Professional Documents
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PATIENT MONITOR
OPERATOR’S MANUAL
Mercury AKAS Portable Patient Monitor Manual
CONTENT
CONTENT......................................................................................................................................................................................................................2
CHAPTER 1 INTRODUCTION......................................................................................................................................................................................5
1.1 About the Manual.............................................................................................................5
1.2 Safety Information............................................................................................................5
1.3 Explanation of Symbols...................................................................................................7
1.4 Description of Abbreviation............................................................................................8
CHAPTER 2 OVERVIEW OF MONITOR......................................................................................................................................................................9
2.1 General Information..........................................................................................................9
2.2 Special Feature.................................................................................................................9
2.3 Appearance of Monitor..................................................................................................10
2.3.1 Screen display.........................................................................................................................10
2.3.2 Function buttons......................................................................................................................12
2.3.5 Rear panel................................................................................................................................15
2.4 Specification....................................................................................................................15
CHAPTER 3 PATIENT SAFETY.................................................................................................................................................................................20
3.1 Environment....................................................................................................................20
3.2 Condensation..................................................................................................................20
3.3 Grounding.......................................................................................................................20
CHAPTER 4 GETTING STARTED..............................................................................................................................................................................21
4.1 Unpacking and Inspection.............................................................................................21
4.2 Connect the Power Cables............................................................................................21
4.3 Power on the Monitor.....................................................................................................21
4.4 Connecting Patient Sensors..........................................................................................22
4.5 Check the recorder.........................................................................................................22
CHAPTER 5 MENU TREE OF OPERATION..............................................................................................................................................................23
CHAPTER 6 SYSTEM MENU......................................................................................................................................................................................30
6.1 Time..................................................................................................................................30
6.2 Volume.............................................................................................................................30
6.3 Printer..............................................................................................................................30
6.4 Color.................................................................................................................................32
6.5 Mode.................................................................................................................................33
6.6 Extend..............................................................................................................................34
CHAPTER7TABLE TRENS…………………………………………………………………………………………………………………………………40
7.1 Table…………………………………………………………………………………………...40
7.2 BP table............................................................................................................................41
7.3 GRAPH.............................................................................................................................42
7.3.1 HR..................................................................................................................................42
7.3.2 NIBP...............................................................................................................................43
7.3.3 SpO2..............................................................................................................................43
7.3.4 ST..................................................................................................................................44
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Mercury AKAS Portable Patient Monitor Manual
7.3.5 CO2................................................................................................................................44
7.3.6 TEMP.............................................................................................................................45
7.4 OxyCRG...........................................................................................................................45
7.5 ALARM.............................................................................................................................46
7.6 Time..................................................................................................................................46
CHAPTER 8 ALARM and SILENCE...........................................................................................................................................................................47
8.1 Alarm Mode.....................................................................................................................47
8.2 Alarm Setup.....................................................................................................................48
8.3 Common Method of Alarm Setup.................................................................................48
8.4 Silence.............................................................................................................................49
CHAPTER 9 ECG
Monitoring………………………………………………………………………………………………………………………………………..50
9.1 What is ECG Monitoring……………………………………………………………………50
9.2 Precautions during ECG Monitoring…………………………………………………… 50
9. 3 Monitoring Procedure……………………………………………………………………..50
9.4 ECG Screen.....................................................................................................................53
9.4.2 ECG displaying area................................................................................................................53
9.4.2 ECG waveform........................................................................................................................53
9.5 ECG Menu........................................................................................................................54
9.5.1 AMPLITUDE..........................................................................................................................54
9.5.2 ALARM...................................................................................................................................54
9.5.3 ECG ANALYSE and REPLAY..............................................................................................54
9. .5.4 CASCADE or LEAD…………………………………………………………………...60
9.5.5 SWEEP SPEED………………………………………………………………………….60
9. .5.6 OTHER…………………………………………………………………………………61
9.6 Maintenance and Cleaning............................................................................................60
CHAPTER 10 NIBP MONITORING.............................................................................................................................................................................62
10.1 Introduction...................................................................................................................62
10.2 Preparation for Cuff......................................................................................................62
10.3 NIBP Displaying Area...................................................................................................63
10.4 Operation of NIBP Monitoring.....................................................................................64
10.4.1 BP TYPE................................................................................................................63
10.4.2 ALARM...................................................................................................................63
10.4.3 UNIT.......................................................................................................................64
10.4.4 CYCLE...................................................................................................................64
10.4.5 MODE.....................................................................................................................64
10.4.6 None-stop (STAT)..................................................................................................65
10.5 Pressure Safety Protection..........................................................................................66
10.6 Maintenance and Cleaning..........................................................................................67
CHAPTER 11 SPO2 MONITORING............................................................................................................................................................................68
11.1 What Is SpO2 Monitoring.............................................................................................68
11.2 Precautions during SpO2/Pulse Monitoring..............................................................68
11.3 Monitoring Procedure..................................................................................................69
11.4 SpO2 Displaying Area..................................................................................................69
11.5 Operation of SpO2 Monitoring……………………………………………………………..70
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Mercury AKAS Portable Patient Monitor Manual
CHAPTER 1 INTRODUCTION
This manual explains how to set up and use the Mercury Patient Monitor. Important safety
information relating to general use of the Mercury Patient Monitor appears before this
manual. Other important safety information is located throughout the text where appropriate.
Before the use of the Mercury Patient Monitor, the user must carefully read this manual so
that the user can operate the Mercury Patient Monitor properly and make it reach the
specific safety standard and performance index.
The Mercury Patient Monitor is to be operated by qualified personnel only. Before use,
carefully read this manual, directions for use of any accessories, all precautions, and all
specifications. The user must check that the equipment functions safely and ensure that
it is in proper working condition before being used.
The Mercury Patient Monitor is intended for use only as an adjunct in patient
assessment. It must be used in conjunction with clinical signs and symptoms.
To avoid an electrical hazard, never immerse the unit in any fluid or attempt to clean it
with liquid cleaning agents. Always disconnect monitor from AC Main Power before
performing cleaning of maintenance.
If monitor becomes accidentally wet during use, discontinue operation of the monitor
until all affected components have been cleaned and permitted to dry completely.
Contact our local representative if additional information is required.
Connect the monitor to a three-wire, grounded, hospital-grade receptacle.
By replacing the fuse, please use the safety device of the same type and rated fuse.
Before use the equipment, inspect whether all the cables are in good condition, the
damaged cables and connectors must be replaced. Operator should examine whether
the system is in correct working state and operating condition.
As with all medical equipment, carefully route patient cabling to reduce the possibility of
patient entanglement or strangulation.
To avoid monitor fall, secure monitor on the shelf or bracket prior to use.
Be sure to use defi-protected electrodes and ECG cable if the monitor is used with
defibrillation equipment.
If any parameters displayed on monitor and working station are not accurate, adopt the
other methods to diagnosis patient.
The medical equipment must be manipulated by personnel who have already got
relative training of operation.
For safe and accurate operation, use only our company recommended patient cable,
lead wires, cuffs, hose, sensors, tubing, etc. Request for the special children or infant
accessories when monitor infant.
Single use devices should never be reused.
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Mercury AKAS Portable Patient Monitor Manual
Do not use the monitor in the presence of a flammable anesthetic mixture with air or
with oxygen or nitrous oxide.
The system may not conform to all performance specifications if stored or used outside
the environmental specification identified in specification.
If the accuracy of any measurement does not seem reasonable, first check the patient’s
vital signs by alternate means and then check the Mercury Patient Monitor for proper
functioning.
Alarm must be set up according to different situation of individual patient. Make sure
that audio sound can be activated when alarm occurs.
When an “X” appears in the Alarm Bell symbol, the audible alarm tone will not sound
for any reason.
Do not only depend on the alarm system, the doctor and nurse will not draw attention
when an alarm turn down or turn off.
When connecting the monitor to any instrument, verify proper operation before clinical
use. Refer to the other device’s manual for full instructions. Accessory equipment
connected to the monitors data interface must be certified according to IEC Standard
60601-1 for electro medical equipment. All combinations of equipment must be in
compliance with IEC Standard 61601-1-1 systems requirements. To avoid potentially
hazardous leakage currents, always check the summation of leakage currents when
several item of equipment are interconnected.
For proper equipment maintenance, perform the service procedures at the
recommended intervals as described in the manual.
If the Mercury Patient Monitor needs to be used continuously long-term, please note to
connect the Mercury Patient Monitor with the main power supply by the alarm of battery,
otherwise, the Mercury Patient Monitor will automatically shut down, which leads to the
break-off of the monitoring.
Do not use the Mercury Patient Monitor during Magnetic Resonance Imaging (MRI)
scanning. Induced current could potentially cause burns. The Mercury Patient Monitor
may affect the MRI image, and the MRI unit may affect the accuracy of the Mercury
Patient Monitor measurements.
Do not place the monitor in any position that might cause it to fall on the patient. Do not
lift the monitor by the power supply cord or patient connections.
The monitor can monitor only one patient synchronously.
As to the other points for attention, please carefully read the relevant chapter in this
instruction.
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Mercury AKAS Portable Patient Monitor Manual
Resistant defibrillator Heart Beat Detected
BF type equipment
Sound on Silence
Equi-potential grounding AC
terminal 50/60 HZ
Fuse
This symbol indicates that the instrument is IEC 60601-1 Type CF equipment. The
unit displaying this symbol contains an F-type isolated (floating) patient applied part
providing a high degree of degree of protection against shock, and is suitable for use
during defibrillation.
This item is compliant with Medical Device Directive 93/42/EEC of 14 June 1993,
a directive of the European Economic Community.
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Mercury AKAS Portable Patient Monitor Manual
D: Diastolic
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Mercury AKAS Portable Patient Monitor Manual
The Mercury Patient Monitor is a portable Mercury Patient Monitor that has abundant
monitoring functions and is used for the clinical monitoring of adult, pediatric and neonate. In
addition, the user may select the different parameter configuration according to different
requirements.
The Mercury Patient Monitor can be connected to the central monitoring system via our
company’s network so as to form a network monitoring system.
72-hour Trend for NIBP, SPO2, HR, ST and 72-hour data records
Support Ethernet, wireless LAN and could connect with Central monitoring system
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Mercury AKAS Portable Patient Monitor Manual
Fig.2-1
1
0
1
1
6 12
7
13
8
14
18 17
20 Fig. 2-2 19 16 15
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Mercury AKAS Portable Patient Monitor Manual
⑴ Bed No.: Indicates the bed number of the patient being monitored when the Mercury Patient
Monitor is connected with the Central Monitoring System Workstation.
⑵ DEMO: indicates the device is in DEMO monitoring mode now. In clinical application, this
function is not recommended because the DEMO will mislead the hospital workers to treat
the waveform and parameter as actual data of the patient, which may result in delay of
treatment or mistreatment.
⑶ Start time: indicates the time powered on the monitor, it shows in “13:14”.
⑷ Current time: indicates the date and the current time, it shows in “11/17/2005, 13:40:20”
The numeric area lies on the right side of the graphic area, which includes:
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Mercury AKAS Portable Patient Monitor Manual
Menu
The menu always occupies the fixed position on the bottom of the screen; user can set the
system and perform operation.
⒄ Alarm on/off: shows the status of alarm on or off , the detailed operation please
refer to Chapter 8 Alarm and Silence.
⒅ Table&Trend: the function is for operator observing the patient’s latest 72 hours change,
including historical data table, HR, NIBP, SpO2, ST,TEMP,CO2, the detailed operation
please refer to Chapter 7 Table&Trend.
⒆ System setup: you can configure various aspects of the monitor, including system time,
simulation, print setup, color, display wave mode, language, etc., The detailed operation
please refers to Chapter 6 System Menu.
⒇ Menu bar: it shows the different menus of every operation, the detailed operation please refer
to Chapter 6 to Chapter 14.
Fig.2-3
(1) Alarm
ALARM button, pressing the button will prohibit all the technically audio alarm and
physically audio alarm for 3 minutes. The audio alarm function will be restored
automatically after 3 minutes or be activated when new alarm occurs. As pressing the
button, the icon in menu status shows , which indicates all the audio alarms have
been shut off. And there will be the information of 180s count down for alarm on the top of
the screen
NOTE
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Mercury AKAS Portable Patient Monitor Manual
When “ ” mark appears, the system can not give the audio alarm prompt.
(2)Silence
SILENCE button, when pressing the button, this mark appears in the menu status,
indicating that all kinds of sound including the audio alarm and heart beep have been
manually muted until the button has been pressed again, the system will immediately
restore the normal status, and the icon shows as
(3)Freeze
FREEZE button, pressing the button can freeze the waveform of ECG. The screen
displays two traces of ECG waveform. When one trace is active, pressing the FREEZE
button will freeze another trace. Pressing “FREEZE” button again will restore the normal
monitor status. In ECG EXT, 7-leads ECG waveforms are frozen once you press
“FREEZE” button.
(4)Start/Cancel (NIBP)
START/CANCEL (NIBP) BP measuring button, pressing the button will inflate the cuff to
start a new NIBP measurement. When measuring, press to cancel the measurement and
deflate the cuff, including the “CYCLE” and “STAT (NOT STOP)” measuring mode.
(5)Print
PRINT button, pressing this button will motivate the recorder or desktop printer to output
the results if the monitor is equipped with them.
(7)Rotary Knob
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Mercury AKAS Portable Patient Monitor Manual
Green: internal battery power supplying and 50% power has been consumed.
Fig.2-5
(1) ECG socket:connect ECG 5-lead wire with 6 PIN connector
2.3.4 Recorder
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Mercury AKAS Portable Patient Monitor Manual
Fig. 2-6
A thermal array recorder with standard 50mm (+1/-1) wide printout paper is used for
MMED6000DP portable Mercury Patient Monitor. Detailed information please refers to Section
6.3 Printer Setup.
NOTE
The thermal array recorder should be installed by the adequate technician.
AKAS Medical
240/1, Periya colony, Athipet,
Ambattur, Chennai- 600 058.
www.akasmedical.com
Model No. :
S.No. : L 0809 125 8
FORSUPPORT
Fig.2-7
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2.4 Specification
Environment
The operation environment should comply with the following conditions:
Operating Temperature: 5℃ to 45℃
Relative Humidity: 0 to 80%, non-condensing
Height of sea level: -500m ~ 4600m
The transport and storage environment should comply with the following conditions:
Storage Temperature: -20℃ to 70℃
Relative Humidity: 0 to 93%, non-condensing
Height of sea level: -500 m~ 13100m
Display
Type: 640X480 pixel color TFT
Screen Size: 10.4 inch diagonal
Displayed Parameters
Time: Battery-backed quartz crystal clock
Alarms: High and low limits selectable on patient parameters
ECG: ECG Waveform Scale
Heart Rate: Derived from ECG or SPO2
NIBP: Pressure (systolic, mean and diastolic)
Pulse Oximeter: Pulse Rate, Pulse waveform, and percent saturation.
Respiration Rate: Respiration rate derived from ECG.
Trends: HR,RR,NIBP, ST,TEMP ,CO2 and SpO2
Temperatures: Two channels
Trace Freeze Traces A or B
ECG
Protected against defibrillator and electro surgery potentials
Standard Lead I, II, III, AVL, AVR, AVF, Vx
Display Gain Scales 2.5mm/mV,5mm/mV,7mm/mV,10mm/mV,15mm/mV,
20mm/mV, 25mm/mV
Sweep Speed 6.25 mm/s,12.5mm/s, 25mm/s, 50mm/s
Input Resistance > 5M Ohm (at 10 Hz, not including patient cable)
Frequency Response 0.05Hz-100Hz (3dB)
CMRR >80dB
Electrode Offset potential Maximum ±0.3V
Baseline Recovery <5s after 5KV defibrillation
Heart Rate range 15 to 300bpm
Resolution 1bpm
Accuracy <100bpm ±1% ≥100bpm ±2%
Alarm Heart rate high and low limits alarm delay<12s
Lead Off condition Detected and displayed
ST segment
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Mercury AKAS Portable Patient Monitor Manual
ST segment range -1.2mV to +1.2mV
Accuracy ±0.02mV
Spo2
Display range 0 to 100%
Accuracy 80-100%:±2digits; 70-80%:±3digits;0-69% Unspecified
LED Specifications Wavelength Radiant Power
RED 660±2nm 1.8mW
IR 905±10nm 2.0mW
Alarm delay Spo2 high and low limits alarm delay<7s
Display Update <5s
Resolution 1%
Pulse Rate
Measurement Range 20 to 250bpm
Resolution 1bpm
Accuracy ±1bpm
Alarm delay Pulse rate high and low limits alarm delay<7s
NIBP
Technique Oscillometric method (with inflatable cuff)
Determines systolic, diastolic and mean arterial pressures.
Patient Types Adult, Pediatric and Neonatal
Cuff Inflation Time 3-15 seconds depending on cuff size.
Cuff Inflation Pressure Adult/Pediatric/Neonatal, Subsequent inflation pressures
determined by last measured systolic pressure.
Measurement Modes Manual: Immediate upon operator command
AUTO: Determinations automatically made with selectable
intervals
STAT: Determinations continues in 5 minutes
First Inflation Measurement Adult/Pediatric/Neonatal
Measurement Interval Time 1-240min
Step:1min(1-10min),5min(10-30min),10min(30-90min),
30min(90-240min)
Measurement Range Adult
Systolic 30-255mmHg
Diastolic 15-220mmHg
Mean Arterial 20-235mmHg
Measurement Range Infant
Systolic 30-135mmHg
Diastolic 15-110mmHg
Mean Arterial 20-125mmHg
Pressure Resolution 1mmHg
Accuracy Cuff Pressure Range: 0 to 275mmHg
Pressure Span Accuracy: ±3mmHg
Mean difference: ±5mmHg
Standard deviation: 8mmHg
Determination Time Typically 25seconds.Varies with patient’s pulse rate, pulse
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Mercury AKAS Portable Patient Monitor Manual
Technique Oscillometric method (with inflatable cuff)
Determines systolic, diastolic and mean arterial pressures.
pressure and amount of artifact present.
Overpressure Valve Automatically releases cuff pressure if inflation pressure
Adult/Neonate exceeds 280mmHg/150mmHg
Overtime Protection Stop determinates if the measurement time exceeds
Adult/Neonate 120s/90s.
Alarm delay Pressure high and low limits alarm delay<7s
RR
Technique Trans_thoracic impedance (RA-LL)
Range 0-100 rpm
Resolution 1 rpm.
Accuracy ±2 rpm (0-60 rpm)
Alarm delay Respiration rate high and low limits alarm delay < 7s
TEMP
Technique Resistance
Channel 2 (T1 and T2)
Scales F. Or C.
Probes Resistive; recta and skin (reusable and disposable)
YSI 400 Series types
Range 0-50℃
Revolution 0.1℃
Accuracy ±0.1℃
Alarm delay Body temperature high and low limits alarm delay<7s
CO2 (Optional)
Technique
Side Stream, non-dispersive infrared (NDIR) absorption technique. Including multiple water
trapped / filtration system and microprocessor logic control of sample handling and
calibration.
Sensor Operating Infrared Spectroscopy
Principle
CO2 Range 0% to 13%
CO2 Accuracy ±2 mmHg @ < 5.0% CO 2 (at ATPS)
< 10% of reading @ > 5.0% CO 2 (at ATPS)
Breath Rate 2 - 150 bpm
Response Time Detector 28 mSec (typical)
:
System: 100 mSec (typical)
(Dependent Upon Implementation, Pneumatics and Water
Separation Technique)
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Mercury AKAS Portable Patient Monitor Manual
Flow adjustable 50ml/min
100ml/min
150ml/min
IBP (Optional)
Range -50mmHg—350mmHg
Accuracy ≤13.33kPa(100mmHg) is ±0.27kPa(2mmHg) ;
≥ 13.33kPa(100mmHg) is ±2%
Gain Accuracy 0.5%
Bandwidth 0 to 12Hz
Sensitivity 5uV/V/mmHg
Inspiration Voltage 5V (DC)
Isolation Voltage 4kV
Power Requirements
Power Supply: 100~240VAC,50/60Hz 1.6A max
Internal Battery: 12V 7AH; Type- sealed lead-acid
Operating Time: 2 hours typical at 25℃,no printing, one NIBP measurement
(fully charged battery) per 15 min.
Alarm Range
High Range 40-300 12.0-34.0 8.0-29.3 4.6-29.3 80-100 10-120 25.5-45 20-75 30-300
90-255 60-220 35-220 77.9-113
Low Range 20-160 8.0-29.3 4.0-24.0 4-26.6 70-99 5-80 25-44.5 5-70 15-290
60-220 30-180 30-200 77-112.1
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Mercury AKAS Portable Patient Monitor Manual
The portable Mercury Patient Monitor is designed to comply with the International Safety
requirements for medical electrical equipment. This device has floating inputs and is protected
against the effects of defibrillation and electro surgery. If the correct electrodes and ECG cable
are used and applied in accordance with the manufacturer instructions, the screen display will
recover within 10 seconds after defibrillation.
3.1 Environment
Follow the instructions below to ensure a completely sage electrical installation. The
environment where the Mercury Patient Monitor Portable Mercury Patient Monitor will be used
should be asonably free from vibration, dust, corrosive or explosive gases, extremes of
temperature, humidity, and so on. For a cabinet mounted installation, allow sufficient room at the
front for operation and sufficient room at the rear for servicing with the cabinet access door
open.
The Mercury Patient Monitor operates within specifications at ambient temperatures between
0℃ and 40℃. Ambient temperatures that exceed these limits could affect the accuracy of the
instrument and cause damage to the modules and circuits. Allow at least 2 inches (5cms) space
around the instrument for proper air circulation.
3.2 Condensation
Make sure that during operation, the instrument is free of condensation. Condensation can form
when equipment is moved from one building to another, thus being exposed to moisture and
differences in temperature.
3.3 Grounding
To protect the patient and hospital personnel, the cabinet of The Portable Mercury Patient
Monitor must be grounded. Accordingly, The Portable Mercury Patient Monitor is equipped with
a detachable 3-wire cable which grounds the instrument to the power line ground (protective
earth) when plugged into an appropriate 3-wire receptacle. If a 3-wire receptacle is not available,
consult the hospital electrician. If the capacity of the protective grounding wires is in doubt, the
equipment must be operated with internal power supply.
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Mercury AKAS Portable Patient Monitor Manual
Open the package and take out the monitor and accessories carefully. Keep the package for
possible future transportation or storage. Check the components according to the packing list.
Check for any mechanical damage.
Check all the cables, modules and accessories.
If there is any problem, contact the distributor immediately.
NOTE
Connect the power line to the jack special for hospital usage.
The battery needs to be charged after transportation or storage. If the power supply
is not properly connected before turning on the monitor, it may not work properly
because of insufficient power. Connect the power supply to charge the battery.
Press POWER (on the rear panel) to power on the monitor. Then a beep will be heard and the
self-test will last for about 10 seconds. When the system will enter monitoring status, then you
can perform normal monitoring.
NOTE
Check all the functions that may be used to monitor and make sure that the monitor
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Mercury AKAS Portable Patient Monitor Manual
is in good status.
The battery must be recharged to the full electricity after each use of monitoring so
as to reserve sufficient power in battery.
WARNING
If any sign of damage is detected, or the monitor’s display some error message, do
not use it on any patient. Contact the biomedical engineer in the hospital or the
distributor immediately.
NOTE
The interval between twice presses of POWER should be more than 1 minute.
Connect all the necessary patient sensors between the monitor and the patient.
NOTE
For information on correct connection, refer to related Chapter.
If your monitor is equipped with a recorder, open the recorder door to check if paper is properly
installed in the output slot. If no papers present, do not press “PRINT” function button.
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PROMPT
Color: there are 15 colors for each parameters, the clockwise sequence is: red, purple,
brown, light blue, blue, peak green, aqua, rosiness, pink, yellow, white, black, sky blue,
green, cyan. You’d better keep the background color to black for getting the better view.
SYSTEM: the function is set by manufacturer, please keeps them constant.
NIBP mode: if the inflating pressure is selected between 70~120mmHg, the monitoring
patient should be neonate; if the inflating pressure is selected between 140~180mmHg, the
monitoring patient is adult.
MENU TREE:
DAY
MONTH
SYSTEM
MENU TIME
SETUP
YEAR
HOUR
MINUTE
SECOND
VOLUME 1-7
PRINT SETUP TYPE CS-TR48
ON
GRID
OFF
TIME 5SECONDS
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10SECONDS
15SECONDS
20SECONDS
25SECONDS
30SECONDS
ON
ALARM PRINT
OFF
OFF
CYCLE
1--480MIN
NONE
PRINT WAVE
ECG
SPO2
NIBP RESP
COLOR
SPO2 ECG+SPO2
RESP ECG+RESP
TEMP SPO2+RESP
ECG 3 CHANNELS
BACKGROUD
STANDARD
MODE
GRAPH EXT
IBP EXT
ECG EXT
LARGE FONT
EXTEND SYSTEM
DEMO
NAME
MESSAGE
SEX
AGE
SWITCH
FAN
ALARM
HIGH
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SEND
SETUP
RECEIVE
SPFC
BED
RETURN
GRAPH HR
NIBP
SPO2
ST
CO2
TEMP
8h
TIME
24h
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Mercury AKAS Portable Patient Monitor Manual
72h
ALARM HR HIGH
LOW
OFF
ALARM
High
Medium
Low
ON
LEADOFF ALARM
OFF
NIBP SYSTOLIC HIGH
LOW
MEAN HIGH
LOW
DIASTOLIC HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
CALIBRATE
SPO2
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Mercury AKAS Portable Patient Monitor Manual
PR HIGH
PR ALARM
PR LOW
ALARM ON
OFF
ON
PROBEOFF
ALARM
OFF
HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
RESP HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
ON
APNEA
OFF
TEMP HIGH
LOW
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OFF
ALARM
HIGH
MEDIUM
LOW
0.0--20.0
DIFFERENT_LIMIT
OFF
CO2 HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
SOUND
2.5mm/mV
5mm/mV
7mm/mV
10mm/mV
15mm/mV
20mm/mV
ECG AMPLITUDE
25mm/mV
ALARM HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
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ON
LEADOFF ALARM
OFF
ANALYSIS
ST SETUP POSITIVE
& REPLAY
NEGATIVE
ALARM
QUICK
REPLAY
NORMAL
SLOW
TIME
CHART
>> >>
HR V
ON
ANA
OFF
FAST
HR A
SLOW
ANALYSIS
NIBP CTR
CASCADE ON
(STANDARD)
OFF
LEAD(ECG EXT) Ⅰ---Vx
6.25mm/s
SPEED
12.5mm/s
25mm/s
50mm/s
OPERATION
OTHER FILTER
MONITOR
DIAGNOSIS
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OFF
ON
BEEP
OFF
ECG
HR FROM
SPO2
NIBP
TYPE BP
BP
(IBP EXT)
IBP1
IBP2
ALARM SYS HIGH
LOW
MEAN HIGH
LOW
DIAS HIGH
LOW
OFF
ALARM
High
Medium
Low
CALIBRATE
mmHg
UNIT
kPa
MANUAL
CYCLE
1-240m
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AUTO
MODE
70-180 mmHg
ON
STAT(NON-STOP)
OFF
SPO2 AMPLITUDE 1-5
4
AVERAGE
8
16
ON
PR SOUND
OFF
ALARM PR ALARM PR HIGH
PR LOW
ALARM
ON
PROBEOFF
ALARM
OFF
HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
FILL
WAVEFORM
LINE
RESP AMPLITUDE 1-12
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TYPE IMPEDAN
CO2
ALARM HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
OFF
APNEA
5-90 SECONDS
CO2 SETUP HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
ON
INSCO2
OFF
90ml/min
PUMP MODE
150ml/min
200ml/min
OFF
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mmHg
UNIT
%
TEMP ALARM HIGH
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
OFF
DIFFERENT_LIMIT
0-20
C
UNIT
F
IBP1
IBP BP TYPE
IBP2
HIGH
ALARM SYS
LOW
HIGH
MEAN
LOW
HIGH
DIAS
LOW
OFF
ALARM
HIGH
MEDIUM
LOW
ZERO
CALIBRATE
ADJUST
mmHg
UNIT
KPa
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BASELINE 0-50
20, 40 mmHg/cm
SCALE
60 ,80mmHg/cm
100,200mmHg/cm
ABP
LABEL
PAP
CVP
In monitoring status, rotate the knob to highlight the MENU icon, and then press the
knob, the menu bar of “system setup” appears on the bottom of screen.
Fig.6-1
The “system setup” menu includes 6 items. Rotating and pressing the knob to select the menu
to be set. Having finished the setup, just press “RETURN”, the system will return to the previous
menu. All the settings will be stored automatically when powering off the monitor.
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6.1 Time
Select “TIME” item in “SYSTEM SETUP” menu to access the sub-menu of “TIME” as shown
below Fig.6-2:
Fig.6-2
System time is in format of day, month, year, hour, minute and second. Pick the item you wish to
modify and turn the knob, the figure will increase or decrease by 1 at each switch. Then select
“Return” to the previous menu.
6.2 Volume
User may select different level of volume as per clinical requirement. There are 30 levels for you
to select. Along with the number increasing, the volume will be loud.
6.3 Printer
NOTE
When the recorder is working, the record paper goes out steadily. Do not pull the
paper, or the recorder will be damaged.
Do not operate the recorder without record paper.
⑵ Inserting paper
① Open the recorder catch. Print the button on the top right of the recorder. The cassette will
be pop-up.
② Insert a new roll of paper into the paper cassette.
③ When the paper is inserted into cassette completely, pull it out. Ensure proper position
and tidy margin.
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Fig.6-3
(1)TYPE: set the type of thermal recorder, please keep “CS_TR48” remained.
(2)GRID : select whether the grid is shown on printing paper or not. Pressing “ON” item, the
grid will appear on the paper, which is for doctor to have more facility for observe the patient’s
status. Pressing “OFF”, there will be only printed waveforms on the paper.
⑶TIME : represents the length of the printing time, 6 selections are available :
“5s,10s,15s,20s, 25s,30s”. It means that the recorder will last to print the waveform for
the length of time you chosen.
⑷ALARM PRINT: select “ON” for this item, the printer will print alarm event when it occurs.
⑸TIMING: represent “time interval between two times of timing recording”. “OFF and 1Min
~480Min” are available to select. It means the system will activate the recording operation
according to the selected time interval. The length of printing time is in accordance with the
setup in “TIME” item.
NOTE
If you select “OFF” item in this menu, the real-time recording will be performed.
(6) Print Wave : user may select the waveforms to be output in this item. 8 selections are
available “None, ECG, SpO2, ECG+SpO2, Resp, ECG+ Resp, SpO2+ReSP, Three Chn”
①ECG: the ECG waveform on the screen (if no ECG waveform is currently displayed on the
screen, the waveform will be printed as beeline on the paper.)
②SpO2: SpO2 plethysmogram (if there is no SpO2waveform being currently displayed on the
screen, the waveform will be printed as beeline on the paper.)
③RESP: respiration waveform (if no RESP waveform is currently displayed on the screen, the
waveform will be printed as beeline on the paper. If Et CO2 module is working, CO2 waveform
will be printed instead of RESP waveform. )
④Three Channel: including ECG waveform, SpO2 waveform, RESP waveform will be entirely
printed.
⑤None: none waveforms will be printed on the paper.
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Fig.6-4
The printed-paper is shown as Fig.6-4:
① Bed No.
② The printed data and time, they are shown as “07/28/2004 15:17:36”.
③ Waveforms: waveforms will be printed as per you selected. When recorder prints 3
waveforms, they would be overlapped.
④Parameters: parameters are recorded on the bottom of the printing paper, the contents are:
RR, HR,SpO2, ECG lead, sweep speed, PR, TEMP.
6.4 Color
The item is used to define the color of the waveform and parameters displayed on the screen.
Rotate the knob to select the “COLOR” item to access the sub-menu shown in the Fig. 6-
5.There are 15 colors for each parameters, clockwise rotating the knob, the sequence is: red,
purple, brown, light blue, blue, peak green, aqua, rosiness, pink, yellow, white, black, sky blue,
green, cyan. You’d better keep the background color to black for getting the better view.
Fig.6-5
6.5 Mode
It is for defining how many waveforms will be represented on the screen. Rotate the knob to
select the “MODE” item, then choose “STANDARD” ,“GRAPH EXT”、 “IBP EXT” and “ECG
EXT” to display as your requirement.
“STANDARD” mode indicates that there are 4 waveforms and data table displayed on the
screen, including: two traces of ECG waveform, SpO2 waveform, RESP waveform and one
table (shown as Fig.6-6). Rotate the knob to make the cursor be on the type of lead in the ECG
frame, then press and rotate the knob to select the ECG waveforms of various leads displayed
on the screen.
Fig.6-6
“GRAPH EXT” mode indicates that there are 4 waveforms, data table and trend graphs
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Trend graph
Mercury AKAS Portable Patient Monitor Manual
displayed in the screen, including: two traces of ECG waveform, SpO2 waveform, RESP
waveform and one-hour trends of ECG,NIBP,SPO2,RESP (shown as Fig.6-7).
Fig.6-8
“IBP EXT” mode indicates that there are 6 waveforms on the display screen, including: two
traces of ECG waveform, SpO2 waveform, RESP waveform and two traces of IBP waveform
(shown as Fig.6-8).
IBP waveforms
Fig.6-9
“ECG EXT” mode indicates there are 9 waveforms displayed on the screen, including:
7 channels of ECG waveforms, SpO2 waveform, RESP waveform without IBP waveform.
(Shown as Fig.6-9).
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Fig.6-10
NOTE
If operator selects Et-CO2 (side stream) to monitor the patient’s respiration, the CO2
waveform will instead of the RESP waveform acquired by Trans-thoracic impedance to
display on the screen.
6.6 Extend
Rotate the knob and select “EXTEND” item to access the sub-menu shown as below Fig.6-10
Fig.6-11
(1) SYSTEM: this function is set by the distributor, please keep them unchanged.
(2) DEMO: Turn on or turn off the demo mode.
(3) FAN : Rotate the knob and select ‘FAN” item to access the sub-menu shown as below:
Fig: 6-12
SWITCH: By this menu you can select ON, OFF or AUTO. AUTO mode, the fan will
automatically be opened when the monitor inner temperature is higher than the fan-on limit (the
default setting is 65 C) and will automatically be closed when the monitor inner temperature
reaches the fan – off limit (the default setting is 55 C).
ALARM: if you set ALARM beep sounds with high level mode, and the temperature value will
turn red and flash when the monitor inner temperature is higher than the temperature alarm
limit.
HIGH: You can set the temperature alarm limit by this item, when the monitor inner
temperature higher than the temperature alarm limit, the alarm function will be triggered.
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NOTE
The monitor inner temperature limits for fan – on or fan-off can not be set by user.
4) Setup: By this item you can realize communication with the 808 module.
Fig: 6-13
SEND: Select the “send” item and confirm, you will see the following menu.
Fig: 6-14
CHANNEL: The channel from which the heart rate is computed
LEAD SEL: The type of lead. (when type is LEAD III’, the heart rate is only can be
computed from the channel I.)
ECG From: The screen only can display one channels wave form. You can set which
channel’s wave form is displayed.
PACE SEL: You can set the information that if the patient using the pace maker.
808 ID: Read the ID number from the 808module.
RECEIVE: By this menu you can see the following message.
Fig: 6-15
frame.
NOTE
The item “EXTEND” is useful to the engineers and technicians to adjust the monitor’s
configurations. But for the doctors we do not propose them to use this item. As for the
detail of the item’s usage please refer to the SERVICE MANUAL correspondingly.
Fig.6-14
①CHANGE U:
This function is set by the user to change the unit of drug. The user could choose four
options, Does/MIN、Does/HR、Does/WT/MIN、Does/WT/HR.
When you choose the Does/MIN option, the monitor will auto to add the drug per minute.
The other three options are similar to the Does/MIN.
②CHANGE V:
This function is set by the user to change the value of drug. The value consists of amount,
volume, weight and so on. There is a range for these values. When the value is beyond of
range, the value will be displayed as “---.-”
③TYPE:
The user could set this option to choose the type of drug. There are five options could be
chose, but the user only could select one type once.
NOTE: the A, B, C, D is not the name of drug, just is the code.
④CALCULATE:
The user could get the result of calculation according to expressions like below:
⑤TABLE:
This option is the titration table as below,
Fig.6-13
1. R-STEP:
This is the speed pace option. The user could change the injection speed pace through
this option. There are “blank, 1, 2, 3, 4, and 5” six options could be selected. The default
value is “2”.
2. D-STEP:
This is the option for the pace of the drug volume speed. The user could change the
pace of the drug volume speed through this option. There are “blank, 1~10” eleven
options could be selected. The default value is 5mg/min.
3. R-DISP:
This is the fresh button for displaying the R-STEP. The user could get the result after
setting,
4. D-DISP:
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This is the fresh button for displaying the R-STEP. The user could get the result after
setting.
5. PAGE:
The user could change the display page through this button.
Fig.6-14
(4) BED : indicates the bed number of the patient being monitored when the Mercury
Patient Monitor is connected with the workstation; it always shows on the top left corner
in the monitor status frame.
NOTE
The item “EXTEND” is useful to the engineers and technicians to adjust the monitor’s
configurations. But for the doctors we do not propose them to use this item. As for the
details of the item’s usage please refer to the SERVICE MANUAL correspondingly.
CHAPTER 7 TABLE&TREND
The Mercury Patient Monitor provides 72-hour trend data of parameters and 72-hour table data.
Table &Trend Setup
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In monitoring status, rotate the knob to highlight the TABLE icon, and then press the knob, the
menu bar of “Trend setup” appears on the bottom of screen.
Fig.7-1
7.1 Table
Please select the TABLE to enter into the submenu, and then pick the record item to call
up the following chart shown as Fig.7-2:
Fig.7-2
The latest 72-hour data table can be displayed at every 1 minute. The first column shows the
items of the parameters. The first and the second line of the table indicate the date and time of
measurement respectively. The left column of the table always shows the latest measurement.
Rotate the knob to turn pages. The page number is displayed on the bottom right corner. When
“END” appears, it indicates this is the last page of records.
When the interface shown as Fig.7-2, press “SILENCE” function key to enter the “set page”.
Rotate the knob to set the passing pages at each switch. Press “SILENCE” again to exit the
page set,and then rotate the knob to turn the pages you want.
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7.2 BP table
Pick BP TABLE in the TREND MENU to call up the following chart as Fig.7-3:
Fig: 7-3
In the menu, when you press the “start (NIBP)” button which on the front panel, you will call up
the following chart:
Fig: 7.3a
7.3 GRAPH
Pick GRAPH in the TREND MENU to call up the following chart as Fig.7-4
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Fig.7-4
7.3.1 HR
Fig.7-5
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7.3.2 NIBP
Pick NIBP in the GRAPH MENU to call up the following chart as Fig.7-6:
Fig.7-6
7.3.3 SpO2
Pick SpO2 in the GRAPH MENU to call up the following chart as Fig.7-7:
Fig.7-7
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7.3.4 ST
Fig.7-8
7.3.5 CO2
Pick CO2 in the GRAPH MENU to call up the following chart as Fig.7-9:
Fig.7-9
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7.3.6 TEMP
Pick TEMP in the GRAPH MENU to call up the following chart as Fig.7-10:
Fig.7-10
7.4 OxyCRG
Pick OxyCRG in the TABLE MENU to call up the following chart as Fig.7-11:
OxyCRG show HR trend、SPO2 trend、RR trend in one screen. The first one is HR trend, the
second one is SPO2 trend, and the third one is RR trend.
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Fig.7-11
7.5 ALARM
Pick the ALARM item to enter the setup of alarm event storage shown as Fig.7-12:
100 alarm events can be totally recorded in the system.
Fig.7-12
7.6 Time
Four selections are available: 8hour, 24hour or 72 hour and ERASE. Rotate the knob to select
the item you want to set for “TIME” item. The length of trend of every parameter is accordance
with the time length you set in this sub-menu. ERASE indicates deleting all the stored data.
NOTE: having pressed ERASED button, you should power the monitor off and on again,
the data will be erased.
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When alarm occurs, The Mercury Patient Monitor may raise the user’s attention in two ways,
which are audio prompt and visual prompt. Physiological and technical alarms are displayed in
the displaying areas of the relative parameters.
ALARM function button on the front panel of the monitor, pressing the button will prohibit all the
technically and physically audio alarm for 3 minutes. The audio alarm will restore automatically
after 3 minutes or be activated when new alarm event occurs. As pressing the button, the icon in
menu status shows ,which indicates all the audio alarms have been shut off.
In monitoring status, rotate the knob to highlight the icon, and then press the knob, the
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menu of “alarm setup” appears on the bottom of screen as shown below Fig.8-1:
Fig.8-1
PROMPT
There are two methods to set the alarm of each parameter, one of which is setting all
alarms of every parameter when you press the icon, another is setting
“ALARM” in the individual menu of each parameter setup.
In “ALARM SETUP” menu, you can set the alarm information of following parameters: HR,
NIBP, SpO2, RESP, TEMP, and ST. For example:
The method to set up alarm information of ECG-HR:
⑴ Select “ECG-HR” in alarm menu to call up the sub-menu shown as below Fig. 8-2:
Fig. 8-2
⑵ Four items are available for the user to set up, which are HIGH (high limit), LOW (low limit),
and ALARM (OFF, HIGH, MEDIUM, and LOW). LEADOFF ALM (alarm of the leadoff).When
use the knob to select each item and press the knob, a pull-down list appears for the user to
choose his desired selection.
Fig.8-3
NOTE
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Selecting “ONOFF” item for “ON” in sub-menu of the parameter only prohibits the
alarm of the relevant parameter individually.
If you select “ONOFF” item in sub-menu for OFF, even if the alarm icon is on,
showing as the alarm will not be activated.
Triggering the alarm function should simultaneously satisfy the three requests:
(1) Rotate knob and highlight in the frame of menu status to call up alarm
sub-menu of each parameter, keep “ON/OFF” items be ON. OR
enter the each parameter menu to keep “ON/OFF” item to be ON to open the alarm
function of the monitor.
(2) Make SILENCE icon in the frame of menu status showing as
(3) Make ALARM icon in the frame of menu status showing as
Only when the user finished the three steps the monitor can alarm orderly when the alarm event
happens to the patient. The method for setting the alarm information of other parameters is the
same as HR.
8.4 Silence
PROMPT
The function is the same as the “SILENCE” function button on the front panel.
In monitoring status, rotate and press the knob on the icon it will change into,
indicating that all kinds of sound including the audio alarm and heart beep have been
manually muted until the button has been pressed again; the system will immediately
restore the normal status, and the icon shows
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Monitoring the ECG produces a continuous waveform of the patient’s cardiac electric activity to
enable an accurate assessment of his current physiological state. Only proper connection of the
ECG cables can ensure satisfactory measurement. The Mercury Patient Monitor can display the
Heart Rate (HR), ST segment and Arrhythmia analysis. The ECG waveforms are showing on
the top of graphic area.
WARNING:
Do not touch the patient, table nearby, or the equipment during defibrillation.
Use only the original The Mercury Patient Monitor ECG cable for monitoring.
When connecting the cables and electrodes, make sure no conductive part is in
contact with the ground. Verify that all ECG electrodes, including neutral electrodes,
are securely attached to the patient.
9.3.1 Precondition
⑴ For patient’s skin is not in a good condition, which need to be preconditioned before placing
electrode in order to make the leads connect to skin tightly.
a) Washing skin completely using soap and water. Ether and pure alcohol is prohibited
because they can increase skin’s impedance.
b) Shave body hair on where electrodes are placed, if necessary.
c) Rub skin briskly to increase capillary flood flow in the tissues and remove skin scurf and
grease.
d) If electrodes without conducting cream are used, conducting cream should be smeared on
skin before placement.
⑵ Attach clip or snap to electrodes prior to placement.
⑶ Put the electrodes on the patient. Before attaching, apply some conductive jelly on the
electrodes if the electrodes are not electrolyte self-supplied.
⑷ Connect the electrode lead to the patient’s cable.
⑸ Make sure the monitor is ready with power supply.
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WARNING
Check everyday whether there is skin irritation resulted from the ECG electrodes. If
so, replace electrodes every 24 hours or change their sites.
Verify lead fault detection prior to the start of monitoring phase. Unplug the ECG
cable from the socket, the screen will display the error message “LEAD OFF” and the
audible alarm is activated.
Fig.9-1
Color Coding:
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NOTE
To ensure patient safety, all leads must be attached to the patient.
For 5-lead set, attach the C- electrode to one of the indicated positions as below Fig.9-2:
WARNING
When using electro surgery equipment, leads should be placed in a position in equal
distance from electro surgery electro tome and the grounding plate to avoid cautery.
Electro surgery equipment wire and ECG cable must not be tangled up.
The placing of ECG electrodes placement is depended on the type of operation. For example,
electrode can be placed in back or flank of chest for operation of opening chest. Sometime ECG
wave can be influenced with artificial because of using ES in operation room. In this case, place
electrodes at left and right shoulder close with left and right side of abdomen and chest lead at
left side of internal in chest to avoid placing in upper arm, which will lead ECG wave smaller.
WARNING
When using electro surgery equipment, never place an electrode near the grounding
plate of the electro surgery device, otherwise there will be a great deal of interference
with the ECG signal.
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ATTENTION
For the movement of the lead cable will result in the inaccurate HR value, try to avoid the
interference.
The Mercury Patient Monitor can detect ECG signal when at least standard three ECG
leads are properly attached to the patient. Should one or more of the leads come off (or lose
good electrical contact), after the monitor has established that all related leads are attached,
a low-priority “Lead Off” alarm will be issued, alerting the caregiver to remedy the problem.
When the leads are unattached from patient’s skin, “LDOFF” technical alarm will be
displayed in the ECG displaying area.
“ECG ERROR” indicates ECG board with trouble. Please stop ECG monitoring at once and
contact with the distributor or Customer Service Dept.
All the information related to ECG is displayed at ECG display area on the right upper of the
screen.
Heart rate
ECG lead
ST segment
Analysis result
Fig.9-3
PROMPT
By picking ECG, the monitor prompts HR and activates HR beep. By picking SpO2, the
monitor prompts PULSE and activates pulse beep. Both mode display HR and PR
simultaneously, when this item is picked, PR parameter is displayed to the right side of
SpO2. As for the sound of HR or PR, HR is given the priority, i.e., if HR is available,
whose sound will be sent out, but if HR is not available, then the sound will be for PR.
The ECG waveform shows on the left of the ECG numeric display area, whose color matches
with the color of ECG parameter. A scale bar is displayed to the right side of ECG waveform as
Fig.9-4.
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Scale bar
Fig.9-4
Fig.9-5
9.5.2 ALARM
Prompt
The operation and function are the same as the ECG sub-menu when
Pressing alarm icon in the frame of menu status.
Select “ALARM” in ECG menu to call up the sub-menu shown as below Fig.9-6:
Fig.9-6
NOTE
It only sets HR alarm individually; the alarms of other parameters will not be affected.
Four items are available for the user to set up, which are HIGH (high limit), LOW (low limit),
ALARM (OFF, HIGH, MEDIUM, LOW), LEADOFF ALM (LEADOFF ALARM).When use the
knob to select each item and press the knob, a pull-down list appears for the user to choose his
desired selection. The detailed operation, please refer to Chapter 8 Alarm and Silence.
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9.5.3 ECG ANALYSE and REPLAY
NOTE
Doctor should not only rely on the diagnosis made by the monitor, the accurate result
must be combined with doctor’s experience and knowledge.
Select “ANALYSE” item in ECG setup menu to access the sub-menu shown as below Fig.9-7:
Fig.9-7
(1) ST Segment
The information of ST segment is useful for physician’s diagnosis. Normally, the doctor observes
its graph carefully to judge whether the patient’s heart work orderly.
NOTE
This menu is available on the condition that you select “DIA-MODE” for “FILTER MODE”,
the relevant operation of “FILTER MODE” please refer to 9.5.6 instruction.
Pick “ST setup” item to call up the sub-menu as below Fig.9-8:
Fig.9-8
It defines the alarm setup of ST segment. There are three items are available for the user,
which are POSITIVE, NEGATIVE and ALARM. When using the knob to select each item and
press the knob, a pull-down list appears for the user to choose.
NOTE
If you select “OFF” for alarm item, the alarm will not be activated when alarm event
occurs
(2) Press “REPLAY” item to call up the sub-menu shown as below Fig. 9-9:
Fig. 9-9
Having selected “REPLAY” item, the first trace of ECG waveform goes on showing the real-time
patient’s status, the second trace will replay the previous ECG waveform shows as Fig.9-10:
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Fig.9-10
(3) Pick “HR V” item to call up the analyzing chart of heart rate variation as Fig. 9-11:
Fig.9-11
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LORENZE chart
LORENZE chart is a kind of way to analyze HR V by statistical method. The X axis of the
LORENZE chart is the n times RR interphase value (RR interphase is another way to denote the
HR value, it represents the time between the twice of R wave, if the HR value is 60 times/min,
then the RR Interphase should be 1000ms), The Y axis is (n-1) times, namely the previous time
interphase value according to the n time in the X axis.
Thus, if suppose the ideal situation, the HR is steady and does not vary, the LORENZE chart
should be a line whose slope is 1 namely the bevel is 45 degree. If the HR varies, LORENZE
chart is the figure composed by the dots upper or lower than the line whose bevel is 45 degree.
The different statistic charts have some analysis and diagnosis meaning in the clinic situation.
The data in the LORENZE chart is selected from the data table, one dot per minute, totally 5
minutes for the complete chart
(4) Select “ANA” item to startup the analyzing software of monitor. Rotate the knob to pick “ON”,
the analyzed result will be shown on the right of ECG display area in time.
NOTE
We don’t recommend use this function while monitoring the patient. The analysis results
are only references helping doctor to make diagnosis.
(5) Select “HR A” item to enter into the submenu shown as Fig.9-12
Fig.9-12
The items in this menu are for setting the alarm of arrhythmia. The numerical options are the
period of RR interval. The Mercury Patient Monitor calculates the patient’s heart rate via
reckoning the times of RR interval. Therefore, in the fixed time, shorter the period of RR interval
is, faster the heartbeat is.
1 FAST: the alarm is for tachyrhythmia. As Fig.9-12 shown, the alarm will be activated if
RR interval is less than 500ms.
2 SLOW: the alarm is for bradycardia. As Fig.9-12shown, the alarm will be activated if RR
interval is more than 2000ms
3 ANALYSIS: the menu is for setting the standard of judging arrhythmia. Pick
“ANALYSIS” item to enter the analyzed results shown as below screen Fig.9-13.
Arrhythmias are disorders of the regular rhythmic beating of the heart. The monitor offers 13
kinds of arrhythmia for reference. When arrhythmia occurs, alarm Messages will be displayed in
the ECG display screen, and the audio and visual alarms will be activated if the parameter value
exceeds the limit.
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Fig.9-13
The monitor can judge the ECG abnormal events include: ASYST,TACHY,VENT
TACHY,BRADY,MISS BEAT,FREQ PVC,RUN PVC,TRIG,BIG,RonT,INTER PVC,COUPL,PVC.
ASYST: Asystole
TACHY: Tachycardia
VENT TACHY : Ventricular Tachycardia
BRADY: Bradycardia
MISS BEAT: Miss Beat
FREQ PVC: Frequent PVC
RUN PVC: Run PVC
TRIG: Trigeminy
BIG: Bigeminy
RonT: RonT
INTER PVC: Interposal PVC
COUPL: Couplet PVC
PVC: Premature Ventricular Counter
④NIBP CTR: this function relate the NIBP with the ECG. When the user start-up this function,
once the value of ECG is beyond the limitation of arrhythmia, the NIBP function will be auto-run
to measure the patient.
NOTE:
The limitation is according to the value of FAST and SLOW. For example, when the FAST
value is 500ms that is means the low limitation is the 120bpm, meanwhile, when the LOW
value is 2000ms that is means the high limitation is the 300bpm. If the ECG value is
beyond this interzone value, the NIBP function will be auto-run.
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Fig.9-14
NOTE
Doctor should not only rely on the diagnosis made by the monitor, the accurate result
must be combined with doctor’s experience and knowledge.
Condition
Tachyrhythmia ARt<0.5s
(TACHY)
Bradycardia RRt >1.5s, ARt>1.2s
(BRADY )
R on T RRt-1<0.33(ARt-2), RRt-1+RRt≈2(ARt-2)
Bigeminy Rhythm RRt-3<0.9(ARt-4), RRt-1<0.9(ARt-4)
(BIGEMINY) RRt-3+RRt-2≈2(ARt-4),RRt-1+RRt≈2(ARt-4)
Trigeminy Rhythm RRt-4<0.9(ARt-5), RRt-1<0.9(ARt-5)
(TRIGEMIN) RRt-4+RRt-3≈2(ARt-5),RRt-1+RRt≈2(ARt-5)
ASYSTOLE RRt > 6s
Miss Beat RRt-1>=1.7ARt-2, RRt-1<=ARt-2,
RRt>=0.9ARt-2 ,RRt<=1.1ARt-2
PROMPT:
RR is RR interphase; AR is the average time of 8 RR intervals, and the suffixes indicate time
sequence, for example, RRt means the latest RR interval and RRt-1 refers the previous RR
interphase of RRt.
Press “WAVE” menu to call up the stored abnormal waveforms as Fig.9-14:
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Fig.9-15
NOTE
We don’t recommend use this function while monitoring the patient. The analysis results
are only references helping doctor to make diagnosis.
The Mercury Patient Monitor adopts the standard 5-lead to detect the patient’s
electrocardiogram. When the ECG is 5-lead, the selectable leads are Ⅰ , Ⅱ , Ⅲ ,
aVL , aVF , aVR , V1-V6, AUTO CASCADE When you select the “STANDARD”, ”GRAPH
EXT” or “IBP EXT” mode in the MODE of SYSTEM SETUP, the ‘cascade’ item is available and
be displayed in the ECG menu.
Fig.9-16
When you set it “ON”, two traces of ECG waveform only shows one lead status, it is continuous
and ceaseless waveform. If you set it off, 2-lead waveform will display on the screen
synchronously, each of leads can be set individually.
LEAD
When you select the “ECG EXT” mode, the ‘lead’ item will be displayed in the ECG menu as I,
II, III, aVL, aVF, aVR, V, AUTO can be set by you, the selected lead is main lead, which is the
ECG waveform printed by the recorder and sent to workstation.
Fig.9-17
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PROMPT
LeadⅡis default which can get the best view of ECG waveform.
AUTO: the ECG waveforms of various lead display on the screen circularly when the
item is selected.
9.5.5 SWEEP SPEED
The menu defines the sweep speed of ECG waveform, the available options are 6.25 mm/s,
12.5mm/s, 25mm/s, 50mm/s, select the proper sweep speed according the clinical requirement.
9.5.6 OTHER
Select “OTHER” in ECG menu to call up the sub-menu shown as below
Fig.9-18
1) Filter method: used for displaying clearer and more detailed waveform.
There are three filter modes for selection. DIA-MODE, MON-MODE, OPR-MODE may reduce
interference from other electro surgery equipment.
The difference mode is the corresponding bandwidth.
OP MODE :Operation mode, bandwidth: 1 - 25 Hz
MO MODE :Monitor mode, bandwidth: 0.5 - 75 Hz
DG MODE :Diagnosis mode, bandwidth: 0.05 - 100 Hz
2) BEEP: you can turn on or off the sound of heartbeat.
3) HR FRPM:
The monitor can use ECG and SPO2 to get the value of HR and use SPO2 to get the value of
PR. Normally When we setup this item to “ECG” that means we select use ECG to get the value
of HR on the other side if we setup this item to “SPO2” that means we select use SPO2 to get
the value of HR. Normally we use ECG to get the value of HR so there is a little difference
between the HR and PR. But if we select “SPO2” in this item then the HR and the PR are same.
WARNINGS
Power must be shut off and main supply plug must be pulled out before cleaning
monitor or sensor.
Do not use damaged ECG leads. Do not immerse ECG leads completely in water,
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solvents, or cleaning solutions because the connectors are not waterproof. Do not
sterilize ECG leads by irradiation, steam, or ethylene oxide.
Clean: Clean the monitor or sensor using a wet no-floss cloth, which is washed in 70% alcohol
or neutral soap.
10.1 Introduction
⑴ The Non-invasive Blood Pressure(NIBP) module measures the blood pressure using the
oscillometric method.
⑵ It is applicable for adult, infant usage.
⑶ There are three modes of measurement available: manual, cycle and STAT(Not-stop). Each
mode displays the diastolic, systolic and mean blood pressure.
WARNING
You must not perform NIBP measurements on patients with sickle-cell disease or
under any condition which the skin is damaged or expected to be damaged.
For a thrombasthemia patient, it is important to determine whether measurement of
the blood pressure shall be done automatically. The determination should be based
on the clinical evaluation.
Ensure that the correct setting is selected when performing measurements on
children. It may be dangerous for the children to use an over pressure level.
WARNING
Before starting a measurement, verify that you have selected a setting appropriate
for your patient.(adult or infant)
Do not apply the cuff to a limb that has an intravenous infusion or catheter in place.
This could cause tissue damage around the catheter when infusion is slowed or
blocked during cuff inflation.
Make sure that the air conduit connecting the blood pressure cuff and the monitor is
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neither blocked nor tangled.
⑴ Plug in the air hose and switch on the system.
⑵ Apply the blood pressure cuff to the patient’s arm
Ensure that the cuff is completely deflated.
Apply the appropriate size cuff to the patient, and make sure that the symbol “Ф” is over
the appropriate artery. Ensure that the cuff is not wrapped too tightly around the limb.
Excessive tightness may cause discoloration and eventual ischemia of the extremities.
NOTE
The width of the cuff should be either 40% of the limb circumference (50% for
neonates) or 2/3 of the upper arm length. The inflatable part of the cuff should be
long enough to encircle 50~80% of the limb. The wrong size of cuff can cause
erroneous readings. If the cuff size is in question, then use a larger cuff.
Make sure that the cuff edge falls within the range of mark <->. If it does not, use a
larger or smaller cuff that fits better.
⑶ Connect the cuff to the air hose. The limb chosen for taking the measurement should be
placed at the same level as the patient’s heart. If this is not possible you should apply the
following corrections to the measured values.
① If the cuff is placed higher than the heart level, add 0.9 mmHg(0.10kPa) for each inch of
different.
② If it is placed lower than the heart level, deduct 0.9 mmHg (0.10kPa)for each inch of
different.
⑷ Check whether the patient mode is appropriately selected. The detailed operation please
refers to Section 10.4.5 MODE.
⑸ Select a measurement mode in the NIBP SETUP menu. The detailed operation please refers
to Section 10.4.4 Cycle.
⑹ Press the START button on the front panel to start a measurement.
NIBP measurement result and corresponding message are displayed as follows Fig.10-1:
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Fig.10-1
S: Systolic 119
D: Diastolic 78
M: Mean arterial 92
Adult: The type of current measuring patient, two selections are available: INFANT and
ADULT, the detailed operation please refers to Section 10.4.5 MODE.
Unit: mmHg
MANU: The present measurement mode, MANUAL, CYCLE and STAT (none-stop) modes
are available, the detailed operation please refer to Section 10.4.4 Cycle.
22:20: The latest time of measurement
In monitoring status, rotate the knob to highlight the NIBP icon in the NIBP displaying area, and
then press the knob, the menu of “BP setup” appears on the bottom of screen as shown below.
Different BP setup menus will be shown as per different modes. There are 3 types: NIBP, IBP1,
and IBP2. Selected “NIBP” item for “HP TYPE”, the sub-menu will be shown as Fig.10-2:
Fig.10-2
(a) BP TYPE
BP TYPE: after selecting this item, rotate the knob to select the different BP type, NIBP, IBP1,
IBP2
(b) ALARM
PROMPT
The operation and function are the same as the ECG sub-menu when pressing alarm
icon in the frame of menu status.
Select “ALARM” in NIBP menu to call up the sub-menus. Different ALARM sub-menus
respond the different BP types. If you have picked NIBP type then pressed ALARM item,
which sub-menu will be shown as Fig.10-3:
Fig.10-3
NOTE
It only sets NIBP alarm individually; the alarms of other parameters will not be affected.
Five items are available for the user to set up, which are SYS (systolic limit), MEAN (the limit of
mean arterial pressure), DIAS (diastolic limit), ALARM (OFF, HIGH, MEDIUM, and LOW), and
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CALIBRATE (ON/OFF). When use the knob to select each item and press the knob, a pull-down
list appears for the user to choose his desired selection.
10.4.3 UNIT
Pick this item to set measurement unit. (Selection: mmHg or KPa.)
10.4.4 CYCLE
There are three methods to conduct NIBP measurement: manual, cycle and STAT (Not-stop). In
manual mode, only one measurement is conducted for each time. In the AUTO mode, the
measurement is cycle; you can set the interval time to 1/2/3/4/5/6/7/8/9/10/15/20/25/30 /40/50/
60/70/80/90/120/150/180/210/240minutes.
Manual
In which one measurement of each of the three blood pressures (Systolic/Mean Arterial
Pressure/Diastolic) is made and displayed in the numeric frame.
Press START/CANCEL (NIBP) button on the front-panel. A single blood pressure measurement
will be made. Press START/CANCEL (NIBP) button again to cancel this measurement.
The measurements remain in the numeric frame as long as what you set up.
As soon as an NIBP measurement begins, any existing NIBP values in the numeric frame are
removed, and the current, variable value of the cuff pressure is shown. Systolic, diastolic and
MAP values are presented when the measurement is completed. If fail to measure, the numeric
frame displays “_ _”
Automatic
NIBP measurements are performed at the intervals as per you set.
Access NIBP SETUP menu and pick the CYCLE item to set measuring mode. Select the
CYCLE selection. Then press START/CANCEL (NIBP) button on the front panel to start the first
auto measuring. Selected interval indicates you have set AUTO Monitoring Mode, the device will
successively measure patient’s BP after taking break for the time you set in “CYCLE” item If you
press “START” menu during AUTO mode, the measurement in progress will stop to another
manual measurement. After this manual measurement, the device will enter AUTO monitoring
mode again. You want to get the patient’s NIBP value by manual operation, just pick “MANUAL”
in “CYCLE” item.
10.4.5 MODE
Access NIBP SETUP menu and pick the MODE item to set the type of monitoring patient. There
are three monitoring modes: ADULT, PEDIATRIC and NEONATAL. The AUTO mode is adult.
When setting the auto adult mode, inflated pressure is 22 kPa (165 mmHg). Normally, due to the
oscillometric technique, the setup of inflated pressure greatly affects the result of the monitored
NIBP value. The highest inflated pressure is +4 kPa (30 mmHg) more than the Systolic
pressure.
10.4.6 None-stop (STAT)
In the STAT mode, the monitor measures the blood pressure as many times as possible in five
minutes, it will measure the pressure again at the 5 seconds end of last measurement. Pick
NIBP SETUP menu and select the NONE-STOP item to set the monitoring mode.
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NOTE: Ensure that the correct setting is selected when performing measurements on
children. It may be dangerous for the children to use an over pressure level.
WARNING
This monitor displays results of the last blood pressure measurement until another
measurement is completed. If a patient’s condition changes during the time interval
between measurements, it will not detect the change or indicate an alarm condition.
Prolonged non-invasive blood pressure measurement in AUTO mode may be
associated with purpuric, ischemia and neuropathy in the limb wearing the cuff.
When monitoring a patient, examine the extremities of the limb frequently for normal
color, warmth and sensitivity. If any abnormality is observed, stop the blood
pressure measurements.
The blood pressure cuff should not be applied to the limb attaching the SPO2
sensor, since cuff inflation will disrupt SPO2 monitoring.
Do not place the cuff on an extremity being used for intravenous infusion or any area
where circulation is compromised or has the potential to be compromised.
When the measurement be performed on the infant and neonate. Make sure that
correct mode setting has been selected (refer to NIBP menu setting section). For
higher adult NIBP doesn’t fit for infant and neonate, wrong selection of patient mode
may be dangerous to them.
Inaccurate measurements may result from such causes:
a. Limb’s twitch and tremble will cause inaccuracy or prolonged the cycling of
measurement; serious tremble will lead to the failure of measure.
b. Placing the cuff too loosely or tightly on the patient.
c. Leaky cuff or hose
d. Insure the NIBP and pulse rate within the range of this monitor.
e. Excessive patient motion will cause the inaccuracy, patient should be relax and
avoid movement.
Automatic deflation will be activated when the cuff pressure exceed 280 mmHg under the
adult mode and exceed 150 mmHg under the infant mode.
Automatic deflation will be activated when the continuous inflation last more than 30
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seconds.
If there is no value when measurement time exceeds 120 seconds under the adult mode
and 90 seconds under the infant mode, the measurement will be canceled.
Patient can press the START/CANCEL (NIBP) button whenever it is necessary.
WARNING
Do not squeeze the hose of cuff.
Do not allow liquid to enter the connector socket when cleaning the monitor.
Do not wipe the inner part of the connector socket when cleaning the monitor.
When the reusable cuff is not connected with the monitor, or being cleaned, always
place the cover on the rubber tube to avoid liquid permeation.
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WARNING
ES (Electro surgery) equipment wire and SpO2 cable must not be tangled up.
Do not put the sensor on extremities with arterial catheter or venous syringe.
Verify sensor cable fault detection before beginning of monitoring phase. Unplug the
SpO2 sensor cable from the socket, the screen will display the error message
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“SENSOR OFF” and the alarm is activated. If “PLETH ERROR” message displays on
the displaying area, which means the SPO2 board with trouble.
Do not use the sterile supplied SpO2 sensor if the packaging or the sensor is
damaged and return them to the vendor.
Prolonged and continuous monitoring may increase jeopardy of unexpected change
of dermal condition such as abnormal sensitivity, rubescent, vesicle, repressive
putrescence, and so on. It is especially important to check the sensor placement of
neonate and patient of poor perfusion or immature dermogram by light collimation
and proper attaching strictly according to changes of the skin. Check per 2~3 hours
the sensor placement and move it when the skin deteriorates. More frequent
examinations may be required for different patient.
NOTE
Do not perform SpO2 measuring and NIBP measuring in same limb, because
obstruction of blood flow during NIBP measuring may adversely affect the reading of
SpO2 value.
Make sure the nail covers the light window.
The wire should be on the backside of the hand.
NOTE
Ensure the finger insert the sensor completed (has touched the bottom of the sensor).
Limitation for measurement
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SpO2 measurement result and corresponding message are displayed as follows Fig.11-1:
Fig.11-1
In monitoring status, rotate the knob to highlight the SPO2 icon in the SPO2 displaying area, and
then press the knob, the menu of “SPO2 setup” appears on the bottom of screen as shown
below Fig.11-2:
Fig.11-2
11.5.1 AMPLITUDE
The amplitude indicates the status of the patient’s blood circulation. Pick this item to access the
amplitudes setup of SpO2 waveform. 5 selections are available: 1, 2, 3, 4, 5. the amplitude of
SpO2 waveform will be changed as setting.
11.5.2 AVERAGE
The Mercury Patient Monitor calculates SPO2 value with quantity of the SPO2 full wave (one top
appearance of the SPO2 wave) You can find three selections which is 4,8,16 in this menu which
indicate that The Mercury Patient Monitor use 4,8 or 16 full waves to calculate the SPO2 value.
11.5.3 PR SOUND
It is for setting sound on/off of pulse beep.
11.5.4 ALARM
Select “ALARM” in SpO2 menu to call up the sub-menu shown as below Fig.11-3:
Fig.11-3
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NOTE
It only sets SpO2 alarm individually; the alarms of other parameters will not be affected.
Audio and visual alarm will be activated when alarm events occur.
Five items are available for the user to set up, which are PR ALARM (PRHIGH, PRLOW,
PRALARM), PROBEALARM (ON/OFF for ALARM of probe off), HIGH (high limit of SpO2),
LOW (low limit of SpO2%) and ALARM (OFF, HIGH, MEDIUM, and LOW). When use the knob
to select each item and press the knob, a pull-down list appears for the user to choose his
desired selection.
11.5.5 WAVEFORM
It is for setting the mode of displaying SpO2 waveform. Pick the “FILL” item in “WAVEFORM”
menu, SpO2 waveforms displaying on the screen is filled as Fig.11-4:
Fig.11-4
Fig.11-5
WARNING
Cut off and disconnect the AC power before cleaning the monitor or sensor.
Do not immerse sensor completely in water, solvents, or cleaning solutions because
the sensor and connector are not waterproof.
Do not sterilize SPO2 sensors by irradiation, steam, or ethylene oxide.
Do not soak the sensor in the detergent liquid; if any abnormity of the sensor or
cable is detected, stop using it immediately.
Cleaning:
Moisten the soft cloth or gauze with alcohol and use it to wipe the surface of sensor, and then
use the clean cloth to dry it. The same method can be used to clean the light source and photo
detector.
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Cables can be disinfected by 3% of hydrogen-peroxide or 7% of isopropyl alcohol .Do not
immerse the connector into the liquid.
The monitor measures respiration from the amount of thoracic impedance between two ECG
electrodes. The change of impedance between the two electrodes, (due to the thoracic
movement), produces a respiratory waveform on the screen.
NOTE
The RESP monitoring is not recommended to be used on patients who are very activated,
as this can cause false alarm.
NOTE
Place the red and green electrodes diagonally to optimize the respiration waveform.
Avoid the liver area and the ventricles of the heart in the line between the RESP
electrodes so as to avoid cardiac overlay or artifacts from pulsating blood flow. This
is particularly important for neonates.
⑶ Switch on the monitor
WARNING
The respiration signal is acquired using the ECG. Refer to the ECG Monitoring
section, for information regarding patient connection.
Respiration signals are relatively more sensitive than any other physiological
signals. It can cause inaccurate respiration readings by the interference of patient
activity and electrical surgery equipments .Do not rely entirely on the respiration
readings of this monitor for patient assessment.
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RESP measured result and corresponding message are displayed as follows Fig. 12-1:
Fig. 12-1
In monitoring status, rotate the knob to highlight the RESP icon in the RESP displaying area,
and then press the knob, the menu of “RESP setup” appears on the bottom of screen as shown
below as Fig.12-2:
Fig.12-2
12.5.1 AMPLITUDE
Pick this item to access the WAVE amplitudes setup of RESP waveform. 5 selections are
available: 1, 2, 3, 4, 5. the amplitude of RESP waveform will be corresponding changed as
setting.
12.5.2 TYPE
It is for setting the type of RESP measurement. Two methods are available: IMDPRESP trans-
thoracic impedance; CO2 (end tidal CO2).
NOTE
When you set “RESP-TYPE” to “CO2” item, the Et-CO2 waveform will be instead of RESP
waveform gained by trans-thoracic impedance.
12.5.3 ALARM
Select “ALARM” in RESP menu to call up the sub-menu shown as below Fig.12-3:
Fig.12-3
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NOTE
It only sets SpO2 alarm individually; the alarms of other parameters will not be affected.
Four items are available for the user to set up, which are HIGH (high limit), LOW(low limit),
ALARM(OFF,HIGH,MEDIUM,LOW) , APNEA (OFF, 10-90 seconds).When use the knob to
select each item and press the knob, a pull-down list appears for the user to choose his desired
selection.
Apnea: Set the standard of judging an apnea case, it ranges from 10 to 90 seconds. Time
(10-90 seconds): Apnea alarm is triggered according to the time set by user. OFF: set the
Apnea alarm off.
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TEMP measured result and corresponding message are displayed as follows in the displaying
area as Fig.13-1:
Fig.13-1
T1: Temperature 1
T2: Temperature 2
In monitoring status, rotate the knob to highlight the TEMP icon in the TEMP displaying area,
and then press the knob, the menu of “TEMP setup” appears on the bottom of screen as shown
below Fig. 13-2:
Fig. 13-2
13.3.1 ALARM
Select “ALARM” in TEMP menu to call up the sub-menu shown as below Fig. 13-3:
Fig. 13-3
NOTE
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It only sets TEMP alarm individually; the alarms of other parameters are not affected.
Five items are available for the user to set up, which are HIGH (high limit), LOW (low limit),
DIFF_LMT and ALARM (OFF, HIGH, MEDIUM, and LOW). When use the knob to select each
item and press the knob, a pull-down list appears for the user to choose his desired selection.
Rotate and press the knob to enter the submenu, and proceed to the relevant setup.
DIFFERENT-LIMIT: it indicates the difference of TEMP (△T). The Mercury Patient Monitor
offers two channels of TEMP, one of the channels can connect with the skin probe, the
other can connect with the rectal probe, which would induce the difference of TEMP. The
clients are able to set the value of difference of TEMP to trigger the alarm. you can set OFF
to this item, you do not hear the audio alarm of △T.
13.3.2 UNIT
Pick this item to set measurement unit: Centigrade (℃) or Fahrenheit (℉).
WARNING
Before cleaning the monitor or the probe, make sure that the equipment is switched off
and disconnected from the power line.
Cleaning
⑴ The TEMP probe should not be heated above 100℃ (212℉). It should only be subjected
briefly to temperatures between 80℃ (176℉) and 100℃ (212℉).
⑵ The probe must not be sterilized in steam.
⑶ Only detergents containing no alcohol can be used for disaffection.
⑷ The rectal probes should be used, if possible, in conjunction with a protective rubber cover.
⑸ To clean the probe, hold the tip with one hand and with the other hand rubbing the probe
down in the direction of the connector using a moist line-free cloth.
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14.1 Introduction
The Portable Mercury Patient Monitor measures direct blood pressure (SYS, DIA and MAP) of
one selected blood vessel through two channels, and displays two BP waveforms measures
direct blood pressure (SYS, DIA and MAP). The pressure labels are as follow:
ABP: Arterial blood pressure
PAP: Pulmonary arterial pressure
WARNING
If there are air bubbles in the pressure line or the transducer, you should flush the
system with the solution to be infused.
⑷ Position the transducer so that it is at the same level with the patient’s heart, approximately
mid-axillary line.
⑸ Check if you have selected the correct label name.
⑹ Zero the transducer.
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Fig.14-1
IBP measured result and corresponding message are displayed as follows in the displaying area
as Fig.14-2:
Fig.14-2
S: systolic
D: diastolic
M: mean arterial pressure
Labels: ABP, CVP, PAP
WARNING
Only operator selects “IBP EXT” for “DIS WAVE” item in SYSTEM MENU SETUP, IBP
operation will be realized. Now IBP displaying area is shown under NIBP displaying area.
14.5.1 BP TYPE
Press the knob to switch from one mode to other mode. There are three modes are viable:
NIBP, IBP1, IBP2. NIBP is none invasive blood pressure, IBP1, IBP2 channels are invasive
blood pressure, whose menus are different as per various modes. If you selected IBP1 item for
“BP TYPE”, the following sub-menu will be pop-up as Fig.14-3:
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Fig.14-3
If you have selected IBP2 item for “BP TYPE”, the following sub-menu will be shown as Fig.14-
4:
Fig.14-4
14.5.2 ALARM
If you have picked IBP1 type then pressed ALARM item, which sub-menu will be shown as
Fig.14-5:
Fig.14-5
If you have picked IBP2 type and pressed ALARM item, which sub-menu will be shown as
Fig.14-6:
Fig.14-6
NOTE
It only sets NIBP alarm individually; the alarms of other parameters will not be affected.
Five items are available for the user to set up, which are SYS (systolic limit), MEAN (the limit of
mean arterial pressure), DIAS (diastolic limit), ALARM (off, high, medium, low), and
CALIBARTE. When use the knob to select each item and press the knob, a pull-down list
appears for the user to choose his desired selection.
14.5.3 UNIT
Pick this item to set measurement unit. (Option: mmHg or KPa.)
14.5.4 BASELINE
The user may adjust the BASELINE of the waveforms displayed on the screen. Three options
are available: 0-50
Fig.14-7
14.5.5 SCALE
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Used to access the sub-menu of IBP SCALE ADJUST, in which the user may adjust the
amplitude of the two waveforms displayed on the screen. Three options are available:
20mmHg/cm, 40mmHg/cm, 60mmHg/cm, 80mmHg/cm, 100mmHg/cm, and 200mmHg/cm.
14.5.6 Label
Press the knob to switch from one mode to other mode. Set the data according to the tube
location of monitoring BP, the relevant label will be displayed in the IBP displaying area.
WARNING
You must never perform this procedure while patient is being monitored.
Close the 3-way that was open to atmospheric pressure for the zero calibration.
Attach the tubing to the sphygmomanometer.
Ensure that connection that would lead to patient is off.
WARNING:
Close the one way of the transducer’s three-way connected to the patient before zeroing.
Transducer should be connected with air before zeroing
Put the transducer at the same level with the patient’s cardio, namely approximately
mid-axillary line’s level.
The zeroing must be done before the monitor used to monitor the patients and at
least one time everyday. (The zeroing must be done after inserting or taking out the
power supply wire.)
1. Connect the transducer with cable, install DOME. The both ends of DOME should be
connected with air (e.g.: IBP1)
2. Set the pressure revising value to zero.
3. The pressure value will be shown on the IBP channel1, S, D value also will be shown, and
please take the shown S value as criterion
4. The S value should be 0, 1, 2, or 3. The tolerance is 0.4 kPa (3mmHg).
5. If the error exceeds the tolerance, please enter into IBP1 pressure revising item to adjust IBP1
revising value and let S value be zero.
Fig.14-8
14.6.2 Mercury manometer calibrations:
Keys
Mercury manometer calibration should be processed when starting to use the new
transducer or regularly be processed according to hospital’s rules.
The purpose of the calibration is to insure that the system can give accurate
measure result.
You must zero the transducer before the mercury manometer calibration.
If you want to calibrate the transducer by yourself, required equipment should be:
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Standard sphygmomanometer
3-way switch
About 25 centimeter pipeline
Calibration steps
1. Close the 3-way that was open to atmospheric pressure for the zero calibration
2. Connect the pipeline to the sphygmomanometer
3. Ensure the patient isn’t connected with the transducer.
4. Connect another 3-way switch with the 3-way that disconnects with the patient’s pipeline.
Connect injector to one port of the 3-way, then the sphygmomanometer and pipeline be
connected the other port, open one way of the 3-way which connect with sphygmomanometer.
Ensure pressure value is zero, press “ZERO” item to set the value as “0”.
Fig.14-10
Fig.14-11
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Fig.14-12
7. After one time calibration the mercury manometer can be deflated, then add pressure
renewably, checking the transducer’s veracity after calibration. If not correct, please repeat the
above steps and redoing calibration operation.
8. Remove the blood-pressure pipeline and the additive 3-way.
WARNING:
Never perform this calibration while patient is being monitored.
WARNING
Before cleaning the monitor or the transducer, make sure that the equipment is
switched off and disconnected from the power line.
Cleaning of IBP transducer (Reusable)
After the IBP monitoring operation is completed, remove the tubing and the dome from the
transducer and wipe the transducer diaphragm with water. Soaking and /or wiping with soap can
clean the transducer and cable and water or cleaning agents such as those listed below:
Cetylcide
Wavicide-01
Wescodyne
Cidex
Lysol
Vesphene
Do not immerse the connector in any liquid. After cleaning, dry the transducer thoroughly before
storing. Slight discoloration or temporary increase of surface stickiness of the cable should not
be considered abnormal if adhesive tape residue must be removed from the transducer cable,
double seal tape remover is effective and will cause a minimum of damage to the cable if used
sparingly. Acetone, Alcohol, Ammonia and Chloroform, or other strong solvents are not
recommended because over time the vinyl cabling will be damaged by these agents.
NOTE
The disposable transducer or domes must not be re-sterilized or reused.
For protecting environment, the disposable transducers or domes must be recycled
or disposed of properly.
Sterilization
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Liquid Chemical Sterilization
Remove obvious contamination by using the cleaning procedure described previously. Select
a sterilant that your hospital or institution has found to be effective for liquid chemical
sterilization of operation room equipment. Buffered gluteraldehyed (e.g. Cidex or Hospisept)
has been found to be effective. Do not use quaternary cationic detergents such as zephiran
chloride. If the whole unit is to be sterilized, immerse the transducer but not the electrical
connector into the sterilant for the recommended sterilizing period. Be sure that the dome is
removed. Then rinse all transducer must be thoroughly dried before storing.
Gas Sterilization
For more complete asepsis, use gas sterilization.
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NOTE
Do not use the device in the environment with flammable anesthetic gas.
The device can only be operated by personnel having taken professional training
and familiar with this manual.
WARNING
The instruction is only for the Mercury Patient Monitor installed with CO2 module.
The instruction only describes the connection of accessories of ETCO 2. The part of
the EtCO2 parameter setup is described in the operation manual.
CO2 module should be avoided from crash and vibration.
1. Take out the CO2 module from the accessories. Connect the sampling line with the CO 2
module. Refer to fig.15-3.
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2. Connect the CO2 module to the trap receptacle on the monitor side panel. Refer to Fig. 15-4.
Fig: 15-4
These kits are intended for monitoring the CO 2 of non-intubated patients. For a non-intubated
patient, the sample line can be connected to patient’s nose directly. (Refer to Fig.15-5)
Fig: 15-5
CAUTION
The nasal and nasal/oral cannula kits are intended for single patient use. Do NOT reuse
or sterilize the cannula kit as system performance will be compromised.
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Directions for use of single patient use nasal and nasal/oral side stream kits:
1. Verify that the cannula kit is clean, dry and undamaged. Replace the cannula kit if
necessary.
2. Insert the sample cell into the sample cell receptacle as shown in Fig.15-4. A “click” will
be hazard when properly inserted.
3. Perform a sample cell zero if prompted by the host system.
4. Place the nasal cannula kits onto the patient as shown in Fig.15-5.
5. Some patients are prone to mouth breathing. The oral/nasal sampling cannula should be
used on these patients, as most, if not all of the CO 2 is exhaled through the mouth. If a
standard nasal CO2 sampling cannula is used with these patients, the ET CO 2 number
and capnogram will be substantially lower than actual.
6. When using the nasal or oral/nasal CO 2 sampling kits with oxygen delivery, place the
cannula on the patient as shown in Fig.15-5 and then attach the oxygen supply tubing to
the oxygen delivery system and set the prescribed oxygen flow.
7. If the oral/nasal cannula is used, the oral sampling tip may need to be trimmed to
adequately fit the patient (see Fig.15-6). Place the cannula onto the patient as shown in
Fig. 15-6. Observe the length of the oral cannula tip. It should extend down past the
teeth and be positioned in the mouth opening. Remove the cannula from the patient if
the tip needs to the trimmed.
CAUTION
Do NOT cut the oral cannula tip when the cannula is on the patient.
Remove the LoFlo sampling kit sample cell from the LoFlo CO 2 module inlet port
when not in use.
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Fig.15-11
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Fig. 15-12
Fig. 15-13
WARNING
Ensure to select “CO2” for “RESPTYPE” item in RESP sub-menu before monitoring
patient’s Et-CO2.
NOTE
When you set “RESPTYPE” to “CO2” item, the Et-CO2 waveform will be instead of RESP
waveform gained by trans-thoracic impedance.
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Fig.15-14
Fig. 15-16
Following function can be realized via CO2SETUP Menu
15.3.1 Rotate the knob to highlight the RESP icon in the displaying area, pick the RESP icon to
call up the RESP setup menu as Fig. 15-16, and then select CO2 for the type item.
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Fig.15-16
15.3.2 Then press ALARM icon to enter ALARM submenu, set the high limit to 75 (maximum),
and low limit to 70(maximum), and next please press RETURN to back the former
menu.
Fig.15-17
15.3.3 Enter into the CO2SETUP again, OFFSET item is appeared on the menu, then you can
adjust the offset from –20 to +20 to calibrate the CO2 value.
Fig.15-18
COMPENSA: BY selecting this menu you can set the compensation items (refer to fig: 15-18)
ETCO2: By selecting this menu you can set the calculation time of the ETCO2,
NORETIME: The numeric displaying time after without respiration. 10s ~ 60s for selection.
ZEROGT: By selecting this menu you can set the measuring environment. There are “Room air”
and “100% Nitrogen”,
UNIT: By selecting this menu you can set unit of measurement. There are mmHg. % and KPa
for selection.
Select the “COMPENSA” to calibrate the CO2 module if necessary:
Fig: 15-19
BAR PRE: By selecting this menu you can set the current air pressure. The setting range is from
400 to 850.
O2: By selecting this menu you can set the O2 compensation. The compensation numerical
value is from 1% to 100%
ANE AGEN: By selecting this menu you can set the compensation of anesthetic. The
compensation range is from 0.0% to 20%.
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FGTMP: By selecting this menu you can compensate the temperature of the following gases the
compensation ranges from 0% to 50%.
BAL GAS: By selecting this menu you can select the balance gas. There are Helium, N2O and
None for selection.
Then press CO2 SETUP item to enter the CO2 SETUP submenu, set the high limit to 75
(maximum), and low limit to 70 (maximum), and next please press RETURN to back the former
menu (For WELLYN or CPT CO2 module, the menus are as Fig 15-20, Fig15-21).
Fig: 15-20
HIGH: By selecting this menu you can set the upper alarm of CO2.
LOW: By selecting this menu you can set the lower alarm of CO2.
ALARM: By selecting this menu you can set the alarm level. HIGH, MEDIUM, LOW or OFF for
selection.
InsCO2: By selecting this menu you can set whether considering the breathing in CO2. ON or
OFF for selection.
PUMP: By selecting this menu you can set the unit of the pump rotate speed. There are
50ml/min, 100ml/min, 150ml/min, and OFF for selection.
UNIT: By selecting this menu you can set the unit of CO2 value, there are “mmHg” and “%” for
selection.
NOTE: Be sure to set the upper alarm and the lower alarm to the maximum value shown
as figure 15-21.
Enter into the CO2SETUP menu again, OFFSET item is appeared on the menu, then you can
adjust the offset value from -20 to +20 to calibrate the CO2 value.
Fig: 15-21
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16.1 Maintenance
Customers should responsible for periodic maintaining of the product and its accessories. It is
very important for our company to warranty the service and repairs. We reserve the rights to
change the time limit of warranty and replacement if the following steps are non-implemented:
⑴An effective maintenance plan should be designed for the product and its reusable
accessories. It includes periodic inspections and cleaning. It should be accord with the
policy of local infection control department or health institution.
⑵Be sure to disconnect power line to the product before cleaning and inspecting.
⑶Periodic cleaning (accordance with the policy of local infection control department or health
institution). Dampen a cloth with a commercial, nonabrasive cleaner and wipe the tip,
bottom, and front surfaces lightly. The following admissive liquor can be used:
● Ammonia (diluted),
● Glutaraldehyde,
● Sodium hypochlorite bleacher (diluted), or
● Mildness suds (diluted).
Please obey the following rules to prevent from damaging the product:
● Always using diluted liquor recommend by the manufacture.
● Always wipe up cleaning liquor after cleaning.
● Always not use cleaning matter containing wax.
● Always not spray water or cleaning liquor over the product, neither allows any liquid to
flow into power switcher, connector, or other intake.
● Always not use the following cleanser:
○ any kinds of abrasive cleaner and menstruum
○ acetone
○ ketone
○ spirituous cleanser, or
○ lycine.
● In order to clean display, please use clean flexible cloth and make it wet with cleanser
in the glass. Always not spray cleanser in the glass on the screen, neither use alcohol
or medical disinfector, such as glutaraldehyde or lycine.
● Please use warm wet cloth and mildness suds to clean cables and lead wires. Other
cleaning ways may reduce the life of cables and lead wires.
Recommendation:
● Do not power on/off frequently.
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● Take down and safekeeping probes, lead wires, gluey tube after using product.
● Please hold the product in packaging if the product would not work for a long time.
● Do not make the product contact with chemical medicine and reagent.
● Battery Maintenance
If the Mercury Patient Monitor has not been used for a long period of time, the battery will
need charging.
If there is any abnormity, stop working. It can be reused after inspecting and repairing by
technician.
16.2 Troubleshooting
⑴ Warranty does not apply to the damage or loss sustained due to well-known act of god, such
as fire, earthquake, flood, thunder, cyclone, hail, electrical storm, blast, building collapse,
commotion, etc.
⑵ Non-service items:
① The cost and insurance of dismantling and testing, overhauling, reinstall, transfer, moving
the instrument or parts.
② Damage or loss sustained due to inspected or repaired by other institute that is not certified
③ Damage or alteration by anyone other than our company authorized service personnel.
⑶ The damage or lose sustained due to connection to peripheral equipment (such as printer,
computer etc.), that are not provided by our company are not covered by the warranty.
⑷Obligation restriction: In the duration of warranty, if the operators use other fittings that are not
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provided by us, we reserve the right to cancel warranty.
● The work environment is not eligible. For example, if the relative humidity exceeds
70%, circuit boards of the instrument may be damaged due to condensate.
● If voltage of power supply is fluctuant and exceeds 240VAC, the power adapter
may be damaged.
● There is smear or marks that are not belong to the instrument and cannot be
removed from the outside surface of the instrument.
● The instrument or its fittings are mechanically damaged.
● The circuit is short and damaged due to liquor or other stuff flow in the instrument
or its fittings.
● All probe and its accessories are not free replacement.
● Leakage of air cell of blood pressure sleeve due to improper storage or operation is
not free replacement.
● The malfunction with result form improper repair by anyone other than our
company authorized service personnel.
● The malfunction with result from improper use.
Due to we stipulate the warranty period according to the relevant electronic regulation of
country, which we stipulate is on year, accessory is three months. When customer requires to
extending the warranty period, you should consider whether it is reasonable. Because electronic
product quickly replace, as to the warranty period over three years, purchased accessories may
be out of stock. In this case, we will adopt to entirely upgrade or replace the old; you should pay
the minimum acceptable cost of renewed device.
16.3.6 Repackaging:
Remove all the detectors, leads and accessories and put them into the plastic bag.
Try to use the original packaging case and materials. Any damage due to the improper
packaging during the transportation shall be responsible by the user.
If you are still within the period of warranty, please present the warranty card and one copy of
the invoice or receipt.
Please present a written note detailing all the troubles when repairing the instrument.
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Appendix
List of Accessories
The accessories list below is specified to be used in this device of our company. The user can
order the various accessories according to the hospital requirements.
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Hospital Name.........
Head of Dept...........
Department.............
Address...................
................................
City..........................
State........................
Pin code..................
Phone......................
Installed By
Model
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The above equipment is warrantee under normal usage against defects in workmanship and
materials to the original purchaser for a period of 12 months from the date of installation or 13
months from the date of dispatch, whichever is earlier, provided the following conditions are met.
01. This warranty will be valid if warranty card with all the required information i.e. purchaser's name
and address, date of purchase, model and serial number, date of installation is lodged with the
company within 30 days of the date of purchase. The company will issue confirmation of warranty
card receipt. This confirmation must be presented with the product when service during warranty
period is required.
02. This warranty is void if the product has been damaged after delivery by any cause whatsoever.
This warranty is also void if the product is damaged due to mishandling, failure to follow instructions
as per operation manual, repair by unauthorized personnel, improper safe keeping, or operating the
same in the environment not suitable to it as explained in clause 3.
03. This warranty is void if proper earthing, power supply of 230V AC within + 5% variation,
temperature between 10° C & 40° C without condensation, humidity between 20-85%, does not
exist. This warranty is also void, in case machine is stored near place like water heaters, humidifiers,
refrigerators, heat sources, dust atmosphere, direct sunlight, improper ventilation, where the
temperature and humidity is different from once above mentioned.
04. During warranty period free Repairs/Service will be provided by AKAS Medical or their
Authorized Dealers at their service centers except where specifically agreed in writing and their
decision in the
matter as to whether the replacement of any part has been necessitated as a result of wear and tear
will be final and binding.
05. The purchaser has to deliver and collect the unit from the nearest servicing point to avail of the
service under warranty except when specifically agreed in Writing by the company, service rendered
to the equipment as a result of misuse, improper repair by unauthorized persons will be charged.
06. This warranty shall not operate or, be construed to cover any claims in respect of consequential
losses of whatever nature, either from malfunction or otherwise and, shall be limited only to the
replacement of defective parts as a result of any defect in manufacturing within the warranty period.
07. This warranty does not cover the replacement of accessories such as Rechargeable battery
packs & power chards, unless they are proved to be faulty material or workmanship, at the time of
delivery.
08. The warranty expressly provided for herein, is for the sole warranty provided in connection with
the product and no other warranty, expressed or implied, is provided. Supplier assumes no
responsibility for any other claims, not specifically stated in this warranty.
09. Upon expiry of this warranty period, all servicing will be undertaken by AKAS Medical or their
Authorized Service Dealer at the option of the customer as per the prevailing than service contract
charges.
10. Is also a condition of this warranty that the Service Engineer will service or repair the equipment,
only during the normal working hours of the Company.
11. Force Majeure Neither the purchaser nor AKAS Medical shall be liable to the other for any delay
in or failure of performance of their respective obligations under this Agreement caused by
occurrences beyond the control of Purchaser or AKAS Medical (as the case may by) because of fire,
floods, power failures or reductions, acts of God, acts of the public enemy, wars, insurrections, riots,
labour disturbances, Strikes, lockouts, go-slows, sabotage, accidents to machinery.
12. This warranty is issued subject to the jurisdiction of Tiruchirapalli Court.
13. The company shall be released from all obligations under the warranty, in the event of
repairs/modifications being carried out by unauthorized person.
14. The warranty is not transferable on resale.
15. Accessories and probe not covered under warranty.
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Hospital Name.........
Head of Dept...........
Department.............
Address...................
................................
City..........................
State........................
Pin code..................
Phone......................
Installed By
Model
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