Table of Contents. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 1

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2 Table of Contents Section 1 - Introduction A. About this Manual....2 B. Manufacture's Responsibility....2 C. Warranty....2 D. General Safety....2 E. Unpacking and Accessories....3 Section 2 Quick Start A. Description....4 B. Turning-On...8 C. Alarm and Pulse Sound....8 D. Patient Management...8 E. Date and Time...9 F. Monitoring Screen...9 G. Traces Setting...9 H. Patient Type...9 I. ECG Monitoring...10 J. SpO2 Monitoring...10 K. CO2 Monitoring...10 L. NIBP Monitoring...11 M. Temperature Monitoring...11 N. Invasive Pressure Monitoring...12 O. FIO2 Monitoring...12 P. Trends Q. Discharge Patient and Save Data..13 R. Battery Operation B. Turning-OFF Section 3 Print, Reports and Networking A.. Printing and Reports...14 B. Networking Section 4 - ECG Monitoring A. Patient Connections B. ECG Scale...26 C. Lead Selection...26 D. ECG Filter...26 E. Heart Rate Limits...26 F. ECG Seep Speed...27 G. ECG Pulse Test...27 H. ECG Patient Type...27 I. ECG Alarms...27 Section 5 Pulse Oximetry Monitoring A. Patient connections B. SpO2 monitoring C. SpO2 Waveform and Bar-graph...31 D. SpO2 Alarm Limits E. SpO2 Alarm Messages Section 6 - CO2 Mainstream Monitoring A. Overview Section CO2 Mainstream Monitoring A. Principle of Operation B. Indications for Use C. Patient Connections D. Monitoring CO Section CO2 Sidestream Monitoring A. Principle of Operation B. Indications for Use C. Patient Connections D. Monitoring CO Section 7- NIBP Monitoring A. Cuff Selection and Placement B. NIBP Monitoring...48 C. NIBP Alarm Messages...49 Section 8- Temperature Monitoring A. Patient Connections B. Temperature Monitoring Section 9- Invasive Pressure Monitoring A. Pressure Transducer B. Transducer Connection C. IP Scale and Label D. Trigger Source E. Pulsatile / Static Mode F. Transducer Zero G. IP Alarm Limits H. IP Alarm Messages Section 10 Fraction of Inspired Oxygen A. Principle of Operation...54 B. Patients Connections C. Calibration D. FIO2 Monitoring Section 11 - Technical Specification A. Mechanical Description B. Power Requirements...58 C. ECG D. SpO2 Pulse Oximeter E. Non-Invasive Blood Pressure...59 F. Temperature G. CO H. Invasive Pressure I. FIO J. Display K. Environment Specifications L. Trends M. Auxiliary Output (Rear Panel) Section 12- Maintenance A. The Monitor B. Probes C. Patient Cables D. Battery Warranty Terms & Conditions Rev5 Jan 10 Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 1

3 SECTION 1 INTRODUCTION A. ABOUT THIS MANUAL This operator s manual has been prepared to provide information on the correct use of the LifeWindow Lite LW8 multi-parameter patient monitor. It contains performance specifications, installation, operation and maintenance information. It is intended for trained health-care professionals. B. MANUFACTURER S RESPONSIBILITY The manufacturer of this equipment is responsible for the effects on safety, reliability, and performance of the equipment only if: The equipment is used in accordance with the instructions in this manual. The electrical installation complies with all applicable regulations. Assembly operations, extensions, re-adjustments, or repairs are carried out by person s authorized by the manufacturer. Incorrect operation or failure of the user to maintain the monitor in accordance with proper maintenance procedures relieves the manufacturer or his agent from all consequent non-compliance, damage or injury. It is up to the user to ensure that any applicable regulations respecting the installation and operation of the monitor be observed. C. WARRANTY All products manufactured by Digicare Biomedical Technology Inc. are warranted to be free from defects in material and workmanship and to operate within published specifications, under normal use, for a period of one year from date of original shipment. The warranty on accessories is ninety (90) days. If an examination by Digicare, discloses such products or component parts to be defective, then our obligation is limited to repair or replacement (at our option). D. GENERAL SAFETY 1 - INDICATIONS The LifeWindow LW8 Lite series is a Class 1 device designed for continuous operation in accordance with the Safety Standard EN The Class 1 device MUST BE connected to the external protective conductor to be operated with the external MAINS LINE. It is intended for use by person s trained in professional health care, in the hospital / clinic environment. The operator must be thoroughly familiar with the instructions in this manual before using the instrument. The unit is configured to measure and monitor the following available parameters: ECG Waveform (3 and 5 leads); Heart Rate (HR) from ECG ; ECG arrhythmia and ST segment analysis (5 Leads ECG); Blood oxygen saturation (SpO 2 or pulse oximetry); SpO2 waveform (Plethysmogram); Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 2

4 Two Temperature channels; Two Invasive Pressure channels; Pulse (from SpO 2, NIBP, IP1 or IP2) rate; NIBP Systolic, Diastolic and mean arterial pressure; End-tidal CO2 concentration (EtCO2) Mainstream or Sidestream; Inspired CO2 concentration (inco2) Mainstream or Sidestream; Respiration rate (from EtCO2 waveform); Inspired Fraction of O2 ( FIO2 ); CONFIGURATION CODE Electrocardiogram 3 Lead ECG... E Electrocardiogram 5 Lead ECG...5E Pulse Oximetry and Plethysmogram... S FIO2 Inspired Fraction of Oxygen... F CO2 - Sidestream Capnography... C CO2 - Mainstream Capnography... M CO2 DualCap Mainstream and Sidestream Capnography... D Non-invasive Blood Pressure - NIBP... N Invasive Pressure (up to two channels)... #P Temperature (up to two channels)...#t The applied parts are classified accordingly to the degree of electrical isolation from the patient and defibrillation protection. The ECG patient connection is DEFIBRILLATION PROOF type CF applied part. The Invasive Pressure connection is type CF applied part and is not DEFIBRILLATION PROOF. The Temperature connection is type BF applied part and is not DEFIBRILLATION PROOF. The SpO2 is type BF applied part and is not DEFIBRILLATION PROOF. All other patient connections are NOT DEFIBRILATION PROOF type B applied part. 2 - CAUTIONS The LifeWindow Lite LW8 was designed and tested accordingly to the ELECTRO-MAGNETIC COMPATIBILITY Standard IEC However, the operator is responsible to verify if the monitor is been affected or affecting others electrical equipment. Equipments like electrocautery and image scanners can generate interference and cause degradation of the LifeWindow Lite LW8 performance. To avoid this situation, it should be installed as far as possible of those equipment. 3- CONTRAINDICATIONS The LifeWindow Lite LW8 series is NOT intended to be used during MRI (magnetic resonance imaging). The LifeWindow Lite LW8 is NOT suitable for use in the presence of a flammable anaesthetic mixture with air or with oxygen or nitrous oxide. E. UNPACKING AND ACCESSORIES Carefully remove the monitor and its accessories form the shipping carton. Save the packing materials in case the monitor must be shipped or stored. Ensure your LifeWindow Lite LW8 has the items listed in the SHIPPING LIST inside the carton. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 3

5 SECTION 2 QUICK START A. DESCRIPTION 1 FRONT PANEL FIG.1 1- TFT Active Matrix Color Flat Panel Display: Windows based Graphic Interface displays 6 user selectable physiologic waveforms, numeric values, indicators, alarm messages and physiologic parameters menu. 2- ALARM DISABLE dedicated pushbutton. 3- FREEZE TRACES dedicated pushbutton. 4- ECG LEAD SELECTION dedicated pushbutton. 5- NIBP START dedicated pushbutton. 6- NIBP STOP dedicated pushbutton. 7- PRINT dedicated pushbutton. 8- BATTERY charge status LED indicator. 9- AC mains line LED indicator. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 4

6 2 PATIENT CONNECTIONS PANEL FIG Internal CO2 Sidestream module receptacle. Accept sample line to Sidestream CO2 and Respiration Rate determination and monitoring. 11- NIBP hose receptacle. Accept cuff to Non Invasive Blood Pressure and Pulse determination and monitoring. 12- SpO2 connector. Accepts pulse oximetry patient sensor cable to non-invasive determination and monitoring of the blood oxygen content. 13- ECG connector. Accepts ECG cable for electrocardiogram and Heart Rate monitoring. 14- Invasive Pressure Channel 1 connector. Accepts pressure transducer cable to invasive determination and monitoring of blood pressure. 15- FIO2 connector. Accept cable and sensor to Inspired Fraction of Oxygen determination and monitoring, using an air way adaptor. 16- Temperature Channel 1 and Channel 2 connectors. Accepts temperature cable and sensor for non-invasive Temperature determination and monitoring. 17- CO2 External Sidestream or Mainstream module connector. Accepts CO2 mainstream cable connector. Also accepts External Sidestream module cable connector, for determination and monitoring of CO2 and Respiration Rate. 18- Invasive Pressure Channel 2 connector. Accepts pressure transducer cable to invasive determination and monitoring of blood pressure. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 5

7 3 REAR PANEL FIG On / Standby switch. Momentary contact switch to turn-on and off the unit. To turn-on the unit, double click this switch. 20- Video Connector. Connection to a standard CRT video. 21- Keyboard Connector. PS2 connection to a standard AT type keyboard used only to service purposes. 22- Auxiliary Connector. Supply analog output signals, trigger signals and one RS232 communication port. 23- Ethernet Connector. Connection to Ethernet network standard. 24- Mains Line IEC connector. Accepts power cable from mains line. Have 1 main fuse and 1 spare fuse inside. 25- General Power switch. Interrupt power from internal battery and mains power supply. 26- Antenna for wireless networking. 27- USB 1 and USB 2 connectors. 28- Internal CO2 Sidestream Vent port. Keep it always open to room air. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 6

8 4 MONITORING SCREEN FIG.4 29 First waveform user selected area, showing ECG waveform in Thin Line Style, scale (-1 to +1mV), sweep speed of 25mm/s and QRS detected INDICATOR (HEART). 30 Second waveform user selected area, showing Invasive Pressure 1 waveform in Thin Line Style, scale (0 to 180mmHg), sweep speed of 25mm/s. 31 Third waveform user selected area, showing Invasive Pressure 2 waveform in Thin Line Style, scale (0 to 180mmHg), sweep speed of 25mm/s. 32 Fourth waveform user selected area, showing SpO2 waveform in Thin Line Style, with Pulse Level strength scale (1 to 8), sweep speed of 25mm/s. 33 Fifth waveform user selected area, showing Capnogram (CO2) waveform in Fill In Style, with scale (10 to 50mmHg), sweep speed of 12.5mm/s. 34 Sixth waveform user selected area, showing Capnogram (CO2) waveform in Fill In Style, with scale (10 to 50mmHg), sweep speed of 12.5mm/s. 35 ECG menu selection. 36 SpO2 menu selection. 37 FIO2 menu selection. 38 CO2 menu selection. 39 NIBP menu selection. 40 Invasive Pressure menu selection. 41 Temperature menu selection. 42 Traces configuration menu selection. 43 Trends menu selection. 44 Print menu selection. 45 System configuration menu selection. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 7

9 46 Patient Name and ID indicator 47- Date and Time indicators. 48 Battery Status Indicator. 49 Adult / Neonatal Mode selector and indicator. 50 ECG Heart Rate (BPM) and ECG settings. 50 Invasive Pressure 1 Indicator and IP1 settings. 51 Invasive Pressure 2 Indicator and IP2 settings. 53 SpO2 Indicator in % and SpO2 settings. 54 Indicators and settings: End tidal CO2 (EtCO2) value display in %. Inspired CO2 (InsCO2) value display in %. Respiration Rate in RPM. 55 FIO2 Indicator in % and settings: 56 Indicators: NIBP mode selected indicator: Manual, Stat or Auto. NIBP cycle interval selected indicator. NIBP time to next cycle remaining indicator. 57 Indicators: Systolic arterial pressure determined by NIBP in mmhg. Diastolic arterial pressure determined by NIBP in mmhg. Mean Arterial Pressure (MAP) determined by NIBP in mmhg. 58 Temperature Indicators and settings B. TURNING-ON Plug the AC power cord in AC MAINS receptacle at rear panel connector (24) and in the AC outlet. The LifeWindow Lite LW8 accepts 110 or 220 VAC with automatic selection by the power supply. The electrical installation of the room must have three pin outlets with earth connection for protection of patient, users and equipment. The AC-ON LED indicator will light green and the BATTERY status indicator will light green if the battery is fully charged or yellow if charging. Power-on the unit by double-clicking the ON switch ( 19 ) on the rear panel. The monitor will then perform a boot sequence (approx. 1.5 min.). C. ALARM AND PULSE SOUND When the unit turns-on, the Alarm Sound is disabled by 2 minutes. To disable the Alarm Sound for more 2 minutes press and release the Alarm Sound dedicated pushbutton ( 2 ) in the front panel. The AUDIBLE ALARMS OFF message flashes in screen. To permanently disable the Alarm Sound press and hold 4 seconds the Alarm Sound dedicated pushbutton ( 2 ). The AUDIBLE ALARMS OFF message is displayed steady on screen. The Pulse and Alarm sound volume levels are set to default levels. To change the Pulse and Alarm Sound volume level, touch in System menu and Sound Volume. Select the Beep Volume, Alarm Volume and Beep Source, if it is from the ECG, SpO2 or OFF (no Beep). D. PATIENT MANAGEMENT the LifeWindow Lite LW8 starts the monitoring screen and start storing all Vital Signs. The Patient Management screen can be opened at any time by touching the System menu. The Patient Management screen is automatically displayed when the monitor is turned-on with two options: Admit New Patient and Cancel Pat Mangmt. Touching Cancel Pat Mangmt, closes the Patient Management screen. Although the Patient can be admitted at a later time, we recommend to admit the Patient before Patient data starts to be stored to prevent losing Patient Data. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 8

10 To admit a patient, touch on the Admit New Patient button. Enter the Patient s Name and Patient Control ID. Touch the Admit Patient & Start Monitoring button. If less then 5 minutes of monitoring occurred, the Patient is admitted and the screen is closed. If more then 5 minutes of data is available, you need to choose what to do with the with the patient s data in the buffer, with three options: Keep for the new patient. Touch to include data to new patient. Save as different patient. Touch to save data to different patient. Discard Data. Touch to discard. E. DATE AND TIME Check if the current Date and Time displayed in the Indicator (47) are correct. To change the Date and Time, touch the SYSTEM menu and touch Date/Time Settings. Set current location Date and Time. Touch OK to finish. F. MONITORING SCREEN The LifeWindow Lite LW8 monitoring screen is pre-configured accordingly to the Vital Signs parameters that are installed and turned-on. The traces are pre-configured to keep In-line Logic with the Indicators area in the right of the traces area. To turn-off any Vital Sign that is not going to be used in patient s monitoring, touch the Vital Sign menu and touch ECG OFF or SPO2 OFF, etc. The monitoring screen may change some Traces settings and Indicators. Factory Default Settings are configured to standard applications. As the user changes Alarm Limits and other settings, the LifeWindow Lite LW8 will save the changes when turned-off. Next time the unit is turned-on, the last saved settings will remain. To return the unit to the Factory Defaults, touch in the System menu and touch in Load Factory Default Settings. G. TRACES SETTING The LifeWindow Lite LW8 six traces are configured and cascaded accordingly to the Vital Signs parameters installed and turned-on. You can select any physiological waveform from one to six of the available traces. You can also cascade the traces up to 3 individual loops. Move the Pointer to TRACES icon and press the Select pushbutton. Select TRACE waveform source (ECG, SpO2 Plethysmogram, Capnogram, or No Selection). Select TRACE sweep speed (6.25mm/s, 12.5mm/s, 25mm/s, 50mm/s or 100mm/s). Select TRACE color. Select TRACE style (Thin line or Fill In). Press the Cascade Traces button if you want to cascade two or more traces. You can create until 3 cascade loops: Loop 1, Loop 2 and Loop 3. Select the Loop waveform Source. Select the Sweep Speed, Color and Style for each trace. Press the Done button to finish. Note: When the LifeWindow Lite LW8 is turned-off and turned back on, the traces will return to the original pre-configuration accordingly to the physiological parameters that are installed and turned-on, to keep In-line Logic with the Indicators area in the right of the traces area. H. PATIENT TYPE Patient Type has two modes: Adults and Neonatal. It affects the ECG and NIBP functions only. All other Vital Signs functions are not affected by the Patient Type selected. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 9

11 Selection of Patient Type shall be based on the Patient s Heart Rate range for ECG monitoring and Cuff size to be used for NIBP monitoring. Adult Patient Type : ECG Heart Rate Range: 5 to 220 BPM NIBP Cuff Size #: 5, 7, 8, 9, 10 and 11 Neonatal Patient Type : ECG Heart Rate Range: 30 to 350 BPM NIBP Cuff Size #: 1, 2, 3, 4 and 6 I. ECG MONITORING The ECG function is pre-configured with the following default settings. To change the ECG settings touch the ECG menu and change the desired setting. Heart Rate High Limit : 140 BPM Heart Rate Low Limit : 60 BPM Heart Rate Averaging : 8 Beats for Adult, 16 Beats for Neonatal ECG Scale : mv to +1.0 mv ECG Filter Mains Notch : ON ECG Filter Digital : ON ECG Lead Selection : II Prepare the electrode sites in the standard configuration for RA (Right Arm), LA (Left Arm) and LL (Left Leg). Application sites should be clean and dry. Shave or clip excess hair if necessary. Use conductive ECG gel if necessary. Connect the 3 Leadwires to the ECG cable. Connect the ECG cable to the receptacle (13) in the patient panel. Install the 3 electrodes in the patient. More details in Section 4. A visual indicator ( ) and a beep Sound indicates R wave detection and the ECG waveform and Heart Rate reading are displayed. J. SpO2 MONITORING The SpO2 function is pre-configured with the following default settings. To change the SpO2 settings touch the SpO2 menu and change the desired setting. SpO2 % High Limit : OFF SpO2 % Low Limit : 88% SpO2 Pulse High Limit : 140 BPM SpO2 Pulse Low Limit : 60 BPM Choose the SpO2 sensor type and prepare the SpO2 sensor and clip. The preferred sensor application site is the finger. Alternatively, the sensor and clip may be applied to patient s ear, hand or foot. Connect the sensor assembly to the SpO2 Patient Cable: Plug the SpO2 Patient Cable into the SpO2 connector (12) on the side panel of the monitor. Push the cable in until you hear an audible click. The yellow SpO2 SENSOR message changes for the green Searching SpO2 message, the Bar-graph shows the SpO2 Pulse Level, the SpO2 waveform, SpO2 % and Pulse Rate values are displayed. K. CO2 MONITORING The LifeWindow Lite LW8 automatically starts the CO2 function when CO2 sensor is connected to the unit. The CO2 function is pre-configured with the following default settings. To change the CO2 settings touch the CO2 menu and change the desired setting. CO2 Waveform Scale : 0 to 50 mmhg EtCO2 High Limit : 45 mmhg Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 10

12 EtCO2 Low Limit : 20 mmhg InsCO2 High Limit : 10 mmhg InsCO2 Low Limit : OFF Resp Rate High Limit : 50 BPM Resp Rate Low Limit : 5 BPM Select the appropriate airway adapter for mainstream or sample line with adapter for sidestream based on the patient and monitoring situation. Connect the sample line with adapter to receptacle (10) in the Patient Panel, or; Connect the sample line with adapter to the External Sidestream module and connect the module to connector (17) in the Patient Panel, or; Connect the Mainstream sensor assembled in the airway adapter to connector (17). Wait for the Sensor Warm Up message to clear. If the Zero Required message is displayed, proceed with a Zero Calibration Procedure as explained in Sections 6.1 and 6.2. Connect the airway adapter to the patient s air way assembled circuit. L. NIBP MONITORING The NIBP function is pre-configured with the following default settings. To change the NIBP settings touch the NIBP menu and change the desired setting. NIBP Cycle Mode : Manual NIBP Systolic Upper Limit : 160 mmhg NIBP Systolic Lower Limit : 100 mmhg NIBP Diastolic Upper Limit : 100 mmhg NIBP Diastolic Lower Limit : 60 mmhg NIBP Mean Upper Limit : 120 mmhg NIBP Mean Lower Limit : 80 mmhg NIBP Pulse Upper Limit : 140 BPM NIBP Pulse Lower Limit : 60 BPM The widest cuff that can be placed on the patient, without extending beyond the joint, should be selected. Cuff width should be 40 60% of limb circumference. The cuff should be wrapped for a snug fit. The monitor comes standard with six different sizes of cuffs. They are marked to aid in proper cuff selection. When a cuff is wrapped around a site, its index edge should be in the range indicated on the cuff. The cuff is too small or too large if the index edge is outside the range. For best results, a cuff should be wrapped for a snug fit and be positioned reasonably close to heart level. Avoid compression or restriction of the NIBP Inflation Hose. The hose must not be kinked or pinched. It can be placed in any position, but it should be kept off the table surface to avoid equipment vibrations. The cuff should not be applied on a limb being used for an intravenous infusion. Do not place the cuff on any extremity being used for SpO2 monitoring. M. TEMPERATURE MONITORING The Temperature function is pre-configured with the following default settings. To change the Temperature settings touch the TEMPs menu and change the desired setting. Temperature Channel 1 : On Temperature Channel 2 : OFF Temperature Unit : F Temperature 1 Upper Limit : F (38.0 C) Temperature 1 Lower Limit : 95.9 F (35.5 C) To enable Temperature 2 channel, touch in TEMPs menu, Temperature 2 and select ON. To enable Differential T1-T2, touch in TEMPs menu, Differential T1-T2 and select ON. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 11

13 Connect the temperature patient cable to receptacle (16 ) Temperature 1 or Temperature 2. In the Temperature menu select Temperature1, Temperature2 or T1-T2. The temperature value is displayed when the probe temperature is in the 50 to 122 F (10 to 50 C), range otherwise the temperature display is blanked. N. INVASIVE PRESSURE MONITORING The Invasive Pressure function is pre-configured with the following default settings. To change the Invasive Pressure settings touch the IBPs menu and change the desired setting. IP # : OFF IP # Scale : 0 to +150 mmhg IP # Mode : Pulsatile IP # Label : IP # IP # Trigger Source : Pulse IP # Systolic Upper Limit : 160 mmhg IP # Systolic Lower Limit : 60 mmhg IP # Diastolic Upper Limit : 160 mmhg IP # Diastolic Lower Limit : 60 mmhg IP # Mean Upper Limit : 120 mmhg IP # Mean Lower Limit : 60 mmhg The Invasive Pressure Channels 1 and 2 are turned off in the factory default settings, to avoid alarms when not in use. Turn-on Invasive Pressure Channel 1 or 2 touching in the IBPs menu. The message NO TRANSDUCER is displayed until a Transducer is connected. Connect the pressure transducer cable to connector IP1 (14) or IP2 (18). Connect the catheter to the pressure transducer. Install the flow system and maintain the entire system with liquid. Hold the transducer at the heart level (axial line). Additional information in Section 9. The message ZERO TRANSDUCER is displayed until a zero calibration is executed. Open the TRANSDUCER input to the air (Local Atmospheric Pressure). Touch in the IBP menu and touch in the Invasive Pressure 1 or 2. Touch the Zero Xducer button. If the transducer Zero calibration procedure was successful, the Invasive Pressure waveform shall be displayed at ZERO baseline and the Invasive Pressure readings are displayed. If the transducer Zero calibration procedure was NOT successful, the IP# ERROR ZEROING message is displayed on screen. O. INSPIRED FRACTION OF OXYGEN MONITORING The FIO2 function is pre-configured with the following default settings. To change the FIO2 settings touch the FIO2 menu and change the setting. FIO2 function : OFF FIO2 Upper Limit : OFF FIO2 Lower Limit : 20 % Turn-on the FIO2 function touching the FIO2 menu and select ON. Connect one end of the FIO2 patient cable into the jack receptacle on the back end of sensor. Connect the other end of the cable into the receptacle (15) located on the patient connections panel of the unit. The LifeWindow Lite LW8 should be calibrated before each use and every 8 hours to maintain maximum accuracy. See Section 10 for more information. The LifeWindow Lite LW8 can be used to measure a gas mixture for oxygen in two basic modes: In the inhalation side of breathing circuit ahead of humidifiers and medicating devices or other instances where gases are flowing to a patient in breathing circuits. When monitoring oxygen Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 12

14 in breathing circuits, the flow diverter must be used. In confined volumes such as tents and hoods. In these applications the flow diverter must be removed from the sensor so that it does not interfere with the rapid exchange of gases to and from the sensing surface of the sensor. Never install the sensor in a location that will expose the sensor to patients exhaled breath or secretions unless you intend to dispose of the sensor and flow adapter after use. P. TRENDS The LifeWindow Lite LW8 stores all measured parameters from patient, every minute since the monitoring screen starts until the monitor is turned-off. The stored values can be visualized in tabular or graphic form, for trend analysis. Touch the Trends menu. Touch in Tabular to visualize all values trends in a tabular form, with indication of values measurement time. Touch in Graphical to select display all stored physiologic values in graphic trends format. Touch the period of time to display the Trends: 15min, 1H, 4H, 12H, 24H, 48h e 72h. The Trends for all measured physiologic parameters are displayed simultaneously. Touch in the windows maximize button to increase the trends screen size. Use the cursor to move the Trends up, down, right or left. Q. DISCHARGE PATIENT AND SAVE DATA At the end of monitoring, touch the System menu and Patient Management menu. Touch Discharge Patient button. Press Yes to confirm. Press Yes to save the patient data. Make sure the selected directory is the desired place to save the data (default is c:\patient Data). To save to a different directory in a network computer, touch the Select Another Directory button. Select the desired directory in the Look in field and touch the Done button. Touch the Save Report button to save the report to the selected directory. R. BATTERY OPERATION The LifeWIndow Lite LW8 internal battery has autonomy to approximately 30 minutes of operation when fully charged. The CHARGE STATUS LED indicator ( 8 ) stays yellow when battery is recharging, green when the battery is fully charged and Off when the battery is disconnected or during battery operation. With the monitor ON, the battery status indicator ( 48 ) displays the battery charge status of the battery. In battery operation, the LOW BATTERY alarm message is triggered when there is charge to approximately 10 minutes of operation. After 5 minutes with LOW BATTERY message, the unit shut-down. S. TURNING-OFF To Shut down the unit just press and release the ON / Standby (19) pushbutton on the rear panel or touch the Shutdown option in the system menu. A screen asking to confirm if you want to shutdown the unit is displayed. If any problem occurs with the shutdown function, the user can shut-off the unit by pressing and hold the ON / Standby (19) pushbutton for 15 seconds. In this option patient data is lost. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 13

15 SECTION 3 PRINT, REPORTS AND NETWORKING A. PRINTING AND REPORTS The LifeWindow Lite LW8 can connect to any external windows based printer, connected to the rear panel of the unit USB 1 or 2 connector (27), or to a network printer. The Epson C88 Plus is installed as default printer. It also prints to a PDF virtual printer creating PDF print reports. An optional Strip Chart Recorder can be installed in the unit. 1 EXTERNAL PRINTER The Epson C88 Plus printer is pre-configured with the following default settings. To change the printer settings touch the Print Menu and select Printer and PDF. To install another Local or Network printer, read Section 3 F. ECG Trace Settings Printer DPI : 360 DPI Printers Charting Speed : 25 mm/s Scales : 5 mm/mv Grid : Grid On Tabular Reports Interval Between Measurements (minutes) : 1 Numbers of Pages to Print : 1 (45 measurements / Page) Set the Print DPI. Default is set to 360 DPI (Epson). Other manufacturer uses 300 DPI. Check your printer documentation to verify correct DPI. Set Charting Speed. Options are: 6.25, 12.5, 25, 50, 100 and 200 mm/s. Set Scale. Changing scale will change the amplitude of the ECG in the printout. Options are: 2.5, 5, 10, 20, 40, 80 and 160 mm/mv. As you increase the Scale it will increase the size of the ECG in the printout. Set Grid On (default) or Off. Set Interval Between Measurements (minutes), for Tabular Reports printout. Set Numbers of Pages to Print. Each page has 45 measurements. Touch the Print ECG to Printer button to start printing in the installed printer. The printout will have the last 10 seconds of ECG followed by current time ECG. Touch the Print ECG to PDF button to create a PDF printout of the ECG. The printout will have the last 10 seconds of ECG followed by current time ECG. Touch the Print Report to Printer to print the Tabular Report in the installed printer. Touch the Print Report to PDF to create a PDF Tabular Report. 2 STRIP CHART RECORDER (Optional) The Strip Chart Recorder is pre-configured with the following default settings. To change the printer settings touch the Print Menu and select Strip Chart. ECG Trace Settings Charting Speed : 25 mm/s Scales : 20 mm/mv Grid : Grid On Triggering Events : OFF Tabular Reports Interval Between Measurements (minutes) : 1 Numbers of Pages to Print : 1 (45 measurements / Page) Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 14

16 The Tabular Reports # measurements in memory is displayed in the Strip Chart Setup. The Tabular Reports # of pages that can be printed is displayed in the Strip Chart Setup. Select the charting speed to the ECG trace :6.25mm/s, 12.5mm/s, 25mm/s or 50mm/s. Select the Grid ON or OFF to be printed with the ECG waveform. Select the ECG Scale :2.5mm/mV, 5mm/mV, 10mm/mV, 20mm/mV, 40mm/mV, 80mm/mV or 60mm/mV. Activate or disable the Triggering events to automatically start printing the ECG in case of an ECG alarm. Press the PRINT (7) button in the Front Panel overlay or the Start Charting button in the Strip Chart Setup to start printing the ECG waveform on the Strip Chart Recorder. Press the Print Report button in the Strip Chart Setup to print the report in the Strip Chart. Press the Stop Recorder button in the Strip Chart Setup to stop printing. 3 EXCEL REPORTS The LifeWindow Lite LW8 Excel report contains a Tabular Report and Trends Graphical Report. The Tabular Report stores the patient s Vital Signs every minute. The Report can be reconfigured at the moment of printing, changing the time between readings from 1 minute up to 99 minutes. The Graphical Trends Report has options for 2, 4 and 24 Hours graphic trends report. To generate a Excel Report the patient shall be admitted in the Patient Management Setup. SAVING PATIENT VITAL SIGNS TO EXCEL REAPORT. As soon the LifeWindow Lite LW8 start the monitoring screen, the patient data is being stored. Admitting the patient, transfers these data to the patient s buffer. The patient can be admitted any time after start monitoring. To save the patient s data touch in the System menu and touch in the Save Patient Vital Signs Report. If the current patient is not admitted at this time, an Error No Patient has been admitted screen is displayed. Touch OK and follow the steps to Admit Patient. If the current patient is admitted the Save Vital Signs Report screen is displayed. The Current Selected Directory to save the patient data is displayed (default is c:\patient Data), with the Report File Name. The Report File Name contains the Patient s ID and the date and time of the Report generation. To save to a different directory in a network computer, touch the Select Another Directory button. Select the desired directory in the Look in field and touch the Done button. Touch the Save Report button to save the report to the selected directory. VIEWING PATIENT S VITAL SIGNS EXCEL REPORT. To view the Patient s Vital Signs Excel Report, touch in the System menu and touch in the View Reports with MS Excel. In the Microsoft Excel screen, touch in File and Open. All saved Excel reports will be listed. Touch in the desired report name to select it and touch in Open. The Excel Report has three tabs : Tabular, 2 Hour, 4 Hour and 24 Hour. The Tabular report default time interval is 5 minutes. To print the Tabular Report with the default time interval touch in the Printer icon or in File and Print. In the Print screen touch to select the desired printer and touch OK. To change the Excel Report time interval, touch in the maximize button in the top right corner to expand the report screen. Using the right arrow button, move the Tabular Excel Report to the left. Using the Up and Down big arrows, change the Measurement Interval in Minutes. Touch in the Click here to renew the interval of Measurement button. The Excel Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 15

17 Report will change to the selected interval. To view the Graphical Trends Report, touch in the 2 Hours, 4 Hours or 24 Hours tab in the bottom of the Microsoft Excel screen. B. Networking The LifeWindow Lite LW8 can be connected to your local network using Ethernet and wireless LAN. The Ethernet connector (23) is standard in all units. Note: Digicare Biomedical Technology Inc can supply WIFI cards for your Life Window Lite LW8. Contact sales and support for more information on this at LIFEWINDOW LITE LW8 SETUP Turn on the LifeWindow monitor Move the touch screen mouse pointer to the TRACES icon on the top of the monitor screen. Hold down the FREEZE and NIBP Start buttons and touch the TRACES icon simultaneously. (This will cause the LW program to stop and start the Windows Desktop.) 2 - WINDOWS XP SETUP To change the computer name, to join a domain or workgroup, or to add a computer description for a Windows XP-based computer, use the Computer Name tab in the System Properties dialog box. To locate this tab, use one of the following methods: Click Start, Settings click Control Panel, double-click System. Click Start, click Run, type sysdm.cpl, and then click OK. 3 - CHANGE COMPUTER NAME AND JOIN A DOMAIN OR A WORKGROUP To change a computer name and to join a domain or a workgroup, follow these steps. Warning Before you change a computer's membership from a domain to a workgroup, be sure that you know the user name and the password for an account in the local Administrators group. You cannot log on after you remove the computer from the domain 1. Click the Computer Name tab, and then click Change. 2. Type the new computer name in the Computer name dialog box. 3. Type the new domain or workgroup in either the Domain dialog box or the Workgroup dialog box. 4. Click More to change the primary Domain Name System (DNS) suffix. 5. Click OK three times, and then restart the computer. 4 - ADD A COMPUTER DESCRIPTION To add a computer description, type a name or a description in the Computer description box on the Computer Name tab, and then click Apply. Network ID Wizard If you do not know how to complete these tasks, you can use the Network Identification (ID) Wizard to help you. To start the Network ID Wizard, follow these steps: 1. In the System Properties dialog box, click Network ID. (Refer to steps 1-5 under Change the Computer Name to find Systems Property) Note This wizard is new to Windows XP. With this wizard, you can add the computer to a workgroup or to a domain. 2. Move backward and forward in the wizard by using the Back and Next buttons. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 16

18 The first set of options in the Network ID Wizard is as follows: Option 1 "This computer is part of a business network, and I use it to connect to other computers at work." Option 2 "This computer is for home use and is not part of a business network." If you select option 1, the following options appear: Option 1a "My company uses a network with a domain." Option 1b "My company uses a network without a domain." If you select option 1a, a dialog box appears that requests the following information: User name Password User account domain Computer name Computer domain If you select option 1b, you can also configure the computer as a "Workgroup Member," and you can type the name of the workgroup. If you select option 2, you are prompted to click Finish to restart the computer. If you follow this step, the computer is configured as a "Workgroup Member." By default, the name of the workgroup is "Workgroup." Then, the next page requires the domain name to which the computer is to be added. Also, the next page requires the username and the password of an account that has the rights to add a computer to the domain. Additionally, the next page enables the user account from the previous page to be added to this computer. Finally, the next page enables the new user to have various rights on the local computer. The user may be added to the following built-in groups on the local computer: Administrators Backup operators Debugger users Guests HelpServicesGroup Network configuration operators Power users Remote desktop users Replicator Users Note If the computer is a member of a domain, the computer also maintains a local domain that has security accounts. If the Domain box does not appear, click the Options button to display the Domain box, and then select the required domain from the menu. The first step to discuss printing is to install a local print device. A local print device could take many forms an inkjet printer, a local laser printer, or a label printer. The printer could be connected to the machine in a number of ways USB, parallel, Bluetooth, or infrared. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 17

19 5 INSTALLING A LOCAL PRINTER Most local printers, when connected via USB, will initiate a Plug n Play installation of the printer driver. Occasionally, we are required to install the printer manually: 1. Connect the printer to the PC and power both on. 2. Click Start, Settings and then Printers and Faxes. 3. Click Add a printer in the taskbar on the left. 4. Click Next. 5. Click Next for a local printer attached to the computer. 6. Windows will search for a Plug n Play printer. If it does not find one, click Next. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 18

20 7. Select the port you have the printer plugged into and click Next. 8. Select the Manufacturer on the left and the Printer on the right. Click Next. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 19

21 9. Enter a Printer Name. Click Next. 10. If you d like to share the printer on the network, click on Share name and enter a friendly name. Click Next. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 20

22 11. If you d like to print a test page, click Next. Otherwise, click No then click Next. 12. Click Finish to complete the printer install. 13. You now have a printer installed. 6 CONNECT TO A NETWORKED PRINTER 1. Click Start, Settings and then Printers and Faxes 2. Under Printer Tasks, click Add a printer to open the Add Printer Wizard, and then click Next. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 21

23 3.Click A network printer, or a printer attached to another computer, and then click Next. 4. Connect to the desired printer using one of the following three methods. Click a method for instructions. Search for it in Active Directory. This method is available if you are logged on to a Windows domain running Active Directory. 1.Click Find a printer in the directory, and then click Next. 2.Click the Browse button to the right of Location, click the printer location, and then click OK. 3.Click Find Now. 4.Click the printer you want to connect to, and then click OK. Type the printer name or browse for it. 1.Click Connect to this printer. 2.Do one of the following: Type the printer name using the following format: \\printserver_name\share_name Browse for it on the network. Click Next, click the printer in Shared printers. 3.Click Next. Connect to an Internet or intranet printer. Using a printers URL allows you to connect to a printer across the Internet, provided you have permission to use that printer. If you cannot connect to the printer using the general URL format below, please see your printer's documentation or contact your network administrator. 1.Click Connect to a printer on the Internet or on your intranet. 2.Type the URL to the printer using the following format: 3.Follow the instructions on the screen to finish connecting to the network printer. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 22

24 Note To open Printers and Faxes, click Start, click Control Panel, click Printers and Other Hardware, and then click Printers and Faxes. You can also connect to a printer by dragging the printer from the Printers folder on the print server and dropping it into your Printers folder, or by right-clicking the icon and then clicking connect. Another way to add a printer is to double-click Add Printer. This option is available only if folders are set to the Windows XP classic folder look, and if a printer is not currently selected. After you have connected to a shared printer on the network, you can use it as if it were attached to your computer. 7 SHARING FILES AND FOLDERS Sharing a folder is even easier than sharing a printer: 1. Open a folder (such as My Documents), click Make A New Folder in the Task Pane and name your new folder. 2. With the new folder highlighted, click Share This Folder. 3. In the Sharing tab of the Properties dialog box, select Share This Folder On The Network. 4. Provide a descriptive name for the folder. This name should make it easy for others on the network to recognise the folder; it doesn't have to be the same as the folder name you selected in step You can let other people on the network view and edit your files or view them only. If you want to protect your files from tampering, remove the tick from Allow Other Users To Change My Files. There are a variety of ways to access a shared folder. Here's one way: 1. Click Start -> My Network Places -> View Workgroup Computers. 2. Click the computer whose files you wish to access and then click the shared folder. You can create shortcuts to shared folders to make them easier to access. Note: Be wary of sharing files and printers if you have an always-on Internet connection. Doing so can make your files vulnerable to outside access. If you do enable sharing, make sure you use password protection, that you don't share the root (C:\) folder of any computer on the network, and that you install and use a strong, commercial firewall. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 23

25 SECTION 4 - ECG MONITORING The LifeWindow Lite LW8 continuously monitors the ECG waveform and Heart Rate (HR). The screen displays the electrocardiogram, the Mean Heart Rate, the High and Low Heart Rate alarm limits, the selected lead (I,II or III), the QRS detected ( ), filters and alarm messages. A. PATIENT CONNECTIONS To ensure conformance with all safety and performance specifications, use only the recommended accessories. These are available from DIGICARE with the following part number: ECG Accessories Description P/N ECG patient cable (10 length) 3 Leads Digicare EC101 Set of 3 ECG lead-wires with snap-in (40 length) for Digicare Patient Cable PN EC101 EC104 ECG Patient Cable (10 Length) 5 Leads Digicare EC111 Set of 5 ECG lead-wires with snap-in (40 length) for Digicare Patient Cable PN EC111 EC113 ECG electrode (bag of 30) (20 bags of 30) EC008 EC009 Use only high quality silver-chloride electrodes or equivalent which have a negligible offset potential. The ECG patient circuit and connections are electrically isolated type CF. The monitor is protected against damage from defibrillator discharge. Do not let patient connections contact other conductive parts including earth. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 24

26 Prepare the electrode sites in the standard configuration for RA (Right Arm), LA (Left Arm) and LL (Left Leg). Application sites should be clean and dry. Shave or clip excess hair if necessary. Connect the ECG cable to the receptacle in the patient panel. Press the adhesive inwards about 1.5 cm towards the center, being careful, NOT to actually apply any direct pressure to the center section of the electrode. Any direct excessive pressure applied to the center of these electrodes while attaching them could cause the conductive gel to be dispensed away from the effective working area. Install the electrodes as following: 1 - WHITE (RA) 2 - BLACK (LA) 3 - RED (LL) A sound beep and the indicator ( ) indicates the QRS detection. Connect the ECG leads to the electrodes; ensure that the leads are in the correct ECG patient cable position. Connect the leads to the ECG patient cable. The ECG leads and patient cable connector are color coded according to AAMI standard for ECG leads. Leakage current is limited internally by this monitor to less than 10uA. However, always consider additional leakage current that can be caused by other equipment used on the patient at the same time as this monitor. Avoid electro-surgery burns at monitoring sites by ensuring proper connection of the electrosurgery return circuit. If improperly connected, some electro-surgery units might allow energy to return through the electrodes. B. ECG Scale To change ECG scale, touch the ECG menu and select the desired scale in the ECG SCALES menu. The ECG scales options are: mv to +0.1 mv -0.1 mv to +0.2 mv mv to +0.5 mv -0.5 mv to +1 mv (factory default) -1 mv to +2 mv -1.5 mv to +3 mv mv to +0.1 mv mv to +0.2 mv mv to +0.5 mv - 1 mv to +1 mv - 2 mv to +2 mv - 3 mv to +3 mv Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 25

27 C. LEAD SELECTION The LifeWindow Lite LW8 operates with three leads ECG: I, II and III. RA I LA II III LL FIG.7 The LEAD selection enable a proper Heart Rate detection when the ECG has low amplitude and poor quality. To change the LEAD, press the dedicated ECG LEADS pushbutton on the front panel or in the ECG menu. Adult mode sensitivity is 0.3mV QRS amplitude. Neonatal mode sensitivity is 0.1 mv QRS amplitude. D. ECG FILTER The LifeWindow Lite LW8 has two filters to decrease mains line and other interference. The Mains Notch filter when activated reduces the ECG waveform frequency response from 40Hz (diagnostic mode) to 25Hz (monitoring mode). It improve the QRS detection and Heart Rate count. The Digital filter when activated reduces the noise present in the ECG waveform that is displayed on the screen. It does NOT improve the QRS detection and Heart Rate count. To enable or disable the Mains Notch and Digital Filter, touch the ECG menu and select the ECG Filters on or off. The Mains Notch and Digital Filters are set ON by default. E. HEART RATE LIMITS Heart Rate Limits are set by default to: High Heart Rate Limit: 140 BPM. Low Heart Rate Limit: 60 BPM. Change the Heart Rate Limits in the ECG menu. High Heart Rate Limit Range: 5 to 300 BPM or OFF - non overlapping. Low Heart Rate Limit Range: 0 to 295 BPM or OFF - non overlapping. The values selected are stored by the unit after power-off. To return to the factory default values, go to the SYSTEM menu and select the Load Factory Default Settings. F. ECG SWEEP SPEED There are 5 sweep speeds for the ECG waveform in the display: 6.25, 12.5, 25, 50 and 100mm/sec. To change the sweep speed, touch the TRACE menu and select the sweep speed for the desired trace. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 26

28 G. ECG PULSE TEST An ECG Test waveform is generated to test the functioning of the ECG module. To generate the ECG Test, touch the ECG menu and press the Test ON-OFF button. A screen ECG Test Waveform will open with the message: This command will generate calibration test waveforms for: ECG Channel input > 1mV / 70 BPM. Press Yes and the Test waveform will be generated in the screen, with 1mV amplitude and 70 BPM Heart Rate. H. ECG PATIENT TYPE Patient Type has two modes: Adult and Neonatal. Selection of Patient Type changes the ECG sensitivity, Heart Rate range and Heart Rate Average. The Average options are: 8, 16, 32 and 64 Beats. Adult mode sensitivity : 0.3mV QRS amplitude. Adult mode Heart Rate Range : 5 to 220 BPM Adult mode Heart Rate Average : 8 Beats Neonatal mode sensitivity : 0.1 mv QRS amplitude. Neonatal mode Heart Rate Range : 30 to 450 BPM Neonatal mode Heart Rate Average : 16 Beats Change the Patient Type direct in the main screen Patient Type Selector Indicator ( 49 ). I. ECG ALARM MESSAGES ECG LEADS OFF ECG ASYSTOLE ECG LOW HR ECG HIGH HR Yellow message - indicates that any of the three leadwires, LA, RA or LL are disconnected from the patient. Red message - indicates NO detection of R waves from ECG waveform. Red Message - indicates that HR value is lower than the selected LOW HR LIMIT. Red Message - indicates that HR value is higher than the selected HIGH HR LIMIT. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 27

29 SECTION 5 PULSE OXIMETRY MONITORING The LifeWindow Lite LW8 Pulse Oximetry provide continuous, non-invasive, automatically calibrated measurements of oxygen saturation. The Pulse Oximeter (SpO2) determines arterial oxyhemoglobin saturation by measuring the absorption of red and infrared light passing through the tissue. Changes in absorption caused by pulsations of blood are used to determine Arterial Saturation (%SpO2) and Pulse Rate (PR). A. PATIENT CONNECTIONS To ensure conformance with all safety and performance, use only the recommended accessories. These are available from DIGICARE using the following part number: SpO2 Finger Sensor with 10 (3m) cable for Digicare PO731 Patient Cable for Digicare and Nellcor OxiMax SpO2 Sensors PO734 SpO2 Finger Sensor with 3 (1m) cable for Digicare PO732 SpO2 Ear sensor with 3 (1m) cable for Digicare PO725 SpO2 wrap sensor with 3 (1m) cable for Digicare PO723 Nellcor OxiMax Finger Sensor with 3 (1m) cable PO733 Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 28

30 RDIGICA E Digicare Biomedical Technology Nellcor OxiMax SpO2 Wrap Probe with 3 (1m) cable PO735 Band for Nellcor OxiMax SpO2 Wrap Probe (Box of 50) PO721 B. SPO2 MONITORING FINGER PROBE ADULT WRAP PROBE - NEONATAL Connect the sensor assembly to the Interface Cable and lock the plastic hinged cover to prevent accidental cable disconnection (If using 3 cable sensors). Connect the sensor patient cable into the LifeWindow Lite LW8 SpO2 side panel connector (12). Push the connector in until you hear an audible click. The message SpO2 SENSOR is displayed on screen until the probe is placed in the patient. A few seconds after the sensor is placed in the patient, the SpO2 SENSOR message changes to Searching SpO2, the Bar-graph shows the SpO2 Pulse Level and SpO2 and Pulse Rate values are displayed. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 29

31 Verify if the sensor is properly positioned by observing at least ten seconds of a continuous plethysmogram waveform being displayed. If the Bar-graph Pulse Level is at a low level, weak pulse message will be displayed. Reposition the sensor or try a different sensor. The LifeWindow Lite LW8 audible beep is by default generated by the ECG detection, modulated in tone by the SpO2 value. The source of the beep can be changed to SpO2 pulse detection. To change the beep source, touch the System menu and touch Sound Volume menu. Select the Beep Source to SpO2. NOTE: Reusable sensors may be used on the same site for a maximum of four (4) hours, provided the site is inspected routinely to ensure skin integrity and correct positioning. Because individual skin condition affects the ability of the skin to tolerate sensor placement, it may be necessary to change the sensor site more frequently with some patients. Loss of pulse can occur if: The sensor is to tight. There is excessive illumination (e.g., a surgical or bilirubin lamp or direct sunlight). The sensor is placed on an extremity with a blood pressure cuff, arterial catheter or intravascular line. The patient experiences shock, hypertension, severe vasoconstriction, severe anemia, hypothermia, arterial occlusion to the sensor, or cardiac arrest. Inaccurate measurements may be caused by: Incorrect application of dysfunctional hemoglobin s, such as carboxyhemoglobin or methemoglobin. Significant, levels of indocyanine green, ethylene blue or other intravascular dyes. Exposure to excessive illumination, such as surgical lamps, especially ones with a xenon light source; bilirubin lamps, fluorescent lights; infrared heating lamps; or direct sunlight. Excessive patient movement. Venous pulsation s. Electrosurgical interference. Placement of the sensor on an extremity that has a blood pressure cuff, arterial catheter or intravascular line. Do not attach a probe to the same limb with a blood pressure cuff. The data received will not be valid when the cuff is inflated. Attach the probe to the limb opposite the site used for the blood pressure cuff. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 30

32 C. SpO2 WAVEFORM AND BAR GRAPH The SpO2 waveform sweep speed can be selected from: 6.25, 12.5, 25, 50 and 100 mm/sec in TRACE menu. The amplitude of the pulse waveform is automatically adjusted in screen. The Bar graph indicates the pulse signal height and varies from 1 to 8. Increasing the signal amplitude increases the Bar graph value. Bellow number 2 in bar graph, the message WEAK PULSE is displayed. D. SpO2 ALARM LIMITS SpO2 Alarm Limits are set by default to: SpO2 Upper Limit: OFF SpO2 Lower Limit: 88 % Change the SpO2 Alarm Limits in the SpO2 menu. SpO2 Upper Limit Range: 1 to 100 % or OFF - non overlapping. SpO2 Lower Limit Range: 0 to 99 % or OFF - non overlapping. Pulse Alarm Limits are set by default to: Pulse Upper Limit: 140 PPM Pulse Lower Limit: 60 PPM Change the Pulse Alarm Limits in the SpO2 menu. Pulse Upper Limit Range: 5 to 450 PPM or OFF - non overlapping. Pulse Lower Limit Range: 0 to 445 PPM or OFF - non overlapping. The values selected are stored by the unit after power-off. To return to the factory default values, go to the SYSTEM menu and select the Load Factory Default Settings. E. SpO2 ALARM MESSAGES SENSOR SpO2 - Indicate that SpO2 probe is disconnected from the patient or the patient cable is disconnected from the monitor or a malfunction in sensor or in patient cable. SpO2 LOW AND HIGH ALARM LIMITS - Indicate that SpO2 value overlap the LOW or HIGH ALARM LIMIT selected. WEAK PULSE - Indicate the pulse signal amplitude is low causing instability in SpO2 monitoring. Check the probe installation, site perfusion and body temperature. CHECK SITE - Indicate instability in the SpO2 readings. Verify the probe installation and change probe site. NO PULSE - Indicate the SpO2 pulse amplitude is smaller then the minimum pulse. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 31

33 SECTION 6 CO2 MONITORING A. OVERVIEW The LifeWindow Lite LW8 Patient Monitor has a plug and play CO2 technology, with Micro- Flow sidestream CO2, MainFlow mainstream CO2 and Dual Capnography, designed with sophisticated infrared absorption spectroscopy. The Micro-Flow sidestream module can be assembled internally in the unit or it can be one small and lightweight external module. The sample lines used are the same for both internal and external Micro-Flow sidestream modules. The MainFlow mainstream sensor is assembled in the air way adapter. The connection of the MainFlow mainstream sensor is the same as the external Micro-Flow sidestream CO2 module. The Dual Capnography is enabled by the interchangeability of the Micro-Flow sidestream and MainFlow mainstream external sensors. The LifeWindow Lite LW8 automatically recognize what type of CO2 external sensor is connected and configures the CO2 function. The LifeWindow Lite LW8 with internal Micro-Flow sidestream module does not have the connection for the external Micro-Flow sidestream and the MainFlow mainstream sensor. SECTION 6.1 MAINSTREAM CO2 MONITORING A. Principle of Operation The LifeWindow Lite LW8 MainFlow mainstream CO2 sensor is used for the continuous measurement of CO2 and respiratory rate. The sensor measures CO2 by using the infrared absorption technique. The principle is based on the fact that CO2 molecules absorb infrared (IR) light energy of specific wavelengths, with the amount of energy absorbed being directly related to the CO2 concentration. When an IR beam is passed through a gas sample containing CO2, the electronic signal from the photodetector (which measures the remaining light energy) is measured. This signal is then compared to the energy of the IR source and adjusted to accurately reflect CO2 concentration in the sample. The MainFlow mainstream CO2 sensor s response to a known concentration of CO2 is stored at the factory in the sensor s memory. A reference channel accounts for optical changes in the sensor, allowing the system to remain in calibration without user intervention. The LifeWindow Lite LW8 MainFlow mainstream CO2 sensor is designed specifically for measurement of CO2 using sophisticated infrared absorption spectroscopy. With mainstream, measurements are taken at the patient s airway at a sampling frequency of 100 Hz, so response is faster and there is less chance of erroneous, artifact data. The analyzer portion of the sensor cannot be contaminated with patient secretions, and there are no pumping or pneumatic components to replace. So, maintenance requirements and overall cost-of-ownership are minimized. The family of airway adapters are easy to use and durable enough even for long-term ventilator patients. B. Indications for Use The MainFlow mainstream CO2 Sensor is to be used by a physician or licensed health care professional trained in the use of the equipment. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 32

34 The use of the MainFlow mainstream CO2 Sensor is contraindicated in patients where the physician or licensed health care professional deems it invalidated by the nature of the patient, procedure or equipment. WARNINGS Explosion Hazard: DO NOT use in the presence of flammable anesthetics. Use of the MainFlow mainstream CO2 Sensor in such environment may present an explosion hazard. Electrical Shock Hazard: Always disconnect the MainFlow CO2 Sensor before cleaning. Do NOT use if it appears to have been damaged. Refer servicing to qualified service personnel. Follow precautions for electrostatic discharge (ESD) and electromagnetic interference (EMI) to and from other equipment. Failure of Operation: If the MainFlow mainstream CO2 Sensor fails to respond as described in this user guide; DO NOT use it until approved for use by qualified personnel. DO NOT position the sensor cables or tubing in any manner that may cause entanglement or strangulation. Support the mainstream CO2 airway adapter to prevent stress on the ET tube. Reuse, disassembly, cleaning, disinfecting or sterilizing the single patient use CO2 airway adapters may compromise functionality and system performance leading to a user or patient hazard. Performance is not guaranteed if an item labeled as single patient use is reused. Inspect the CO2 airway adapters for damage prior to use. DO NOT use the CO2 airway adapters if they appear to be damaged or broken. Replace the CO2 airway adapters if excessive secretions are observed. If the CO2 waveform (Capnogram) appears abnormal, inspect the CO2 airway adapters and replace if needed. Monitor the CO2 waveform (Capnogram) for elevated baseline. Elevated baseline can be caused by sensor or patient problems. Periodically check the MainFlow CO2 sensor and tubing for excessive moisture or secretion buildup. While using the MainFlow CO2 sensor, a system leak, such as that caused by an uncuffed Endotracheal tube or a damaged MainFlow CO2 sensor may significantly effect flow-related readings. These include flow, volume, pressure and other respiratory parameters. Do not operate the MainFlow CO2 Sensor when it is wet or has exterior condensation. CAUTIONS Electrical Shock Hazard; the MainFlow CO2 Sensor is not user serviceable. Follow precautions for electrostatic discharge (ESD) and electromagnetic interference (EMI) to and from other equipment. Use only Digicare Biomedical Technology approved accessories. DO NOT use the MainFlow CO2 sensor if it is wet or has exterior condensation. DO NOT use the MainFlow CO2 sensor if it appears to have been damaged. Refer servicing Digicare. DO NOT use the MainFlow CO2 sensor if it fails to operate properly. DO NOT sterilize or immerse the MainFlow CO2 sensor in liquids. DO NOT clean the MainFlow CO2 sensor except as directed in this guide. Avoid possible damage to the MainFlow CO2 sensor by following the cleaning and disinfection instructions in this guide. Do not apply excessive tension to the MainFlow CO2 sensor cable. Do not apply excessive tension to any sensor cable or pneumatic tubing. Excessive moisture in the MainFlow CO2 sensor may affect the accuracy of the flow measurement. To avoid the affects of excessive moisture in the measurement circuit, insert the MainFlow CO2 sensor in the ventilator circuit with the tubes upright. It is recommended that the MainFlow CO2 sensor be removed from the circuit whenever an aerosolized medication is delivered. This is due to the increased viscosity of the medications which may contaminate the sensor windows, causing the sensor to fail prematurely. Do not store the MainFlow CO2 sensor at temperatures less than -40º F (-40º C) or greater than 158º F (70º C). Do not operate the MainFlow CO2 sensor at temperatures less than 32º F (0º C) or greater than 113º F (45º C). Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 33

35 C. PATIENT CONNECTIONS 1 - CO2 MAIN-STREAM MAINFLOW SENSOR The MainFlow CO2 sensor is a rugged, solid-state, mainstream sensor. It is factory calibrated and does not require further calibration. 2 - CO2 ADAPTERS For monitoring CO2, select an airway adapter based on the patient and monitoring situation. Airway adapter taper meets ISO Airway Adapter Disposable for Main-Stream MainFlow sensors Part Number CAP112 For intubated patients with endotracheal tube diameters greater than 4 mm Adds 5 cc of deadspace Weight: 7.7 grams Pressure drop: LPM Color: Clear Airway Adapter Disposable for Main-Stream MainFlow sensors (Low Dead Space for Neonatal) Part Number CAP113 For intubated patients with endotracheal tube diameters less than or equal to 4 mm Adds less than 1 cc of deadspace Weight: 9.1 grams Pressure drop: LPM Color: Purple Airway Adapter Reusable for Main-Stream MainFlow sensors Part Number CAP110 For intubated patients with endotracheal tube diameters greater than 4 mm Adds 5 cc of deadspace Weight: 12.0 grams Pressure drop: LPM Color: Black Airway Adapter Reusable for Main-Stream MainFlow sensors (Low Dead Space for Neonatal) Catalog No For intubated patients with endotracheal tube diameters less than or equal to 4 mm Adds less than 1 cc of deadspace Weight: 14.9 grams Pressure drop: LPM Color: Red Note: All components are Latex free. Note: All dimensions are in millimeters. Note: Color pigment does not alter the specifications of the material. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 34

36 Attach the MainFlow CO2 sensor onto a clean and dry CO2 adapter. 3 CONNECTION WITH LIFEWINDOW LITE The LifeWindow Lite LW8 CO2 function is a Plug and Play technology built in the hardware and software of the unit. Without the MainFlow CO2 sensor connected, the message CO2 is Off is displayed in the CO2 screen indicator area and no CO2 trace is present. If the CO2 menu or CO2 indicator area is touched in this situation, nothing happen as the CO2 function is turned off. Insert the MainFlow CO2 Sensor connector into the receptacle ( 17 ) of the LifeWindow Lite LW8 Patient Panel. Make sure the arrows on the connector line up the two keys of the connector with the receptacle and insert. To remove the connector, grasp the body portion of the connector back and remove. Note: Do not remove by pulling cable. The CO2 monitoring screen is automatically configured, with the CO2 indicator area, CO2 traces, scales and CO2 alarm messages. Wait for the Sensor Warm Up message to clear. If a Zero Calibration message is displayed, perform a Zero Calibration process. 4 ZEROING THE MAINFLOW CO2 MAINSTREAM SENSOR The MainFlow CO2 sensor is compatible only with Digicare Biomedical Technology CO2 airway adapters. Each airway adapter has a unique set of optical characteristics. The adapter zero allows the MainFlow CO2 sensor to adjust to the optical characteristics of each of the different adapter types. An Adapter Zero is a quick process that allows the LifeWindow Lite LW8 to adjust to the special characteristics of a particular MainFlow CO2 sensor; it is necessary only when requested. Such a request may occur the first time a particular MainFlow CO2 sensor is connected to the LifeWindow Lite LW8, or if a change is detected in the MainFlow CO2 sensor or in the adapter. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 35

37 Keep the MainFlow CO2 sensor attached to the adapter exposed to room air and away from all sources of CO2, including the ventilator, the patient s breath and your own. Touch in the CO2 menu and touch in the Calibration Zero. A Warning message: Is input exposed to 0 mmhg concentration is displayed. Touch in the Yes button to perform a Zero Calibration. The message Zero in Progress is displayed during the zero process, typically 15 to 20 seconds (maximum time of 40 seconds). 5 PATIENT CIRCUIT Attach the MainFlow CO2 sensor and airway adapter to the patient circuit as close as possible to the patient s mouse. D. CO2 MONITORING The LifeWindow Lite LW8 start displaying the CO2 waveform in two cascaded traces and function and ETCO2, insco2 and Respiration Rate measured values, with all alarm limits and settings in the defaults values or the last saved settings. 1 CO2 WAVEFORM AND SCALE The CO2 waveform traces are by default selected to traces 5 and 6 cascaded. The traces and cascade options can be changed in the TRACES menu. The traces settings return to the default every time the unit is turned-on. The CO2 waveform default sweep speed is 6.25 mm/sec. To change the CO2 waveform sweep speed, touch the Traces menu and select the desired sweep speed. The options are: 6.25, 12.5, 25, 50 and 100 mm/sec The CO2 waveform scale default is 0 to 50 mmhg. To change the CO2 waveform scale touch the CO2 menu and select the desired waveform scale. The options are: 0 to 5 mm Hg, 0 to 10 mmhg, 0 to 50 mmhg and 0 to 100 mmhg. 2 CO2 ALARM LIMITS CO2 Alarm Limits are set by default to: ETCO2 Upper Limit: 45 mmhg ETCO2 Lower Limit: 20 mmhg InsCO2 Upper Limit: 10 mmhg InsCO2 Lower Limit: OFF Resp Rate Upper Limit: 50 BPM Resp Rate Lower Limit: 5 BPM Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 36

38 Change the CO2 Alarm Limits in the CO2 menu. ETCO2 Upper Limit Range: 1 to 100 % or OFF - non overlapping. ETCO2 Lower Limit Range: 0 to 99 % or OFF - non overlapping. InsCO2 Upper Limit Range: 1 to 100 % or OFF - non overlapping. InsCO2 Lower Limit Range: 0 to 99 % or OFF - non overlapping. Resp Rate Upper Limit Range: 1 to 150 BPM or OFF - non overlapping. Resp Rate Lower Limit Range: 0 to 149 BPM or OFF - non overlapping. To return to the factory default values, go to the SYSTEM menu and select the Load Factory Default Settings. 3 CO2 ALARM MESSAGES High and Low ETCO 2 Are triggered if the ETCO 2 value overlaps the High or Low Limits respectively High and Low InsCO 2 Are triggered if the InsCO 2 value overlaps the High or Low Limits respectively. High and Low Resp Are triggered if the Resp Rate value overlaps the High or Low Limits respectively. Sensor Falty - Comps not Set - Zero in Progress - Sensor Warm Up Zero Required - CO2 Out of Range - Check Adapter - Indicates a hardware error in the sensor or sensor connection. Reinsert or reset the sensor if necessary. If error persists, contact Digicare. Indicates the Barometric Pressure or gas compensations have not been set since power on. This message normally flashes quickly after power on of the sensor and is automatically cleared as the sensor set all compensations. If the message stays steady reinsert or reset the sensor. If error persists, contact Digicare. Indicates the MainFlow CO2 sensor Zero is currently in progress. Indicates the MainFlow CO2 mainstream sensor is warming up. It takes about 2 minutes typically for the sensor achieve monitoring temperature. Indicates a Zero calibration process is required. This is required every time as new airway adapter is in use. Check the airway adapter and clean if necessary. Perform the Zero Adapter calibration process. If you need to perform the Zero more than once, a possible adapter or sensor faulty may exist. Indicates the value being calculated is out of the CO2 range. Check the airway adapter and perform a Zero calibration process. If error persists, contact Digicare Usually indicates the airway adapter was removed from the MainFlow CO2 sensor or when there is an optical blockage on the windows of the airway adapter. May also be caused by failure to perform MainFlow CO2 sensor Zero when adapter type is Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 37

39 changed. Clean or change airway adapter if mucus or moisture is seen. If the adapter is clean, perform a Zero calibration process. If problem persists contact Digicare. Zero Error - Indicates the Zero calibration process was not successful. Clean or change the airway adapter. Disconnect and reconnect the MainFlow CO2 sensor in the LifeWindow Lite connector. Perform a Zero calibration process. If problem persists contact Digicare. 4 CO2 SENSOR ACCURACY CHECK The MainFlow CO2 sensor is a rugged, solid-state, mainstream sensor. It is factory calibrated and does not require further calibration. The only calibration required is the Zero Calibration, witch does not require any special setup, as explained before. In applications where it is mandatory to perform a routine Accuracy check, the MainFlow CO2 Mainstream sensor shall be compared against calibration gas every 12 months. Contact Digicare Biomedical Technology for more information. SECTION 6.2 SIDESTREAM CO2 MONITORING A. PRINCIPLE OF OPERATION The LifeWindow Lite LW8 MicroFlow Sidestream CO2 module is specifically designed for sidestream measurement of CO2 and Respiratory Rate, using sophisticated infrared absorption spectroscopy. MicroFlow Sidestream is a sidestream sampling system with a 50 ml/ minute low sampling rate that is used to measure the CO2 of non-intubated and intubated patients. Because of its unique design, response is fast and there is less chance of erroneous, artifact data. The analyzer portion of the sensor cannot be contaminated with patient secretions, therefore maintenance requirements and overall cost-of-ownership are minimized. The exclusive Digicare Biomedical Technology family of sidestream sampling and on-airway adapter kits are easy to use and durable enough even for long-term ventilator patients. Yet, they are inexpensive and disposable. The LifeWindow Lite LW8 MicroFlow Sidestream CO2 module can be installed built-in or used as an external module interchangeable with the MainFlow CO2 Mainstream Sensor making it easy for you to configure your patient monitoring systems with state-of-the-art CO2 monitoring technology that is affordable and easy to use. B. INDICATIONS FOR USE The intended use of the MicroFlow Sidestream CO2 module is to provide carbon dioxide monitoring to a during anesthesia / recovery, in the intensive care unit (ICU), and in emergency Medicine/Transport or Respiratory care. WARNINGS Explosion Hazard: DO NOT use in the presence of flammable anesthetics. Use of the MicroFlow sidestream CO2 Module in such environment may present an explosion hazard. Electrical Shock Hazard: Always disconnect the MicroFlow CO2 Sidestream Module before cleaning. Do NOT use if it appears to have been damaged. Refer servicing to qualified service personnel. Follow precautions for electrostatic discharge (ESD) and electromagnetic interference (EMI) to and from Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 38

40 other equipment. Failure of Operation: If the MicroFlow sidestream CO2 Module fails to respond as described in this user guide; DO NOT use it until approved for use by qualified personnel. DO NOT position the sensor cables or tubing in any manner that may cause entanglement or strangulation. Support the sidestream CO2 airway adapter to prevent stress on the ET tube. Reuse, disassembly, cleaning, disinfecting or sterilizing the single patient use cannula kits and on airway adapters may compromise functionality and system performance leading to a user or patient hazard. Performance is not guaranteed if an item labeled as single patient use is reused. Inspect the sidestream on airway adapters and sidestream sampling kits for damage prior to use. DO NOT use the sidestream on airway adapters and sidestream sampling kits if they appear to be damaged or broken. Replace the sidestream on airway adapters and sidestream sampling kits if excessive secretions are observed. Monitor the CO2 waveform (Capnogram). If you see changes or abnormal appearance check the patient and the sampling line. Replace line if needed. Do not operate the MicroFlow CO2 Sidestream Module when it is wet or has exterior condensation. Do not apply excessive tension to any cable. Electrical Shock Hazard; No user serviceable parts inside. DO NOT use device on patients that can not tolerate the withdrawal of 50 ml/min +/- 10 ml/min from the airway or patients that can not tolerate the added dead space to the airway. Do not connect the exhaust tube to the ventilator circuit. CAUTIONS Electrical Shock Hazard; the MicroFlow sidestream CO2 Module is not user serviceable. Refer servicing to qualified personnel. Follow precautions for electrostatic discharge (ESD) and electromagnetic interference (EMI) to and from other equipment. Use only Digicare Biomedical Technology approved accessories. DO NOT use the MicroFlow sidestream CO2 Module if it fails to operate properly, appears to have been damaged, is wet or has exterior condensation. DO NOT sterilize or immerse the MicroFlow sidestream CO2 Module in liquids. DO NOT clean the MicroFlow sidestream CO2 Module and accessories except as directed in this guide. DO NOT apply excessive tension to the MicroFlow sidestream CO2 Module cable. DO NOT store the MicroFlow sidestream CO2 Module at temperatures less than -40º F (-40º C) or greater than 158º F (70º C). DO NOT operate the MicroFlow sidestream CO2 Module at temperatures less than 32º F (0º C) or greater than 104º F (40º C). Remove the LoFlo sampling kit sample cell from the receptacle when not in use. DO NOT stick appendage into sample receptacle. Always insert sample cell before inserting the on-airway adapter into the ventilated circuit. Always remove the on-airway adapter from the ventilated circuit before removing the sample cell. C. PATIENT CONNECTIONS 1- CO2 MICROFLOW SIDESTREAM MODULE The MicroFlow CO2 sidestream Module is a rugged, solid-state, sidestream sensor. It is factory calibrated and does not require further calibration. The Module can be internally installed or external to the LifeWindow Lite LW8. When using the external module, connect it to the ( 17 ) connector in the LifeWindow Lite patient connections panel. 2 - SINGLE PATIENT USE SIDESTREAM ON-AIRWAY ADAPTERS For monitoring CO2, select a sidestream on-airway adapter kit that is appropriate for the patient size and application. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 39

41 Sidestream Sampling line Regular for MicroFlow Capnography (high humidity) Part Number: CAP120 Weight: 4.5 grams Deadspace adds approximately 7 cc For use with ET Tube sizes > 4.0 mm Sidestream Sampling line Regular for MicroFlow Capnography (low humidity) Part Number: CAP121 Weight: 4.5 grams Deadspace adds approximately 7 cc For use with ET Tube sizes > 4.0 mm Sidestream Sampling line Low Dead Space for MicroFlow Capnography (high humidity) Part Number: CAP122 Weight: 5.8 grams Deadspace adds approximately 1 cc For use with ET Tube sizes < = 4.0 mm Sidestream Sampling line Low Dead Space for MicroFlow Capnography (low humidity) Part Number: CAP123 Weight: 5.8 grams Deadspace adds approximately 1 cc For use with ET Tube sizes < = 4.0 mm 3 CONNECTION WITH LIFEWINDOW LITE The LifeWindow Lite LW8 CO2 function is a Plug and Play technology built in the hardware and software of the unit. The LifeWindow Lite LW8 screen, with internal MicroFlow CO2 sidestream module installed, displays the CO2 indicators and waveform after turned-on. It displays a Pump is Off message until a Sample Line is connected. The LifeWindow Lite LW8 screen, with external MicroFlow CO2 sidestream module, displays the message CO2 is Off in the CO2 indicator area and no CO2 trace is present until the CO2 module is connected. If the CO2 menu or CO2 indicator area is touched in this situation, nothing happen as the CO2 function is turned off. Insert the MicroFlow CO2 sidestream module connector into the receptacle ( 17 ) of the LifeWindow Lite LW8. It displays a Pump is Off message until a Sample Line is connected. The LifeWindow Lite LW8 MicroFlow CO2 sidestream Module has one exhaust port located in the rear panel of the unit (28) for internal modules or in the external module itself for attaching scavenging tubing. Insert the sample cell of the sampling kit into the sample cell receptacle of the MicroFlow CO2 sidestream Module or in the ( 10 ) receptacle in the LifeWindow Lite LW8 as shown. A click will be heard when the sample cell is properly inserted. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 40

42 Figure 1 Inserting the sample cell into the receptacle automatically starts the sampling pump. Removal of the sample cell turns the sample pump off. To remove the sampling kit sample cell from the sample cell receptacle, press down on the locking tab and pull the sample cell from the sample cell receptacle. Sample Cell Figure 2 Wait for the Sensor Warm Up message to clear. If a Zero Calibration message is displayed, perform a Zero Calibration process. 4 - ZEROING THE MICROFLOW CO2 SIDESTREAM MODULE The MicroFlow CO2 sidestream Module is compatible only with Digicare Biomedical sidestream CO2 accessories. The sample cell zero allows the MicroFlow CO2 sidestream Module to adjust to the optical characteristics of the sample cell. A Sample Cell Zero is a quick process that allows the LifeWindow Lite LW8 to adjust to the special characteristics of a particular MicroFlow CO2 sidestream Module; it is necessary only when requested. Such a request will occur if a change is detected in the MicroFlow CO2 sidestream Module. Keep the MicroFlow airway adapter exposed to room air and away from all sources of CO2, including the ventilator, the patient s breath and your own. Touch in the CO2 menu and touch in the Calibration Zero. A Warning message: Is input exposed to 0 mmhg concentration is displayed. Touch in the Yes button to perform a Zero Calibration. The message Zero in Progress is displayed during the zero process, typically 15 to 20 seconds (maximum time of 40 seconds). 5 PATIENT CIRCUIT The regular sidestream on-airway adapter kits should be used when monitoring intubated patients with Endotracheal Tube diameters greater than 4.0 mm. Use the Low Dead Space on-airway adapter kits when monitoring intubated patients with Endotracheal Tube diameters less than or equal to 4.0mm. CAUTION: The Regular and the Low Dead Space on-airway adapters are intended for single patient use. Do NOT reuse or sterilize the adapter kit as system performance will be compromised. Verify that the on-airway adapter is clean, dry and undamaged. Replace the on-airway adapter kit if necessary. Insert the sample cell into the sample cell receptacle as shown in the figure 1. A click will be heard when properly inserted. Perform a sample cell zero if prompted by the LifeWindow Lite LW8. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 41

43 Place the on-airway adapter at the proximal end of the airway circuit between the elbow and the ventilator circuit wye. Check that connections have been made correctly by verifying the presence of a proper capnogram on the Patient Monitor. Figure 3 CAUTION: Always insert the Sample Cell of the Sample line into the Sample Cell Receptacle on the MicroFlow CO2 sidestream module before inserting the on-airway adapter into the ventilator circuit. Failure to follow this, may introduce a leak in the circuit, thereby reducing set minute volume. CAUTION: Remove the MicroFlow sample cell from the receptacle when not in use. NOTE: Do not place the on-airway adapter between the ET tube and the elbow as this may allow patient secretions to accumulate in the adapter. If pooling does occur, the on-airway adapter may be removed from the circuit, rinsed with water (or sterile water) and reinserted into the circuit. If rinsed, make sure that no water has entered the sampling tubing. If so, blow out water or replace the sample line. To prevent moisture from draining into the on-airway adapter kit tubing, always place the on-airway adapter tubing in an up position (see Figure 3). 6 CHECK SAMPLE LINE MESSAGE The sample flow rate of the MicroFlow CO2 sidestream module is continually monitored. If the flow rate falls outside the nominal operating range and continues for 15 seconds, the message Check Sample Line will be displayed. The pump will shut off after 2 minutes if the condition that caused this change is not corrected. 7 CONDITIONS THAT CAN CAUSE A CHANGE IN FLOW RATE Water, mucous or other patient contaminate has entered the sample tubing. The sample tubing is crimped or pinched so that the sample flow rate has decreased. The exhaust port of the MicroFlow CO2 sidestream module is obstructed. The sample line is damaged. The sample line has been cut, or split, causing the flow rate to increase. 8 CLEARING THE CHECK SAMPLE LINE MESSAGE When the Check Sample Line message is displayed, the user should inspect the sample line kit to verify that none of the conditions described above are present. Replace with a new sample kit if needed. If the user removes the sample cell for inspection and then reinserts the sample cell without correcting the condition, the Check Sample Line message will reappear. The user should verify that the exhaust port is not obstructed or blocked. If tubing is connected to the exhaust port, the user should also inspect the tubing for any crimping or pinching. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 42

44 The Check Sample Line message will clear and the sample pump will not be turned off if the condition that caused the flow rate change is corrected within 2 minutes. The Check Sample Line message will clear if the sample cell is removed or if the LifeWindow Lite LW8 is reset. D. CO2 MONITORING The LifeWindow Lite LW8 start displaying the CO2 waveform in two cascaded traces and function and ETCO2, insco2 and Respiration Rate measured values, with all alarm limits and settings in the defaults values or the last saved settings. 1 CO2 WAVEFORM AND SCALE The CO2 waveform traces are by default selected to traces 5 and 6 cascaded. The traces and cascade options can be changed in the Traces menu. The traces settings return to the default every time the unit is turned-on. The CO2 waveform default sweep speed is 6.25 mm/sec. To change the CO2 waveform sweep speed, touch the Traces menu and select the desired sweep speed. The options are: 6.25, 12.5, 25, 50 and 100 mm/sec The CO2 waveform scale default is 0 to 50 mmhg. To change the CO2 waveform scale touch the CO2 menu and select the desired waveform scale. The options are: 0 to 5 mm Hg, 0 to 10 mmhg, 0 to 50 mmhg and 0 to 100 mmhg. 2 CO2 ALARM LIMITS CO2 Alarm Limits are set by default to: ETCO2 Upper Limit: 45 mmhg ETCO2 Lower Limit: 20 mmhg InsCO2 Upper Limit: 10 mmhg InsCO2 Lower Limit: OFF Resp Rate Upper Limit: 50 BPM Resp Rate Lower Limit: 5 BPM Change the CO2 Alarm Limits in the CO2 menu. ETCO2 Upper Limit Range: 1 to 100 % or OFF - non overlaping. ETCO2 Lower Limit Range: 0 to 99 % or OFF - non overlapping. InsCO2 Upper Limit Range: 1 to 100 % or OFF - non overlapping. InsCO2 Lower Limit Range: 0 to 99 % or OFF - non overlapping. Resp Rate Upper Limit Range: 1 to 150 BPM or OFF - non overlapping. Resp Rate Lower Limit Range: 0 to 149 BPM or OFF - non overlapping. To return to the factory default values, go to the SYSTEM menu and select the Load Factory Default Settings. 3 CO2 ALARM MESSAGES High and Low ETCO 2 Are triggered if the ETCO 2 value overlaps the High or Low Limits respectively. High and Low InsCO 2 Are triggered if the InsCO 2 value overlaps the High or Low Limits respectively. High and Low Resp Are triggered if the Resp Rate value overlaps the High or Low Limits respectively. Sensor Faulty - Indicates a hardware error in the module or module connection. Reinsert or reset the module if necessary. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 43

45 Comps not Set - Zero in Progress - Sensor Warm Up - Zero Required - CO2 Out of Range - Zero Error - No SS Line - Occlusion - Pump is Off - Check Samp Line - Indicates the Barometric Pressure or gas compensations have not been set since power on. This message normally flashes quickly after power on of the sensor and is automatically cleared as the sensor set all compensations. If the message stays steady reinsert or reset the sensor. Indicates the MicroFlow CO2 sidestream module Zero is currently in progress. Indicates the MicroFlow CO2 sidestream module is warming up. It takes about 2 minutes typically for the sensor achieve monitoring temperature. Indicates a Zero calibration process is required. This is required every time as new sample line and airway adapter is used. Check the sample line and airway adapter and clean if necessary. Perform the Zero Adapter calibration process. If you need to perform the Zero more than once, a possible sample line - adapter or module faulty may exist. Indicates the value being calculated is out of the CO2 range. Check the sample line and airway adapter and perform a Zero calibration process. Indicates the Zero calibration process was not successful. Clean or change the airway adapter. Disconnect and reconnect the MicroFlow CO2 sidestream module in the LifeWindow Lite connector. Perform a Zero calibration process. Indicates that no sample line is connected to the MicroFlow CO2 sidestream module. Indicates the pneumatic pressure in the MicroFlow CO2 sidestream module is out of expected range. Check if the sample line is occluded or kinked. Indicates the MicroFlow CO2 sidestream module pump is turned off. The pump is turned off when no sampling line connected to the module. Indicates the pneumatic pressure in the MicroFlow CO2 sidestream module is out of expected range. Check if the sample line is occluded or kinked. 4 CO2 SENSOR ACCURACY CHECK The MicroFlow CO2 sidestream is a rugged, solid-state, sidestream module. It is factory calibrated and does not require further calibration.. The only calibration required is the Zero Calibration, witch does not require any special setup, as explained before. In applications where it is required to perform a routine Accuracy check, the MicroFlow CO2 sidestream module shall be compared against calibration gas every 12 months. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 44

46 SECTION 7 - NIBP MONITORING A. CUFF SELECTION AND PLACEMENT The use of properly designed and sized cuffs is essential for the accurate non-invasive measurement of blood pressure. The widest cuff that can be placed around the limb should be used. A cuff that is too small for the limb will not supply sufficient occlusion pressure to the artery. This can cause an erroneously high blood pressure reading. Ideally, cuff width should be 40% of the limb circumference. Substitution of a cuff different from that supplied might result in a measurement error. NOTE: Overlapping the cuff will not affect the measurement results. For best results, a cuff should be wrapped for a snug fit and be positioned reasonably close to heart level. Measurements made above the level of the heart will give reduced blood pressure readings. Measurements made below the heart level will give increased readings. NOTE: Avoid compression or restriction of the NIBP Inflation Hose. The hose must not be kinked or pinched. WARNING: The cuff should not be applied on a limb being used for an intravenous infusion. Do not place the cuff on any extremity being used for SpO2 monitoring. CUFF SIZE SELECTION The widest cuff that can be placed on the patient, without extending beyond the joint, should be selected. Appropriate sized cuffs may be selected based on published guidelines that cuff width should be 40 60% of limb circumference. The cuff should be wrapped for a snug fit. Overlapping the cuff will not affect measurement results. Make sure the hook and loop sections of the cuff are fully engaged when it is wrapped around the limb. If not fully engaged, the cuff will detach during bladder inflation. If that happens, select the next size bigger cuff. The correct selection of cuff size have a significant influence measurement accuracy. A cuff that is too narrow will produce artificially elevated readings, while a cuff that is too wide will produce spuriously low values. The monitor comes standard with six different sizes of cuffs. They are marked to aid in proper cuff selection. When a cuff is wrapped around a site, its index edge should be in the range indicated on the cuff. The cuff is too small or too large if the index edge is outside the range. Arm Locate the cuff as you would to do an auscultatory blood pressure. Place the cuff around the patient s upper arm with the bottom edge of the cuff at least one inch above the inner aspect of the arm. As the cuff is wrapped around the arm, be sure it fits snugly and evenly, and the bladder of the cuff is over the brachial artery. Thigh Place the cuff around the patient s thigh with the bottom edge of the cuff at least one inch above the inner aspect of the knee. Be sure the cuff fits snugly and evenly, and the bladder of the cuff is over the popliteal artery. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 45

47 Calf of Leg Place the cuff around the calf of the leg with the top edge of the cuff at least one inch below the inner aspect of the knee. Be sure the cuff fits snugly and evenly, and the bladder of the cuff is over the popliteal artery. Cuff #3 showing artery position and circumference measurements NIBP Cuff #1 3-6cm ( in) (Plastic) for neonatal and similar-sized patients BP006 NIBP Cuff #2 4-8cm ( in) (Plastic) for neonatal and similar-sized patients BP007 NIBP Cuff #3 6-11cm ( in) (Plastic) BP008 NIBP Cuff #4 7-13cm ( in) (Plastic) BP009 NIBP Cuff #5 8-15cm ( in) (Plastic) BP010 Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 46

48 NIBP Cuff #6 8-13cm ( in) (Cloth) BP005 NIBP Cuff # cm ( in) (Cloth) BP003 NIBP Cuff # cm ( in) (Cloth) BP004 NIBP Cuff # cm ( in) (Cloth) BP002 NIBP Cuff # cm ( in) (Cloth) BP001 NIBP Cuff # cm ( in) (Cloth) BP000 NIBP Hose 10 Feet BP011 Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 47

49 B. NON-INVASIVE BLOOD PRESSURE MONITORING The NIBP monitor have three modes of operation: MANUAL, AUTOMATIC and STAT mode. At power-on the MANUAL mode is selected. To start a manual cycle press the dedicated NIBP START ( 5 ) pushbutton in the front panel. To stop the cycle and deflate the cuff, press the dedicated NIBP STOP ( 6 ) pushbutton in the front panel. 1 - MANUAL MODE The MANUAL mode is a ONE CYCLE function. User can START a MANUAL cycle or STOP any type of cycle using the dedicated pushbuttons ( 5 ) and ( 6 ) in the front panel or in the NIBP menu. 2 - AUTOMATIC MODE In the Automatic mode a cycle is repeated upon a selected period of time continuously. In the NIBP menu select the AUTO mode and the cycle interval from 1 to 99 minutes. Press the START button to start the NIBP determinations. 3 - STAT MODE In the STAT mode a cycle is repeated many times as possible during a selected period of time (1 to 4min). In the NIBP menu select the STAT mode and the cycle (1 to 4 min). Press the NIBP START button to start the STAT cycle. At the end of each cycle the SYSTOLIC, DIASTOLIC, MEAN and Pulse values are displayed and the time to STAT total cycle finish is decremented in display. 4 - ADULT / NEONATAL MODE SELECTION The Mode (adult / neonatal) selection affects the NIBP operation. For Cuff sizes 1, 2, 3, 4 and 6 the NEONATAL mode should be selected. For Cuff sizes 5, 7 and 8, or larger, ADULT mode should be selected. 5 - NIBP DETERMINATION On the NIBP menu, select the NIBP mode (Manual, Auto or Stat) and the cycle time. Press the Start button to Start a determination cycle. The pump will raise the pressure in the cuff to a default level for the Mode (Adult or Neonatal) selected. The pressure in the cuff deflates in a determined deflation rate Sensing the pressure oscillations in the cuff. If the Systolic pressure is equal or higher than the start pressure, the pump inflates again to increase the cuff pressure until it is higher than the systolic pressure. When the cuff pressure is lower than the diastolic pressure, at the end of the measurement cycle, the pump fully deflates the cuff and displays the Systolic, Diastolic and Mean Arterial Pressure values. The NIBP function is motion tolerant. C. NIBP ALARM MESSAGES NIBP LOW SYS NIBP HIGH SYS NIBP LOW DIA NIBP HIGH DIA Indicates that Systolic value is lower than the selected SYSTOLIC LOWER LIMIT. Indicates that Systolic value is higher than the selected SYSTOLIC UPPER LIMIT. Indicates that Diastolic value is lower than the selected DIASTOLIC LOWER LIMIT. Indicates that Diastolic value is higher than the selected DIASTOLIC UPPER LIMIT. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 48

50 NIBP LOW MAP NIBP HIGH MAP Air Leak Excessive Motion Time Too Long Indicates that MAP value is lower than the selected MAP LOWER LIMIT. Indicates that MAP value is higher than the selected MAP UPPER LIMIT. Indicates the pressure in the cuff is not reaching the necessary value. Check if the cuff is properly connected in the hose and in the NIBP receptacle in the Patient Panel. Check for air leaks in the cuff or hose. Indicates the motion artifact is affecting the NIBP determination. Indicates the NIBP cycle is lasting too long for the NIBP determination and was aborted. SECTION 8 - TEMPERATURE MONITORING The LifeWindow Lite LW8 has two temperature channels and one Indicator to T1 T2 temperature difference. The temperature probes are YSI 400 series compatible. A. PATIENT CONNECTIONS To ensure conformance with all safety and performance specifications, use only the recommended accessories. These are available from DIGICARE. Temperature rectal/esophageal probe disposable TP001 Temperature skin probe disposable TP002 Temperature patient cable for disposable probe TP003 Temperature rectal/esophageal probe reusable TP004 Temperature skin probe reusable TP005 Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 49

51 B. TEMPERATURE MONITORING Connect the temperature patient cable to receptacle (16 ) Temperature 1 or Temperature 2. In the Temperature menu select Temperature1, Temperature2 or T1-T2. Select Temperature alarm High and Low limits. Select Temperature measurement unit: F or C. The temperature value is displayed when the probe temperature is in the 10 to 50 C (50 to 122 F), range otherwise the temperature display is blanked. 1 - TEMPERATURE ALARM MESSAGES TEMP# SENSOR Indicates the Temperature sensor is not connected to the unit or a sensor failure. TEMP# LOW Indicates the Temperature value is lower than the selected Temperature Lower Limit. TEMP# HIGH Indicates the Temperature value is higher than the selected Temperature Upper Limit. SECTION 9 INVASIVE PRESSURE MONITORING The LifeWindow Lite LW8 can have 1 or 2 Invasive Pressure Channels installed. The following information apply for both channels. The Invasive Pressure Channels 1 and 2 are turned off in the factory default settings, to avoid alarms when not in use. Turn-on Invasive Pressure Channel 1 or 2 touching in the IBPs menu, then touching Invasive Pressure 1 or Invasive Pressure 2 and touching IP1 On or IP2 On. The message NO TRANSDUCER is displayed until a Transducer is connected to the monitor. A. PRESSURE TRANSDUCER To assure the performance specifications in this manual., use only the pressure transducer and accessories recommended by the manufacturer of this equipment. IBP cable for reusable transducer IBP001 IBP reusable transducer Sensitivity: 50µV / V / mmhg IBP002 IBP disposable dome for reusable transducer IBP003 Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 50

52 IBP monitoring kit for reusable transducer (Includes lines, stopcocks and disposable dome) IBP004 IBP IV Pole bracket for reusable transducer IBP008 IBP Dual Transducer bracket for reusable transducer IBP009 IBP cable for disposable transducer IBP005 IBP disposable transducer with line (monitoring kit) Sensitivity: 50µV / V / mmhg IBP006 IBP disposable transducer without line Sensitivity: 50µV / V / mmhg IBP007 B. PRESSURE TRANSDUCER CONNECTION Connect the pressure transducer cable to connector IP1 (14) or IP2 (18). Connect the catheter to pressure transducer. Install the flow system and maintain the entire system with liquid. Hold the transducer at the heart level (axial line). Following is a generic transducer line assembly example. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 51

53 C. IP SCALE AND LABEL Touch in the IBPs menu or in the IBP channel Indicators area to open the desired IP menu screen. The pre-configured default scale for the Invasive Pressure waveform is 0 to +180 mmhg. To change the scale touch in the IP# Scales drop down menu and touch the desired IP scale. The Scale options are: -30 to +30 mmhg 0 to +30 mmhg 0 to +60 mmhg 0 to +90 mmhg 0 to +120 mmhg 0 to +180 mmhg 0 to +240 mmhg 0 to +300 mmhg +30 to +90 mmhg +60 to +120 mmhg +90 to +150 mmhg +120 to +180 mmhg +150 to +210 mmhg +180 to +240 mmhg +210 to +270 mmhg +240 to +300 mmhg The Label displayed in the right side of the Invasive Pressure waveform can be selected to reflect the site where the Invasive Pressure is being measured. The pre-configured default Label is IP1 and IP2 for Invasive Pressure 1 and 2 respectively. To change the IBP Label, touch in the IBP# Label drop down menu and select the desired Label. The Labels are color coded. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 52

54 IP1 - Blue - Invasive Pressure Channel 1 IP2 - Blue - Invasive Pressure Channel 2 ART - Red - Arterial Pressure CVP - Cyan - Central Venous Pressure PA - Yellow - Pulmonary Artery LAP - Green - Left Atrium Pressure ICP - Gray - Intracranial Pressure D. TRIGGER SOURCE The LifeWindow Lite LW8 determine the Systolic (maximum amplitude) and Diastolic (minimum amplitude) values based on a period of time generated by Trigger Pulses. The default trigger pulses are generated by the IP board based on the systole slope of the Invasive Pressure waveform. For each systole detected, the IP board generates one Trigger Pulse and the Invasive Pressure Pulse Indicator is displayed. The CVP and other low frequency Invasive Pressure waveforms do not generate Trigger Pulse, so the unit can not determine the Systolic and Diastolic values. Using the ECG trigger pulses the LifeWindow Lite LW8 is capable to determine the Systolic and Diastolic values in these cases. To use the ECG as the source for triggering the IP function, touch in the IPBs menu and select in the Trigger Source drop down menu to ECG. The LifeWindow Lite LW8 using the ECG as trigger source for Invasive Pressure determination will display the Systolic and Diastolic values of any Invasive Pressure waveform, as long as the ECG is being detected normally and Heart Rate is being displayed. Note: When using the ECG as trigger source for IP, the Invasive Pressure Pulse Indicator is NOT displayed E. PULSATILE / STATIC MODE The LifeWindow Lite LW8 Invasive Pressure function has two main modes of operation, Static Mode and Pulsatile Mode. The Pulsatile mode is pre-configured as default. In the Pulsatile mode, the Invasive Pressure Indicators and Alarms are set for Systolic, Diastolic and Mean Pressure. In this mode, the IP NO PULSE alarm will be displayed if the Invasive Pressure waveform is not generating Trigger Pulses. Note: If the ECG is being used to trigger the IP determination, the IP NO PULSE alarm will NOT be displayed. In the Static mode, the Invasive Pressure Indicators and Alarms are set only for Static Pressure. The IP NO PULSE alarm is disabled in this mode. To change from Pulsatile to Static Mode, touch the IBP menu and select in the drop down menu the Static mode. F. TRANSDUCER ZERO The message ZERO TRANSDUCER is displayed until a zero calibration procedure is executed. Open the TRANSDUCER input to the air (Local Atmospheric Pressure). Touch in the IBP menu and touch in the Invasive Pressure 1 or 2. Touch the Zero Xducer button. If the transducer Zero calibration procedure was successful, the Invasive Pressure waveform shall be displayed at ZERO baseline and the Invasive Pressure readings are displayed. If the transducer Zero calibration procedure was NOT successful, the IP# ERROR ZEROING message is displayed on screen. The invasive pressure range to execute the Zero Calibration procedure is from 150 mmhg to mmhg. Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 53

55 G. INVASIVE PRESSURE ALARM LIMITS The LifeWindow Lite LW8 Invasive Pressure alarm limits default and range is: Systolic Upper Limit: 160 mmhg Range: 0 to 300 mmhg Systolic Lower Limit: 60 mmhg Range: 0 to 300 mmhg Diastolic Upper Limit: 100 mmhg Range: 0 to 300 mmhg Diastolic Lower Limit: 60 mmhg Range: 0 to 300 mmhg Mean Upper Limit: 120 mmhg Range: 0 to 300 mmhg Mean Lower Limit: 60 mmhg Range: 0 to 300 mmhg Static Upper Limit: 120 mmhg Range: 0 to 300 mmhg Static Lower Limit: 60 mmhg Range: 0 to 300 mmhg In the IP# menu, select the Invasive Pressure Systolic, Diastolic and Mean Upper and Lower alarm limits. To return to the factory DEFAULT alarm limits, go to the SYSTEM menu and press the Load Factory Default Settings. H. INVASIVE PRESSURE ALARM MESSAGES IP# NO TRANSDUCER IP# ZERO TRANSDUCER IP# ERROR ZEROING IP# LOW SYSTOLIC IP# HIGH SYSTOLIC IP# LOW DIASTOLIC IP# HIGH DIASTOLIC IP# LOW MEAN IP# HIGH MEAN IP# LOW STATIC IP# HIGH STATIC Indicates the Invasive Pressure transducer is not connected to the unit or a transducer failure. Indicates the need to perform a transducer Zero Calibration procedure. Indicates error in transducer Zero Calibration procedure. Indicates the Systolic value is lower than the selected Systolic Lower Limit. Indicates that Systolic value is higher than the selected Systolic Upper Limit. Indicates the Diastolic value is lower than the selected Diastolic Lower Limit. Indicates the Diastolic value is higher than the selected Diastolic Upper Limit. Indicates that Mean value is lower than the selected Mean Lower Limit. Indicates that Mean value is higher than the selected Mean Upper Limit. Indicates that Mean value is lower than the selected Mean Lower Limit. Indicates that Mean value is higher than the selected Mean Upper Limit. SECTION 10 FRACTION OF INSPIRED OXIGEN - FIO2 A. PRINCIPLE OF OPERATION The LifeWindow Lite LW8 provides fast and accurate oxygen monitoring. It is designed to monitor up to 100% oxygen concentration in medical gas mixtures. It is capable of rapidly measuring the oxygen content of an atmosphere or environment. The LifeWindow Lite LW8 is intended to continuously measure and display the Concentration of oxygen in a gas mixtures used in medical applications such as Anesthesia and Respiratory therapy in veterinary patients. B. PATIENT CONNECTIONS The LifeWindow Lite LW8 uses one polarographyc oxygen sensor. Attached to the sensor is a removable plastic diverter. This diverter is used to facilitate the transport of gas mixtures Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 54

56 through the sensor. The diverter, packaged separately when shipped, is necessary when the tee adapter is used to sample gas flowing through a tube. The diverter is not necessary and should not be used when the sensor is placed directly in a chamber, or when the sensor is used in confined volume monitoring, such as incubators and inhalation tents. 1 - SENSOR INSTALLATION OR REPLACEMENT Remove the new sensor from its protective bag. Inspect the sensor for damage or electrolyte leakage. If the sensor is damaged, obtain a replacement. Do not use the defective sensor as it may damage the unit. WARNING: The sensor electrolyte is caustic. Do not let it come in contact with skin. If it does, flush affected area with water. Do not attempt to open or repair the sensor. WARNING: The sensor also contains lead. Leaking or exhausted sensors should be handled and disposed of in accordance with local regulations. Connect one end of the FIO2 patient cable into the jack receptacle on the back end of sensor. Connect the other end of the cable into the receptacle (15) located on the patient connections panel of the unit. Mounting the Sensor in the Tee Adapter FiO2 Accessories FIO2 Cell F001 FIO2 Cable F002 FIO2 T Adapter F003 Operators Manual Multi-parameter Patient Monitor " LifeWindow Lite LW8 " 55

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