minutes as described previously and reset if necessary.
On the rear panel, set the TIME DATE SET switch to the DISABLE position. .
NOTIE: When the recorder is turned on the date and time are printed. The time will continue to be printed every 10 minutes, unless *e 10 minute time mark coincides with the printing of status message.
Section 6
CARE AND CLEANING
CAUTION: Unplug the monitor from the ac power source and detach all accessories from the monitor. Do not immerse accessories in any liquid. Do not use abrasive cloth or cleaners on monitor or accessories.
MONITOR CLEANING
Wipe any fluids from the surface of the monitor. Dampen a cloth or paper towel with isopropyl alcohol and rub soiled area until clean.
CAUTION: Do not clean the lens that covers the heart rate digital display with isopropyl alcohol; clean' the lens with a soft dry cloth.
TOCOTRANSDUCER, ULTRASONIC TRANSDUCER, AND LEG PLATE CLEANING
CAUTION: Do not immerse transducers or hold under running water.
Dampen a cloth or paper towel in a soapy solution and wring out until slightly wet.
Rub soiled area until clean, taking care not to excessively wet the tocotransducer diaphragm seal or the contact surface of the ultrasonic transducer.
Use a damp cloth on contact surface of ultrasonic transducer and around the seal of the tocotransducer. Do not use a sharp object which might damage the seal of the tocotransducer .
Dry all accessories with a soft, dry cloth.
PHONO TRANSDUCER
CAUTION: The contact surface of this transducer is pressure sensitive. Extreme care should be taken when cleaning.
Moisten a soft cloth in a soapy solution and very gently rub the contact surface until clean.
To remove the patient interface ring, peel gently away from the transducer. Wipe away any remaining residue with your finger. A small amount of isopropyl alcohol may be carefully used. Dry with soft dry cloth.
The Velcro straps for the leg plate and the reuseable stretch belts for the toco and ultrasound transducer may be
Section 6
laundered in warm soapy wafer and rinsed thoroughly. Disposable straps are designed for one use only.
!!XRAIN GAUGE
CLEANING
Remove the plastic dome.
Wash the transducer in a fresh solution of Detergicide (1: 1000) or equivalent solution.
Carefully clean the diaphragm with a cotton swab to remove deposits. Avoid excessive pressure since this may damage the diaphragm. If there are stains on ihs diaphragm or sides of the transducer, remove with a cotton swab and solvents of increasing strength. Do not use pumice, Ajax, Bon Arni, or other abrasives.
With dome loosely in place, immerse the transducer in the cleaning solution, following the manufacturer's instruction for the time required to effect c l h g .
After cleaning, rinse the transducer.lhoroughly in sterile distilled water and replace the dome loosely.
CAUTION: Do not immerse any part of the electrical connector of the transducer in the cleaning solution at any time. Examine the outer sheath of the cable for perforations. If the outer covering is damaged in any way, do not immerse the cable in the cleaning solution; this may result in moisture entering the transducer case, which is vented through the cable.
WARNING: In the event liquids are permitted to enter the electrical connector, resistance between the electrical element &d the transducer case should be checked to ensure that the leakage current is below acceptable levels for safe use on patients. A resistance level of 10 megohms or greater is acceptable.
Replace the dome loosely on the transducer to protect ttre diaphragm from damage in handling.
Cold-soak the transducer in activated Cidex or equivalent, following the manufacturer's instructions.
Section 6
Gas sterilization of the transducer, dome, PRV, and the silicone rubber gasket is acceptable.
NOTE: Some discoloration of the PRV may take place as a result of gas (ETO) sterilization.
Liquid sterilization of the transducer, dome, PRV, and silicone rubber gasket can also be performed.
CAUTION: Precautions should be taken to prevent damage to the transducer diaphragm during handling and storage. If the transducer is to be bagged, it is suggested that it be wrapped in foam rubber prior to bagging and sterilization. Do not autoclave pressure transducer.
Storage: The transparent dome should be left attached to the transducer during storage, but the locking ring slackened at least a quarter of a turn.
Section 7 TROUBLESHOOTING
SOLUTION PROBLEM PROBABLE CAUSE
Monitor connected to AC power, green Power On light does not illuminate upon power switch depression.
Monitor not co~ected to a~-line receptacle. AC power cord defective. AC outlet defective Power cord not connected to Model 115.
Connect power cord to receptacle.
Replace power cord. r .Use different outlet. -%all Biomedical Department.
Recorder does not function. (Record light off) &order not activated.
Recorder out of paper. Depress Record Pushbutton. Install chart paper.
Call Biomed~cal Department (Record light on)
PHONO not functioning properly.
Connector not properly connected to monitor. Transducer placement. Defective transducer. Active fetus or mother. Excessive maternal abdorrLinal movemeni. Excessive transducer cable movement.
Check that the connector is firmly attached to monitor. Reposition transducer. Replace transducer. Use alternate technique.
Call Biomediczl Department.
ULTRASOUND not functioning properly.
Connector not properly connected to monitor. Transducer placement. Too little gel applied to transducer. Defective transducer. Active fetus or mother.
Check that connector is firmly attached to monitor. Reposition transducer. Apply more gel. Replace transducer. Wait before moving transducer, FHR will often return. Use alternate technique Call Biomedical Department.
Fetal arrhythmia, hiccups.
MATERNAL ECG erraticlnot functioning properly.
Connector not properly connected to monitor. Electrodes improperly placed. Clips not attached to electrodes properly. Electrode gel dried.
Check that connector is firmly attached to monitor. Re-apply electrodes. Check clip attachment.
Check electrodes and reapply if necessary. Replace cable. Call Biomedical Department.
Defective MECG Cable.
Tocotransducer not recording contractions.
Connector not properly connected to monitor. Transducer not properly placed. Transducer not secured to patient. Defective transducer cable. No maternal contractions. UA Reference range exceeded.
Check that the connector is firmly attached to monitor. Reposition transducer. Secure transducer to patient. Replace transducer.
Remove transducer. Depress UA reference button. Re-apply transducer. Depress UA reference button again, between contractions. Replace transducer. Call Biomedical Department.
Transducer defective
Flashing " +" sign
46
Relative pressure > 100 Depress UA reference button between contractions.
PROBLEM PROBABLE CAUSE SOLUTION
"+ 199" flashes upon UA Reference range exceeded. Remove transducer. depression of UA Reference Depress UA reference button. Re-apply
button transducer. Depress UA reference button again, between contractions.
Transducer defective Replace transducer. Call Biomedical Department.
Internal pressure not Connector not properly connected to monitor. measuring correctly.
Air bubbles in dome or catheter plugged. Dome is cracked. Strain gauge not at same height as catheter tip. Catheter has fallen out of place. Strain gauge not zeroed.
Internal ECG erraticlnot Connector not properly connected to monitor- recording properly.
Leg plate not finnly secured to patient. Electrode wires not secured to leg plate post.' Correct paste not being used or is dried. Electrode not properly placed. No FECG signal. Defective electrode. Defective leg plate.
"500" to "559" appears Timeldate switch is enabled. in LED window
check that connecto; is firmly attached to moniior . Flush dome and catheter. Replace dome Adjust strain gauge.
Replace catheter. Calibrate strain gauge. Cali Biomedical Department.
Check that connector is finnly attached to monitor. Secure leg plate to patient. Inspect leg plate connection. Check ECG paste. Replace electrode. Check for ECG signal. Replace electrode. Check leg plate by attaching it to leg plate tester on rear panel. If functioning correctly it will display 120 + 1 beat on the display window and print 120 + 1 beat on strip chart. Replace if necessary. Call Biomedical Department.
Disable timeldate switch.
No volume Volume control too low. Turn up volume control. Transducer not connected or loose. Plug in transducer. Head set plugged in. Unplug head set.
No monitoring functions. Monitor not attached to outlet. Timeldate switch is enabled.
Static noise on phono or Active fetus. ultrasound. Environmental noise.
Maternal movement. Defective transducer
Time prints 0:00 SET Clock battery discharged. TIMEIDATE
Check attachment. Disable timeldate switch.
Reposition transducer. Keep sheets and gown off transducer Do not hold transducer with hand. Use alternate monitoring mode.
Reset timeldate. Leave monitor turned on for 24 hours to charge battery.
Incorrect Time and Date Reset TimeIDate
The following problems may occur if the 2115 if plugged into the 115 while the 115 is powered up. 1) Display shows Error 3 2) Display is blank 3) Display shows Error 1 when a message is entered
If these problems occur turn the 115 off then on and the 2115 should respond with the READY message. If the problems persist, call service.
Section 8 SPECIFICATIONS
DIRECT ECG
Technique: Heart rate counting range: Heart rate resolution; Artifact elimination: Input signal range (Differentid):
(Common Mode): Input offset voltage range: Preamplifier bandwidth: Common mode rejection with patient cable:
Input equivalent noise: Input irnpedence Common mode:
Differential Mode: Notch filter mains frequency rejection: Leakage current: Isolation mains to patient connections: Leg plate tester jack:
Technique: Sampling frequency: Sampling resolution: Dynamic range: Transmitter frequency: Transmitter power: Heart rate counting range: Leakage current:
PHONO
Technique: Sampling frequency: Heart rate range: Low noise preamplifier
PRESSURE
Range Strain gauge: Toco:
Excitation Voltage: Input irnpedence Differential:
Common Mode: Resolution: Bandwidth:
Zero temperature drift (electronics only): Leakage current:
Peak detecting beat-to-beat cardiotachometer 30-240 BPM f 1 BPM Switch selectable +_25 BPM artifact rejection 15 uV to 2mV peak to peak (fetal) 100 uV to 2mV peak to peak (maternal) 20 v max f 300 mV DC max 1.0 Hz to 100 Hz
> 120 dB balanced > 110 dB 5K RA or LA unbalanced c 10 u v peak-to-peak > 20 MEGOHMS > 10 MEGOHMS 7 40 dB < 10 uA at 117 Vac > 2 k V Simulator outputs 500 mV +30% peak-to-peak R wave at 120 BPM + 1
Continuous wave doppler with autocorrelation processing 200 Hz 8 Bits > 50 dB 2.3 MHz < 10 mW/cm2 50-210 BPM < 10 uA at 117 Vac (isolated via transducer)
Autocorrelation 200 Hz 50-210 BPM
0-100 mmHg 0-100 Relative units (0-120 grams) +4.0 VDC > 1 M
1 0 M 1 mm Hg DC-1 Hz TOCO DC-3 HZ EUP
< . 1 mmHg/deg C < 10 uA at 117 VAC (isolated via transducer)
RECORDER
HEART RATE SCALE
Chart width: Scaling: Range: Resolution:
UTERINE ACTIVITY SCALE:
Chart width: Scaling: Range: Resolution:
CHART DRIVE
Speeds:
Accuracy:
LINE VOLTAGE FREQUENCY AND POWER REQUIREMENTS:
Voltage: Frequency: Power consumption:
7 cm or 8 cm 30 BPM/cm or 20 BPM /cm 30-240 BPM or 50-210 BPM 1 BPM
120 VAC 60 Hz 100 Watts max.
PHYSICAL CHARACTERISTICS: Height: 6.9 in. (17.6 cm) Width: 16.5 in. (41.9 cm) Depth: 17.2 in. (43.7 cm) Weight: 37 lbs. (16.8 kg.)
Specifications are subject to change without notice.
Section 9
Remote Event >faker , Catalog No. 3919BAO
Detachable Line Cord, Catalog KO. 1392A.%4
Tranurenical Intrauterine Kits. Carton of 50. Catalog KO. 2069.&40
Pressure Relief Valves for 4007BXY, 2802AAX, Package of 5 (Sterile), Catalog No. 8070AAO
Bell & Howell Prrssure Transducer, Includes Pressure Relief Valve, Reusable Domes for Bell & Howell Pressure Transducer UH)7BAX, Catalog So . J007B.LX Package of I , Catalog S o . 5507AAO
UItrasonic Transducer, Catalog No. 5600AA.X
Tocotransducer, Catalog No. 2260-
1 Phonotransducer, Catalog No. 3996BAX
Legplate for Model OllSAAA, Catalog No. 2608DAO
Spiral Electrodes, Carton of 50, Catalog No. 2462AAO
Reusable Transducer Straps Carton of 10 (Mesh Style) Catalog No. 4425AAO Reusable Transducer Straps Carton of 10 (Velcro Style) Catalog No. 4425CAO Disposable Transducer Straps Carton of 150 Catalog No. 8024AAO
Data Entry Keypad, Catalog No. 2115AAX
Data E n t r Keyboard, Catalog No. 2116ArU;
hlodel 115 Fetal 3ionitoi, Catalog No. 0115AAA
Headset for Fetal Monitors, Catalog No. 2432AAO
Reusable Domes for BeIl & Howell Pressure Transducers 4007BAS. W A A X , Package of 5, Catalog No. 5507AAO
Sterile Disposable Domes for Be!! & Howell Pressure Transducers 4007BAX, Package of 10, Catalog No. 55UAAO.
Sterile m b l e Domes for Bell & Howell Pressure Transducers 4007BAX, Case of 120, Catalog No. 5512BAO
Pressure Transducer Hdder Assembly for 4007B.4X, Catalog No. 4516BAO
Chart Guard Records 5lanagement System, Includes 40 pack of chart paper and I.D. kit, Catalog No. 4305AAO
Supplemental Chart Guard Label Packet (200 each: Blue, Form So. 2506 and U'hite, Form Soio. 2505 labels), Catalog KO. 4914BAO
Ultrasonic Coupling Gel, 8 5 ounce (250 m1) bottles, Carton of 12. Catalog No. UMAAO
Ultrasonic Coupling Gel, 4 liter bottle, Catalog No. 2475AAO - ~-
EKG Sol, 4 ounce (118 ml) bottles, Carton of 12, Catalog No. 4514AAO
Reusable Leg Plate Straps, Carton of 25, Catalog No. 2023AAO
Disposable Leg Plate Straps, Carton of 250, Catalog No. 8036AAO
Leg Plate Adapters for 8036AA0, Case of 50, Catalog No. 8090.4AO
Disposable Transducer Srraps, Carton of 150, Catalog No. 8024.t40
Disposable Attachment -s for 3996BAX, Box of 100, Catalog No. 383.AAO
hiaternal ECG Cable. Catalog No. 1313AAO
Disposable ECG Electrodes. Carton of 100; Catalog No. 2922.4AO
Mobit Cart, Catalog 50. 3978BAO
