B40 TRM
B40 TRM
B40 TRM
0459
Revision A4
18 January, 2011
Trademarks
Dash, ProCare, DINAMAP, EK-Pro, Trim Knob, Unity Network, Datex, Ohmeda, S/5, D-fend,
D-fend+, Mini D-fend, OxyTip+, EarSat, FingerSat, FlexSat are trademarks of GE Healthcare. All
other product and company names are property of their respective owners.
1 Introduction
About this manual 1
1 Overview 3
1.1 Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.2 Safety information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.2.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.2.2 Safety message signal words. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.2.3 Safety precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.2.4 ESD precautionary procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
1.2.5 Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2 System description 11
2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.2 Bus structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.3 Distributed processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.4 Module communication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.5 Software loading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.6 Parameter modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3 Frame functional description 14
3.1 Main components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.1.1 Keyboards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.1.2 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.1.3 CPU board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.1.4 Power board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.1.5 AC/DC unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3.1.6 Batteries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3.2 Interfacing computer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3.3 Connectors and signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.3.1 External connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
4 Hemo-dynamic module introduction 23
4.1 Monitor software compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
4.2 Main components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
4.2.1 Hemo-dynamic module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
4.2.2 NIBP board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
4.2.3 ECG board in 5-lead measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
4.2.4 ECG filtering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
4.2.5 STP board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
4.2.6 Power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
4.3 Connectors and signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
4.3.1 Front panel connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
4.4 Measurement principle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
4.4.1 NIBP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
4.4.2 ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
4.4.3 Pulse oximetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
4.4.4 Temperature. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
4.4.5 Invasive blood pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
4.4.6 Respiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
i
Document no. 2050802-001
B40/B20 Patient Monitor
2 Installation
1 System installation 1
1.1 Unpacking instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Choosing location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.3 Mounting the monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.4 Connection to mains. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.4.1 Install the batteries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.5 Connection to Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.5.1 Pre-installation requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.5.2 Network configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.6 Inserting and removing the E-miniC module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.7 Monitor connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.8 Visual indicators. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.9 Functional check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3 Maintenance
1 Instructions 1
1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Recommended tools. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2 Electrical Safety Tests 3
2.1 General. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.2 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.3 Test Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.4 Power Outlet Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.5 Power cord and plug. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.6 Ground (Earth) Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.6.1 Ground Continuity Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.6.2 Impedance of Protective Earth Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.7 Ground (earth) wire leakage current tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.8 Enclosure (Touch) leakage current test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.9 Patient (source) leakage current test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.10 Patient (sink) leakage current test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.11 Test completion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3 Installation checkout 13
3.1 Visual inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.2 Functional inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.2.1 Start-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.2.2 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.2.3 Keyboard(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.2.4 Frame unit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.2.5 E-minC module with CO2 measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.2.6 Multiparameter Hemodynamic Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.2.7 Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.2.8 Network connection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.2.9 Final. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
4 Maintenance and checkout 17
4.1 Visual inspection/preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
ii
Document no. 2050802-001
4.1.1 Before beginning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
4.1.2 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
4.2 Functional inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
4.2.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
4.2.2 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.2.3 Keyboard(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.2.4 Time and date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.2.5 Hemo Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.2.6 Loudspeaker. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
4.2.7 Monitor software. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
4.2.8 Watchdog circuitry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
4.2.9 Batteries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
4.2.10 Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
4.2.11 Final cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
5 Adjustments and calibrations 24
5.1 NIBP calibrations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
5.2 Temperature calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
5.3 Invasive pressure calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
4 Troubleshooting
1 Introduction 1
1.1 General troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.2 Software troubleshooting chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2 Frame troubleshooting 4
2.1 NET section troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
3 Hemo Troubleshooting 7
3.1 Troubleshooting flowcharts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.2 NIBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.2.1 NIBP toubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.2.2 NIBP error code explanation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
3.3 ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
3.4 Impedance respiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3.5 Pulse oximetry (SpO2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.6 Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.7 Invasive blood pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
5 Service Menu
1 Introduction 1
1.1 Service Menu structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Service Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2 Frame 3
2.1 SW Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.1.1 SW Download. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.1.2 Country Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.2 UMBC Board. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
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2.3 Memory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2.4 Network. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.4.1 Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.4.2 Dri Config (in S/5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.4.3 Dri Comm (in S/5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.4.4 Unity Config (in Unity) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.4.5 TCP/IP Config . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.4.6 WLAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.5 Power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.5.1 WPM Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3 Keyboard 16
3.1 Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.1.1 Keyboard Log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
4 Parameters 17
4.1 Gas Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.1.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.1.2 Gases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
4.2 ECG Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
4.2.1 ECG Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
4.3 STP Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
4.3.1 Calibrations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
4.4 NIBP Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
4.4.1 NIBP Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
4.4.2 NIBP Safety Valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
4.4.3 NIBP Pneumatics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
4.5 SpO2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
5 Set/Test 31
6 Service Log 32
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3.6 To download the software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
4 Module disassembly 21
4.1 Before disassembly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
4.2 Tools needed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
4.3 To disassemble the hemo module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
4.4 To disassemble the extended rack and the recorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
7 Technical specification
1 General Specifications 1
1.1 Genenral specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Defibrillator synchronization connector. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2 Parameters specifications 3
2.1 ECG specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.2 Impedance respiration specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.3 GE SpO2 specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.4 Nellcor SpO2 specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2.5 Masimo SpO2 specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2.6 NIBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.7 Invasive blood pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.8 Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.9 Airway gases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
8 E-MiniC Module
1 Introduction 1
2 Specifications 2
2.1 General specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.1.1 Environmental specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.1.2 Functional alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2 CO2 measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2.1 Typical performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2.2 Technical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2.3 Normal conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.2.4 Conditions exceeding normal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.3 Respiration Rate (RR). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
3 Functional description 5
3.1 Measurement principle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
3.1.1 CO2 measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
3.2 Main components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
3.2.1 Gas sampling system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
3.2.2 MiniC measuring unit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.2.3 CPU board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
3.3 Connectors and signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
4 Service procedures 11
4.1 General service information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
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1 Introduction
About this manual
Intended audience
This Technical reference manual is meant for service representatives and technical personnel
who install, configure, maintain, administer, troubleshoot or repair B40/B20 monitor running
the software license VSP-A.
1-1
Product availability
Some of the product parts and accessories mentioned in this manual may not be available in
all countries.
Please, consult your local representative for the availability.
Related documentation
− Clinical aspects, basic methods of measurement and technical background: B40/B20
Patient Monitor User’s Reference Manual
− Installation, technical solutions and servicing: B40/B20 Patient Monitor Technical
Reference Manual
− Options and selections of the software: B40/B20 Patient Monitor Default Configuration
Worksheet
− Compatible supplies and accessories: B40/B20 Patient Monitor Supplies and Accessories
− Other devices closely related to the monitor:
• iCentral and iCentral Client User's Reference Manual
• CIC Pro Clinical Information Center Operator's Manual
Conventions used
To help you find and interpret information easily, the manual uses consistent text formats:
Within this manual, special styles and formats are used to distinguish between terms viewed
on screen, a button you must press, or a list of menu commands you must select:
− Names of hardware keys on the keypad are written in bold typeface: NIBP
Start/Cancel.
− Menu items are written in bold italic typeface: Monitor Setup.
− Emphasized text is in italic typeface.
− When referring to different sections in this manual, section names are enclosed in double
quotes: “Cleaning and care”.
− The word “select” means choosing and confirming.
− Messages (alarm messages, informative messages) displayed on the screen are written
inside single quotes: 'Learning.'
− Note statements provide application tips or other useful information.
1-2
1 Overview
The B40/B20 is a modular multiparameter patient monitor. The monitor is especially designed
for monitoring in intensive care units. It can also be used during transportation within the
hospital.
The modular design makes the system flexible and easy to upgrade.
NOTE: Your system may not include all these components. Consult your local representative
for the available components.
1-3
1.1 Symbols
Alternating current
1-4
Fuse. Replace the fuse only with one of the same type and rating
Gas inlet.
Gas outlet.
IP21
Degree of ingress protection.
SN,S/N Serial number
Date of manufacture. This symbol indicates the date of
manufacture of this device. The four digits identify the year.
Storage temperature
1-5
1-6
A blinking heart next to the heart rate or pulse rate value indicates
the beats detected.
1-7
Warnings
• Use only GE recommended power cords
• When disconnecting the system from the power line, remove the plug from the wall outlet
first
• Due to high voltage, use insulated screw driver
• High voltage on test body; do not touch it during the test
1-8
Cautions
• Set the time of a newly added network device as close as possible to the time of devices
already on the network
1-9
1.2.5 Disposal
Dispose of the whole device, parts of it and its packing material and manuals in accordance
with local environmental and waste disposal regulations.
1-10
2 System description
2.1 Introduction
The B40/B20 monitor build up a freely configurable modular system. The architecture is
designed to enable different module combinations so that the user is able to get the desirable
parameter and feature set. This modular approach makes it possible to add new features
when they are needed.
NAND
Ethernet
Flash
DATA BUS
AT91SA
USB HOSE RS485
M7s256
SDRAM
AT91 ARM IIC BUS Sound
Address bus
1-11
The RS-485 type of serial communication supports so-called multidrop or party line
connections. This means that all parameter modules connected to the module bus use exactly
the same lines for communication. The advantage of this is that all bus connectors are
identical and the modules can be connected in any order and position.
Marker Out
1-12
+5V +13...16V
Isolation VMOD
Analog transformer
electronics
MODULE BUS
Patient isolation
A/D
PATIENT
CPU
convert
Data
RAM
EEPROM
Peripheral RS485
drivers Opto isolation
drivers
1-13
3.1.2 Display
The B40 use 12.1” LCD display with SVGA 800 x 600 resolution has bright long live lamps and a
wide viewing angle.
The B20 use 10.4” LCD display with SVGA 800 x 600 resolution has bright long live lamps and a
wide viewing angle.
NOTE: The LCD display backlight circuit runs on a high voltage. Do not touch the inverter board
or the backlight tube leads when powered.
Backlights
The backlight lamp unit consists of two integrated cold cathode fluorescent lamps. The
backlight lamp unit is driven by a separate inverter board.
1-14
I/O connector
AC INLET Cable or wires
90-246 Vac
50/60 Hz Pin-to-pin connection
AC/DC
module
LCD
display
SVGA
Nurse call
Serial data CPU Backlight CCFL
inverter
Power Board XY/CW Board LAMPS
Module bus
CW
Trim Knob
Battery board User interface
board XY Membrane Power
External interface switch panel indicator
board
SMBUS
SMBUS
BAT1
BAT2
1-15
The board is based on AT91 ARM microprocessor. Other functions include LVDS display driver,
10/100Mbps on board Ethernet, WLAN communication, Alarm Light function, KEY board and
rotor encoder control, audio driver function, nurse call function, defibrillation function, module
bus function.
The CPU section takes care of the central processing.
The main features are:
• AT91 ARM
• 266 MHz Main CPU clock
• 64MBytes SDRAM
• 4 MBytes minimum NAND flash memory
• 8 MBytes Data flash memory
• Main CPU Provides one standard UART communication
Connectors
Ethernet communication connector
WLAN card operation connector
Color LCD operation connector
Audio operation connector
Alarm Light indicator operation connector
Power board connection connector
Voltage supervision
There are two voltage supervision chips that control the system reset signals.
The +3.3V supervision chip outputs reset signals for +3.3V devices. 3.3V Reset Threshold will be
Falling: min 3.00 V; max 3.15 V.
1-16
The +1.2V supervision chip outputs reset signals for +1.2V devices. 1.2V Reset Threshold will be
Falling: min 1.08V; max 1.14 V.
1-17
MUX
+5V_PMC
Battery 2
Over Voltage
VSYS Enable
Protection Power Fail Alarm
Switch (Crowbar)
Over Current
15V Boost
Protection & Current VMOD
Regulator
Sense
LCD Backlight
Backlight_VCC
Enable Switch
1-18
AD/DC unit
The AC/DC unit is a compact medical power supply based on high-efficiency technology. It is
designed for 65 watt continuous output power, universal AC input and 15V output voltage.
3.1.6 Batteries
The B40/B20 has two lithium-ion batteries, located in the battery compartment. The power
board connects one of the batteries to be the power source, if no power is received from the
AC/DC unit.The battery charging is controlled by the power board.
The batteries can be charged separately, and screen symbols and monitor frame LED
indicators indicate their charging level and possible failure.
NOTE: When the monitor is battery powered, the green battery LED is on. When the monitor is
mains powered, the green mains LED is on.
1-19
Network connector
RJ45 connector Pin Signal
1 Tx +
2 Tx -
1 2 3 4 5 6 7 8
3 Rx +
4 N/C
5 N/C
6 Rx -
7 N/C
8 N/C
1-20
1-21
Serial port
9 pin female connector Pin Signal
1 GND
2 SERIAL_RXD
5 1 3 SERIAL_TXD
4 SERIAL+3.3V
6
9
5 GND
6 N/C
7 SERIAL_RTS
8 SERIAL_CTS
9 N/C
Main power
Mains connector Pin Signal
L Live
PE Protected earth
N Neutral
1-22
1. InvBP connector
2. Temperature connector
1 3. SpO2 connector
2 4. ECG connector
5. NIBP connector
3
1-23
The monitor displays waveforms and measurement readings, and handles the trending and
alarm management. The ECG (e.g. heart beat and arrhythmia detection) and the Impedance
Respiration algorithms are in the monitor software. The modules measure signals and send
them to the monitor. The NIBP, SpO2, Temperature and Invasive Pressure algorithms are in the
module.
There are four parameter circuit boards inside the hemo-dynamic module for processing the
measurement signals. Each processing board has a microcontroller with software.
The NIBP parameter measurement requires one signal processing board, pneumatic system,
valve and pump unit connected to NIBP parameter board.
The second parameter board is the optional board, for Nellcor or Masimo SpO2 measurement,
it’s Masimo MS-2011 board or Covidien NELL1GE-S board at different configuration.
The third parameter board is for GE SpO2, IBP and Temperature measurement including input
board. All these three parameter is optional, according to different configuration, using
different board: it’s STP board, TP board for Nellcor, TP board for Masimo, GE SpO2 board,.
The fourth parameter board is for 3/5-lead ECG with the Impedance Respiration measurement
including ECG input unit connected to the ECG parameter board.
All parameter boards are connected together via module bus flex board connecting voltage
and module communication, the module communicates with frame through RS-485 bus.
Valves
connector
EEPROM
1024Bytes
connector
Main CPU
Pump
Pneumatic
AT91SAM7S256 control
RS485
interface
Module bus connector
256KBytes Flash
64KBytes SRAM
10bits ADC
Safety CPU
MSP430F2013
2KB+256B Flash
128B RAM
16bits Sigma-
Delta ADC
1-24
Signal processing
Two signals from the pressure transducers are amplified and sent to the A/D converter. After
the converter, digitized signals are sent to the microprocessor for data processing.
The NIBP board is controlled with an ARM7 microprocessor at 16 MHz oscillator frequency.
Memory
The NIBP program memory (processor flash memory) size is 256k x 8. The processor has 64
kBytes RAM. The EEPROM size is 8K x 8 and it is used to store the calibration values for the
pressure transducers, the pulse valve constants gained during measurements, the PC board
identification, and the module serial number.
Software control
The software controls valves and a pump. In addition to the individual on/off signals for each
component there is a common power switch for the valves and the pump that can be used at
pump/valve failures.
Safety circuit
The NIBP board is equipped with an independent safety circuit to disconnect supply voltages
from the pump and the valves if the cuff has been pressurized longer than the preset
maximum measurement time, or if the pressure of the cuff is inflated over the specified
pressure limit. The maximum measurement time values and pressure limits for different
measurement modes have been specified in the technical specification section of this manual.
Pneumatics
1
5, 6
3
4 1
1-25
4. Safety valve; The safety valve is intended to be used for deflating the cuff in single fault
case, i.e. to prevent too long a measurement time or too high an inflation pressure of the
cuff.
5. Main pressure sensor; for measuring the pressure of the blood pressure cuff and the
pressure fluctuations caused by arterial wall movement.
6. Safety pressure sensor; for detecting the, cuff loose, cuff occlusion situations, etc. and
for recognizing the pressure sensor fault.
7. Cuff connector; for connection and hose identification.
1-26
ECG CABLE
- ECG LEAD SET
- ECG TRUNK CABLE
BASELINE
RESTORATION
ECG CPU
12_lead_ECG_meas_blck_dgrm.vsd
RS 485 POWER SUPPLY
COMMUNICATION NV
MEMORY
ISOLATION ISOLATION
ECG preamplifiers
The buffer amplifiers are used for each lead. The “Leads off” detection is implemented by
measuring the output level of the input buffer amplifiers with the A/D converter of the CPU. The
ECG signals are measured using differential amplifiers.
1-27
Pacer detection
Pacer detection has been made by using four slew rate detector circuits. The pacer detection
amplifiers have been realized at the front of the slew rate detectors independently of the ECG
measuring channels.
ECG CPU
The CPU is a 16 bit H8/3052 single-chip microcomputer. It contains 128 kbytes of flash
memory and 4 kbytes of RAM. The clock frequency is 16 MHz.
RS485 communication
The communication to the CPU board of the monitor uses RS485 protocol. The RS485 driver
circuits are optically isolated from the processor of the module.
Power supply
The ECG board has a driver-controlled half-bridge switching power supply with 5 kV isolation.
The supply voltages have been regulated with linear regulators.
1-28
1-29
A/D CONVERSION
STP CPU
STP_brd_blck_dgrm.vsd
COMMUNICATION NV
MEMORY
ISOLATION ISOLATION
1-30
NV MEMORY
RS 485
POWER SUPPLY COMMUNICATION
ISOLATION ISOLATION
Microprocessor unit
The CPU is a 16 bit H8/3052 single-chip microcomputer. It contains 128 kbytes of flash
memory and 4 kbytes of RAM. The clock frequency is 16 MHz.
High speed I/O is used to obtain a pulse control sequence necessary for pulse oximetry
measurement. Timing for the clock is from the oscillator.
1-31
constant
Defibrillation/ESD protection current
resistors and diodes source
Temperature
sensors T1, T2
R Ref1 Ref2
T1 T2
Differential
R amplifier
0C:7k36 d/dt 0
0 To A/D
15C:3k54
converter
25C:2k53
R
0
38C:1k30
45C: 984 0
PSM_temp_meas_principle.vsd
R
1-32
Vin
Current
measurement G
to AD converter
Pressure
transducer
Instrum entation
amplifier
PSM_pressure_meas_principle.vsd
Vout
Input filter G
to A D converter
1-33
LP Oximeter channel 1
Gain=7.5
DC-
suppression
LP Oximeter channel 2
Gain=7.5
LP Oximeter channel 3
Amplifier: Gain=7.5
Preamplifier: Gain = 2
Current-to-voltage type
Spo2_measurement_blck_diagr.vsd
Bipolar/single-ended modes DC-
Adjustable gain suppression
Oximeter channel 4
LP
DE-MUX Amplifiers
Analog Digital
1-34
Module BUS(RS-485)
Frame
1-35
1-36
1-37
4.4.2 ECG
Electrocardiography analyzes the electrical activity of the heart by measuring the electrical
potential produced with electrodes placed on the surface of the body.
ECG reflects:
• electrical activity of the heart
• normal/abnormal function of the heart
• effects of anesthesia on heart function
• effects of surgery on heart function
See the “User's Guide” or the “User’s Reference Manual” for electrodes’ positions and other
information.
1-38
HbO2
SaO2 frac =
HbO2 + Hb + Dyshemoglo bin Formula 1
or against functional saturation SaO2func;
HbO 2
SaO 2 func =
HbO 2 + Hb Formula 2
Functional saturation is more insensitive to changes of carboxyhemoglobin and
methemoglobin concentrations in blood.
The oxygen saturation percentage SpO2 measured by the Datex-Ohmeda module is calibrated
against functional saturation SaO2func. The advantage of this method is that the accuracy of
SpO2 measurement relative to SaO2func can be maintained even at rather high concentrations
of carboxyhemoglobin in blood. Independent of the calibration method, pulse oximeters are
not able to correctly measure oxygen content of the arterial blood at elevated
carboxyhemoglobin or methemoglobin levels.
Pulse rate
The pulse rate calculation is done by peak detection of the plethysmographic pulse wave. The
signals are filtered to reduce noise and checked to separate artifacts.
Intensity of
Imax (DC-component) Imax
transmitted
light AC-component
Imin
Arterial blood
Venous blood
absorption_of_light.vsd
Tissue
Time
No pulsation Pulsatile blood
Incident light
1-39
IRED
Emitter
RED
PSM_absorption_of_infrared.vsd
Detector
4.4.4 Temperature
The temperature is measured by a probe whose resistance varies when the temperature
changes, called NTC (Negative Temperature Coefficient) resistor.
The resistance can be measured by two complementary methods:
• Applying a constant voltage across the resistor and measuring the current that flows
through it.
• Applying a constant current through the resistor and measuring the voltage that is
generated across it.
Hemo module uses the constant current method. The NTC-resistor is connected in series with a
normal resistor and a constant current is applied through them. The temperature dependent
voltage can be detected at the junction of the resistors, thus producing the temperature signal
from the patient. The signal is amplified by analog amplifiers and further processed by digital
electronics.
1-40
4.4.6 Respiration
Impedance respiration is measured across the thorax between ECG electrodes. The respiration
signal is made by supplying current between the electrodes and by measuring the differential
current from the electrodes. The signal measured is the impedance change caused by
breathing. The respiration rate is calculated from these impedance changes, and the
respiration waveform is displayed on the screen.
1-41
1-42
1 System installation
Safety precautions
Warnings
• The monitor or its components should not be used adjacent to or stacked with other
equipment. If adjacent or stacked use is necessary, the monitor and its components
should be observed to verify normal operation in the configuration in which it will be
used.
• After transferring or reinstalling the monitor, always check that it is properly connected
and all parts are securely attached. Pay special attention to this in case of stacked
mounting.
• The monitor must not be used without a manufacturer approved mounting attached.
• Never install the monitor so that it is above the patient.
Cautions
• The monitor display is fragile. Ensure that it is not placed near a heat source or exposed
to mechanical shocks, pressure, moisture or direct sunlight.
2-1
WARNING The power cord may only be connected to a three-wire, grounded, hospital
grade receptacle
2-2
MC Network
• The MC Network infrastructure shall be installed according to the "CARESCAPE Network
Configuration Guide".
• The installation site of the patient monitor shall have a wall jack and a network patch
cable for the MC Network.
S/5 Network
• The S/5 Network shall be installed according to the "S/5 Network Installation Guide". Refer
to the "iCentral and iCentral Client Service Manual" for iCentral installation instructions.
• The installation site of the patient monitor shall have a wall jack and a network patch
cable for the S/5 Network.
2-3
• Unit Name:
It is used for setting the unit name in the monitor. The default unit name is “X”.
NOTE: Unit Name here should be set to be same as CIC Unit Name.
• Bed Name:
It is used for setting the bed name in the monitor. The default bed name is the last
five characters of the MAC address, excluding the colon delimiter characters.
• Save Changes:
It is gray if the changes have not been done to the menu information.
NOTE: When save changes the monitor will restart automatically.
5. Set up the TCP/IP configuration
TCP/IP (Eth)
TCP/IP Config
• Using DHCP menu to configure the DHCP,
− Please select disabled, this monitor’s IP address, subnet mask, default gateway and
DNS Server must be manually configured.
NOTE: The default setting for DHCP is disable;
NOTE: If the IP address or both of unit name and bed name duplicate, the alarm will
be given to the new added monitors.
• Save the configuration after configuring the TCP/IP. When save changes the
monitor will restart automatically.
6. If the monitor does not connect to network correctly, you may also need to set up the
speed and duplex configuration.
TCP/IP (Eth)
TCP/IP Config
Speed and Duplex
Choose the suitable settings according to your network environment. The default setting
is AUTO.
2-4
To use the E-miniC module, your monitor need pre-configure the extension rack from
manufacture.
To insert module:
1. Align the module with the insertion guides
2. Push the module into the monitor frame until it clicks and stops.
3. Pull the module outwards to insure the module is firmly seated.
To remove module:
1. Pressing the release latch, on the bottom of the module.
2. Grasp the module firmly and pull out of the Frame. Make sure not to drop it when it
comes out.
WARNING When detaching modules, be careful not to drop them. Always support with
one hand while pulling out with the other.
2-5
2-6
2-7
1 Instructions
1.1 Introduction
These instructions include procedures of system maintenance for the B40/B20. It’s include four
sections:
• Electrical safety tests.
• Installation checkout, which should be performed after installation and service
configuration.
• Maintenance and checkout, which should be performed every 12 months.
• Adjustments and calibrations
NOTE: Please complete the check form when performing the corresponding procedures.
NOTE: For the E-MiniC maintenance and calibration, please refer to “8. E-MiniC Module“ or “S/5
Single-width Airway Module, E-miniC Technical Reference Manual Slot” M1027829-1.
The symbol " in the instructions means that the procedure performed should be signed in
the check form.
The procedures should be performed in ascending order, bypassing those that are not
applicable for a particular monitor.
To enter the service menus, you need following passwords:
Monitor Setup - Install/Service (password 16-4-34) - Service (password 26-23-8)
In case you evaluate the measurement accuracy with a patient simulator, add the simulator’s
accuracy specification to the one for the monitor.
CAUTION Failure on the part of all responsible individuals, hospitals or institutions,
employing the use of this device, to implement the recommended
maintenance schedule may cause equipment failure. The manufacturer does
not, in any manner, assume the responsibility for performing the
recommended maintenance schedule, unless an equipment maintenance
agreement exists. The sole responsibility rests with the individuals, hospitals, or
institutions utilizing the device.
CAUTION Only trained personnel with appropriate equipment should perform the tests
and repairs outlined in this section. Unauthorized service may void warranty of
the unit.
CAUTION Wear a static control wrist strap when handling PC boards. Electrostatic
discharge may damage components on the board.
3-1
Accessories
A rigid cylinder or pipe
NIBP cuff
Adult NIBP cuff hose with cuff ID
Infant NIBP cuff hose with cuff ID
Tubing parts to connect a manometer and a pump to
the NIPB cuff and hose.
Dual invasive pressure adapter cable
ECG accessories, IEC or AHA
- Multi-link 3-lead integrated cable and leadwire
- Multi-link 5-leadwire set
- Multi-link 3/5-lead ECG trunk cable
SpO2 finger probe
SpO2 Interconnect Cable
Temperature dual cable
CO2 Sampling line 3m/10 ft
Tool
A multiparameter patient simulator with IBP, Temp
adpter cables
Screwdrivers PH1, PH2
NOTE: For details on recommended accessories see “Supplies and Accessories“ catalog.
3-2
2.2 Recommendations
GE recommends that you perform all safety tests presented in this chapter.
• Upon receipt of the device (monitor and its associated equipment).
• Every twelve months thereafter planned maintenance
• Each time the main enclosure is disassembled or a circuit board is removed, tested,
repaired, or replaced
These instructions are intended for every component in the system. GE recommends that the
qualified personnel performing the tests.
Perform electrical safety tests using an electrical safety analyzer per IEC 60601-1, UL 60601-1,
EN 60601-1 or CSA C22.2 No. 601.1. The schematics in the section provide a general
understanding of the test equipment. Actual configuration of test equipment may vary.
The patient monitor being tested should be placed on an insulating surface.
"
3-3
"
WARNING Use only AC power cords recommended or manufactured by GE.
NOTE: The measuring device (MD) represents the network and voltage measuring instrument
and its frequency characteristics per IEC 60601-1.
"
3-4
Acceptance criteria:
• For equipment without a power supply cord, the impedance between the protective earth
terminal and any accessible metal part which is protectively earthed shall not exceed 0.1
ohms.
• For equipment with a power supply cord, the impedance between the protective earth
pin in the mains plug and any accessible metal part which is protectively earthed shall
not exceed 0.2 ohms.
"
Acceptance criteria
• For equipment without a power supply cord, the impedance between the protective earth
terminal any accessible metal part which is protectively earthed shall not exceed 0.1
Ohms.
• For equipment with a power supply cord, the impedance between the protective earth
pin in the mains plug and any accessible metal part which is protectively earthed shall
not exceed 0.2 ohms.
3-5
Leakage Tester
Power Cord
HIGH NORM Power Cord
LOW
GND
GND
RVS Device
Under
Test
0.15µF
DMM 1K
10
NOTE: The measuring device (MD) represents the network and voltage measuring instrument
and its frequency characteristics per IEC 60601-1.
(1) Configure the safety analyzer as follows (NC):
• Polarity - NORMAL
• Neutral - CLOSED
(2) Power on the device under test.
(3) Read and record the current leakage indicated on the tester.
(4) Configure the safety analyzer as follows (SFC):
• Polarity - NORMAL
• Neutral - OPEN
(5) Read and record the current leakage indicated on the tester.
(6) Configure the safety analyzer as follows (SFC):
• Polarity - REVERSED
• Neutral - OPEN
(7) Read and record the current leakage indicated on the tester.
(8) Configure the safety analyzer as follows (NC):
• Polarity - REVERSED
• Neutral - CLOSED
(9) Read and record the current leakage indicated on the tester.
(10) Power off the device under test.
"
If measured reading is greater than the appropriate specification below, the device under test
fails. Contact GE Technical Support.
3-6
• (USA only) 300 µA, and the device under test is powered from a center-tapped 200-240
V/50-60 Hz, single phase circuit (UL Split Phase Exemption)
• 500 µA, and the device under test is powered from a non-centertapped, 100-240 V/50-60
Hz, single-phase circuit
Perform the test in Normal Condition (NC) and in two different Single Fault Conditions (SFC): 1)
earth open and 2) one of the supply conductors open at a time. Perform the test with normal
and reverse polarity.
NOTE: Refer to the instructions delivered with the safety analyzer to perform this test.
Leakage Tester
Power Cord
RVS
Device
Open
Under
Closed GND Test
0.15µF
DMM 1K
10
Probe to exposed conductive chassis
NOTE: The MD represents the network and voltage measuring instrument and its frequency
characteristics per IEC 60601-1.
(1) Configure the safety analyzer as follows (NC):
• Polarity - NORMAL
• Neutral - CLOSED
• GND (Earth) - CLOSED
(2) Power on device under test.
(3) Read and record the current leakage indicated on tester.
(4) Configure the safety analyzer as follows (SFC):
• Polarity - NORMAL
3-7
• Neutral - OPEN
• GND (Earth) - CLOSED
(5) Read and record the current leakage indicated on the tester.
(6) Configure the safety analyzer as follows (SFC):
• Polarity - NORMAL
• Neutral - CLOSED
• GND (Earth) - OPEN
(7) Read and record the current leakage indicated on the tester.
(8) Configure the safety analyzer as follows (SFC):
• Polarity - REVERSED
• Neutral - CLOSED
• GND (Earth) - OPEN
(9) Read and record the current leakage indicated on the tester.
(10) Configure the safety analyzer as follows (SFC):
• Polarity - REVERSED
• Neutral - OPEN
• GND (Earth) - CLOSED
(11) Read and record the current leakage indicated on the tester.
(12) Configure the safety analyzer as follows (NC):
• Polarity - REVERSED
• Neutral - CLOSED
• GND (Earth) - CLOSED
(13) Read and record the current leakage indicated on the tester.
"
If measured reading is greater than the appropriate specification below, the device under test
fails. Contact GE Technical Support.
Acceptance criteria NC
• 100 µA, and the device under test is powered from 100-240 V/50-60 Hz
Acceptance criteria SFC - earth open or one of the supply conductors open
at a time
• (USA only) 300 µA, and the device under test is powered from 100-120 V/50-60 Hz
• (USA only) 300 µA, and the device under test is powered from a center-tapped 200-240
V/50-60 Hz, single phase circuit (UL Split Phase Exemption)
• 500 µA, and the device under test is powered from a non-centertapped, 110-240 V/50-60
Hz, single-phase circuit
3-8
Center-tapped and non-center-tapped supply circuits produce different leakage currents and
the UL and IEC limits are different.
Leakage Tester
Power Cord
RVS
Device
Under
Closed GND
ECG Test Body Test
or SPO2 Test Body
0.15µF
DMM 1K
10
NOTE: The MD represents the network and voltage measuring instrument and its frequency
characteristics per IEC 60601-1.
(1) Connect the ECG/RESP Test Body to the green connector of the device under test.
(2) Configure the safety analyzer as follows (NC):
• Polarity - NORMAL
• Neutral - CLOSED
• GND (Earth) - CLOSED
(3) Power on the device under test.
(4) Read and record the current leakage indicated on the tester.
(5) Configure the safety analyzer as follows (SFC):
• Polarity - NORMAL
• Neutral - OPEN
• GND (Earth) - CLOSED
(6) Read and record the current leakage indicated on the tester.
(7) Configure the safety analyzer as follows (SFC):
• Polarity - NORMAL
• Neutral - CLOSED
• GND (Earth) - OPEN
3-9
(8) Read and record the current leakage indicated on the tester.
(9) Configure the safety analyzer as follows (SFC):
• Polarity - REVERSED
• Neutral - CLOSED
• GND (Earth) - OPEN
(10) Read and record the current leakage indicated on the tester.
(11) Configure the safety analyzer as follows (SFC):
• Polarity - REVERSED
• Neutral - OPEN
• GND (Earth) - CLOSED
(12) Read and record the current leakage indicated on the tester.
(13) Configure the safety analyzer as follows (NC):
• Polarity - REVERSED
• Neutral - CLOSED
• GND (Earth) - CLOSED
(14) Read and record the current leakage indicated on the tester.
(15) Power off the device under test.
(16) Repeat the steps in this procedure using the appropriate SPO2 Test Body. Connect the
SPO2 Test Body to the blue SPO2 connector of the device under test.
"
If measured reading is greater than the appropriate specification below, the device under test
fails. Contact GE Technical Support.
Acceptance criteria NC
• 10 µA
Acceptance criteria SFC - earth open or one of the supply conductors open
at a time
• 50 µA
3-10
Leakage Tester
Power Cord
HIGH NORM Power Cord
LOW
GND
RVS
Device
120K
ECG Test Body Under
Closed GND
or ECG Cable Test
or SPO2 Test Body
0.15µF
DMM 1K
10 (Keep cable length as
short as possible.)
NOTE: The MD represents the network and voltage measuring instrument and its frequency
characteristics per IEC 60601-1.
NOTE: Per IEC 60601-1, the impedance to protect the circuitry and the person performing the
test, but low enough to accept currents higher than the allowable values of the LEAKAGE
CURRENT to be measured.
WARNING Shock hazard. The following step causes high voltage at the test body. Do
not touch the test body.
(1) Connect the ECG/RESP Test Body to the green connector of the device under test.
(2) Configure the safety analyzer as follows:
• Polarity - NORMAL
• Neutral - CLOSED
• GND (Earth) - CLOSED
(3) Power on the device under test.
(4) Read and record the current leakage indicated on the tester.
(5) Configure the safety analyzer as follows:
• Polarity - REVERSED
• Neutral - CLOSED
• GND (Earth) - CLOSED
(6) Read and record the current leakage indicated on the tester.
(7) Power off the device under test.
(8) Repeat the steps in this procedure using the appropriate SPO2 Test Body. Connect the
SPO2 Test Body to the blue SPO2 connector of the device under test.
"
If measured reading is greater than the appropriate specification below, the device under test
fails. Contact GE Technical Support.
Acceptance criteria
• 50 µA
3-11
3-12
3 Installation checkout
These instructions include procedures for a installation checkout for B40/B20 monitor. It is
recommended to be performed after monitor installation and service configuration.
Skip the tests that are not applicable for the installed monitor.
These instructions include a “Installation and checkout form, B40/B20” to be filled in when
performing the procedures.
An electrical safety check and a leakage current test should be performed prior to the monitor
installation.
"
3-13
3.2.2 Display
1. Verify that all text is readable and all images are clear.
2. Verify that the brightness is good. Adjust if necessary.
"
3.2.3 Keyboard(s)
1. Enter the service menu:
Monitor Setup - Install/Service (password 16-4-34) -
Service (password 26-23-8) - Keyboard
2. Check the keys and Trim knob one by one.
"
3.2.4 Frame unit
1. Check that the clock on the screen shows correct time. Adjust the time and date, if
necessary.
NOTE: The B40/B20 can’t be acted as the TIME MASTER in network. You should adjust the
time and date from the central station.
"
3.2.5 E-minC module with CO2 measurement
1. Block the tip of the sampling line with your finger and check that the message ‘Sample
line blocked’ appears on the monitor screen within 30 seconds. Remove your finger from
the tip of the sampling line.
2. Detach the Mini D-fend and check that the message ‘Check D-fend’ appears on the
monitor screen within 30 seconds. Install the D-fend to the monitor again.
3. Breathe to the sampling line briefly. Check that the CO2 information is updated on the
screen.
"
3.2.6 Multiparameter Hemodynamic Modules
ECG and RESP measurements
1. Connect an ECG cable to the module. Connect the cable leads to a patient simulator.
2. Configure the Resp waveform field to the monitor screen.
3. Select Resp rate source to Imped.
Others -> Resp Setup -> Resp Rate Source
4. Check that all ECG and impedance respiration information is shown on the monitor
screen as configured on the simulator.
5. Turn the simulator off. Check that the “Asystole” and “Apnea” messages are displayed.
"
3-14
Temperature measurement
6. Check the temperature channels with a patient simulator.
Check that temperature measurement information is shown on the monitor screen as
configured on the simulator.
"
Invasive blood pressure measurement
7. Check the InvBP channels with a patient simulator.
8. Zero the InvBP channels and check that the values and waveforms correspond to the
simulator settings.
"
SpO2 measurement
9. Connect an SpO2 finger probe to the module. Check that the message ‘Probe off’ is shown
when the probe is not connected to a finger.
10. Attach the SpO2 probe to your finger. Check that a reading of value and a pleth
waveform appear on the screen
"
Non invasive blood pressure measurement
11. Connect and set up the NIBP integrated tool as following picture, ensure all the
connections made are leak-proof.
12. Enter NIBP menu: NIBP - NIBP Setup. Select Calibration Check and push the Trim Knob.
13. Pump the following pressures to manometer and check the difference between the
manometer and monitor pressure display (The zeroing offset is automatically subtracted
from the pressure readings).
3-15
There is reading of B1 and B2 in help filed under NIBP calibration menu. If the error of pressure
channel B1 is larger than specified above, contact to the qualified person to do calibration.
"
3.2.7 Recorder
1. Press the Recorder Start/Stop key and check that the module starts recording the
selected waveforms. Press the Recorder Start/Stop key again to stop recording.
2. Check that the quality of the recordings is acceptable.
"
3.2.8 Network connection
1. Check that the CAT-5 cable connector is clean and intact, then connect it to the Network
connector on the backside of the monitor.
Check that the monitor connects to the network, i.e. the network symbol appears on the
upper right-hand corner of the screen.
"
3.2.9 Final
• Power off the monitor
• Perform final cleaning
• Fill in all necessary documents
"
3-16
4.1.2 General
1. Check that all parts are intact and that the cables and screws are connected and
tightened properly. Check the connector pins are intact. Check the front cover and the
front panel sticker are intact.
2. Check that the modules go in smoothly and lock up properly.
3. Check the ventilation holes of the monitor and clean of dust if necessary.
4. Check the module and applied parts are clean.
"
NOTE: Batteries are recommended to be conditioned every six months.
"
3-17
4.2.2 Display
1. Check that the image on the screen is correct
2. Check the display brightness
Select
Monitor Setup
Display Brightness
Push the Trim Knob and check that the display brightness follows the selected brightness.
"
4.2.3 Keyboard(s)
1. Tests with the Command Board:
− Enter the service menu:
Monitor Setup - Install/Service (password 16-4-34) -
Service (password 26-23-8) - Keyboard
− Check the keys and Trim knob one by one.
"
4.2.4 Time and date
− Check that the clock on the screen shows correct time.
Readjust the time and date, if necessary.
Monitor Setup - Time and Date
NOTE: The B40/B20 can’t be acted as the TIME MASTER in network. You should adjust the
time and date from the central station.
"
4.2.5 Hemo Module
ECG measurement
• Configure ECG settings in monitor:
ECG - > ECG1 Lead: II; ECG2 lead: V1; ECG3 lead: aVL; ECG Size: 1.0
- >ECG Setup - > Beat Sound Volume: 1 or greater; Pacemaker: Show; HR Source:
Auto
• Configure ECG settings in simulator:
ECG rhythm: a normal sinus rhythm
heart rate: 80 bpm
Amplitude: 1 mV
1. Normal Sinus Rhythm
− Check that the monitor displays the ECG leads II, V1 & aVL and the waveforms are
noise-free. The monitor shall display a 80±5 bpm heart rate and an audible QRS
tone sounds with each QRS complex.
"
3-18
2. Pacemaker Detection
− Configure the simulator to output "Asynchronous Pacemaker Pulse"
− Check that pacemaker spikes are shown on the ECG waveform.
"
3. Asystole Detection
− Configure the simulator to output "Asystole".
− Check that the 'Asystole' alarm appears to the monitor screen.
− Configure the simulator to show "80 beats per minute, Normal Sinus Rhythm".
"
4. Leads Off Detection
− Detach the RA/R leadwire from the simulator.
− Check that the Lead II waveform disappears from the ECG1 waveform field and a
message 'RA/R lead off'' is shown momentarily.
− Check that Lead II is replaced by Lead III in the ECG1 waveform field after a while
and a message 'Lead changed' is followed by a message 'Learning'.
− Reconnect the RA/R leadwire to the simulator.
− Check that Lead III is replaced back to Lead II in the ECG waveform field.
"
Respiration measurement
• Configure RESP settings in monitor:
Set up the Resp waveform field to the monitor screen. And
Others -> RespSetup -> Resp Rate Source: Imped
- > Measurement: ON
• Configure RESP settings in simulator:
Baseline impedance: 1000
Amplitude: 1
Respiration rate: 20 breaths per minute
Lead selection: II (or LL)
5. Respiration Rate
− Check that the RESP waveform is shown and the RR value is 20 (±5).
− Configure the simulator's Apnea Simulation to "32 sec".
"
6. Apnea Detection
− Check that the monitor activates the Apnea alarm.
− Configure the simulator's Apnea Simulation to "OFF"
"
Temperature measurement
• Configure the “T1+T2” digit field to the monitor screen.
3-19
− Check the corresponding temperature value appears and that no error messages
are shown on the monitor screen.
NOTE: If the deviation on a temperature reading on the screen is more than 0.1°C,
calibrate the temperature channels according to the instructions in chapter
“Temperature calibration”.”
"
Invasive blood pressure measurement
• Configure the simulator’s IBP channels as follows:
Sensitivity: 5 µV/V/mmHg
InvBP outputs: " 0 mmHg static pressure" or "atmosphere"
8. Zeroing
− Press IBP Zero All key.
− Check that a message "Zeroing" followed by a message "Zeroed" is shown in the IBP
parameter window.
"
9. Static Pressure
− Configure the simulator's InvBP output to "200 mmHg static pressure".
− Check that the flat pressure line appears on the related waveform field. The reading
in the parameter window shall be 200 ±10 mmHg.
NOTE: Recalibration is needed, if the measured value is not within the specification
limits. Calibrate the invasive pressure channels according to the instructions in
“Invasive pressure calibration” section.
"
10. Pressure Waveforms
− Configure the simulator's InvBP output to "Arterial 120/80".
− Check that the pressure waveform for tested invasive pressure channel appears in
the IBP waveform field and the Sys/Dia (Mean) pressure values are shown in the
related parameter window.
"
SpO2 measurement
11. Test measurement
Connect the SpO2 probe onto your finger. Check that the reading of 90-100 and SpO2
waveform appears. Check that the HR value is calculated from SpO2 when ECG and InvBP
(IBP1 or Art) are not measured.
NOTE: a functional tester cannot be used to assess the accuracy of a pulse oximeter probe or a
pulse oximeter monitor
3-20
"
Non Invasive Blood Pressure measurement
• Connect and set up the NIBP integrated tool as following picture, ensure all the
connections made are leak-proof.
"
13. NIBP calibration
− Calibrate the Non-invasive blood pressure (NIBP) channel according to the
instructions in “NIBP calibrations” on page 3-24 section.
"
14. NIBP hose detection
− Disconnect the calibration setup
− Attach an infant NIBP cuff hose without cuff identification.
− Press the NIBP Start/Cancel key. The monitor shall automatically open the
selections NIBP Setup - Inflation Limits to user to manually select the inflation
limits.
"
3-21
4.2.6 Loudspeaker
Check the loudspeaker by setting the alarm volume:
Alarms Setup
Alarm Volume
Test the whole volume scale from 1 to 10 by turning the Trim Knob and check that the
alarm volume changes correspondingly. The alarm sound should be clear and audible
with all the settings.
"
4.2.7 Monitor software
Enter the service menu:
Monitor Setup
Install Service (Password 16-4-34)
Service (Password 26-23-8)
Take down the information regarding Monitor software.
"
4.2.8 Watchdog circuitry
Select:
Monitor Setup
Install Service (Password 16-4-34)
Service (Password 26-23-8)
Set/Test
Perform the tests WATCHDOG and WD BY OVERLOAD. Check that the monitor restarts in
each case.
NOTE: When selecting WD BY OVERLOAD, auto restarting should take place
approximately after 10 seconds.
"
4.2.9 Batteries
1. Check battery limits
Enter the BATTERY service menu:
Monitor Setup
Install Service (Password 16-4-34)
Service (Password 26-23-8)
Frame
Power Supply
WPM Battery
Smart Batt1
Smart Batt2
3-22
"
4.2.10 Network
− Connection to network
Check that the CAT-5 cable connector is clean and intact, then connect it to the monitor.
Check that the monitor connects to the network, i.e. the network symbol appears in the
screen.
"
4.2.11 Final cleaning
Switch off the monitor and perform final cleaning.
Fill in all necessary documents.
"
3-23
Calibration check
• Refer to the “Non Invasive Blood Pressure measurement” on page 3-21 in installation
checkout section for NIBP integrated tool set up.
1. Enter Calibration menu:
Monitor Setup - Install/Service (password 16-4-34) -Service (26-23-8) - Parameters -
NIBP - Calibrations
Calibration
Active Leak Test OFF
Calibration Check OFF
Protection OFF
Calibrate
Previous Menu
3-24
There is reading of B1 and B2 in help filed under NIBP calibration menu. If the error of pressure
channel B1 is larger than specified above, the module should be recalibrated. The error of B2 is
allowed to be even twice as large because it has no effect on blood pressure measurement
accuracy. However, we recommend recalibrating the module when the error of B2 is larger
than specified above to ensure best possible operation.
Calibration
1. Enter Calibration menu.
2. Remove the hoses from the front panel connector to enable proper zeroing.
3. Select Calibrate. If it is not available, perform the steps a and b.
a. Select Protection OFF in the Calibration menu and push the Trim Knob.
b. Menu selection Calibration is now enabled, and Protection is disabled.
• Start calibration by pushing the Trim Knob. Messages ‘Zeroing’ and ‘Zeroed’ will be
displayed in the NIBP message field. After this, a pressure bar and text ‘Calibrating’ will be
displayed.
• Connect an external mercury manometer with a pump to the module through the both
tubes of the hose - both transducers B1 and B2 must be calibrated simultaneously. Pump
up to a pressure of about 200 mmHg according to the manometer. Calibration is possible
in the range of 150 to 250 mmHg.
• Verify that both pressure values in the prompt field match the manometer reading. If not,
adjust by turning the Trim Knob. When the values of the pressure bar and the manometer
are equal, push the Trim Knob to confirm the calibration. The message ‘Calibrated’ will be
displayed on the NIBP digit field after a few seconds, which means that the calibration
succeeded, and the new calibration data is saved in EEPROM.
NOTE: When calibrating NIBP, always change the displayed pressure value slightly with the
Trim Knob, even in cases where the value would be correct. For example, change the value one
step higher and then back one step lower. ‘Calibrated’ text should appear in the display. This
ensures that the calibration procedure is correctly registered and stored by the module.
• To set the protection on:
Select Protection ON and push the Trim Knob. Then press NIBP module buttons Auto
ON/OFF and Start Cancel simultaneously for 3 seconds.
• Remove the module from the frame and plug it back again. Then perform “Calibration
check” (see the preceding page) to verify the new calibration.
3-25
3-26
1 Introduction
If a problem occurs during the functional examination, check the components of the monitor
according to the below troubleshooting table. If the problem persists, please refer to the
following detail troubleshootings.
Problem What to do
Nothing functions Unplug and re-plug the Power Cord. Also confirm that the cable is intact.
Confirm that the fuses are intact.
Hemo module does not Remove and replace the Hemo module.
function Confirm that the desired parameters are configured to be displayed.
E-miniC module does Confirm that ‘Calibrating Gas Sensor’ messages are not displayed.
not function Confirm that a D-fend water trap and a sample tube are attached.
Confirm that the desired parameters are configured to be displayed.
Remove and replace the module.
Network does not Refer to 1.5. Connection to Network section in Installation chapter about
function network’s configuration.
4-1
Mains power
DC/DC SW functioning
LED lit?
No
No
Yes
Mains power
No
LED lit?
4-2
No
Wait for 80
seconds. Try with another
No
software CD to
download again. Please
read the note below.
Start-up display
No
appears?
OK? Yes
Yes
No
NOTE:
The software CD may be
defective, or all available
software has already been
downloaded before.
4-3
2 Frame troubleshooting
Problem Cause What to do
Monitor is not starting. 1. The batteries are empty. 1. Connect the power cord.
2. Fuses may be blown. 2. Replace fuses.
3. If power cord connected, AC/DC 3. Replace the AC/DC power unit.
unit may be faulty.
4. If AC/DC unit is working, the 4. Replace the power board unit.
power board may be faulty.
5. On/Stby key may be faulty. 5. Replace the command board
panel keyboard foil.
Monitor is not starting. 1. The connection between power 1. Check connection between power
board and CPU board may be board and CPU board.
faulty.
2. Faulty CPU board. 2. Replace the CPU board.
The monitor starts (alarm beep 1. The LCD display cables are loose. 1. Check the LCD display connection
is heard), but the display board connectors.
remains black. 2. The backlights are not lit. 2. Check backlight connector. Check
inverter cable.
Backlights may be faulty. Replace
the backlights.
Backlight Inverter may be faulty.
Replace the Inverter board.
Display and monitor operating 1. Loudspeaker connector or wires 1. Check loudspeaker connector and
but no audible beep in start-up. loose or faulty. wires.
Display is too dim. 1. Incorrect brightness adjustment. 1. Adjust display brightness higher.
2. Backlight faulty. 2. Check inverter cable.
3. Backlight inverter faulty. 3. Replace backlight.
Stripes or white areas on screen. 1. Loose faulty display connection 1. Check display connection cable in
cable in CPU and display. CPU and display.
Module data disappears from Parameter module current (in Detach and change parameter
the screen. ‘Module power module bus) too high. module.
supply overload’ message.
Module data disappears. 1. Module bus voltage or signals 1. Replace module interface board.
path broken.
‘Battery failure’ message on the 1. Problem in communication 1. Replace battery.
screen. between battery and power
board.
2. Battery too old or defected. 2. Replace battery.
3. power board may be faulty. 3. Replace the power board.
4. Problem in communication
between power board and CPU
'Frame temperature high' The temperature inside the frame is Check monitor ventilation holes.
message. too high.
‘Battery temperature high’ Battery SMBus temperature is too Check monitor ventilation holes.
message on the screen. high. Replace battery.
4-4
4-5
4-6
3 Hemo Troubleshooting
3.1 Troubleshooting flowcharts
Insert Hemo
module to a good
Go to service
monitor
menu
No
configuration correct? configuration
Yes
Has module bus Replace flex
failed ? module bus
Yes
No
Refer to frame Has keyboard Yes
troubleshooting failed? Has NIBP board Replace NIBP
Yes failed? board
No
No
Fault not in a
module
Replace ECG Has ECG function
board failed?
Yes
No
failed?
Measurement does
not work.
Yes
Leak test in
Pump check in
Yes Service Menu
Service Menu OK?
OK?
NO
No
Check pump
connector.
explanation in
Is it OK? connectors. Find
service manual
leak and fix it.
and fix it
4-7
3.2 NIBP
3.2.1 NIBP toubleshooting
4-8
4-9
4-10
3.3 ECG
Problem Cause What to do
HR numerical display No heart rate available. If no ECG waveform, check LEADS OFF
shows ‘---’ message and connect the leads.
If ECG waveform exists, check heart rate
source e.g. in the ECG Setup menu behind
ECG key.
Unacceptable ECG Poor electrode or poor electrode skin Electrodes from different manufacturers
waveform contact. are used. /Too much/little gel is used.
Poor electrode condition. Electrodes are dried out.
Improper site of electrodes. Check that electrodes are not placed over
bones, active muscles, or layers of fat.
Improper skin preparation. Remove body hair. Clean attachment site
carefully with alcohol.
Improper bandwidth filter. Check filter.
Faulty/ dirty ECG cable. Change new cable.
No ECG trace Waveform not selected on screen. Press the Monitor Setup key and make
adjustments.
Module not plugged in correctly. Check the hemo module’s installation.
Noise-message High frequency or 50/60 Hz noise. Isolate noise source.
4-11
4-12
4-13
3.6 Temperature
Problem Cause What to do
No temperature displayed Wrong type of probe. Use correct probe.
Temperature out of measurable range. The range is between 10 and 45 °C.
Temperature calibration not protected. Set the protection ON in the Service
Menu.
4-14
1 Introduction
The monitor has a Service Menu, which is a useful tool to examine monitor functions and to
troubleshoot in case a fault occurs.
Service Menu
SW Download
SW Settings
Country Settings
UMBC Board
STP Calibrations
NIBP Calibrations
Set/Test
Safety Valve
SpO2 Pneumatics
Service Log
5-1
5-2
2 Frame
The Frame menu includes frame-specific service
menus. Service Menu Sw version / Unit id
Frame
----------------------------
SW Settings
----------------------------
UMBC Board
Memory ----------------------------
Network ----------------------------
Power Supply
----------------------------
Previous Menu
----------------------------
----------------------------
number:-----------------
200
----------------------------
2.1 SW Settings
SW Settings
SW Download
Country Settings
Previous Menu
5-3
2.1.1 SW Download
This menu is not used, for software download,
please refer to the Appendix for instruction. SW Download
Enable SW
CPU serial number 1200596
Previous Menu
5-4
Languages
Language
Select a language to be used during monitoring. Country Settings
NOTE: Service pages will always appear in English despite Languages
of this selection.
NOTE: For language codes, see the table below. Language ENG.LNG
Load from Card Load from Card ENG.LNG
Not used. Please use the software download CD to Delete Language POR.LNG
download the languages, refer to the Appendix for detail
Previous Menu Cancel
instructions.
Delete Language
Delete a language file from the permanent memory of the
monitor.
Abbreviation Language
CHI Chinese
CZE Czech
DAN Danish
ENG English
FRE French
GER German
HUN Hungarian
ITA Italian
NLB Dutch
NOR Norwegian
POL Polish
POR Portuguese
RUS Russian
SPA Spanish
SWE Swedish
TUR Turkish
5-5
2.3 Memory
A service menu to check the status of the
memory used in the CPU board of the monitor. Memory Service Data
Test Memory tests the condition of the Test Memory EEPROM/ Flash
EEPROM/Flash memory component of the CPU
Test SRAM Test ?
board. If the result of the test is Fail, see section
“Error messages” in chapter “CPU.” Previous Menu
Test SRAM tests the Static RAM memory of the Static RAM
CPU board in a similar way as the
Test ?
EEPROM/Flash memory. If the result of the test
is Fail, see section “Error messages” in chapter
“CPU.” Real - time clock OK
Real-time clock test is run at every start up and
also during the operation of the monitor. If the
result of the test is Fail, the battery for the SRAM
timekeeper should be replaced.
5-6
2.4 Network
2.4.1 Network
For setting the monitor’s network mode: S5/Unity
The Network Status view shows the general status of the network
Frame Frame
5-7
Ethernet
The Ethernet Status view shows the
Ethernet Ethernet Status
general status of the ethernet network Previous Menu Driver DP83907
communication. Cable Connected
Driver: Ethernet chip name. Ethernet Addt 00:40:97:0b:01:fb
Speed (bits/s) 0
Cable: Indicates if the ethernet cable is
connected. Statistics In Out
EthernetAddr: Monitor’s ethernet address. Packets 2527 11327
Bytes 297776 9837268
Speed: Indicates the current ethernet
communication speed. Data errors
The service data related to the ethernet CRC Frame Transm. BER
status view is described in the following 0 0 0 0
table. Hardware errors
Intern. Missed FIFO Overrun
0 0 0 0
5-8
5-9
Logins 0
5-10
TCP/IP config
DHCP: Disable/enable the DHCP mode. If the DHCP
enable, the IP address, subnet mask, default gateway
can’t be edited.
IP address: For setting the static IP address of monitor.
Subnet Mask: For setting the static subnet mask of
monitor.
Default Gateway: For setting the static default gateway
of monitor.
DNS Server: For setting the static DNS Server of monitor.
Speed and Duplex: For setting speed and dupliex of
monitor.
Save Changes: Close menu and save the current menu
information to permanent memory.
Cancel Changes: Close menu without saving changes
Ping
IP Address: For configuring the destination IP address for the ping command.
Ping: Enable the ping command by sending Internet Control Message Protocol (ICMP) echo request packets to
the target host and wait for an ICMP response. The response should be show in the Ping Status view.
2.4.6 WLAN
Reserved for future use.
5-11
5-12
5-13
Smart Batt1
Battx information from SMBus (this information Batt1 information from SMBus
is received from the battery via SMBus) WPM Battery Temperature 30.75 C
Temperature: Battery temperature Batts Voltage 11903 mV
Current 0 mA
Voltage: Battery voltage Smart Batt1 Avg. Current 0 mA
Rel. State of Charge 97 %
Current: Battery current (discharge or charge) Smart Batt2
Abs. State of Charge 72 %
Clear Temp Maxs Remaining Capacity 2532 mAh
Avg. Current: Rolling average of the battery Full Charge Capacity 2604 mAh
current Previous Menu Cvcle Count 33
Design Capacity 3520 mAh
Rel. State of Charge: Relative state of charge of Design Voltage 11100 mV
the battery. Expressed as a percentage of Rem.
Manufacture Date(DD:MM:YY) 20/12/24
Cap. (mAh) / Full Cap.(mAh).
Abs. State of Charge: Absolute state of charge. Manufacture Name NPC A07A90
Device Name SM201-6
Expressed as a percentage of Rem. Cap. (mAh)/ Device Chemistry LION
Design Capacity (mAh). Therm. Status from charger
5-14
Smart Batt2
If Smart Battx is selected for a battery NOT
Batt2 information from Memory and PMC
connected to the SMBus, the menu contains the
WPM Battery Rel. State of Change 0%
following:
Batts Remaining Capacity 0 mAh
Battx information from Memory and PMC (This Full Charge Capacity 0 mAh
Smart Batt1 Design Capacity 0 mAh
information comes from the power Board memory Design Voltage 0 mV
or is measured by the power Board. SMBus data in Smart Batt2
Manufacture Date (DD:MM:YY) 00/00/00
this menu is not real time, because this battery is Clear Temp Maxs
Manufacturer Name
not connected to the SMBus). Previous Menu Device Name
NOTE: This page may not contain information if Device Chemistry LION
SMBus has been connected only to the other DC/DC Board A/D
battery. Page can be updated by battery Batt1 Voltage 12.00 V
Batt2 Voltage 12.34 V
disconnection and reconnection, if desired. Batt Current -0.01 A
Rel. State Charge: Relative state of charge of the Batt Not CHG Temperature 32.24 C
battery. Expressed as a percentage of Rem. Cap.
(mAh) / Full Cap.(mAh).
Remaining Capacity: Remaining battery capacity
(mAh).
Full Charge Capacity: Capacity of the battery
when it is fully charged.
Design Capacity: Theoretical capacity of a new
battery.
Design Voltage: Theoretical value for nominal voltage of a new battery.
Manufacturer Date (DD:MM:YY): The date the battery pack was manufactured
Manufacturer Name: Acronym of the battery pack manufacturer name.
Device Name: Battery pack model name.
Device Chemistry: Battery chemistry of the cells used.
Batt1 Voltage: Battery A voltage measured at the power Board.
Batt2 Voltage: Battery B voltage measured at the power Board.
Batt Current: Battery current (discharge or charge) for the battery connected to SMBus.
Measured at the power Board.
Batt Not CHG Temperature: This is subject to change.
5-15
3 Keyboard
3.1 Keyboard Keyboard Serivce Data
The service menu for testing the command board Message count 0
Upper Led Leds upper OFF lowe OFF
functions.
Lower Led Direct action keys
Upper Led is for testing the upper alarm light (red) on
Dummy Press Admit/ Pt. Data SpO2 ECG
the monitor. When the text is highlighted, the upper Dischar & Trends
alarm light can be turned on and off by pressing the Keyboard Log
NIBP Invasive Normal
Trim Knob. Previous Menu Pressures Screen
Lower Led is for testing the lower alarm light (cyan)
Monitor Print/
on the monitor. When the text is highlighted, the Setup Record
lower alarm light can be turned on and off by Airway Others Silence Alarms
pressing the Trim Knob. Gas Alarms Setup
Dummy Press is for testing the Trim Knob. When the Zero Auto Start Start
text is highlighted, pressing the Trim Knob creates a All On/Off Cancel Stop
sound from the loudspeaker and the corresponding
number on the service data field increases. Control wheel
Press 0
Clokwise 0 Counterclokwise 0
Service Data
Message Count counts the number of messages that are sent out to the main CPU board.
Leds upper and lower indicate the states of the alarm lights on the monitor.
Direct action keys texts are indications to the command board membrane keys. When a key
on the command board is pressed, the corresponding text in the menu changes its color.
Control wheel, Press counts the Trim Knob pressings.
5-16
4 Parameters
NOTE: Parameter values in Service Data fields are only for reference in this section.
----------------------------
----------------------------
2, 2004-03-15
----------------------------
ode not set, 200
----------------------------
5-17
5-18
4.1.2 Gases
ID Not in use
ID unrel. Not in use
MAC Not in use
Sample Flow is calculated from differential pressure and adjusted by the module. Zero value as
measured during initialization when the pump is off. Gain: sample flow measurement can
be calibrated by adjusting the gain.
Ambient Ambient pressure is measured continuously. Amb-Work: ambient pressure - sampling
system internal pressure.
Fall time Not in use
CO2-O2 Delay Not in use
Pump Can be toggled ON/OFF. PWM output 0-100% is shown. Pump voltage is also shown.
Lamp The state, PWM control, and current of the lamp are shown.
Fan Not in use
Zero Valve Can be toggled between the measurement state (MEAS) and the zeroing state (ZERO).
Occl Valve Not in use
Temp Temperatures measured by the module from TPX, CPU, and OM.
Time after power on In minutes after power on.
5-19
5-20
Bad c-s by mod is a cumulative number that indicates how many communication errors the
module has detected.
The monitor starts counting these items at power up and resets to zero at power off. The values
may also be reset when a module is attached to the monitor frame and be set to 32769 or
continuous counting may be started when the module is removed from the monitor frame.
The nonzero values do not indicate a failure, but the continuous counting (more than 5 per
second) or value 32769 indicates either a serial communication failure or a module not in place.
Also failures in other modules may cause these numbers to rise or be set to 32769.
RAM indicates the state of the RAM memory.
ROM indicates whether the checksum at the EPROM is in accordance with the one the software
has calculated.
EEPROM indicates if the values stored in the permanent memory are valid.
The state is either OK, Fail or ? (module not in place or a communication error).
LeadsOff indicates whether the monitor can measure ECG even if one or more leadwires are off:
1 = measurement is not possible, 0 = measurement can be done.
MissedPkgs indicates the number of packages missed.
5-21
5-22
Temp error shows the status of the temperature test. No errors found show the
status (OFF) and errors found (ON).
Protect key and Protect mode show normally ON but can be turned to OFF for
the temperature calibration in Calibration Menu.
Configuration shows the chosen module configuration: T, P, TP, ST, or STP.
Timeouts is a cumulative number that indicates how many times the module
has not responded to the monitor’s inquiry. Bad checksums is a cumulative
number that indicates how many times communication from the module to the
monitor has broken down.
Bad c-s by mod is a cumulative number that indicates how many
communication errors the module has detected.
The monitor starts counting these items at power up and resets to zero at
power off. The nonzero values do not indicate a failure, but the continuous
counting (more than 5 per second) indicates either a serial communication
failure, or a module not in place. Also other modules can cause communication
errors that cause these numbers rise.
RAM indicates the state of the RAM memory.
ROM indicates whether the checksum at the EPROM is in accordance with the
one the software has calculated.
EEPROM indicates if the values stored in the permanent memory are valid.
The state is either OK, Fail or ? (module not in place or a communication error).
5-23
4.3.1 Calibrations
5-24
5-25
How to calibrate
NOTE: Perform NIBP Calibration Check first to evaluate if calibration is needed or not.
NOTE: Both channels B1 and B2 must be calibrated simultaneously.
NOTE: The module must be in the frame during the whole procedure.
NOTE: Calibration selection is available only when protection is OFF.
1. Change the protection setting from ON to OFF to enable the Calibrate selection - the
color of the Calibrate selection changes from grey to white.
NOTE: When calibration has been enabled, the message ‘Calibration not protected’ is shown in
the NIBP digit field.
2. Zeroing:
− Disconnect the NIBP hose from the module connector.
− Select Calibrate and push the Trim Knob.
NOTE: Messages ‘Zeroing’ and ‘Zeroed’ is shown in the NIBP message field and next to the
Calibrate selection momentarily. After this, a pressure bar will appear beside the menu and the
text ‘Calibrating’ is shown in the NIBP digit field.
3. Calibration:
− Connect the NIBP hose to the module connector.
5-26
5-27
Start test is for starting and Stop test for stopping the
Safety Valve test. Safety Valve Safety Valve Data
B1 B2
Pressure 000000 000000
Zero 000000 000000
Safety Valve Data: ADULT
Start Test St1 0000 AD0 -16
For information on general items Pressure, Zero, St1 to St2 0000 AD1 6
Previous Menu
St4, AD0 to AD7 as well as Timeouts etc., see service St3 0400 AD2 -1
St4 0000 AD3 1502
data descriptions in section 4.4 NIBP Module. AD4 2
Max. press and 2 s after stop show the measured AD5 -1643
AD6 4
values at Safety Valve test. AD7 -1505
B1 B2
Max press 0 0
2 s after stop 0 0
Timeouts 2 RAM OK
Bad checksums 0 ROM OK
Bad c-s by mod 0 EEPROM OK
5-28
For information on general items Pressure, Zero, St1 to St4, Timeouts 2 RAM OK
Bad checksums 0 ROM OK
AD0 to AD7 as well as Timeouts etc., see section ”NIBP Bad c-s by mod 0 EEPROM OK
Module.”
Pump, Safety Valve, and Deflate Valve show their states.
5-29
4.5 SpO2
PR: Measured pulse rate value
SpO2%: Measured SpO2 value SpO2 SpO2 Data
NoProbe: If there is a probe connected Previous Menu PR -----
PulseSearch: If the pulse search is being SpO2% -----
done.
CheckProbe: If there is check probe error.
QUART Status: Show quart status. NoProbe 1
POX Status: Show POX measurement PulseSearch 0
status. CheckProbe 0
I/O Status: Show IO status.
POX Error: Show POX error status. QUART Status 0000
POX Status 0000
I/O Status 9E08
POX Error 0000
For information on Timeouts etc., see
section ”NIBP Module.”
Timeouts 2
Return to Bad checksums 0 ROM OK
Previous menu. Bad c-s by mod 0
5-30
5 Set/Test
The power supply unit contains a watchdog
circuitry, which needs refreshment at every 1.5
Service Menu Sw version / Unit id
seconds. If the refreshment did not occur, the Set / Test
watchdog circuitry will reset the main CPU. In ----------------------------
normal operation, the main CPU refreshes the Watchdog
watchdog circuitry at every 0.2 seconds. ----------------------------
WD by Over load
The purpose of the watchdog circuitry is to restart
Set Wd Timeout 10s ----------------------------
the monitor, if there was a serious malfunction. This
feature is useful in two cases: when the main CPU is Factory Reset
----------------------------
not able to control the monitor, or when the CPU Previous Menu
controls the monitor but detects a serious ----------------------------
malfunction. Watchdog tests check proper
----------------------------
functionality of the watchdog circuitry in various
conditions. ----------------------------
Watchdog test ensures directly that the watchdog 2, 2004-03-15
number:-----------------
of the power unit functions properly. Choosing this
test prevents the watchdog circuitry from ----------------------------
refreshing and shows running seconds with an
accuracy of 0.1 seconds.
The test should have the following result when the
watchdog circuitry is working properly: The monitor will restart after 1.5
seconds from the start of the test. In malfunction: ‘>20 s’ is displayed, and the
test will be interrupted. In this case, the fault is in the watchdog circuitry of the
power unit.
WD by Overload test ensures the functionality of a feature, where the
software controls the monitor, but detects an overload situation in the main
CPU.
The test should have the following result when the feature is working properly:
The monitor will restart after 15 seconds from the start of the test.
Set Wd Timeout: Set up the the watchdog test time. The default value is 10 s.
Factory Reset restores the factory default settings and clears the data
memories. Factory reset should be run if the monitor software is replaced or if
the SRAM/Timekeeper battery is replaced.
5-31
6 Service Log
Error, event and alarm data is stored in the Service
Log. Service Log Error History
The service log contains information about the
occurred monitor errors, events and alarms since the Error Log
Last errors:
last factory reset or service log reset. The service log Alarm Log
is saved in the EEPROM memory of the main CPU Scroll Log 2010-Nov-27 13:50:08
board. UMBC handler: LOG Msg<Umbc reset> at
Record Log UmbcChannel. cpp(189)
Reset Log
Error Log is for selecting the error history view onto
the right side of the menu. Error Log shows also Previous Menu
some monitoring events like warm and cold starts.
Alarm Log is for selecting the alarm history view
onto the right side of the menu.
Scroll Log is for scrolling the error/alarm information
on the right side of the menu.
Record Log is for recording the service log
information onto the recorder.
Reset Log is for clearing up the content of the
selected service log. This function should be run after
a performed maintenance.
5-32
6-1
6-2
1.3 Frame
6-3
1.4 Others
6-4
6-5
6-6
3 Frame disassembly
WARNING The B40/B20 is always energized by the internal batteries. A short circuit
may cause internal damage. Do not touch any exposed wiring or
conductive surface inside, this may cause an electric shock.
CAUTION Perform leakage current measurement whenever service or repair has been
done in the monitor.
NOTE: The backlight circuit runs on high voltage.
Do not touch the inverter board or the backlight tube leads when powered.
NOTE: Field repairs are recommended to the field replaceable unit (FRU) only. Attempting a field
repair on a factory sealed component or assembly could jeopardize the safe and effective
operation of the Monitor.
NOTE: GE recommends that you assemble the monitor using the NEW fasteners (screws,
washers, etc.) provided in the FRU kits. Some fasteners, like the screws with a thread locking
coating, are NOT intended to be re-used more than three times.
6-7
3. From the back side of the monitor, pull the extension rack
out of frame, grasp it firmly.
6-8
7. Use the screwdriver to prize, pulling out the multi I/O at the
same time.
6-9
10. Open the cover in the back side of the frame, then remove
the screw inside.
6-10
To remove the alarm light board After opening the front cover
To remove the user interface board After opening the front cover
- Remove 2 screws, the user interface board is on the bottom
of the front cover
- Disconnect the Trim Knob cable
- Disconnect the keyboard cable
6-11
6-12
6-13
6-14
6-15
6-16
3.4 Batteries
3.4.1 Battery indicators
The B40/B20 messages, screen symbols and the LED indicators tell the user about the status of
the batteries. For screen symbols, see “Part 1 Symbols”. For LED indicators, consult the table
below and for messages, see section “Troubleshooting.” in User’s Guide.
Table 12 Battery indicators
6-17
6-18
6-19
4 Module disassembly
4.1 Before disassembly
NOTE: Wear a grounded, antistatic wristband when handling PCB boards. Electrostatic
discharge may damage components on the board.
NOTE: Handle all PCB boards by their edges.
CAUTION When reassembling the module, make sure that all cables are reconnected
properly.
6-21
Document no. 2050802-001
Module disassembly
6-22
6-23
Document no. 2050802-001
Module disassembly
6-24
6-25
Document no. 2050802-001
7 Technical
specification
General Specifications
1 General Specifications
1.1 Genenral specifications
Size
Monitor
Without extension 312±5 mm (H) * 312±5 mm (W) * 158±5 mm (D)
modules
With extension modules 312±5 mm (H) * 352±5 mm (W) * 178±5 mm (D)
Weight
With extension module, 6 kg
recorder and CO2
Environment
Operating temperature Normal operation: +5 to +40°C (41 to 104°F)
Charging batteries: +5 to +35°C (41 to 95°F)
Storage and transport -20 to +60°C (-4 to 140°F)
temperature
Operating humidity 20 to 90% noncondensing
Storage and transport 20 to 90% noncondensing
humidity
7-1
7-2
2 Parameters specifications
2.1 ECG specifications
Leads available 3-lead configuration: I, II, III
5-lead configuration: I, II, III, aVR, aVL, aVF and VA
QRS detection range 0.5 to 5mV
QRS detection width (Q to 40 to 120 ms
S)
Defibrillation protection 5000 V, 360 J
Recovery time <5 s
Input impedance Common mode > 10 M Ω @ 50/60 Hz
Differential > 2.5 M Ω from 0.67 to 40 Hz
Common mode rejection 90 dB minimum at 50 Hz
Tall T wave rejection >1.4 mV
ECG leads off detection Active patient electrode: <30 nA
Reference electrode: <120 nA
Filter modes
Monitoring filter 0.5 to 40 Hz
ST filter 0.05 to 40Hz
Dagnostic filter 0.05 to 150 Hz
Heart rate
Measurement range 30 to 300 bpm
Measurement accuracy ±5 % or ±5 bpm, whichever is greater
resolution 1 bpm
Heart rate response time (ANSI/AAMI EC13-2002 Section 4.1.2.1f)
Step increase from 80 to average 6.9 s (6.5 to 7.5 s)
120 bpm
Step decrease from 80 to average 8.2 s, (7.6 to 10.0 s)
40 bpm
The heart rate calculation operates with irregular rhythms of ANSI/AAMI
EC13-2002 Section 4.1.2.1e, the heart rate after a 20 second stabilization period
is:
Figure 3a 80 bpm
Figure 3b 59 bpm
Figure 3c 122 bpm
Figure 3d 117 bpm
7-3
NOTE: Pacemaker detector may not operate correctly during the use of high-frequency (HF)
surgical equipment. The disturbances of HF surgical equipment typically cause false positive
pacer detection.
7-4
7-5
Measurement accuracy
Without motion Adult/Pediatric 100 to 70% ±2 digits
Neonate 100 to 70% ±3 digits
With motion Adult/Ped/Neo 100 to 70% ±3 digits
Low perfusion 100 to 70% ±2 digits
0~69% unspecified
Display resolution 1% of SpO2
Display averaging 2 to 16 seconds
Pulse rate
Measurement and display 25 to 240 bpm
range
Display resolution 1 bpm
Measurement accuracy Without motion ±3 bpm
With motion ±5 bpm
7-6
2.6 NIBP
Measurement technique Oscillometric with step deflation
Supported modes Manual, automatic and stat
Measurement time Adult/Pediatric inflate duration time exceeds 120 s
Neonate cycle time exceeds 85 s
Measurement ranges
Systolic Adult/Pediatric: 30 to 290 mmHg
Neonate: 30 to 140 mmHg
MAP Adult/Pediatric: 20 to 260 mmHg
Neonate: 20 to 125 mmHg
Diastolic Adult/Pediatric: 10 to 220 mmHg
Neonate: 10 to 110 mmHg
Accuracy According to AAMI SP10-2002 4.4.5.2 B, accuracy of
NIBP parameter was validated against the
intra-arterial method 1.
Default initial inflation Adult/Pediatric: 135 ± 15 mmHg
pressure Neonate: 100 ± 15 mmHg
Over pressure allowed by Adult/Pediatric: 300 to 330 mmHg
independent safety Neonate: 150 to 165 mmHg
controller
1. Blood pressure measurements determined with this device are equivalent to those
obtained by an intra-arterial blood pressure measurement device, within the limits
prescribed by the American National Standard, Manual, electronic, or automated
sphygmomanometers
7-7
2.8 Temperature
Measurement units ° Fahrenheit (F)
° Celsius (C)
Measurement range 10 to 45°C (50 to 113°F)
Measurement accuracy ± 0.1°C without temperature sensor
Display resolution ± 0.1°C at 25 to 45 °C with reusable probes
Probe types supported Use only GE Healthcare recommend temperature
YSI probes.
Temperature self-check At start-up and then every 10 minutes
Probe type time response
Reusable skin temperature 3 s
probe:
Reusable adult central 6s
temperature probe:
Reusable pediatric central 4s
temperature probe:
Disposable skin 3 to 6 s
temperature probe:
Disposable central 5 to 8 s
temperature probe, 12F:
Disposable central 5 to 8 s
temperature probe, 9F:
7-8
Resolution 0.1%
Measurement rise time < 300 ms with nominal flow
Valid for respiration rate < 40 breaths/min at I:E ratio of 1:1. (Relative error is
typically 10% for respiration rate 80 breaths/min at I:E ratio of 1:1.) The accuracy
is specified in simulated ventilation. With higher respiration rates and with
varying ventilation methods the specifications may not be met.
Respiration rate
Breath detection 1% change in CO2 level
Measurement range 4 to 80 breaths/min
Accuracy ±1 breaths/min in the range 4 to 20
breaths/min ±5% in the range 20 to 80 breaths/min
7-9
Resolution 1 breaths/min
Non-disturbing gases are Ethanol C2H5OH (<0.3%)
those with a maximum Acetone (<0.1%)
effect on the CO2 reading
Methane CH4(<0.2%)
at 5.0 vol% < 0.2 vol%. The
effect is valid for specific Nitrogen N2 (0 to 100%)
concentrations shown in Water vapor (0 to 100%)
parentheses of the
Dichlorofluoromethane (<1%)
non-disturbing gas:
Tetrafluoroethane (<1%)
Disturbing gases and their Halothane (4%) increases < 0.3 vol%
effect on the CO2 reading Isoflurane(5%) increases < 0.4 vol%
at 5.0 vol% CO2 are shown Enflurane(5%) increases < 0.4 vol%
below. Errors listed reflect
Desflurane(24%) increases < 1.2 vol%
the effect of specific
concentrations (shown in Sevoflurane(6%) increases < 0.4 vol%
parentheses) of an If O2 compensation is not activated:
individual disturbing gas O2 (40 to 95%) decreases < 0.3 vol%
and should be combined
when estimating the effect If O2 compensation is activated:
of gas mixtures: O2 (40 to 95%) error < 0.15 vol%
If N2O compensation is not activated:
N2O (40%) increases < 0.4 vol%
If N2O compensation is activated:
N2O (40 to 80%) error < 0.3 vol%
NOTE: CO2 measurement is intended for patients weighing over 5 kg (11 lb).
7-10
1 Introduction
This chapter provides information for the maintenance and service of the Datex-Ohmeda S/5
Single-width Airway Module, E-miniC. The Single-width Airway Module is a single-width plug-in
module designed for use with the GE modular monitors. Later in this manual the module may
be referred to without S/5 for simplicity.
The Single-width Airway Module provides airway and respiratory measurements.
Letter C in the module name stands for CO2.
NOTE: Do not use identical modules in the same monitor simultaneously.
NOTE: The Single-width Airway Module or Compact Airway Module and Airway Module,
G-XXXX, cannot be used simultaneously in the same monitor.
NOTE: E-miniC is intended for patients weighing over 5kg (11lb).
8-1
2 Specifications
2.1 General specifications
E-MINIC
Module size, W × D× H 37 × 209 × 112 mm, 1.5 × 8.2 × 4.4 in
Module weight 0.4 kg/0.9 lb.
8-2
Warm-up time 1 min for operation with CO2, 30 min for full specification
Zeroing interval 4, 15, 30 and 60 minutes after start-up, then every 60 minutes.
8-3
8-4
3 Functional description
3.1 Measurement principle
3.1.1 CO2 measurement
MiniC is a side stream gas analyzer, measuring real time concentrations of CO2. It is a non
dispersive infrared analyzer, measuring absorption of the gas sample using an optical narrow
band filter.
The infrared radiation detector is thermopile.
Concentration of CO2 is calculated from absorption measured at 4.2 to 4.3 µm.
8-5
Mini D-fendTM
The sample is drawn through the sampling line. The gas then enters the module through the
water trap, where it is divided into two flows, a main flow and a side flow. The main flow goes
into the analyzer. This flow is separated from the patient side by a hydrophobic filter. The side
flow creates a slight subatmospheric pressure within the Mini D-fend water trap which causes
fluid removed by the hydrophobic filter to collect in the bottle.
Zero valve
The main flow passes through a magnetic valve before proceeding to the analyzer. This valve
is activated to establish the zero point for the MiniC measuring unit. When the valve is
activated, room air is drawn through a filter into the internal system and the gas sensor.
8-6
NafionTM tube 1)
A Nafion tube is used between the water trap and the zero valve to balance the sample gas
humidity with that of ambient air. The tube prevents errors caused by the effect of water vapor
on gas partial pressure when humid gases are measured after calibration with dry gases.
Gas analyzers
After the zero valve and Nafion tube, the gas passes through the miniC measuring unit.
1)
1. Nafion is a trademark of Perma Pure Inc.
8-7
Zero
valve
MiniC
Diff. Abs.
Pressure Pressure
Sensor Sensor
Diff.
Pressure
Sensor
minic_fem_gastubing.vsd
Pump
Gas out
8-8
8-9
13 1
1 I RESET RS485
25 14
2 I -15 VDC (not used)
3 I +15 VDIRTY
4 I +15VDC (not used)
5 I/O -DATA RS485
6 I/O DATA RS485
7 Ground and Shield
8 I -RESET RS485
9 n/c
10 n/c
11 n/c
12 n/c
13 Ground and Shield
14 I +24/+32 VDIRTY depends on power supply (not
used)
15 I Ground DIRTY
16 n/c
17 n/c
18 n/c
19 n/c
20 I GASFR (not used)
21 I CTSD (not used)
22 I TXDD (not used)
23 O RXDD (not used)
24 I +5 VDC (not used)
25 I +5 VDC DIRTY (not used)
8-10
4 Service procedures
4.1 General service information
The field service of the E-miniC module is limited to replacing parts that are available as spare
parts.
GE Healthcare is always available for service advice. Please provide the unit serial number, full
type designation and a detailed fault description.
CAUTION Only trained personnel with appropriate equipment should perform the tests
and repairs outlined in this section. Unauthorized service may void warranty of
the unit.
CAUTION The module electronics can only be repaired and calibrated at the factory.
The symbol " in the instructions means that the check form should be signed after
performing the procedure.
8-11
4.2.3 Inspection
General
1. Check internal parts
• all screws are tightened properly
• all cables are connected properly
• tubes are not pinched and there are no sharp bends on them
• all tubes are connected properly
• there are no loose objects inside the module
"
2. Check external parts
• the front cover and the front panel stickers are intact
• the Mini D-fend latch is moving properly
• all connectors are intact and attached properly
"
Reattach the module and check that the locking system moves properly.
8-12
"
Replace the Mini D-fend and sampling line with new ones.
NOTE: Use only GE Datex-Ohmeda sampling lines in order to ensure proper functioning.
Turn on the monitor.
Configure the monitor screen so that the CO2 curve is shown, for example as follows:
Monitor Setup - Screen Setup - Waveform fields -
Field 6 - CO2
Digit Fields
Lower Field 1 - Gases
"
4. Flow measurement offset
Enter the service menu Gases:
Gas Unit - Gases
Check that the flow measurement offset, i.e. the shown sample Zero value is within ±10
ml/min.
"
5. Ambient pressure
Check that the shown Ambient value corresponds with the current ambient pressure (±20
mmHg).
"
6. Zero valve check
Feed calibration gas and check that the gas readings in the service menu correspond
with the values on the gas bottle sticker. Keep feeding gas, then activate the zero valve
from the menu. The CO2 reading should drop back to near 0%.
"
7. Nafion tube
Replace the Nafion tube, if necessary.
8-13
"
8. Leak test
Perform the sampling system leak test.
Connect a flow cassette with high flow resistance value (50/1.1) to the end of the
sampling line and start following the Amb-Work value in the service menu. When the
value exceeds 130 mmHg, connect the other port of the flow cassette to the sample gas
out connector and switch off the pump.
Wait until the pressure inside the sampling system is stabilized, then observe the shown
Amb-Work value. The value, i.e. the pressure inside the sampling system should not drop
more than 6 mmHg in 20 seconds.
If the pressure drops more, first check the connections and repeat the test.
"
9. Check the flow rates
Wait until the Sample Flow value returns close to 150 ml/min.
Connect a flow meter to the 3 meter sampling line and check that the flow (the flow meter
reading) is within the following range:
Sampling flow (ml/min) 135...165
If necessary, readjust the sampling flow:
Select Sample gain adj from the menu.
To increase the sampling flow, turn the ComWheel counterclockwise. To decrease the
flow, turn the ComWheel clockwise.
A change of 0.050 in the Gain value changes the flow approximately 7.5 ml/min.
After you have changed the gain, wait until the Sample Flow value on the screen returns
near to the original, then check the flow meter reading again.
"
10. Working pressure
Check that the Amb-Work value in the service menu is within the following range:
Amb-Work (mmHg) 20...50
"
11. Gas calibration
Airway Gas - Gas Calibration
NOTE: The calibration should not be performed before 30 minutes warm-up time.
Use calibration gas 755580 (5% CO2, about 20% O2) for calibrating the E-miniC.
"
12. Occlusion detection
8-14
Block the tip of the sampling line with your finger and check that the message ‘Sample
line blocked’ appears on the monitor screen within 60 seconds.
"
13. Check D-fend
Detach the mini D-fend and check that the message ‘Check D-fend’ appears on the
monitor screen within 30 seconds.
"
14. Apnea detection
Reattach the mini D-fend. Simulate at least 5 breaths by feeding calibration gas into the
sampling line. Check that the shown gas information is correct.
Check that the monitor shows the message ‘Apnea’ within 30 seconds after you have
stopped feeding the gas.
"
15. Final cleaning
Turn off the monitor, disconnect and clean the module.
"
• Fill in all necessary documents.
8-15
8-16
8-16
8-17
Document no. 2050802-001
E-MiniC module disassembly and reassembly
8-18
Figure 8 Connecting sampling line to the gas valve and feeding gas
3. Turn on the power. For maximum accuracy, let the monitor warm up for 30 minutes. The
menu item Gas calibration remains gray as long as the message ‘Calibrating gas sensor’
is displayed.
4. Press the Airway Gas key and select Gas calibration.
5. Wait until the ‘Zero ok’ and then the ‘Feed gas’ messages appear after each gas on the
screen.
6. Open the regulator and feed calibration gas until the message ‘Adjust’ appears, then
close the valve. If you use an older brass regulator, the feeding pressure should be
adjusted between 5 and 7 psi.
7. Check that the displayed gas value matches the value on the calibration gas container.
NOTE: When calibrating the E-miniC module, set the O2 level according to the gas, for example
with 755580, set the FiO2 level in the CO2 setup menu to 21-40% and the AIRWAY GAS - CO2
SETUP O2 level to 20%. Adjust the O2 percentage according to the calibration gas (for 755580
the right O2 value is 20%).
NOTE: If an error occurs during calibration or if no gas is fed, the highlighting goes
automatically over the item Recalibrate and the text ‘Calibr. error’ appears. Push the Trim knob
to perform a new calibration.
If adjustments are required:
• Turn the Trim knob to highlight the first gas to be adjusted and then push the Trim knob.
• Turn the Trim knob until the displayed value matches the desired value in the gas bottle
and push it again.
8-19
Document no. 2050802-001
E-MiniC module disassembly and reassembly
If the message ‘Zero error’ is displayed, press the Normal Screen key and repeat the
calibration procedure.
The time of the last calibration is shown at the bottom of the menu page.
8-20
After you have changed the gain, wait until the Sample Flow value on the screen returns near
to the original, then check the flow meter reading again.
8-21
Document no. 2050802-001
Troubleshooting
6 Troubleshooting
6.1 Troubleshooting chart for CO2 measurement
Problem Cause/What to do
No response to breathing Sampling line or water trap blocked or loose, or improperly attached.
Water trap container full.
See the gas sampling system troubleshooting.
‘SENSOR INOP.’ message The temperature is too low or high, check the temperature in the service
menu. Supply voltage is too low or high, IR source current or voltage is
too low or high, check current in the service menu.
Pump is not working properly, check sample flow and pump voltage in
the service menu.
Ambient pressure too low or high, check the ambient pressure in the
service menu.
Zero valve not working properly, check the functionality by switching
zero valve on and off in the service menu.
‘ZEROING ERROR’ message Gas zeroing failed. Condensation or residual gases are affecting the zero
measurement. Allow the module to run drawing room air for half an hour
and calibrate again.
‘CHECK D-FEND’ message Amb – Work pressure difference too small.
Probably water trap or the sampling line is not attached properly. Gas
zero valve failure. Pump failure or gas outlet blockage.
‘REPLACE D-FEND’ message Amb – Work pressure difference too big.
Indicates residue build-up on the water trap membrane. This decreases
air flow. Replace the D-fend.
‘SAMPLE LINE BLOCKED’ message Amb – Work pressure difference too big.
Sampling line or water trap is occluded. Water trap container is full. If
occlusion persists, check internal tubing for blockages.
No response to any gas Check Sample Gas Out.
Amb - Work pressure low, flow too small and pump voltage too high.
Sampling line, water trap, or internal tubing is blocked or loose, or
improperly attached. Gas out connector or tubing is blocked.
Zero valve malfunction. Pump failure or pump is worn. Supply voltage
missing. Serial communication error.
Sudden increase in gas display Water trap malfunction. Check all internal tubing and the interior of the
water trap for occlusions or leaks. Replace water trap. Check flow rates.
Abnormally high (or abnormally Pressure transducer failure. Check the Ambient and Amb – Work
low) pressures in Gases service menu.
response to CO2
or sudden occlusion warning
Strong drift in all gases Leak in sampling line or internal tubing (especially in conjunction with too
low readings).
8-22
• D-fend malfunction
• change D-fend
ETCO2>PaCO2 • unit is mmHg or kPa and ETCO2 is close • change to “wet gas” by using
to arterial PCO2 install/service menu
• “dry gas” as default
8-23
Document no. 2050802-001
Troubleshooting
CAUTION The special internal sample tube is mechanically fragile. Sharp bends will
cause leaks.
NOTE: D-fend water trap should be replaced, when the ‘REPLACE D-FEND’ message appears
during the monitor startup.
NOTE: If any liquid has entered the miniC measuring unit due to water trap filter failure, leave
the module running without a sampling line for several hours and check the functions after it
has dried out.
8-24
Message Explanation
Gas out blocked - Gas out connector on the front panel, or the exhaust line
connected to it, is blocked.
- If the sample gas is returned to the patient circuit, the filter in the
return kit may be occluded.
- Make sure the sample gas outlet is connected to an open
scavenging system only where gas is removed in room pressure.
Recalibration Time out, fluctuating gases, gain adjusted “over”.
Zero error Unsuccessful zeroing.
Unstable, Calibr error Unsuccessful calibration.
Menu messages during
calibration:
Zero error Unsuccessful zeroing.
Adjust Calibration gas accepted and monitor is ready for adjusting the gas
values to match the calibration gas concentration.
Unstable Unsuccessful calibration.
8-25
Document no. 2050802-001
Software download instruction
1.1 Overview
This software download tool is a Windows-based software download application for B40 and
B20 patient monitor.
WARNING The installation must only be done while the monitor is not connected to a
patient in order to protect the patient and user from electrical shock.
CAUTION All user settings will be lost after installation of new monitor software. Save
user settings before starting software installation.
CAUTION Make sure that the monitor is connected to AC power source, or the batteries
are fully charged. Lost of power during software installation may result in
software installation failure.
A-1
6. Click Full Download button will download all the images including bootstrap, uboot, logo,
kernel, file system, vsp and language packages.
Click Quick Download button only will download file system, vsp and language packages.
A-2
After you click Full Download or Quick Download button, a dialog will appear to notice
you
Make sure to click “OK” first to close the dialog, then reset the monitor, if the monitor is
power off, please power on the monitor.
According to the status bar and progress bar, you can see the download status. When
the download is complete, the status bar will show “Downloading is Complete”.
7. Disconnect the main power and batteries to turn off the monitor, then connect the power
and press ON/OFF button to restart the monitor.
1.4 Troubleshooting
First, check the Ethernet and COM port connection, then restart the software to try it again. If
still not worked, please refer to the flow chart in Troubleshooting chapter, the 1.1. General
troubleshooting
A-3
A-4
B-1
<5% UT <5% UT
(>95% dip in UT) (>95% dip in UT)
for 5 sec for 5 sec
Power frequency 3 A/m 3 A/m Power frequency magnetic field
(50/60 Hz) magnetic should be at levels characteristic of a
field typical location in a typical
IEC 61000-4-8 commercial or hospital environment.
NOTE UT is the a.c. mains voltage prior to application of the test level.
B-2
NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones
and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be
predicated theoretically with accuracy. To assess the electromagnetic environment due to fixed RF
transmitters, an electromagnetic site survey should be considered. If the measured field strength in
the location in which the equipment is used exceeds the applicable RF compliance level above, the
equipment should be observed to verify normal operation. If abnormal performance is observed,
additional measures may be necessary, such as reorienting or relocating the equipment.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
B-3
B-4
Monitor Installation
L- E- N-
C-1
Notes
3.2.1. Start-up
. Temperature measurement
. SpO2 measurement
3.2.7. Recorder
3.2.9. Final
Notes
C-2
Signature
C-3
C-4
Monitor Installation
D-1
Notes
4.1.2. General
Notes
4.2.1. General
4.2.2. Display
4.2.3. Keyboard(s)
Notes
. ECG measurement
2. Pacemaker Detection
3. Asystole Detection
D-2
Notes
. Respiration measurement
5. Respiration Rate
6. Apnea Detection
Notes
. Temperature measurement
7. Temperature detection
Notes
8. Zeroing
9. Static Pressure
Notes
. SpO2 measurement
Notes
Notes
4.2.6. Loudspeaker
D-3
4.2.9. Batteries
4.2.10. Network
Notes
Notes
Signature
D-4
Notes
CO2 measurement
7. Nafion tube
E-1
Document no. 2050802-001
B40/B20 Patient Monitor
Notes
Notes
Signature
E-2
0459