This User’s Guide is designed to be used in Using This Guide

conjunction with the Agilent CMS, V24 and V26

This User’s Guide contains information on all the
User’s Reference Manual.
most commonly performed tasks for the Agilent V24
Please refer to this document for full details about the and V26 Monitors.
functionality of the Agilent V24 and V26 Monitors.
Keys on the control panel are printed on a white
background, for example, Alarms .
Notice
Keys on the screen are printed on a shaded
Agilent Technologies makes no warranty of any kind background, for example, Alarm Limits .
with regard to this material, including, but not limited
to, the implied warranties of merchantability and
fitness for a particular purpose. Agilent Technologies
shall not be liable for errors contained herein or for
incidental or consequential damages in connection
with the furnishing, performance, or use of this
material.

© Copyright Agilent Technologies GmbH 2000 s1

Table of Contents
Notice............................................................................... i REALTIME (preset) recording:............................. 13
Using This Guide ............................................................. i REALTIME (non-configured) recording:.............. 13
Turning Recordings On/Off .......................................... 14
Setup Reminders Changing the Recorder ................................................. 14
Using the Agilent V24 and V26 ..................................... 1 Vital Signs/Blood Recording ........................................ 15
Agilent V24 and V26 Main Screen................................. 1 Making a Single Recording ................................... 15
Basic Troubleshooting ................................................ 2 Making a Trended Recording ................................ 15
Parameter Setup Reminders............................................ 5 Neonatal Event Review.......................................... 16
To switch ECG/Resp/Pulse and NBP on or off: ...... 5 oxyCRG Episode ................................................... 16
To enter a parameter setup window:........................ 5 Recording Summary ................................................. 17
To turn all other parameters on:............................... 5
To change a setting: ................................................. 5 Alarms
Control Keys ................................................................... 6 Silence/Reset Alarms .................................................... 19
Switching Split Screen Trending on or off ..................... 8 Suspend Alarms ............................................................ 19
To switch Split Screen Trending on ........................ 8 Set/Change Alarm Limits ............................................. 19
To switch Split Screen Trending off:....................... 8 View Current Alarms/INOPs:....................................... 19
Switching oxyCRG on or off .......................................... 8 Individual Alarms On/Off............................................. 20
To switch oxyCRG display on:................................ 8 via alarm limits Task Window ............................... 20
To switch oxyCRG display off:............................... 8 via parameter Task Window .................................. 20
All Alarms On............................................................... 20
Battery Standby Mode ............................................................... 20
Charging Batteries .......................................................... 9
Using Battery Power....................................................... 9 Overview/Arrhythmia
Viewing Other Patients ................................................. 21
Recording Viewing Waves and Vital Signs ............................ 21
Making Recordings....................................................... 13 Sending/Receiving Alarms .................................... 21
DELAYED recording (normally ECG): ................ 13 Using Enhanced Arrhythmia Monitoring ..................... 22
Setting Up Arrhythmia........................................... 22
iii
 Displaying Delayed Wave ..................................... 22 Viewing Values in Table Form.............................. 31
Turning off the autmatic pop up of the Arrhythmia Val- Printing Scheduled Reports........................................... 32
idation task window:.............................................. 23 Calculations................................................................... 33
Viewing Collection Times ..................................... 33
Admit / Discharge / End Case Specifying a Calculation Time............................... 33
Admitting a Patient / Editing Patient Information ........ 25 Viewing Ranges ..................................................... 34
Printing Patient Information: ........................................ 25 Viewing Previous Calculations.............................. 34
Ending a Case / Discharging a Patient.......................... 26 Reviewing Calculations ......................................... 34
Ending a case: ........................................................ 26 Showing Normal Ranges ....................................... 35
Discharging a Patient:............................................ 26 Printing Displayed Calculations ............................ 35
Printing Scheduled Reports.................................... 35
Trends / Calcs Canceling a Report................................................. 35
Making Drug Calculations ..................................... 35
Using Vital Signs .......................................................... 27
Viewing Vital Signs............................................... 27 Modifying an Input Field ....................................... 35
Viewing Parameters Not Displayed....................... 27 Assigning an Unknown Entity Field...................... 36
Calculating ............................................................. 36
Viewing Older and Newer Data ............................ 27
Viewing Patient Data in Detail .............................. 27 Displaying the Titration Table ............................... 36
Printing Vital Signs................................................ 27 Printing the Titration Table.................................... 36
Marking and Reviewing Events.................................... 37
Changing Trend Priorities...................................... 28
Using Graphs ................................................................ 29
Selecting Parameters for Viewing ......................... 29 Neonatal Event Review
Viewing Graph Trends .......................................... 30 Viewing Neonatal Events ............................................. 39
Viewing Graphs Not Displayed............................. 30 Neonatal Events ..................................................... 39
Viewing Older and Newer Data ............................ 30 oxyCRG Episodes.................................................. 39
Viewing Data in Detail .......................................... 30 Adjusting Trigger Conditions ....................................... 40
Expanding the Vertical Axis.................................. 30 Manually storing an event............................................. 40
Changing the vertical axis of a specific graph channel:
30 oxyCRG
Printing Graphs...................................................... 31 oxyCRG Measurements ................................................ 41
iv
 Displaying the oxycrg............................................ 41 Adjusting the Size of RESP Wave......................... 49
Making an oxyCRG Recording ............................. 41 Selecting The RESP Detection Method ................. 49
Changing Oxygen Channel and Recorder Speed... 41 ST Measurement Points ............................................ 50
Configuring to be the Alarm Recording ................ 42 ST Segment Monitoring................................................ 51
Setting Up ST Monitoring ..................................... 51
Data Transfer Adjusting the Measurement Points ........................ 51
Transfer to Module ....................................................... 43 Changing the Reference Wave............................... 52
Blinking ................................................................. 44 Adjusting ST Alarms ............................................. 52
Stopping a Transfer to Module .............................. 44 ECG Troubleshooting ............................................... 53
Quick Transfer .............................................................. 45
Transferring Quickly ............................................. 45 Invasive Pressure
Transfer to Monitor....................................................... 46 Pressure Measurements................................................. 55
Stopping a Transfer to Monitor ............................. 46 Changing the Waveform Size ................................ 55
Changing the Pressure Label ................................. 55
ECG / RESP / ST Adjusting Alarm Limit........................................... 55
ECG Measurements ...................................................... 47 Zero Transducer ..................................................... 56
Selecting the Required Lead.................................. 47 Pressure Troubleshooting .......................................... 57
Standard ECG:
Viewing Multi-Lead ECG: .................................... 47 NiBP
Recording Multi-Lead ECG .................................. 47 NBP Measurements ...................................................... 59
EASI 12-lead ECG: Changing Mode...................................................... 59
Viewing EASI 12-lead ECG:................................. 47 Changing Repetition Time ..................................... 59
Recording EASI 12-lead ECG............................... 47 Single Manual Measurement or Auto Cycle.......... 59
Printing EASI 12-lead ECG................................... 47 Making a Stat Measurement .................................. 59
Adjusting the Size of the QRS............................... 48 Stopping a Measurement........................................ 60
Selecting the Filter Setting..................................... 48 Inflating the Cuff to prevent venous backflow: ..... 60
Selecting the QRS Detection Method.................... 48 NBP Troubleshooting ................................................... 61
Turning Off Channels 2 and 3 ............................... 48
Respiration Measurements............................................ 49 SpO2/Pleth
v
SpO2/Pleth Measurements............................................ 63 Cardiac Output
Setting Up SpO2 .................................................... 63 Making Cardiac Output Measurements ........................ 83
Deriving Pulse From SpO2/Pleth .......................... 64 Cardiac Output Troubleshooting................................... 84
SpO2 Troubleshooting.................................................. 65 Physiological reasons:............................................ 84
Reduced arterial blood flow................................... 65 Catheter related errors:......................................... 84
Injection errors:...................................................... 84
CO2 & ssCO2 Instrument errors:................................................... 84
Adjustments to CO2...................................................... 69
Calibrating CO2 Measurements.................................... 70 Temp
When to perform an accuracy check. .................... 70 Temperature Measurements.......................................... 89
When to calibrate................................................... 70 Setting Up Temperature ......................................... 89
Performing an Accuracy Check............................. 71 Measuring Temperature Differences when Monitoring
If calstick and screen values are the same ............. 71 more than one Temperature ................................... 89
If calstick and screen values are different.............. 71
Perform the Calibration ......................................... 71 Anesthesia Gas Monitoring
Mainstream CO2 Measurement: CO2 Transducer and Setting Up Anesthetic Gas Module............................... 91
Breathing Circuit ....................................................... 72
Setting Up Anesthetic Gas Module with Watertrap
Sidestream Module, CO2 Transducer and Breathing (Option A02) ................................................................. 93
Circuit ....................................................................... 73 Accessing the Airway Gas Task Window ............. 95
Turning the Sidestream Pump On................................. 74
Standby Mode ............................................................... 96
CO2 and Sidestream Mode Troubleshooting................ 75 Activating the Standby Mode: ............................... 96
Deactivating the Standby Mode............................. 96
tcpO2/tcpCO2 Calibration..................................................................... 97
tcpO2/tcpCO2 Measurements....................................... 77 Automatic Zero Calibration: .................................. 97
Changing Site Time or Reset Timer ...................... 77 Manual Zero Calibration:....................................... 97
Changing Transducer Temperature ....................... 77 Span Calibration: ................................................... 97
Changing Alarm Limits ......................................... 78 Selecting Agent Identification ...................................... 98
Calibrating the tcpO2/tcpCO2 measurement......... 78 Automatic agent identification:.............................. 98
Tc Gas Troubleshooting ............................................ 79 Automatic agent selection...................................... 99
vi
 Manual agent selection .......................................... 99
Adjusting Anesthetic Gas Module Alarms ................. 100

Blood Analysis
Setting Up The Blood Analysis Module..................... 101
Viewing Blood Analysis Results ................................ 102

BIS
Setting up BIS measurements ..................................... 108
Adjusting BIS measurements .............................. 108

Agilent V24/26 Web Link

Intended Use ............................................................... 110
Overview..................................................................... 110
Viewing the Welcome Page........................................ 110
Viewing Application Pages ........................................ 110
Adding a page to the Favorites Menu......................... 111
Updating a Favorites link (address) ............................ 111
Updating a Favorites link (name) ............................... 111
Deleting a Favorites link............................................. 111
Agilent V24/26 Web Link Troubleshooting ............... 112
 Setup Reminders

Using the Agilent V24 and V26

Pressing Main Screen always returns you to the Main Screen.
Pressing Alarms , then Monitor Standby stops all patient monitoring, but preserves the monitor
settings.
Pressing any control panel key (except Suspend ) causes monitoring to be resumed.

Agilent V24 and V26 Main II

ICU Adult 10 JAN 95 20:05
HR PULSE 70
NUMERICS
Screen CHANNEL #1
F HR
70
ST1 0.3
LAYOUT: #1 NON-OVERLAP ST2 -0.2
1mV
ABP
ABP 120
CHANNEL #2 135/72 (94)
PAP
0 34/16
(23)
PLETH SpO2
CHANNEL #3
SpO SQI
97
2

CO2 40
ETCO2
CHANNEL #4 0
20
IMCO 2 0 NBP 19:47
AWRR 37 115/65
(81)
Alarm Vol 165 QRS Vol 150

Setup Reminders
Setup Reminders

Basic Troubleshooting
Problem Possible Cause Corrective Action
Wave is not on the Transducer is not plugged Plug in transducer
screen. in.

Parameter is not switched Switch on parameter:

on. 1. Press Module Setup → Parametr On/Off
2. Press Select Parametr
(to highlight the parameter)
3. Press Parametr On/Off
(to switch wave on).

The monitor is not showing Change to the required screen display:

the display required. 1. Press Change Screen .
2. Press Screen A , Screen B , Screen C .
Screen D or Screen E

2
 Problem Possible Cause Corrective Action
Wave is not on the The wave has not been Assign wave to a channel:
screen. assigned to a channel. 1. Press Monitor Setup → Display 1 Setup .
2. Press Select Item
(to select required channel).
3. Press Change Content repeatedly to select
desired wave.
(Change speed and # of waves on screen or wave
layout as required.)

Numeric is not switched on. See “Switch on Parameter/Numeric:” below

Setup Reminders
Setup Reminders

Problem Possible Cause Corrective Action

Numeric is not on Parameter/Numeric is not Switch on Parameter/Numeric:
the screen. switched on. 1. Press Module Setup → Parametr On/Off .
2. Press Select Parametr
(to select the required parameter).
3. Press On/Off Parametr if parameter is off.
4. Press Monitor Setup → Display 1 Setup
→ Numeric On/Off .
5. Press Select Numeric to select the required
numeric. (Press Next Page if necessary).
6. Press On/Off Numeric if numeric is off.

4
 Parameter Setup Reminders

To switch ECG/Resp/Pulse and NBP on To turn all other parameters on:

or off: Plug the transducer into the parameter module.
1. Press Module Setup Å Parameter is turned on automatically.
Parametr On/Off
To turn a parameter on when the transducer is
2. Press Select Parametr (to select the unplugged, press On/Off Setup in the Parameters
required parameter). On/Off Task Window.
3. Press Parametr On/Off (to turn the required
parameter on). To change a setting:
To change a setting in a Task Window, move the
To enter a parameter setup window: highlighting by pressing
1. Either press key on module which has parameter either
name (e.g., ECG ). the softkey for the action you wish to perform
or (e.g., Change Lead ),
Press Module Setup . or
the highlighted arrow keys: , , ▲ and ▼ .

▲
Press softkey with parameter name
(e.g., ECG ).

Setup Reminders
Setup Reminders

Control Keys
Alarms Procedures
– to turn all alarms off/on and individual alarms on/ – to perform Cardiac Output measurements, make ST
off, adjust alarm limits, show the alarm messages, go segment monitoring adjustments, review ST wave
to standby mode and other functions. segments, admit and discharge patients or end a
particular patient case and transfer patient data.
Monitor Setup
– to change settings such as screen displays and Module Setup
patient type, set up oxyCRG and recording and make – to set up and change settings for all modules that are
general configuration changes. plugged into the Agilent V24 or V26.
Trends/Calcs
– View data in graphs and tables, print reports and
enter calculation task windows and arrhythmia
functions.
Other Patients
– to view data and alarms from other beds.

6
 Silence/Reset
– silences an alarm and, if cause has been eliminated,
resets it.
Suspend
– Switches all alarms on/off.
Main Screen
– returns you to the standard monitoring screen.
Delayed Record
– starts a delayed recording.
Realtime Record
– leads you to a selection window, from which you
can start a realtime preset recording or a realtime
selected recording.
, , ▲, ▼
▲

Arrow Keys –
▲

– to move highlighting and make selections in Task

Windows – only active when lit.

Setup Reminders
Setup Reminders

Switching Split Screen Trending on Switching oxyCRG on or off

or off
To switch oxyCRG display on:
To switch Split Screen Trending on 1. Press Monitor Setup
1. Press Monitor Setup 2. Press Display 1 Setup
2. Press Display 1 Setup 3. Press Select Item and select Applic Window
3. Press Select Item and select ApplicWindow 4. Press Change Content and select oxyCRG
4. Press Change Content and select Split
To switch oxyCRG display off:
To switch Split Screen Trending off: 1. Press Monitor Setup
1. Press Monitor Setup 2. Press Display 1 Setup
2. Press Display 1 Setup 3. Press Select Item and select Applic Window
3. Press Select Item and select ApplicWindow 4. Press Change Content and select None
4. Press Change Content and select None

8
Battery

Charging Batteries 6. The battery fuel gauge also reads full.

To charge batteries:
Using Battery Power
1. New batteries, or batteries that have been stored for
an extended period, require 4 hours (with monitor To use battery power:
switched off) or 16 hours (with monitor in use) of 1. Once charged, disconnect the AC line power to
charging before use . operate on internal battery power.
2. Insert 2 40488A 12 Volt lead-acid batteries into the 2. As power discharges, the battery fuel gauge will
monitor. decrease indicating your battery power capacity.
3. Plug the power cord into AC (line power). 3. The rate that batteries discharge (lose power) is
AC Power green LED illuminates. dependent on the power load or number of modules
4. Battery Charging amber LED illuminates installed in the rack assembly.
and blinks, indicating your batteries are charging 4. When you have approximately less than 15 minutes
and are inadequate for transport. of battery power left, the monitor will sound an
5. Battery Charging LED will go off when INOP alarm tone and flash the message
batteries are at 90% charged capacity. “REPLACE BATTERIES.”
The Battery Charged green LED will be 5. Replace with fully charged batteries or plug the
illuminated when the batteries are 90% charged, and monitor into AC line power.
will stay on steady even when the batteries are fully
charged.

Battery
 Battery

6. To preserve battery integrity, keep batteries FULLY

charged by keeping the monitor plugged into AC
line power whenever possible.

10
 Warning

When connecting a non-medical device such as a printer to the RS-232 Interface of an Agilent V24CT
or V26CT, the monitor must be properly grounded, or the non-medical device properly isolated. This
must be done in order to prevent the possibility of an electrical shock hazard (to the user and or
patient) from excessive ground leakage currents from the non-medical device such as a printer, and to
maintain compliance with IEC 601-1-1 where applicable. This hazard is especially prevalent when the
Agilent V24CT or V26CT is operated in battery mode.

In normal AC line operation grounding the monitor is accomplished by ensuring that the AC line cord
is connected from the monitor to a properly grounded AC receptacle. Alternatively and additionally,
proper grounding may be achieved by attaching a safety grounded wire to the threaded safety ground
stud found on the rear of the monitor.

Isolation may be acheived by powering the printer through a safety isolation transfomer.

11

Battery
Battery

12
Recording

Making Recordings 4. Press Stop Recordng to stop, if key

available
A DELAYED recording records waves that ocurred
or
10 to 15 seconds before you requested the recording.
press STOP on the recorder.
A REALTIME recording records waves that occur at
the time you request the recording. REALTIME (non-configured) recording:
1. Press Realtime Record .
DELAYED recording (normally ECG):
2. Press Select RecWaves , if key available.
1. Press Delayed Record .
or 3. Select up to two waves.
On the plug-in recorder, press Run/Cont . 4. Press Start Recordng .
2. Press STOP on the recorder if it does not stop 5. Press Stop Recordng to stop
automatically. or
press STOP on the recorder.
REALTIME (preset) recording:
6. Press Main Screen .
1. Press Realtime Record .
2. Press Preset Recordng (if available). 1.The name of the actual recorder appears
3. Press Mode X PLUG-IN 1 on the key. This can be PLUG-IN, Central,
4CH BS-1, or 4CH BS-2.
13

Recording
 Recording

Turning Recordings On/Off Changing the Recorder

To turn alarm recordings on/off: To change the recorder:
1. Press Monitor Setup . 1. Press Monitor Setup .
2. Press Recordng Setup 2. Press Recordng Setup .
3. Press AlarmRec On/Off . 3. Select the type of recording, e.g.
4. Configure alarm recordings for each parameter. Procedur Recording .
The availability of the following softkeys depends 4. Press Change Recorder to select the
on the configuration of the monitor appropriate recorder.
5. Press Select Parametr . 5. Press Main Screen .
6. Press Change AlarmRec to select
sensitivity of alarm.
7. Press All Rec On to enable red or red and
yellow conditions.
8. Press All Rec Off for no alarm recordings.
9. Press Main Screen .

14
Vital Signs/Blood Recording

Making a Single Recording Making a Trended Recording

To make a single Vital Signs/Blood recording: To make a trended Vital Signs recording:
1. Press Monitor Setup . 1. Press Trends/Calcs
2. Press Recordng Setup , 2. Press Vital Signs
then VS/Blood Recordng . 3. Press Vitals PLUG-IN
To determine the recording trigger is NBP:
Press NBP Start and select Yes
To determine the recording trigger is blood:
Press Blood Start and select No
To determine the recording trigger is timer
event
Press Timer Start , select Yes and press
Repeat Time to select the desired time
interval.

15

Recording
 Recording

Neonatal Event Review

To make a Neonatal Event Review recording:
1. Press Alarms
2. Press Event Review
3. Press Record Summary

oxyCRG Episode
To make an oxyCRG Episode recording:
1. Press Alarms
2. Press Event Review
3. Select an event with the cursor.
4. Press oxyCRG Episode
5. Press Record Episode

16
Recording Summary
Delayed Realtime/Preset Realtime/Your Selection

To Start • Delayed Record • Realtime Record • Realtime Record

• Preset Recordng (if • Select RecWaves
available) (if available)
• Mode X PLUG-IN 1 • Select the wave(s).
• Start Recordng

To continue Run/Cont on recorder Run/Cont on recorder if Realtime/Your Selection is

indefinitely preset to timed preset to continued

To extend Delayed Record Mode X PLUG-IN 1 Realtime/Your Selection is

preset to continued

17

Recording
 Recording

Delayed Realtime/Preset Realtime/Your Selection

To Stop Stops automatically or • STOP on recorder • STOP on recorder
• STOP on recorder or or
or Record then Record then
Record then
• Preset Recordng • Preset Recordng
• Preset Recordng (if available) (if available)
(if available)
• Stop Recordng while • Stop Recordng .
• Stop Recordng highlighted.
while highlighted.
(Highlighted for local
delayed recordings.)

To Change • Realtime Record • Realtime Record • Realtime Record

Speed while • Preset Recordng • Preset Recordng • Preset Recordng
Recording is (if available) (if available) (if available)
running
• Change RecSpeed • Change RecSpeed • Change RecSpeed
(as soon as key bcomes (as soon as key bcomes (as soon as key bcomes
available) available) available)

1
The name of the actual recorder appears on the key. This can be PLUG-IN, Central, 4CH BS-1 or 4CH BS-2.

18
Alarms

Silence/Reset Alarms Set/Change Alarm Limits

Before silencing or resetting alarms, make sure you To set/change alarm limits:
check what other parameters are in alarm. All 1. Press Alarms → Alarm Limits .
parameters that are in alarm will be reset.
To silence and reset alarms that are sounding: 2. Press Select Parametr
(to select the required parameter).
Press Silence/Reset
3. Press ↓ Low Limit ↑ or ↓ High Limit ↑
(to adjust limits)1.
Suspend Alarms
View Current Alarms/INOPs:
To suspend all alarms (turn alarms off):
Press Suspend . Press Alarms Å
or Alarm Messages (if available).
Press Alarms → Suspend Alarms . Either
“Alarms Suspended” or “Alarms Suspended 1, 2 or
3Min” message, depending on how the monitor is
configured; Large appears on control panel.

▲
▲
1. - To adjust the SpO2 Desat alarm press and .
- The Extreme Bradycardia alarm difference is
adjustable in Configuration mode only.

19

Alarms
 Alarms

Individual Alarms On/Off All Alarms On

To turn individual parameter alarms on/off: To turn all alarms on:
1. Press Suspend .
via alarm limits Task Window or
1. Press Alarms → Alarm Limits . Press Alarms .
2. Press Select Parametr 2. Press SwitchOn Alarms .
(to select required parameter). Note — Any individual alarms previously turned off
3. Press On/Off Alarms will still be off ( next to label).
(to turn alarms on or off).
or
Press Alarms → Confirm to switch all Standby Mode
alarms off then proceed as in 2. and 3. above to
To go into Standby Mode:
switch specific alarms on.
1. Press Alarms .
via parameter Task Window 2. Press Monitor Standby .
1. Press key on module. Pressing any control panel key (except Suspend )
2. Press Adjust Alarms → On/Off Alarms causes monitoring to be resumed.
(to turn alarms on or off).
(If Off, appears next to the parameter label.)

20
Overview/Arrhythmia

Viewing Other Patients

Viewing Waves and Vital Signs Sending/Receiving Alarms

To view waveforms and vital signs on another patient: To send alarms to/receive alarms from another bed:
1. Press Other Patients . 1. Press Other Patients .
2. Change selection to line of softkeys with bed you 2. Press Controls .
want. 3. Press Show Roster to see which group the
3. Press the softkey for that bed. For groups, select bed you’re sending to/receiving from is in. If
bed, using More Beds if necessary needed, press Select Group and highlight
4. Press Show NextWave to view other waves. the desired group. Press Send Alarms or
Receive Alarms and highlight YES.
5. Press Show Next Bed or group label to
view another bed. 4. Press Main Screen .

6. Press Main Screen .

21

Overview/
Arrhythmia
 Overview/
Arrhythmia

Using Enhanced Arrhythmia Monitoring

The Agilent V24 and V26 provides basic arrhythmia analysis on the patient’s ECG waveform. This includes
triggering alarms on asystole, bradycardia, ventricular fibrillation and tachycardia conditions.
Enhanced arrhythmia must be assigned to your bed before you can monitor the patient
Press either Trends/Calcs , or Alarms then Arrhyth Functns . “Arrhyth assigned” on screen shows
that you have been assigned arrhythmia. If arrhythmia has not been assigned to your bed and there are no
channels available, you must UNASSIGN one of the other beds using the arrhythmia channel so as to assign
arrhythmia to this bed. You cannot UNASSIGN the other bed from your monitor, you must do so at the Central
Station or arrhythmia monitor. Assign your bed to the Central Station. (The QRS detection mode switches to
“Automatic”. The softkey Auto/Man & Pacing does not function.)

Setting Up Arrhythmia Displaying Delayed Wave

To set up Arrhythmia: 1. To display the delayed Arrhythmia wave:
1. Press Paced Yes/No until either “Yes” or 2. Press Module Setup .
“No” appears next to the question “Is patient 3. Press Delayed ArrhWave .
paced?”. (This key will only work if arrhythmia is
2. The heartrate shown in any window is calculated assigned.)
by the arrhythmia computer, not the heartrate 4. Press Main Screen .
counter of the monitor.
3. Press Main Screen .

22
Turning off the autmatic pop up of the
Arrhythmia Validation task window:
1. Press Trends/Calcs
2. Press Rcv Arrhyth -> No
Press Rcv Arrhyth -> Yes to turn pop up back on.

23

Overview/
Arrhythmia
 Overview/
Arrhythmia

24
 Admit / Discharge / End Case

Admitting a Patient / Editing Patient

Information
1. Press Procedures
2. Press Admit Patient to admit new patient or
edit existing patient data
3. If necessary, press Select Line to select the
field
4. Enter or change patient information using the
keypad
5. Press Confirm
6. To assign arrhythmia, press Trends/Calcs
Å Arrhyth Functns .

Printing Patient Information:

Press Print Admit

25

Admit / Discharge /
End Case
Admit / Discharge /
End Case

Ending a Case / Discharging a 5. If the monitor is connected to an Agilent

Patient Component Central Monitor, discharge the
patient at the Central.
Ending a case:
1. If arrhythmia is assigned through an Agilent Discharging a Patient:
Arrhythmia Monitor, press Trends/Calcs 1. If arrhythmia is assigned through an
Å Arrhyth Functns and unassign Agilent Arrhythmia System, press
arrhythmia. Trends/Calcs Å Arrhyth Functns
and unassign arrhythmia.
2. Press Procedures
2. Press Monitoring Procedures
3. Press End Case
3. Press Discharg Patient
4. Press Confirm to:
4. Press Confirm to delete previous patient's
• print a scheduled report (if configured)
data, or Main Screen to cancel.
• discharge the patient
• erase the database 5. If Monitor is connected to an Agilent Component
• reset all settings to user defaults Central Monitor, discharge the patient at the
• enter Monitor Standby Central.
or press Main Screen to cancel.
or press Confirm again to cancel an ongoing
report and continue with End Case.

26
Trends / Calcs

Using Vital Signs

Viewing Vital Signs Viewing Patient Data in Detail

To view Vital Signs: To see patient information in greater or lesser detail:
1. Press Trends/Calcs . 1. Press Zoom In Time or
2. Press Vital/Signs . Zoom Out Time .

Viewing Parameters Not Displayed Printing Vital Signs

To view parameters not currently displayed: To print vital signs:

1. Press Next Page . 1. Press Print Vitals .

Viewing Older and Newer Data

To view older and newer data:
▲

1. Press and .
▲

27

Trends / Calcs
 Trends / Calcs

Changing Trend Priorities

To change Trend Priorities:
1. Press Trends/Calcs .
2. Press Trending Priority .
3. Press Select Parametr to highlight
parameter.
4. Press Change Priority to set priority to
“must” or “normal”.
5. Press Confirm to change default value.

28
Using Graphs

Selecting Parameters for Viewing no symbol: the parameter is not selected for
To select parameters for viewing in graph trends: viewing in graph trends.
1. Press Trends/Calcs . 4. Press Graph Trends to view graphs.
2. Press Vital/Signs to display trends. Note — Selected parameter graphs are only available
upon entry to graph trends. When you press
3. Select parameters using ▲ and ▼ and Next Group , the default graph groups are
press On / Off / Combined for each selected displayed. To see the selected parameter graphs again,
parameter. The system will try to combine select Vital/Signs , and in the Vital Signs window,
parameters in one graph channel. If this fails, a select Graph Trends .
new graph channel will be assigned
automatically.

The assignement to graph channels is indicated

by the following symbols next to the parameter
label:
 : the parameter is the sole parameter assigned
to a graph channel
#: the parameter is combined with others in one
graph channel

29

Trends / Calcs
 Trends / Calcs

Viewing Graph Trends Viewing Data in Detail

To view graph trends: To see data in greater or lesser detail:
1. Press Trends/Calcs . 1. Press Zoom In Time and
2. Press Graph Trends to view graphs. Zoom Out Time .

Viewing Graphs Not Displayed Expanding the Vertical Axis

To view graphs not currently displayed: To expand the vertical axis:

1. Press Next Group . 1. Press Change Scale . (Press key again to

return the graphs to normal scale.)
Note —To select different parameters for viewing
graph trends, press Vital/Signs , then
On / Off / Combined for each parameter you
want.
Changing the vertical axis of a specific
graph channel:
1. Press Select Graph (to select the graph
Viewing Older and Newer Data channel).
To view older and newer data: 2. Press Change Scale
▲

1. Press and .
▲

30
Printing Graphs Viewing Values in Table Form
To print graphs: To view values in table form:
1. Press Print Graphs . 1. Press Trends/Calcs .
2. Press Vital Signs .

▲
3. Press and to move time bar to the

▲
preferred time.
4. If selected time is not displayed, press
Zoom In Time .

31

Trends / Calcs
 Trends / Calcs

Printing Scheduled Reports

1. Press Trends/Calcs .
2. Press Print SchedRep to produce a
scheduled report.
3. Press Cancel Report to cancel the report.
4. Press Main Screen .

32
Calculations
Performing Calculations b. Enter new value using handheld keypad.
To perform calculations: c. Press Confirm
1. Press Trends/Calcs .
To print the displayed calculations
2. Press Hemo Calc , Ventil Calc or
a. Press Print Calc
Oxygen Calc to display the Calculations
Task Window (Displayed values may have been
automatically or manually entered.)
Optionally: Press Resample Vitals and Viewing Collection Times
check that the values are representative of the To view collection times of non-calculated values:
patient state at the current time. If values are not 1. Press On/Off Data Time
representative press Resample Vitals again.
Press Confirm to store values without
calculation. Specifying a Calculation Time
3. Press Perform Calc to store any resampled To specify a calculation time
values and perform calculations with the
1. Press Select Item until calculation time is
displayed values
highlighted.
To change or enter an input value

▲
2. Press and to move selection to hours/

▲
a. Press ▲ and ▼ to select value. minutes

33

Trends / Calcs
 Trends / Calcs

3. Change hours/minutes by using ▲ and ▼ . To view older or newer data:

a. Press or

▲
▲
4. Press Confirm
5. Press Perform Calc To modify input values used to perform
calculations:
Viewing Ranges a. Highlight the time of the calculation to be
To view ranges of calculated values:

▲
modified using the and keys

▲
1. Press On/Off Ranges b. Press Original Calc
c. Enter modifications, as needed:

Viewing Previous Calculations •Press Select Item

To view previous calculations: •Enter the value using the left/right and up/
1. Press Review Calc down arrow keys.

•Press Confirm after each entry

using the handheld keypad.
Reviewing Calculations
d. Press Confirm
To review calculations:
e. To recalculate, press Perform Calc
1. Press Trends/Calcs
2. Press Hemo Review , Ventil Review or
Oxygen Review to display Calculation
Review Task Window.
34
Showing Normal Ranges Making Drug Calculations
To show normal ranges for calculated parameters: To make drug calculations:
1. Press On/Off Ranges 1. Press Trends/Calcs
2. Press Drug Calc
3. Press Select Drug or ▲ and ▼ to highlight
Printing Displayed Calculations
desired drug
To print the displayed calculations:
4. Press Perform Calc to access the Drug
1. Press Print Calc Calculation Task Window

Printing Scheduled Reports Modifying an Input Field

To print scheduled reports: To modify an input field:
1. Press Trends/Calcs 1. Press Select Item
2. Press Print SchedRep 2. Enter the value using the left/right and up/down
arrow keys.
3. Press Confirm after each entry
Canceling a Report
To cancel a report:
1. Press Cancel Report

35

Trends / Calcs
 Trends / Calcs

Assigning an Unknown Entity Field Printing the Titration Table

To assign a field to be the unknown entity in the To print the Titration Table:
calculation: 1. Press Print Table
1. Press Choose Unknown
2. Press and to select the unknown field

▲
▲

Calculating
To calculate rate, dose, amount or volume when all
inputs are complete:
1. Press Perform Calc

Displaying the Titration Table

To display the Titration Table:
1. Press Display Table
2. Use the Scroll keys to view nondisplayed
parts of the table.

36
Marking and Reviewing Events
To mark an event:
1. Press Trends/Calcs
2. Press Mark Event
3. Press an event key (labelled A-D). The message
“Mark recorded” appears.
To review an event:
1. Press Trends/Calcs
2. Press Graph Trends
3. move the time bar along the Events line by
▲

pressing and until it rests on the Events

▲

marker you want to examine.

4. Press Zoom In Time
Neonatal Event Review

Viewing Neonatal Events

Neonatal Events oxyCRG Episodes

To view Neonatal Events: To view an oxyCRG episode for a selected event:
1. Press Alarms 1. Press Alarms
2. Press Event Review 2. Press Event Review
To view previous events 3. Select an event with the cursor.
Press Previous Event or

▲
4. Press oxyCRG Episode
To view newer events in greater detail To view previous episodes
▲

Press Next Event or Press Previous Episode

To record the event summary To view newer episodes
Press Record Summary Press Next Episode
To return to the Neonatal Event Review task
To print the event summary
Press Print Summary window
Press Event Review
To record an episode
Press Record Episode
39

Neonatal Event
Review
 Neonatal Event
Review

To print an episode Adjusting Trigger Conditions

Press Print Episode
To make changes to neonatal event trigger
To delete an event conditions:
Press Delete Event (deleted events cannot
1. Press Alarms
be retrieved).
2. Press Event Review
3. Press Event Setup
To step through the group items
Press Select Item
To change the contents of an item
Press Change Content
To return to the Neonatal Event Review task
window
Press Event Review

Manually storing an event

1. Press Alarms
2. Press Capture Episode

40
oxyCRG

oxyCRG Measurements

Displaying the oxycrg Changing Oxygen Channel and

To display the oxyCRG: Recorder Speed
1. Press Monitor Setup To change oxygen channel (on the display and
recording) and recorder speed:
2. Press Display 1 Setup or Display 2 Setup
1. Press Monitor Setup .
3. Press Select Item and select Applic Window
2. Press OxyCRG Setup .
4. Press Change Content and select oxyCRG
a. Press Change Channel to change the
oxygen channel for recording and display.
Making an oxyCRG Recording
To make an oxyCRG recording: b. Press Change Speed to change the
recorder speed.
Note —M1116B Recorder is required.
c. Press Main Screen .
1. Press Realtime Record .
2. Press oxyCRG PLUG-IN to produce the
recording.
3. Press Main Screen .

41

oxyCRG
 oxyCRG

Configuring to be the Alarm Recording

To configure oxyCRG to be the alarm recording:
1. Press Monitor Setup .
2. Press Recording Setup .
3. Press Delayed&Alarm .
4. Press Change AlRecTyp to highlight
“oxyCRG”.
Press Main Screen .

Note —If Neonatal Event Review is not installed

configure the Apnea, Bradycardia and Desat alarms to
red for neonatal event triggered oxyCRG recordings.

42
Data Transfer

Transfer to Module
1. Plug the Data Transfer module into the rack. b. Updates:
Press Collect New Data to send only
2. Press monitor updates once a minute starting at the
current time.
Press Clear Yes/NO .
or (for non-english). Yes erases any data existing in the module
before the transfer begins.
3. Select the type of transfer. No appends new data to data currently
a. All Data: existing in the module. If the patient name
Press Transfer All Data . Any existing and ID do not match or if the monitor name
data in the module will be erased. The is blank, the Combine in Module Task
monitor data will be transferred, followed by Window will be displayed. Select the patient
monitor updates once a minute. name to be used in the module.
4. Press Confirm to start the transfer.

43

Data Transfer
 Data Transfer

Blinking
• Rapid blinking of module light indicates a trans-
fer in progress.
• Slow blinking indicates that the module is col-
lecting new data.

Stopping a Transfer to Module

To Stop a Transfer to the Module:
Unplug the Data Transfer module from the rack.
or

1. Press

or (for non-english).

2. Press Confirm .
When the module is unplugged, it retains data for at
least one hour.

44
Quick Transfer
Cautions: Transferring Quickly
• Be sure that the patient in the monitor matches To transfer quickly:
the one in the module before performing a trans- 1. Plug the Data Transfer module into the rack.
fer to the monitor. To prevent accidental over-
writing of patient data or name, the module will 2. Press
ask you to choose a name/MRN if the monitor
name and module name don't match or if there is
no name/MRN. or
• Be sure to discharge the previous patient at cen-
tral before performing a transfer, or the name or
moved into the monitor from the module will be
overwritten by the name from the central moni-
or
tor.
Notes: (for non-english) to select transfer direction.
• After insertion, the Data Transfer Module 3. Press Confirm .
requires approximately 8 seconds to synchronize Remove the module when the transfer is
with the monitor. complete.
• If you are transferring data to the Component
Transport Monitor, erase any existing data in the
transport monitor before performing the transfer.
45

Data Transfer
 Data Transfer

Transfer to Monitor
2. Press Confirm to start the transfer and
1. Plug the Data Transfer module into the rack. incorporate the module data into the
monitor's existing patient record.
2. Press c. If Discharge = Yes, the Discharge Task
Window will be displayed.
or (for non-english). 1. Press Confirm to discharge the
monitor patient first and then start the
3. Select whether or not to discharge the current transfer of data from the module.
patient data in the monitor before starting the
transfer.
Stopping a Transfer to Monitor
a. If Names Match, press Confirm to start
the transfer without discharging the patient in To Stop a Transfer to the Monitor:
the monitor. Unplug the Data Transfer module from the rack.
b. If Names Don’t Match (or either is blank) After a transfer is completed, the data in the module is
and Discharge = No, the “Combine in erased. If the transfer is interrupted, the module data
Monitor” Task Window will be displayed. will remain intact.
1. Select the patient name to be used in the
monitor.

46
ECG / RESP / ST

ECG Measurements

Selecting the Required Lead EASI 12-lead ECG:

To select the required lead: Viewing EASI 12-lead ECG:
1. Press ECG on module. Press 12-Lead ECG Å View ECG
2. Press Change Lead
Recording EASI 12-lead ECG
Press 12-Lead ECG Å Record ECG
Standard ECG:
Viewing Multi-Lead ECG: Printing EASI 12-lead ECG
To view multi-lead ECG:
Press 12-Lead ECG Å Print ECG
1. Press Multi-Ld ECG/ST → View ECG
Note —EASI 12-Lead ECG requires special Electrode
Recording Multi-Lead ECG Placement with a 5-Lead Set. Please refer to the Agilent
To record multi-lead ECG: CMS, V24 and V26 User’s Reference Manual for
details
1. Press Multi-Ld ECG/ST → Record ECG

47

ECG / RESP / ST
ECG / RESP / ST

Adjusting the Size of the QRS Selecting the QRS Detection Method
To adjust the size of the QRS complex: To select the QRS detection method:
1. Press ECG on module. 1. Press ECG on module.
2. Press Adjust Size . 2. Press Auto/Man & Pacing .
PACED or NONPACED / MANUAL or AUTO.
Use AUTO except in rare cases where the
Selecting the Filter Setting monitor miscounts - if change to MANUAL,
To select the filter setting: adjust detection level so only QRS complexes
cross dotted threshold line.
1. Press ECG on module. (not available when arrhythmia is assigned).
2. Press Filter Mon/Diag .
FILTER - use only if excessive electrical Turning Off Channels 2 and 3
interference (can impede ECG analysis). To turn off channels 2 and 3:
MONITOR - use for normal monitoring
DIAG - use when diagnostic quality required 1. Press ECG on module.
(may increase false alarms). Press Setup Next ECG .
Press On/Off ECG-CH2 to highlight off.
(Channel 3 is turned off automatically.)

48
Respiration Measurements

Adjusting the Size of RESP Wave

To adjust the size of the RESP wave:
1. Press RESP on module.
2. Press Adjust Size .

Selecting The RESP Detection Method

To select RESP detection method:
1. Press RESP on module.
2. Press Auto/Manual .
AUTO - monitor counts respiration and adjusts
detection level automatically.
MANUAL - you adjust the detection level (place
the dotted threshold line just below peaks in the
curve) using the ▲ and ▼ keys.

49

ECG / RESP / ST
ECG / RESP / ST

ST Measurement Points
R-WAVE PEAK AT 0 MSEC

J POINT

T
P

DIFFERENCE =
ST VALUE
Q
S
ISOELECTRIC POINT ST MEASUREMENT POINT
DEFAULT = R – 80 MSEC DEFAULT = R + 108 MSEC

The ST measurement for each beat complex is the You can adjust both measurement points. Your
vertical difference between the points where the wave monitor is configured so that you set the ST Point in
intersects two measurement points: reference to: either the R-wave peak or the J Point,
1. The isoelectric point provides the baseline for the which is the transition between the QRS and the ST
measurement. segment. The ST point is referenced from the J point
at either +60 or +80 msec.
2. The ST point provides the other measurement
point.
50
ST Segment Monitoring

Setting Up ST Monitoring Adjusting the Measurement Points

To Set Up for ST monitoring: To adjust the measurement points:
(from the ST Analysis Task Window)
1. Ensure that the ECG channel(s) to be used for ST
measurement are turned on. (Channel does not 1. Press Adjust Meas Pts .
have to be displayed.) 2. Press On/Off Freeze to freeze the waveform.
2. If necessary, turn ST on in the Parameters On/Off 3. Adjust the isoelectric point and J/ST points.
Task Window
4. Press ST Analysis to return to ST Analysis
3. Press ECG on the module, followed by Task Window.
Multi-Ld ECG/ST (or Procedures ),
then ST Analysis to display the ST Analysis
Task Window.
If ECG configured for EASI, select the
12-Lead ECG/ST key.
4. If necessary, turn individual ST channels on
using On/Off ST . Then press
ST Analysis to return to ST Analysis Task
Window.

51

ECG / RESP / ST
ECG / RESP / ST

Changing the Reference Wave Adjusting ST Alarms

To change the reference wave: To adjust ST alarms:
(from the ST Analysis Task Window) (from the ST Analysis Task Window)
1. Press Adjust Refernce 1. Press Adjust Alarms .
2. Move the cursor to the point of interest in the 2. Press Select Channel .
trend. (This displays the trended beat in the right a. To adjust the alarm limits:
waveform.) Press ↓ Low Limit ↑ or ↓ High Limit ↑
3. Press Temp Refernce to also display beats softkeys.
in the left spot b. To turn alarms on or off:
a. To make temporary reference beat Press On/Off Alarms . This turns the
permanent, alarms off for all channels simultaneously.
Press Change Refernce → 3. Press ST Analysis to return to ST Analysis
Confirm . Task Window.
b. To redisplay the original saved reference
beat,
Press Saved Refernce .
3. Press ST Analysis to return to the ST
Analysis Task Window.

52
ECG Troubleshooting
Problem Possible Cause Corrective Action
No display of ECG System not plugged in or switched on. ECG Connect and switch on system. Check ECG or
or ECG/RESP module is not plugged in. ECG/RESP Module is plugged in correctly.
System not connected to satellite module Check that contrast control is correctly
rack. adjusted.

LEADS OFF message. ? ECG cable is not connected. One or more Check ECG cable is connected. Check that
instead of HR/RESP electrodes are detached. No gel on electrodes are not detached. Check that
numerics. INOP tone. electrodes. Strong solvent used for cleaning electrodes have enough gel. Change to a
skin. A 3-lead set is used and channels 2 and suitable skin cleaning solvent. Ensure that
3 are not switched off. channels 2 and 3 are switched off if a 3-lead set
is used.

ECG waveform is present One of the RESP electrodes is loose. No gel Check that RESP electrodes are not loose.
but the RESP channel on the electrodes. Patient’s breathing is too Check that electrodes have enough gel.
shows a flat line. shallow to be detected in auto mode. Reposition electrodes to try and optimize
signal. Change RESP detection mode from
auto to manual if necessary.

NO PULSE SOURCE The pulse source (PRESS or SpO 2/PLETH Check that module is plugged in. Check that
message (only if PULSE is Module) is unplugged, or the transducer is transducer is connected.
the active alarm parameter). not connected, or equipment malfunction.

53

ECG / RESP / ST
ECG / RESP / ST

54
Invasive Pressure

Pressure Measurements

Changing the Waveform Size Adjusting Alarm Limit

To change the size of the waveform: To adjust the alarm limit:
1. Press PRESS on module. 1. Press PRESS on module.
2. Press Change Scale . 2. Press Adjust Alarms .
(To automatically optimize the scale to suit the 3. Change alarm parameter (sys, dia, mean), if
amplitude of the incoming wave, select needed.
“optimum” → Confirm .)
4. Press ↓ Low Limit ↑ or ↓ High Limit ↑
(to adjust alarm limits).
Changing the Pressure Label
To change the pressure label:
1. Press PRESS on module.
2. Press Change Label .
IMPORTANT: For information on Pressure
labeling, refer to the Agilent CMS, V24 and V26
User's Reference Manual.

55

Invasive Pressure
 Invasive Pressure

Zero Transducer Zero all Pressures

To zero transducer from the module: To zero all pressures with one keypress:
1. Open transducer to air (closing it to the patient). 1. Open transducer(s) to air (closing it to the
patient)
2. Press ZERO on module for one second - you
should see the message “Zero in Progress”. 2. Press Procedures .
To zero transducer from task window 3. Press Zero AllPress .
1. Press Zero Xducer 4. Press Confirm .
2. Open transducer to air (closing it to the patient). 5. Verify that all zero opeartions have been
completed successfully.
3. Press Zero Xducer again -
Wait for screen message saying that procedure is 6. Close the transducer(s) to air and open it to the
complete, then close transducer to air and open it patient.
to the patient.

56
Pressure Troubleshooting
Problem Possible Cause Corrective Action
Noise or fling in the pressure Movement of P.A. catheter tip. Reposition catheter (in accordance with
waveform Motion of pressure tubing. your Hospital Procedures Policy). Make
sure patient or ventilator tubing is not
touching pressure tubing.

Resonating Arterial Small air bubbles in, or very close Carefully flush the transducer and tubing
Waveform; to the transducer. when setting up. Debubble carefully after
each flush.

or Abnormally High Systolic Tubing too long. Shorten tubing.

Pressure

Dampened Arterial Thrombus formation or blood left Use syringe to withdraw air or particles in
Waveform in catheter following blood catheter, then flush the line with fresh
sampling. solution.

57

Invasive Pressure
 Invasive Pressure

Problem Possible Cause Corrective Action

Dampened Arterial Large air bubble in tubing. Use syringe to withdraw air in tubing, then
Waveform flush line with fresh solution.

Catheter tip against the vessel wall. Reposition the catheter to relieve the spasm.
Catheter kinking or arteriospasm.

Tubing too long or too compliant. Shorten the tubing (recommended length
3-4 ft. or replace with large diameter stiff
tubing.

Improper sequence of stopcock Flush line, re-zero and recalibrate.

operation.

Defective transducer and/or Replace transducer and have the monitor

amplifier. checked.

Abnormally Low Pressure Transducer level higher than heart. Check patient and transducer positions.

Loose connections. Check and tighten connections.

No Pressure If monitor turned on and there is no Replace transducer and cable. Check
pressure. The transducer or stopcocks.
connector wire could be broken.

58
NiBP

NBP Measurements

Changing Mode Single Manual Measurement or Auto

To change mode: Cycle
1. Press NBP on module To do a single manual measurement or initiate the
AUTO cycle:
2. Press Auto/Manual .
1. Press NBP on module
2. Press Start NBP
Changing Repetition Time or
To change repetition time (AUTO mode only: START on module.
1. Press NBP on module
Making a Stat Measurement
2. Press Change Rep Time . To do a STAT measurement (as many times as
possible in a 5-minute period)
1. Press NBP on module
2. Press Stat NBP .
or
STAT on module.
59

NiBP
 NiBP

Stopping a Measurement
To STOP a measurement:
1. Press Stop NBP .
or
STOP on module.

Inflating the Cuff to prevent venous

backflow:1
1. Press NBP on module
2. Press Venous Puncture
Note — Use appropriate cuff size for NBP
measurements.

1.Venous Puncture is only possible

using NBP modules marked with the Venous
Puncture Symbol in the upper right corner

60
NBP Troubleshooting
The following factors can make the NBP measurement unreliable or impossible to detect:
Patient movement: Movement, shivering and Heart rate extremes: Measurements can not be
convulsions may all interfere with the measurement made at a heart rate of less than 40 bpm or greater than
of the arterial pressure pulses. Measurement time will 300 bpm.
also be increased Incorrect cuff size: Using the incorrect cuff size
Cardiac arrhythmias: An irregular heart beat will will give erroneous readings
make the measurement unreliable or impossible. The Obese patients: A thick layer of fat surrounding a
measurement time will be increased. limb tends to dampen oscillations coming from the
Heart-lung machine: Measurements will not be artery, and stops them from reaching the cuff.
possible if the patient is connected to a heart-lung Accuracy may be lower than normal.
machine.
Pressure changes: Rapid changes in blood
pressure, while the arterial pressure pulses are being
analyzed, may make the measurement unreliable or
impossible.
Severe shock: Reduced blood flow to the
peripheries will cause reduced pulsation to the
arteries in conditions of severe shock or hypothermia.
This will make measurements unreliable.

61

NiBP
NiBP

62
SpO2/Pleth

SpO2/Pleth Measurements

Setting Up SpO2 To adjust the Averaging Time:

Press Avg/Trig Times (these settings are
To set up SpO2:
only adjustable in Monitoring Mode if they have
1. Press SpO2 on the module to bring up the been Enabled in Configuration Mode.)
Task Window.
Press ↓ Low Limit ↑ and ↓ High Limit ↑ To switch Tone Modulation on/off:
softkeys to adjust the limits. Press On/Off Tone Mod
▲

Press and to adjust the SpO2 desaturation

▲

limit. To adjust the QRS volume from the SpO2

2. Either use the ↓ High Limit ↑ softkey to window:
switch the high alarm off individually, Press Volume Control → ↓ QRS Tone ↑
or 3. Press Main Screen .
use the On/Off Alarms softkeys to switch all
the SpO2 alarms off.
Setting the high SpO2 alarm limit to 100% is the equivalent to switching off the high alarm. High oxygen
levels may predispose a premature infant to retinopathy of prematurity. Therefore the upper alarm limit
for oxygen saturation must be carefully selected in accordance with accepted clinical practices.

63

SpO2/Pleth
 SpO2/Pleth

Deriving Pulse From SpO2/Pleth

To derive pulse from SpO2/Pleth:
1. Press Module Setup .
2. Press HR/Pulse .
3. Press Change Source to highlight PLETH.
(This Task Window enables you to select either
Pleth or one of the pressures you are monitoring
as the pulse source.)
4. Press Main Screen .

64
SpO2 Troubleshooting
The following factors can cause errors in the measurement of the SpO2

Reduced arterial blood flow Absorption of light by other chemicals in the

can be caused by: blood
for example:
• shock
• hypothermia • carboxyhemoglobin
• use of vasoconstricting drugs • methemeglobin
• anemia • methylene blue
• indocyanine green
A “SpO2 NON PULSATILE” message appears on the • indigocarmine
display, if the pulsations are undetectable.
High levels of electrical interference
High levels of ambient light An “SpO2 INTERFERENCE” message will appear
An “SpO2 INTERFERENCE” message will appear on the display. Always keep power cables away from
on the display. The measurement quality can be the transducer, cable and connector.
improved by covering the transducer with a suitable
opaque material.

65

SpO2/Pleth
 SpO2/Pleth

Problem Possible Cause Corrective Action

Light interference Surgical lamps, bilirubin lights, The sensor site must be covered with opaque,
overhead fluorescent lights, infra-red non-reflecting material.
heater/lamp, direct sunlight.
Electrical interference Power cable too near to the sensor or Do not position the power cable too near to the
connector on the adapter cable. sensor or connector on the adapter cable.

66
Problem Possible Cause Corrective Action
Erratic readings, or Using inappropriate sensor for patient Select correct sensor based on patient weight,
screen messages: or clinical condition. application site, clinical condition.
SpO2 non pulsatile, Sensor applied to inappropriate site. Apply sensor to recommended site.
inaccurate or Weak
Signals Sensor applied incorrectly. Apply sensor to recommended site, check LED/
detector are lined up, check sensor still sticks.
Patient movement. Secure sensor cable with tape to prevent it from
coming off.
Poor sensor adhesion. Use new sensor if necessary. Do not use
additional tape.
Using too many adhesive dots. Do not use more than 3 dots for each LED and
detector. Do not use dots with sensors for which
they were not intended.
Tissue between LED and detector too Apply sensor to thinner or thicker tissue site.
thick or too thin.
Different values on Cardiac shunts. Check with blood sample. Accuracy of value
different extremities questionable, depending on shunt size.

67

SpO2/Pleth
 SpO2/Pleth

Problem Possible Cause Corrective Action

No SpO2 numeric, or Reduced arterial flow due to shock, Change transducer site. In neonates try moving
Weak Signal message hypothermia, vasoconstricting drugs. sensor to thinner part of extremity, for instance,
towards toes.
Nail polish Remove nail polish.
Hematoma. Change transducer site.
SpO2 waveform looks Poor application of probe Check probe application
flattened and monitor Inappropriate waveform size Adjust waveform size (Perfusion Mode only):
is questioning the
Press Pleth on front of module
reading
→ Optimize Size

68
CO2 & ssCO2

Adjustments to CO2
After calibrating the sensor, attach it to either: c. AWRR: set apnea delay time and low and
• mainstream - the patient's breathing circuit. high limit

• sidestream - the sidestream module 5. Press On/Off Alarms to turn alarms on.
(No next to parameter numeric.)
1. Press CO2 on module to bring up Task
Window. 6. Press Main Screen .

2. Press Change Scale to change size of The following waveform represents a normal
waveform. capnogram:

3. Press N2O Corr On/Off and set to ON if

anesthetic gas contains N2O, OFF if it doesn't.
4. Press ETCO2 Alarms , AWRR Alarms
or IMCO2 Alarms , and use
↓ Low Limit ↑ or ↓ High Limit ↑ softkeys
to adjust alarm limits.
a. ETCO2: set low and high limits
b. IMCO2: set high limit

69

CO2 & ssCO2

 CO2 & ssCO2

Calibrating CO2 Measurements

For accurate measurements, allow sensor to warm up
until “CO2 Warmup” message disappears (up to 20
minutes if it has not been plugged into a module).

When to perform an accuracy check.

• Once a day.
• If module is moved with sensor plugged in to
another monitor or used with another patient.

When to calibrate.
• If a new (or different) sensor is attached to the
module.
• When the Accuracy Check values displayed do
not coincide with the calstick value.
• Once every 1-2 weeks.

70
Performing an Accuracy Check If calstick and screen values are differ-
Note —This should be done once a day ent
1. Press CAL on module, and check calstick 1. Press ↓ Change Cal Value ↑ to set the
value on the screen. correct value.
2. Press Confirm .
If calstick and screen values are the 3. Go to Perform the calibration.
same
1. Place sensor on cell labelled 0.0 mmHg. Reading Perform the Calibration
on display should be within +0.3mmHg within 1
1. Place sensor on calstick cell. Wait 3 minutes.
minute.
2. Press Start Calibr. .
2. Place sensor on other cell. Reading on display
should be +1mmHg of calstick value within 1 3. Repeat process with other cell. (For both cells,
minute. values on screen should match values on
calstick.)
3. If the values match, you don’t need to calibrate;
Press Main Screen . 4. Press Main Screen .
4. If values don’t match, you need to calibrate. Press A more detailed version of this procedure can be
Start Calibr. . found in the Agilent CMS, V24 and V26 Series User’s
Reference Manual.
5. Go to Perform the calibration.

71

CO2 & ssCO2

 CO2 & ssCO2

Mainstream CO2 Measurement: CO2 Transducer and Breathing Circuit

To Patient

Connects
to Module

Inspiratory
Airway Adapter Limb
and CO2 Sensor
Y-Piece
To Anesthesia
Machine

Expiratory
Limb

To Anesthesia
Machine

72
Sidestream Module, CO2 Transducer and Breathing Circuit

Sidestream Module CO2 Module

M1015A CO 2 M1016A T

Bacterial Filter
CO 2 CAL

Transducer

Gas Sample Tube

“J”Elbow Airway Adapter

Connects to Ventilator

Connects to Patient

73

CO2 & ssCO2

 CO2 & ssCO2

Turning the Sidestream Pump On

To turn sidestream pump on (if pump turns off
automatically):
1. Press CO2 on module.
2. Press Restart Sidestrm key:
ONCE — if key is already highlighted.
TWICE — if key is not highlighted.

74
CO2 and Sidestream Mode Troubleshooting
Problem Possible Cause Corrective Action
CO2 wave line Module not plugged in, transducer Check that module and accessories are plugged
disappears not connected, Equipment in. Sidestream - check pump switched on.
malfunction, sidestream pump off.
CO2 wave set to zero, Not in monitoring mode, calibration Change filter (may be blocked, check sample
other numerics taking place or failed, barometric tube (may be kinked). Check whether monitor in
displayed as -?- preesure out of range. calibration mode. Check that transducer is
placed on correct cal cell. Call service engineer
to check barometric pressure.
Wave Display Clipped Incorrect scale selected - complete Change wave scale size, by pressing CO2 on
wave display cannot be seen.
module then Change Scale .

75

CO2 & ssCO2

 CO2 & ssCO2

76
tcpO2/tcpCO2

tcpO2/tcpCO2 Measurements

Changing Site Time or Reset Timer Changing Transducer Temperature

To change site time or reset the timer: To change the transducer temperature:
1. Press O2/CO2 on the module to bring up the 1. Press O2/CO2 on module to bring up the Task
Task Window. Window.
2. Press Set Timer . 2. Press Change Temp .
3. Press the arrow keys to highlight required time, 3. Press the arrow keys to highlight required
or Off to switch off site timer (if available). temperature.
4. Press Confirm . 4. Press Confirm .
5. Press Main Screen 5. Press Main Screen .
Note —After changing the transducer temperature, a
new calibration is required.

77

tcpO2/tcpCO2
tcpO2/tcpCO2

Changing Alarm Limits

To change the alarm limits:
1. Press O2/CO2 on module to bring up the Task
Window.
2. Press tcpO2 Alarms or tcpCO2 Alarms .
3. Adjust the High or Low Limit, or switch the
Alarm On/Off as required.
4. Press Main Screen .

Calibrating the tcpO2/tcpCO2 measure-

ment
1. Press Module Setup and tcpO2 / tcpCO2

When to Calibrate:
• After you have fitted a new membrane on the
transducer.
• After you have changed the transducer operating
temperature.
• When INOP message “tcCAL Required” is dis-
played on the screen

78
Tc Gas Troubleshooting
Problem Possible Cause Corrective Action
CAL FAILED inop 1. Poor supply of calibration Check cal unit, tubing and tubing
gas. connections, then restart calibration.

2. Transducer did not stabilize Restart calibration. If calibration not

during first calibration (just complete after 5 minutes, interrupt the
after new membrane fitted). calibration and see Condition 3.

3. Membrane/electrolyte worn Remembrane transducer and start calibration.

out. If first calibration is not successful
(stabilizing), restart calibration.

4. Dry transducer Activate the transducer for 24 hours, then

(new or after long storage). remembrane and start calibration.
If that fails, calibrate again.

5. Transducer has been Replace defective transducer.

activated, remembraned and
calibration has failed more
than once.

79

tcpO2/tcpCO2
tcpO2/tcpCO2

Problem Possible Cause Corrective Action

Readings constantly Transducer improperly applied. Reapply fixation ring. Reattach transducer.
drift Air leaks.

Old electrolyte not fully removed Place transducer in cal chamber and turn on
during remembraning procedure. gas. Do not calibrate. If transducer does not
give stable reading after 5 minutes,
remembrane, taking care to clean out old
electrolyte. Check groove. Calibrate.

Readings not stable Patient status unstable. None.

20 minutes after
application. Inadequate vasodilation. Increase transducer temperature if not contra-
indicated by patient’s condition. (Reduce the
transducer site time if appropriate).

tcpO2 values too low or Capilliary samples taken Take arterial samples. Capilliary samples do
too high (Astrups, heelsticks). not correlate well with paO2.

Blood taken while patient Take another sample when patient is quiet.
agitated (crying, feeding,
suctioning, positioning).

80
Problem Possible Cause Corrective Action
tcpO2 values too low Hypoperfusion. No corrective action possible. tcpO2 levels
will underestimate paO2.

tcpO2 values too high Incorrect handling of blood Take another sample. Ensure that
sample. atmospheric oxygen does not enter sample.

Transducer improperly applied. Reapply fixation ring. Reattach transducer.

tcpCO2 values too high Correction factor not ON. Either ask biomed or service to configure
correction ON, or take the rise of pCO2 due
to heating and metabolic CO2 production into
account.

Hypoperfusion. None possible.

Shock. None possible.

Leakage in calibration tubing, or Replace tubing.

non-original tubing used. Use correct tubing (M2205A).

tcpCO2 values too low Transducer improperly applied. Reapply fixation ring.
Air leaks. Reattach transducer.

81

tcpO2/tcpCO2
tcpO2/tcpCO2

82
Cardiac Output

Making Cardiac Output Measurements

1. Press C.O. on module. 6. Repeat Step 5 for each injection. Wait at least one
2. Adjust the computation constant: minute (or longer, depending upon patient's
clinical condition) between injections. Press
a. Press Adjust Constant or arrows to Record Curve if you want to make a
change computation constant. (See catheter recording.
insert for comp. constant appropriate to
catheter type, injectate temperature and 7. Press Edit C.O. .
volume.) 8. Delete any unwanted values:
b. Press Confirm . a. Press Select Curve and highlight curve
3. Press Measure C.O. . to delete.

4. Press Start C.O. or START on module. b. Press Delete Yes/No .

5. When “Inject Now” appears, inject. (For 9. Press Confirm to store average in Trends.
accuracy start within 15 seconds - complete in 4 10.Press Main Screen .
seconds.)
To perform hemodynamic calculations:
1. Press Hemo Calc

83

Cardiac Output
 Cardiac Output

Cardiac Output Troubleshooting

The following factors can cause errors in the measurement of the Cardiac Output

Physiological reasons: Injection errors:

• Patient movement during the procedure • Use of the wrong catheter injection port
• Anxious patient • Poor timing of injection
• Variations in cardiac rate and rhythm • Incorrect or unsuitable volume of injectate
• Cardiac abnormalities, for example, incompetent • Unsuitable injectate temperature
valves
• Shock
• Mechanical ventilation of patient Instrument errors:
• Incorrect computation constant
Catheter related errors: • Instrument failure
• Balloon inflated during measurement
• Catheter not positioned properly
• Damaged catheter

84
Screen Message Possible Cause Corrective Action
1. Noisy Baseline Mechanical Ventilation Synchronize injections to end-expiration

Variations in venous return Maximize signal amplitude by:

(coughing, shivering, abnormal 1. Increasing injectate volume to 10cc
respiration) (if not contra-indicated)
2. Using iced injectate (change comp constant)
3. Increasing number of measurements to be
averaged (if not contra-indicated)

2. Thermal Baseline Drift Administration of I.V. fluids; Try to stabilize patient temperature; Maximize
Rewarming after hypothermia, signal amplitude (as above); Increase number of
fever, shock measurements to be averaged.

3. Unsteady Baseline Combination of messages 1 and 2 see above

4. Multiple Peaks Injection not smooth Repeat smoothly and rapidly.

Cardiac shunt Check with blood samples. Accuracy of values

questionable, depending on shunt size.

5. Abnormal Decay Time Low Cardiac Output Maximize signal output

85

Cardiac Output
 Cardiac Output

Screen Message Possible Cause Corrective Action

6. Very Short Curve Injection too fast Inject again as soon as possible after the prompt.

7. Very Long Curve Injection too slow Inject again as soon as possible after the prompt.

8. Irregular Curve Combination of messages 4-7 See above.

9. Delayed injection Low stroke volume, Low flow rate Inject as soon as possible after prompt.
Low flow rates need 15-20 seconds to pass by
thermistor.

Delayed injection Repeat

Kinked catheter Check for kinks below dressing.

Check chest x-rays for interior kinks.

10. Injectate temperature too Incorrect positioning of injectate Make sure that probe is positioned in a
high probe solution identical to the one injected.

Hypothermic patient <34°C, 93.2°F. Use iced injectate with hypothermic patients.
Room temperature injectate (Remember to change comp. constant.)

Room temperature > 25°C (77.8°F) Cool injectate. (Remember to change

computation constant.)

86
Screen Message Possible Cause Corrective Action
11. Excessive Curve Height Injectate too cold Heat up injectate and start measurement
again
12. Curve Below Baseline Rewarming after hypothermia, Try to stabilize patient temperature and start
fever, shock measurement again.

87

Cardiac Output
Cardiac Output

88
Temp

Temperature Measurements

Setting Up Temperature 2. Press Diff 1 or Diff 2

To Set Up Temperature: 3. Press Select First
1. Press Temp on module to bring up Task (to select the first temperature)
Window. 4. Press Select Second
2. Press Change Label to change the label (to select the second temperature)
3. Press Adjust Alarms , then IMPORTANT: For information on the Temperature
↓ Low Limit ↑ or ↓ High Limit ↑ softkeys labeling, refer to the Agilent CMS, V24 and V26
to adjust alarm limits. Series User’s Reference Manual.
4. Press On/Off Alarms to turn alarms on.
(No next to parameter label).

Measuring Temperature Differences

when Monitoring more than one Tem-
perature
1. Press Module Setup

89

Temp
Temp

90
Anesthesia Gas Monitoring

Setting Up Anesthetic Gas Module

To set up the Anesthetic Gas Module: 7. When the module is ready for use, the waveforms
1. Press the power-on switch. and numerics are shown on the Main Screen.

2. Fit the bacterial filter (1) to the gas sample tube

(2).
3. Connect the gas sample tube to the Anesthetic
gas Module:
a. Move the cover (3) to reveal the inlet (4).
b. Insert the tube into the slot.
c. In a clockwise direction, rotate the tube
through 90°.
4. Wait until the Anesthetic Gas Module has
finished its self test and has warmed up.
5. Connect the other end of the gas sample tube to
the airway adapter (5).
6. Connect the airway adapter to the patient.

91

Anesthesia Gas
Monitoring
 Anesthesia Gas
Monitoring

s$JLOHQW M1026A
R

Airway Gases

2
3
4
1

92
Setting Up Anesthetic Gas Module with Watertrap (Option A02)
1. Insert a watertrap into the watertrap housing by 2. Switch on the Anesthetic Gas Module by
gently pushing it up and in. pressing the power-on switch.
3. Connect the gas sample tube to the water
separation filter.
Warning
Ensure that the connections are tight when fitting
the tube. Any leak in the system can result in
erroneous readings due to ambient air mixing with
patient gases.

4. Connect the other end of the gas sample tube to

the patient via the airway adapter.
Caution
Caution
To minimize the risk of internal contamination, never
The airway adapter must be positioned so that the part
leave the Anesthetic Gas Module running without a
connecting to the gas sample tube is pointing upwards
watertrap attached (except during the exchange of a
(see figure below). This prevents condensed water from
watertrap).
passing into the gas sample tube and causing an
Note — To avoid condensed water collecting in the gas occlusion.
sample tube, it is recommended that you position your
Anesthetic Gas Module at or above the patient level.

93

Anesthesia Gas
Monitoring
 Anesthesia Gas
Monitoring

1.

2.
3.
5.

7. 4.

6.
1. Watertrap Housing 5. 13902A/M16112A Airway Adapter
2. M1657A Watertrap 6. Connects to patient
3. Water Separation Filter 7. Connects to anesthesia machine.
4. M1658A Gas Sample Tube
94
Accessing the Airway Gas Task Window
To Access the Airway Gas Task Windows:
1. Press the Airway Gases set-up key on the
module or Module Setup followed by
Airway Gases to bring up the Overview
Task Window.
2. Select the airway gas task window you wish to
access by pressing:
Airway CO2 .
Airway N2O .
Airway Agent .
Airway O2 (optional).
3. Press the item you want to adjust: for example,
scales or alarms.
4. Press Main Screen when finished.

95

Anesthesia Gas
Monitoring
 Anesthesia Gas
Monitoring

Standby Mode

Activating the Standby Mode:

To Activate the Airway Gas Module Standby Mode:
1. Press the Airway Gases set-up key on the
module or Module Setup followed by
Airway Gases to bring up the Overview
Task Window.
2. Press the Airway Standby softkey to
activate standby mode.

Deactivating the Standby Mode

To Deactivate the Airway Gas Module Standby
Mode:
1. Press the Airway Gases set-up key on the
module or Module Setup followed by
Airway Gases to bring up the Overview
Task Window.
2. Press the Airway Resume softkey to
deactivate standby mode.

96
Calibration

Automatic Zero Calibration:

Done automatically when the module is switched on
at the following intervals:
8, 15, 30 and 90 minutes, then every 8 hours. The
calibration takes 15 seconds. During zero calibration,
the patient’s AWRR is not measured.

Manual Zero Calibration:

1. Press the Airway Gases set-up key on the
module or Module Setup followed by
Airway Gases to bring up the Overview
Task Window.
2. Press the Airway Zero softkey to activate a
zero calibration.

Span Calibration:
The Anesthetic Gas Module should be checked at
least once per year to determine if span calibration is
necessary.

97

Anesthesia Gas
Monitoring
 Anesthesia Gas
Monitoring

Selecting Agent Identification

Automatic agent identification: Option A05 - 5-Agent-Identification (w/ Watertrap

Option A01 & A02 - 3-Agent-Identification version only)
The Anesthetic Gas Module can automatically detect With 5-Agent-Identification, the module is able to
one agent out of the following: automatically detect one agent out of the following:
• Halothane • Halothane
• Isoflurane • Enflurane
• Sevoflurane or Desflurane • Isoflurane
• Sevoflurane
Option C01 • Desflurane
Alternatively, Option C01 allows the Anesthetic Gas
Module to detect one agent out of the following:
• Halothane
• Isoflurane
• Enflurane

98
Automatic agent selection Manual agent selection
To select automatic agent identification (the default): To manually select an anesthetic agent:
1. Press the Airway Gases set-up key on the 1. Press the Airway Gases set-up key on the
module or Module Setup followed by module or Module Setup followed by
Airway Gases to bring up the Overview Airway Gases to bring up the Overview
Task Window. Task Window.
2. Press Airway Agent 2. Press Airway Agent
3. Press Select Agent 3. Press Select Agent
or → to select the agent you want to
→
4. Select Auto for automatic agent identification 4. Use
5. Press Main Screen when finished. measure, for example ISO for isoflurane or
None if no specific anesthetic agent is being
measured.
The measured agents are as follows:
Anesthetic Agents Display Abbrev.
Halothane HAL
Isoflurane ISO
Enflurane ENF
Sevoflurane SEV
Desflurane DES
5. Press Main Screen when finished.

99

Anesthesia Gas
Monitoring
 Anesthesia Gas
Monitoring

Adjusting Anesthetic Gas Module Alarms

To adjust the alarms:
1. Press the Airway Gases set-up key on the
module or Module Setup followed by
Airway Gases to bring up the Overview
Task Window.
2. Press the softkey corresponding to the gas to
adjust (for example, Airway Agent )
3. Press Agent Alarms
4. Select the ‘‘et’’ or ‘‘in’’ value as required, using
the arrow keys.
5. Use ↓ Low Limit ↓ or ↑ High Limit ↑
softkeys to adjust alarm limits.
6. Press Main Screen when finished.

100
Blood Analysis

Setting Up The Blood Analysis Module

To setup Blood Analysis Module: To select a source for patient temperature:
Press Setup on module followed by Press Select Pat. Temp
Analysis Setup then either:
Select a Temperature module as source
To enter the blood sample source: or:
Press Select Sample Press Manual Entry to enter a value
manually using the arrow keys.

To enter the operator ID: To enter an O2 value or information in one of the free-
Press Select Oper.ID entry fields:
then either: Press Select O2/Field once for O2 entry
Select a pre-configured ID or
or: Press Select O2/Field twice to get to free
Press Manual Entry to enter your ID field entry then use the arrow keys to enter the
manually using the arrow keys. data.

101

Blood Analysis
 Blood Analysis

Viewing Blood Analysis Results

To select Blood Analysis results for display: To accept and transmit measurement results as
Press Setup on module displayed:
Press Select Results to select specific Press Confirm
results for display in the Blood Analysis Results
Task Window
To view Blood Analysis results:
Press Setup on module
To switch between display of ranges, units or
neither:
Press Ranges/Units
To view Blood Analysis trend data:
Press Blood Review

To change settings for measurement:

Press Setup on module
1. To reject measurement results:
Press Reject/Undo - marks all results with
"?"
2. Press Confirm

102
Blood Analysis Troubleshooting
Screen Message Possible Cause Corrective Action
Sample Positioned Short The cartridge was underfilled. Try another cartridge.
of Fill mark (XX)1 The sample must reach the fill mark.

Sample Positioned The cartridge was overfilled. Try another cartridge.

Beyond Fill Mark (XX) The sample was passed the fill mark.
message appears.1

Insufficient Sample Either not enough sample in the sample Try another cartridge.
(XX)1 well of the cartridge or bubbles in the
sample.

Unable to Position The module did not detect movement of Try another cartridge.
Sample (XX)1 sample across sensors:
• the cartridge was not closed properly
• a clot in the sample prevented
movement, or
• aberrant cartridge

103

Blood Analysis
 Blood Analysis

Screen Message Possible Cause Corrective Action

Cartridge Preburst, Use The module detected fluid on the sensors Try another cartridge.
Other Cartridge too early. This can come from:
• mishandling of cartridges e.g. putting
pressure on the center of the cartridge
• cartridges stored too warm or frozen

Cartridge not Inserted The cartridge or electronic simulator is Reinsert the cartridge or simulator. If
Properly not pushed in all the way. the problem recurs it may indicate a
module problem. Call your service
representative.

104
Screen Message Possible Cause Corrective Action
Temperature Out of The module is too warm or too cool If the module has been moved, leave it
Range because it has just been moved from, or for 30 minutes to reach room
is now in, a room that is too warm or too temperature before use. If not, check
cool. that room temperature is between 16
and 30 degrees Celsius.

Cartridge Error, Use This error can have various causes Try another cartridge. If one error
Other Cartridge (XX)1 related to the equipment, the sample or code appears repeatedly, the module
the user. may be defective. In this case, try
another module or contact your
service representative.

1
XX represents an error code which may assist the service representative to diagnose the problem.

105

Blood Analysis
 Blood Analysis

106
 BIS

BIS

Setting up BIS measurements Switching Filters on or off

Press On/Off Filters
1. Connect the BIS Engine to the BIS Module using
the Module Cable. Switching Continuous Impedance Check on
2. Connect the Digital Signal Converter (DSC-3) to or off:
the BIS Engine by plugging the DSC cable into Press Cont/Off ImpChk .
the DSC port on the BIS Engine.
Adjusting Alarms
3. Attach the Patient Interface Cable (PIC) to the
1. Press Adjust Alarms .
Digital Signal Converter.
2. Press ↓ Low Limit ↑ or ↓ High Limit ↑ to
4. Attach BIS sensor to patient
set the high and low limit for the BIS alarm
5. Using the attachment clip, secure the DSC to a
3. Press Setup BIS to return to the BIS Task
convenient location near the patient’s head.
Window

Adjusting BIS measurements Starting a Cyclic Impedance Check

Press BIS on module Press Start Check in the BIS Task Window.

Adjusting the size of the EEG wave Stopping a Cyclic Impedance Check
Press Change Scale Press Stop Check in the Cyclic Check Task
Window.

108
 109

BIS
 Agilent V24/26
Web Link

Agilent V24/26 Web Link

Intended Use Viewing the Welcome Page

The intended use of Agilent V24/26 Web Link is to To view the Welcome page (the main page for V24/
provide access to existing web based patient 26 Web Link), select the Welcome Page link from
information for decision support. Serving as an Favorites, or press the Home icon on the toolbar, or
information access point at the patient bedside, it type the appropriate URL in the address line.
allows the quick, easy and reliable review of web-
based patient reports for non-diagnostic purposes. Viewing Application Pages
Trained healthcare professionals use it in healthcare
To view application pages, click on the appropriate
facilities.
page name from the favorites list. The application
page displays in the main pane (right) of the web
Overview browser.
To view the Agilent V24/26 Web Link pages, you
must first launch your web browser. Then, to get to
the Favorites list, press the Favorites icon on the
toolbar. This displays a list of links that allow the
viewing of various applications that can be used for
decision support.

110
Adding a page to the Favorites Menu 2. Change the name when it becomes boxed.
1. Navigate to the page you want to add. 3. Press Enter . The name is now changed.
2. Click the Favorites icon on the toolbar.
Deleting a Favorites link
3. Click the Add button. Enter the name of the link
you want to create (i.e. TraceMaster Web) 1. Right click on the link in the favorites list and
select Delete from the menu.
4. Click OK . The link is now added to the
Favorites list.

Updating a Favorites link (address)

1. Right click on the link in the favorites list and
select Properties from the menu.
2. Click the Web Document tab in the Properties
dialog box.
3. Edit the URL for the link.
4. Click OK when finished.

Updating a Favorites link (name)

1. Right click on the link in the favorites list and
select Rename from the menu.

111

Agilent V24/26
Web Link
 Agilent V24/26
Web Link

Agilent V24/26 Web Link Troubleshooting

Problem Possible Cause Corrective Action

Welcome Screen • System not plugged in or • Check the system connections and verify
does not display switched on. the display switch is in the correct posi-
when the link is tion.
selected. • The link to the Welcome page is • Check the link information by right click-
broken. ing on the link and selecting Properties.
Select the Web Document tab and verify
the URL box has the correct path. If not,
type the correct path and click OK.

112
Problem Possible Cause Corrective Action

No Welcome/ • The Favorite menu items have • Re-enter the Favorite menu application
application page(s) been erased. pages. Refer to the V24/26 Web Link
are listed in the Installation Manual for instructions if
Favorites menu. • The links that point to the necessary.
Favorites menu are broken. • Check the links by placing the cursor on
the link and right clicking and selecting
Properties. Select the Web Document tab
and verify the URL box has the correct
path. If not, type the correct path and
click OK.

113

Agilent V24/26
Web Link
 Agilent V24/26
Web Link

Problem Possible Cause Corrective Action

Application’s page • The server that hosts that applica- • Check the other pages to see if they work.
shows an error when tion may be down. If they do, than that particular applica-
selected tion’s server may be experiencing trou-
ble. If others are also inaccessible, then
the V24/26 Web Link PC may need to be
rebooted.
Note — When you reboot the PC, it does
not effect the V24/26 monitor. (The PC
• The page is not configured cor- reboots in the background, indepedent of
rectly. the V24/26 monitor.)
• Follow the directions on the screen. If no
directions display, check each link by
right clicking the link and selecting Prop-
erties. Select the Web Document tab and
verify the URL box has the correct path.
If not, type the correct path and click OK.

Keyboard/Trackball • The cable that connects the key- • Verify the keyboard/trackball cable is
isn’t working board/trackball to the PC is loose. securely attached to the PC.

114
Problem Possible Cause Corrective Action

Monitor doesn’t • The cable that connects the PC to • Verify the PC and monitor cables are
display the correct the monitor is loose. securely attached to each other.
information

115

Agilent V24/26
Web Link
 Index

A BIS 108 D
Absorption of light by other chemicals in the Blinking 44 Data Transfer 43
blood 65 Blood Analysis 101 Deactivating the Standby Mode 96
Accessing the Airway Gas Task Window 95 Bottom Row 7 DELAYED recording (normally ECG) 13
Activating the Standby Mode 96 Deleting a Favorites Link
Adding a page to the Favorites Menu C V24/26 Web Link 111
V24/26 Web Link 111 Calculating 36 Deriving Pulse From SpO2/Pleth 64
Adjusting Alarm Limit 55 Calculations 33 Discharging a Patient 26
Adjusting Anesthetic Gas Module Alarms Calibrating CO2 Measurements 70 Displaying Delayed Wave 22
100 Calibration 97 Displaying the Titration Table 36
Adjusting EEG measurements 108 Canceling a Report 35
Adjusting ST Alarms 52 Cardiac arrhythmias 61 E
Adjusting the Measurement Points 51 Cardiac Output 83 EASI 12-Lead ECG 47
Adjusting the Size of RESP Wave 49 Cardiac Output Troubleshooting 84 ECG / RESP / ST 47
Adjusting the Size of the QRS 47 Changing Alarm Limits 78 ECG Measurements 47
Adjusting Trigger Conditions 40 Changing Oxygen Channel 41 ECG Troubleshooting 53
Adjustments to CO2 69 Changing Repetition Time 59 Ending a Case 25, 37
Agilent V24/26 Web Link 110 Changing Site Time or Reset Timer 77 Expanding the Vertical Axis 30
Agilent V24/26 Web Link Troubleshooting Changing the Pressure Label 55
112 Changing the Recorder 14 F
Alarms 19 Changing the Reference Wave 52
fitting the gas sample tube to the watertrap
All Alarms On 20 Changing the Waveform Size 55
93
Anesthesia Gas Monitoring 91 Changing Transducer Temperature 77
Assigning an Unknown Entity Field 36 Changing Trend Priorities 28
Automatic agent identification 98 Charging Batteries 9 H
Automatic agent selection 99 CO2 69 Heart rate extremes 61
Automatic Zero Calibration 97 CO2 Transducer and Breathing Circuit 72 Heart-lung machine 61
Configuring to be the Alarm Recording 42 High levels of ambient light 65
B Control Keys 6 High levels of electrical interference 65
Basic Troubleshooting 2
Battery 9

117
I Overview Recording Multi-Lead ECG 47
If calstick and screen values are different 71 V24/26 Web Link 110 Recording Summary 17
If calstick and screen values are the same 71 Overview/Arrhythmia 21 Reduced arterial blood flow 65
Incorrect cuff size 61 oxyCRG 41 Respiration Measurements 49
Individual Alarms On/Off 20 oxyCRG Episode 16 Reviewing Calculations 34
Injection errors 84 oxyCRG Episodes 39
Instrument errors 84 oxyCRG Measurements 41 S
Invasive Pressure 55 Selecting Agent Identification 98
P Selecting Parameters for Viewing 29
M Parameter Setup Reminders 5 Selecting the Filter Setting 48
Making a Single Recording 15 Patient Data 25, 27 Selecting the QRS Detection Method 48
Making a Stat Measurement 59 Patient movement 61 Selecting the Required Lead 47
Making a Trended Recording 15 Perform the Calibration 71 Selecting The RESP Detection Method 49
Making an oxyCRG Recording 41 Performing Calculations 33 Sending/Receiving Alarms 21
Making Cardiac Output Measurements 83 Physiological reasons 84 Set/Change Alarm Limits 19
Making Drug Calculations 35 Pressure changes 61 Setting Up Anesthetic Gas Module 91
Making Recordings 13 Pressure Measurements 55 Setting Up Anesthetic Gas Module - Option
Manual agent selection 99 Pressure Troubleshooting 57 A02 93
Manual Zero Calibration 97 Printing Displayed Calculations 35 Setting Up Arrhythmia 22
Middle Row 6 Printing Graphs 31 Setting Up SpO2 63
Modifying an Input Field 35 Printing Scheduled Reports 32, 35 Setting Up ST Monitoring 51
Printing the Titration Table 36 Setting Up Temperature 89
N Printing Vital Signs 27 Setting Up The Blood Analysis Module 101
Setup Reminders 1
NBP 59
NBP Measurements 59 Q Severe shock 61
Quick Transfer 45 Showing Normal Ranges 35
NBP Troubleshooting 61
Sidestream Module, CO2 Transducer and
Neonatal Event Review 16, 39
R Breathing Circuit 73
Neonatal Events 39
Silence/Reset Alarms 19
REALTIME (configured) recording 13
Single Manual Measurement or Auto Cycle
O REALTIME (non-configured) recording 13
59
Obese patients 61 Recording 13

118

Index
 Index

Span Calibration 97 calculations 34 via parameter Task Window 20

Specifying a Calculation Time 33 To print the displayed calculations 33 Viewing Application Pages
SpO2 Troubleshooting 65 To redisplay the original saved reference V24/26 Web Link 110
SpO2/Pleth 63 beat 52 Viewing Blood Analysis Results 102
SpO2/Pleth Measurements 63 To Switch Split Screen Trending off 8 Viewing Collection Times 33
ST Measurement Points 50 To Switch Split Screen Trending on 8 Viewing Data in Detail 30
ST Segment Monitoring 51 To switch Tone Modulation on/off 63 Viewing Graph Trends 30
Standby Mode 20, 96 To turn alarms on or off 52 Viewing Graphs Not Displayed 30
Stopping a Measurement 60 To turn all the parameters on 5 Viewing Multi-Lead ECG 47
Stopping a Transfer to Module 44 Transfer to Module 43 Viewing Neonatal Events 39
Stopping a Transfer to Monitor 46 Transfer to Monitor 46 Viewing Older and Newer Data 27, 30
Stopping a Trended Recording 16 Transferring Quickly 45 Viewing Other Patients 21
Suspend Alarms 19 Transferring to Module 43 Viewing Parameters Not Displayed 27
Switching Split Screen Trending 8 Transferring to Monitor 46 Viewing Patient Data in Detail 27
Turning Off Channels 2 and 3 48 Viewing Previous Calculations 34
T Turning Recordings On/Off 14 Viewing Ranges 34
Tc Gas Troubleshooting 79 Turning the Sidestream Pump On 74 Viewing the Welcome Page
tcpO2/tcpCO2 77 V24/26 Web Link 110
tcpO2/tcpCO2 Measurements 77 U Viewing Values in Table Form 31
Temp 89, 91 Updating a Favorites Link address Viewing Vital Signs 27
Temperature Measurements 89 V24/26 Web Link 111 Viewing Waves and Vital Signs 21
To adjust the alarm limits 52 Updating a Favorites Link name Vital Signs/Blood Recording 15
To adjust the Averaging Time 63 V24/26 Web Link 111
To adjust the QRS volume from the SpO2 Using Battery Power 9 W
window 63 Using Enhanced Arrhythmia Monitoring 22 When to calibrate. 70
To change a setting 5 Using Graphs 29 When to perform an accuracy check. 70
To change or enter an input value 33 Using the M1205A Monitoring System 1
To enter a parameter setup window 5 Using Vital Signs 27 Z
To make temporary reference beat Zero Transducer 56
permanent 52 V
To modify input values used to perform via alarm limits Task Window 20

119