CNAP Monitor HD Quick Guide EN

CNAP® MONITOR 500 “HD“
QUICK GUIDE
This Quick Guide DOES NOT REPLACE the user manual!
Version 07/2016 | V1.5.5 EN
2
CONTENT
SET UP
MEASUREMENT
FAQs
NAVIGATION
FUNCTIONS:
FAST ACCESS
Hemodynamic Parameters...................................................................................5
Set Up Checklist for fast Set Up.............................................................6
Power Up CNAP® Monitor.......................................................... 7
Prepare CNAP® Monitor for Measurement - Components................8
Prepare CNAP® Monitor for Measurement - Connections...................9
Connecting to a Patient Monitor.............................................10
Zeroing of CNAP® and patient monitor...................................11
Overview CNAP® Monitor Patient Set Up ...............................12
Choose correct CNAP® finger sensor size.................................13
Place CNAP® finger sensor and CNAP® Controller...................14
Place NBP Cuff ..........................................................................15
Measurement Select Measurement Mode / Start Measurement...................16
Started Measurement: Perfusion Index / Signal Quality.........17
Choose Patient Category / Enter Biometric Data....................18
Stop / Resume Measurement...................................................19
Navigation Navigation Frames....................................................................20
Function of Navigation Frames................................................21
3
4
CONTENT
Functions Fast Access
FAQs:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Main Keys and Status Indicators............................................. 23
The “SETUP“ Key......................................................................25
Calibration Modes: Function / Benefits.................................. 26
Triggering A Manual NBP - Fast Access...................................27
When is it recommended to trigger a manual NBP?.............28
“Change Finger“ manually......................................................29
How can I change alarm settings for current measurement?......31
How can I change alarm settings permanently?...........................32
Enabling hemodynamic parameters for a measurement?...........33
How can I improve measurement quality?....................................34
How can I adjust trend, signal and time settings?........................35
The battery?....................................................................................36
Service intervals for the CNAP® Monitor? .................................... 37
What to do if CNAP® needs service ?............................................38
SERVICE HOTLINE ?.........................................................................39
Where can I get additional information?......................................40
How can I contact CNSystems directly? .........................................41
HEMODYNAMIC PARAMETERS
CNAP® Monitor Measurement Type
BP
BP + PPV
BP + HD
CNAP
continuous noninvasive arterial pressure, sys,
dia, mean
x
x
x
NBP
noninvasive oscillometric blood pressure
sys, dia
x
x
x
Pulse
pulse rate
x
x
x
PPV
pulse pressure variation
x
x
SVV
stroke volume variation
x
CO
continuous noninvasive cardiac output
x
CI
cardiac index
x
SV
stroke volume
x
SVI
stroke volume index
x
SVR
systemic vascular resistance
x
SVRI
systemic vascular resistance index
x
®
5
SET UP
6
CHECKLIST
SET UP CHECKLIST
!
STEP 1
Start the device and connect the CNAP® Controller Cable (orange connectors)
to CNAP® Monitor and CNAP® Controller (see also p.7,9)
STEP 2
Use the indicator on the CNAP® Controller to find the correct CNAP® finger
sensor size for the patient. (see p. 13)
STEP 3
Slide the finger sensor over two neighbouring fingers, and fix the CNAP®
Controller on the forearm using the Velcro fixation cuff. (see p. 14)
STEP 4
Be sure that the CNAP® Controller is in the center of the forearm cuff so
that the patient can freely bend his / her wrist. (see p.14)
STEP 5
Select the right NBP cuff size for the patient using the indicator on the inside of
the NBP cuff and connect the black hose to the CNAP® Monitor. (see p.15)
STEP 6
Fit the NBP cuff on the patient‘s upper arm. The NBP cuff can be placed
ipsilaterally or contralaterally to the CNAP® finger sensor. (see p.15)
STEP 7
Start measurement by clicking “Start New Measurement“. Choose patient
category “Adult“ or “Pediatric“. (see p.16, 18)
During CNAP ® initialisation the patient needs to be in a stable position.
ATTENTION During general anesthesia start CNAP ® before or after the induction phase!
POWER UP CNAP® MONITOR
1 Press POWER ON / OFF
button
2 When alarm sounds,
confirm by pressing the
yellow alarm button.
SET UP
7
SET UP
8
PREPARE CNAP® MONITOR FOR MEASUREMENT
COMPONENTS
1 CNAP® Monitor
1
2 CNAP® Controller Cable
3 CNAP® Controller
2
6
3
4 CNAP® Finger sensor
5
5 NBP Cuff
4
2
6 NBP Air hose
3
4
5
6
PREPARE CNAP® MONITOR FOR MEASUREMENT
CONNECTIONS
3 Connect NBP air
hose to NBP Cuff
1 Connect the controller cable to
the orange connector of the
CNAP ® Controller.
4
2 Connect finger
sensor to black
connection of
CNAP ® Controller.
!
Connect the
NBP air hose and the
CNAP ® Controller
cable to the CNAP ®
Monitor.
Plug in straight, not
ATTENTION tilted!
SET UP
9
SET UP
10
CONNECTING TO A PATIENT MONITOR
1
Interface cable
Prepare patient
monitor Interface Cable
and connect it to the
arterial port of your
patient monitor.
2
Transducer Cable
connect to
3
Connect Transducer cable and
patient monitor interface cable.
!
Select right color from
list in user manual
(Chapter 4-5-2) and
connect it to the BP
wave out port on the
CNAP ® Monitor.
ATTENTION
Zeroing neccessary! (see next page)
BP Wave
Out port
ZEROING OF CNAP® AND PATIENT MONITOR
1 Go to parameter frame on CNAP ® Monitor: *click*
2 Select IBP: Zeroing Start - *click*
oi
n
f p a tie n t m o
n
go
*click*
it o
r
Ze
*click*
r
then zero transducer on patient monitor
*click*
3 Stop Zeroing
on CNAP ®:
Select IBP:
Zeroing Stop
- *click*
TIP
SET UP
CNAP ® Zeroing is automatically active when the CNAP ®
Monitor is on and connected to the patient monitor but no
measurement has been started so far.
11
SET UP
12
OVERVIEW: PATIENT SET UP
Connections
NBP Cuff
CNAP® Controller
CNAP® Finger sensor
STEP 1. CHOOSE CORRECT CNAP® FINGER SENSOR SIZE
AVAILABLE SIZES: small, medium or large
1
Put proximal phalanx of
index finger on indicator
of CNAP ® Controller align
with the grey line on the
left.
SET UP
B
2
Choose the sensor
size indicated
on the shortest
bar which is still
visible.
!
2
ATTENTION
Always choose the
larger sensor if you
are in doubt about
the size!
13
SET UP
14
STEP 2. PLACE CNAP® FINGER SENSOR AND CNAP® CONTROLLER
!
ATTENTION
1 Slide the finger sensor over two
neighbouring fingers, make sure
that it is not placed on the finger
joints!
NOTE
slide back fully!
2 Make sure that the
CNAP ® Controller is placed in
central position of the slide
and fix the strap.
12 hours before lifetime expiration
of the finger sensor a message
appears. It automatically disappears
and does not affect measurements.
Please make sure to contact your
local distributor in time for a new
sensor.
See also: Operators Manual – chapter 16.1
STEP 3. PLACE NBP CUFF
1
Choose the right NBP cuff from 4 different sizes
by using the size indicator
on the inside of the cuff.
See also: Operators Manual –
chapters 3.2.3 and 10.
2
Fasten NBP cuff on the upper arm
(ipsilaterally or contralaterally to
arm with fingersensor).
Align marker (white arrow) with
the brachial artery in the crook of
the arm.
SET UP
3
15
MEASUREMENT
16
SELECT MEASUREMENT MODE / START MEASUREMENT
1 Once the patient set up is completed,
select the measurement mode in the
pop-up menu from three options:
> BP only
> BP + PPV
> BP + HD (full hemodynamics)
2 Confirm by clicking the wheel.
*click*
To start the
measurement, select “Start New Measurement“ and
confirm with the click wheel.
3
NOTE
BP + PPV and BP + HD must be enabled to be selectable.
Contact your distributor for a licence key if you cannot
select these options.
STARTED MEASUREMENT
1 Once measurement has started, finger
TIP
sensor checks perfusion index (PI):
If perfusion is poor (=red), try
pushing the finger sensor to the
back of the finger, warming the
hand (use exam glove or towel),
changing finger sensor size, or
changing hands.
no signal
good perfusion
2 At the same time menu window
opens for choosing patient category and for entering biometric
data (see next page).
Calibration to NBP reference
value also takes place.
MEASUREMENT
!
•
•
ATTENTION
Keep patient still, do not move
hand!
No changes in body posture!
17
MEASUREMENT
18
CHOOSE PATIENT CATEGORY AND ENTER BIOMETRIC DATA
1 Choose patient category (Adult or Pediatric) in the pop-up menu and enter
biometric patient data (for full hemodynamics).
This is important as
NOTE
alarm ranges and NBP
inflation pressure are different!
2 Confirm with “ok“ by clicking the wheel.
*click*
3 Calculation of hemodynamic parameters
starts; display after a few seconds.
Before starting any
interventions, make sure
that the calibration has been completed: numerical
values should not have gray background anymore!
!
ATTENTION
*click*
STOP / RESUME MEASUREMENT
1
!
Press the Start/Stop Button
to STOP measurement (e.g.
when finished or to readjust
set-up).
ATTENTION
Do not remove the
CNAP ® finger sensor when
measurement is still in progress!
STOP MEASUREMENT FIRST!
2
MEASUREMENT
RESUME a measurement
with the Start/Stop Button
(e.g. after readjusting set-up,
patient transfer, etc.) Patient
data remain displayed!
19
NAVIGATION
20
NAVIGATION FRAMES
The monitor has a clickwheel and 5 different “frames“ on the screen to access all menus / functions.
Alarm frame
Signal & Trend
frame
Signal and
Trend View
selector frame
*turn*
*click*
clickwheel
Parameter frame
(= default)
Hemodynamic
frame
FUNCTION OF NAVIGATION FRAMES
Parameter frame
Signal & Trend frame
Alarm & Status frame
> intervention setting
> change of trend view
(graphic
numeric)
> scaling of trend curve
> selection of trending
parameters (up to 2 additional)
> change of time range
> display of alarm and
status messages
> direct access to alarm
settings as long as alarm
message is visible
> display of battery status,
date, next finger change,
next NBP measurement
This is the default frame!
> manual NBP triggering
> manual finger change
> finger change interval setting
> alarm settings
> zeroing of IBP port
> NBP measurement type
NAVIGATION
21
NAVIGATION
22
FUNCTION OF NAVIGATION FRAMES
Signal & Trend View Selector
> switch between signal
view and parameter trends
Hemodynamic frame
> activating/ deactivating HD
> changes between absolute
and indexed values
> manual entry or change of
patient data
> manual entry of external
CO value for calibration
> discharging of patient (data of
current measurement are deleted for > selection Fluid Parameter
measurement with new patient)
PPV or SVV
> manual entry of CVP
MAIN KEYS FOR FAST ACCESS
FAST ACCESS KEYS and STATUS INDICATORS
MAIN SCREEN:
return to main
screen from any
submenu
POWER ON / OFF:
hold for 2 seconds to
power on/off.
power “on“ indicator:
> green: switched on
> orange: system error
SETUP:
access to configuration
menu
FUNCTIONS
23
FUNCTIONS
MAIN KEYS FOR FAST ACCESS
ALARM PAUSE/ OFF:
alarm functions control:
> Press once: alarm
acknowledgement
> Press twice: set alarm
to pause / off
> Press three times:
re-activate alarm function
PRINTING START/ STOP:
> press once: print blood
pressure curve
> press and hold for one
second: print trend view
START/ STOP:
> stop and resume
measurement
Battery charge status:
> green = ok
> orange = less than 25%
> red = less than15 minutes
left!
24
THE “SET UP“ KEY
1. Monitor Settings
> Change Language / Time / Date
> En-/ disable device features:
PPV, HD, Record, Analog Out, enter licence keys, etc.
> Recording on/off (if activated)
> Switch between Metric / US customary units
> Access PPU measurement statistics
2. Measurement Settings
3. Service Settings
For service purposes
only!
> NBP Mode: select calibration mode (see next page)
> NBP Interval
> CNAP Calibr. Interval
> Hemodynamic (on/off, change settings)
> Display Options: Interventions, Views, Scales,etc.
> Trend Parameters: select parameters to be displayed in the trend view
> Print options
> Parameter averaging
> Patient category
FUNCTIONS
25
FUNCTIONS
26
CALIBRATION MODES
Calibration to a manually entered NBP , IBP
or height offset reference value from external
devices.
Benefit
Function
Function
AUTOMATIC NBP CALIBRATION: “INTERNAL“ (= DEFAULT)
Calibration to automatic NBP measurements triggered by the integrated NBP module in adjustable
intervals between 5-60 minutes. Can be stopped
any time by pressing Start/Stop Button.
This is the default mode delivering absolute values
automatically as long as no other blood pressure
reference value (NBP or IBP) is entered manually
(see also: external calibration mode).
Benefit
MANUAL BP CALIBRATION: “EXTERNAL“
CNAP® can be operated without internal NBP
measurement calibrating to a manually entered
value for absolute BP information. Useful for special applications.
Automatic calibration to a heart level value based
on an emipric database for bridging the short
time until CNAP® is calibrated to a measured or
externally entered NBP value.
Benefit
Function
TRENDING MODE: “EMPIRIC CALIBATION“
Blood pressure curve is displayed only 10 secs after
start-up for a quick trending prior to calibration to
the directly measured reference value.
TRIGGERING A MANUAL NBP
NOTE
Triggering a manual NBP is possible at ANY TIME in any mode!
1 Go to parameter frame:
2 Choose NBP: Start - *click*
*click*
*click*
FUNCTIONS
27
FUNCTIONS
WHEN IS IT RECOMMENDED TO TRIGGER A MANUAL NBP ?
1. Upon hand movement
or patient repositioning
Trigger a manual NBP after moving
or repositioning the patient or the
patient‘s hand or whenever hydrostratic change/ offset happens.
!
ATTENTION
2. In situations that quickly
require updated calibration
After an intervention or whenever
you feel that an update to the NBP
reading may be beneficial.
28
“CHANGE FINGER“ MANUALLY
Switching a measurement to the other finger is possible at
ANY TIME except during a NBP measurement!
NOTE
1 Go to parameter frame:
2 Choose CNAP: Change Finger - *click*
*click*
TIP
FAST ACCESS: Parameter frame
is the default frame. If not
changed, just click wheel 2
times to change finger!
*click*
FUNCTIONS
29
FAQs
FREQUENTLY ASKED QUESTIONS
FAQs:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
How can I change alarm settings for current measurement?......31
How can I change alarm settings permanently?...........................32
Enabling hemodynamic parameters for a measurement?...........33
How can I improve measurement quality?....................................34
How can I adjust trend, signal and time settings?........................35
The battery?....................................................................................36
Service intervals for the CNAP® Monitor? .................................... 37
What to do if CNAP® needs service ?............................................38
SERVICE HOTLINE ?.........................................................................39
Where can I get additional information?......................................40
How can I contact CNSystems directly? .........................................41
30
1. HOW TO CHANGE ALARM SETTINGS: CURRENT MEASUREMENT
ALARMS OFF/ON AND CHANGE LIMITS
•1 Go to parameter frame with click-wheel
and *click*
*click*
•2 Select “Adult alarm limits“ and turn
values to “Off“ or change limits
TIP
*click*
Whenever a physiological alarm is active, the
settings can be directly
changed by clicking on
the alarm frame.
FAQs
31
FAQs
2. HOW TO CHANGE ALARM SETTINGS: PERMANENTLY
ALARMS OFF/ON AND CHANGE LIMITS
•1 Press Setup key.
•2 Change the alarm default settings
in the submenu
Service | Alarm Defaults
(Password: 8737)
32
3. ENABLING HEMODYNAMIC PARAMETERS FOR A MEASUREMENT
1 If HD is not enabled, hemodynamic frame shows
•
question marks: select with click-wheel - *click*
2 Choose Measurement
Mode: “BP+HD“ and
confirm with“ok“.
NOTE
If BP + HD is active,
BP + PPV is automatically
enabled.
!
*click*
Hemodynamic
parameters
visible now!
TIP
Hemodynamic parameters can also be set permanently in
Set Up | Measurement | Hemodynamic
ATTENTION
If it is not possible to enable the Hemodynamic
parameters, please request a license key from CNSystems
or your distributor.
See also: Operators Manual – chapters 4.4 and 12.2
FAQs
33
FAQs
4. HOW TO IMPROVE MEASUREMENT QUALITY
RED: no signal can be detected
Reasons / limitations:
> poor peripheral perfusion (shock, severe
Raynaud‘s, hypothermia, vasoconstriction)
> edema
TIP
for improving signal quality:
> Check position of CNAP ® finger sensor:
Do not place on finger joints!
> Check if CNAP ® finger sensor size is correct
> Warm up fingers to improve blood flow
(use disposable exam glove or towel)
> Try to measure on the other hand
GREEN: measurement starts automatically.
See also: Operators Manual – chapter 3.7
no signal good perfusion
34
5. HOW TO ADJUST TREND SETTINGS, SIGNAL AND TIME SCALES
1 Go to Signal & Trend frame with
click-wheel and *click*
Trend
Menu:
2 Trend adjustments
TREND PARAMETERS
*click*
TREND DISPLAY
For switching
> graphical,
> numerical,
> alarm history,
> Intervention
views.
> Parameter 1+2:
You can choose up to
2 additional parameters shown in Trend
TIME SCALE / TIME SHIFT
view (SVV, PPV, CO, SV,
SVR).
> Adjust displayed time range
> Adjust “MEAN“ and
NOTE of BP
according to your needs.
“AMPLITUDE“
and Pulse in case trends > Trend navigation in time back
are not visible within
and forth with arrows.
scale range.
Switching parameters here also causes
NOTE
changes in the Hemodynamic frame!
FAQs
35
FAQs
6. THE BATTERY
HOW LONG CAN I MEASURE RUNNING ON BATTERY POWER?
•
up to 120 minutes
•
Battery charge status is indicated with
Battery-status-LED.
•
Battery charge status is also shown in right
edge of alarm & status frame in steps of 25%.
green = ok
orange = 25% left
red = 15 minutes left!
HOW CAN I IMPROVE THE LIFECYCLE OF THE BATTERY?
!
ATTENTION
•
Never completely discharge the battery!
•
Immediately connect to power supply if battery charge
status is below 25%!
•
Send device to CNSystems for maintenance every 24 months.
See also: Operators Manual – chapter 3.3.2
36
7. CNAP® MONITOR SERVICE INTERVALS
WHAT ARE THE DEFINED SERVICE INTERVALS?
EVERY 12 months
•
SAFETY CONTROL: is usually done according to medical directives.
Please contact your biomedical department.
See Service Manual for Users for more details.
EVERY 24 months
•
CALIBRATION/ METROLOGICAL CONTROL: must be done by CNSystems
or an authorized service partner.
• MAINTENANCE: must be done by CNSystems or an authorized service
partner.
See also: Operators Manual – chapter 17.4
FAQs
37
FAQs
8. WHAT TO DO IF CNAP® MONITOR NEEDS SERVICE
!
ATTENTION
Metrological control or repair work must be performed by
CNSystems or an authorized service partner!
•1 For all service requests let us know
serial number and software version
(displayed on start-up screen).
2 Contact CNSystems via
Website:
http://www.cnsystems.com/
support/service-order
Email:
service@cnsystems.com
Online service order QR-Code:
38
9. SERVICE HOTLINE
Service hotline QR-Code:
SERVICE HOTLINE:
+43 316 723456 33
NOTE
Service work is usually finished
within five working days.
Express-Service is possible on request!
FAQs
39
FAQs
10. WHERE TO GET ADDITIONAL INFORMATION
CNSYSTEMS INFO LIBRARY
CNAP® Monitor - Operators Manual
- Comes in hard copy with every CNAP® Monitor
- Available as PDF-file by CNSystems
Website - Applications
- http://www.cnsystems.com/applications
Downloads – Website
- http://www.cnsystems.com/support/downloads
Newsletter - Regular news about our products
- Register online:
http://www.cnsystems.com/news-events/newsletter
Website - Description of the technology
- http://www.cnsystems.com/innovation
Still didn‘t find what
you are looking for?
Contact us directly!
http://www.cnsystems.com/
support/contact
office@cnsystems.com
40
11. HOW TO CONTACT CNSystems DIRECTLY
i
GENERAL REQUESTS
Contact form: Email: Phone: Fax: http://www.cnsystems.com/support/contact
office@cnsystems.com
+43 316 723456
+43 316 723456 2
REGISTER FOR OUR NEWSLETTER
Online: http://www.cnsystems.com/
news-events/newsletter
Email: feedback@cnsystems.com
Newsletter registration
FAQs
41
42
CNAP® Monitor 500 HD Quickguide
© CNSystems Medizintechnik AG, 2016
Version: 07/2016, V1.5.5 EN
43
Backcover:
Currently using your
CNAP® Monitor
for blood pressure
monitoring only?
Upgrade to the full set of
hemodynamic parameters:
BP I PR I CO I SV I SVR I
PPV I SVV
with Software Upgrade V5.2:
Full hemodynamics available
after 90 secs upon startup
• Noninvasive HD for all low &
intermediate risk surgeries
• as an addition to arterial line
•
•
Perfect match with all other
monitoring equipment
•
Improved accuracy through
calibration to manual CVP &
CO/CI
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