Page 3 Conformity according to the Council Directive 93/42/EEC concerning Medical Devices. All specifications are subject to change without notice. Document no. 2039820-001 15th July, 2009 GE Medical Systems Information Technologies, Inc. GE Healthcare 8200 West Tower Avenue 3F Building 1, GE Technology Park...
Page 4 Responsibility of the manufacturer GE Medical Systems Information Technologies, Inc. is responsible for the effects on safety, reliability and performance of the equipment only if: •...
Page 5 In no case, including without limitation any breach of a fundamental term or a fundamental breach of this Software license, shall GE be liable for any damages, including but not limited to indirect, exemplary, special, consequential or incidental damages of any kind (including without limitation lost profits), even if GE has been advised of the possibility of such damages.
Page 6 7. No waiver. The failure of GE to enforce any provision of this Software License shall not be considered a waiver of any subsequent breach of that provision or as a waiver of any other provision hereof.
Page 7 Product has been repaired by anyone other than GE or otherwise than in accordance with written instructions provided by GE, or altered by anyone other than GE, or if the Product has been subject to abuse, misuse, negligence, or accident.
Page 9 Table of contents Table of contents About this manual Safety precautions System description Monitoring basic Alarms Monitor setup Trends Patient data management Printing and recording Cleaning and care Troubleshooting Pulse oximetry Temperature Invasive blood pressure Impedance respiration Non-invasive blood pressure Airway gas (CO2) Index...
Page 10 Table of contents...
Page 11: Table Of Contents
Table of contents Table of contents About this manual Intended audience ..............About-1 Overview .
Page 12 Table of contents...
Page 13: About This Manual
About this manual About this manual Intended audience This manual is intended for clinical professionals. Clinical professionals are expected to have a working knowledge of medical procedures, practices, and terminology, as required for monitoring critically ill patients. Overview This User’s Reference Manual describes the functions offered by the B30 patient monitor running the software license L-DICU08.
Page 14: Conventions Used In This Manual
B30 Patient Monitor Conventions used in this manual To help you find and interpret information easily, the manual uses consistent text formats: Hard keys Names of the hard keys on the Command board, side panel and Others modules are written in the following way: Menu items Software terms that identify window parts or menu items are written in bold italic: Lab Data.
Page 15: Installation And Service
About this manual Installation and service A separate “Technical Reference Manual” describes installation, interfacing, connectors, service, maintenance and reparation procedures of the monitor. Medical electrical equipment needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in the “Technical Reference Manual”...
Page 16 B30 Patient Monitor...
Page 17 Table of contents Table of contents Safety precautions Warnings ................. 1-1 Cautions .
Page 18 Table of contents...
Page 19: Safety Precautions
Safety precautions 1 Safety precautions The following list contains all the general warnings and cautions you should know before starting to use the system. Warnings and cautions specific to parts of the system can be found in the relevant section. Warnings WARNING A WARNING indicates a situation in which the user or the patient may be in...
Page 20: Cautions
B30 Patient Monitor • When detaching modules, be careful not to drop them. Always support with one hand while pulling out with the other. • If you accidentally drop the monitor or modules, have them checked by authorized service personnel prior to clinical use. •...
Page 21: Points To Note
Safety precautions discharge one’s body to earth or to the frame of the equipment or bond oneself by means of a wrist strap to the equipment or the earth prior to making a connection. Points to note • Medical electrical equipment needs special precautions regarding electromagnetic compatibility, EMC, and needs to be installed and put into service according to the EMC information provided in the "Technical Reference Manual"...
Page 22 B30 Patient Monitor NOTE: − This Monitor conforms to particular safety standard for multifunction patient monitoring equipment to IEC 60601-2-49 with the exception of Sub- clause 51.103.1: A new technical alarm only triggers a visual indication, not the audible alarm. −...
Page 23 Safety precautions NOTE: − The ECG parameter conforms to IEC 60601-2-27 with the exception of Sub-clause 51.103.2: SILENCE/RESET of PHYSIOLOGICAL ALARMS/Sub-clause 51.104.1: Auditory manifestation of TECHNICAL ALARMS: A new alarm only triggers a visual indication, not the audible alarm. − Refer IEC 60601-2-49 item for monitor’s performance and warnings.
Page 24 B30 Patient Monitor − The alarm systems of the Monitor conform to IEC 60601-1-8 with the exception of Sub-clause 6.3.3.1a: An ALARM SYSTEM provided with auditory ALARM SIGNALS shall have at least one set of ALARM SIGNALS. − The characteristics of auditory alarm signals are different from IEC 60601-1-8 requirement.
Page 25 Table of contents Table of contents System description Principles of functions ..............2-1 System introduction .
Page 26 Table of contents...
Page 27: System Description
System description 2 System description Principles of functions The B30 monitor is a modular multiparameter patient monitor. The monitor is especially designed for monitoring in PACU, ED, Wards, Step down units, ICU, CCU and OR in regions where anesthesia gas monitoring is not required. It can also be used during transportation within the hospital.
Page 28: Components
B30 Patient Monitor WARNING Before starting to use the system, ensure that the whole combination complies with the international standard IEC 60601-1-1 and with the requirements of the local authorities. Do not connect any external devices to the system other than those specified. CAUTION The monitor display is fragile.
Page 29: Optional Components
System description Optional components Optional components are: • Patient Side Modules E-PSMW and E-PSMPW • Extension Modules N-FREC, N-FCREC and N-FC Rear panel connections Figure 2-3 Rear panel connections Battery compartment Slot for infusion pole mounting Module connector (marked with X4) Guide rail for GCX mounting Receptacle for power cord Fuse holder...
Page 30: Module Overview
B30 Patient Monitor Module overview Different modules measure different parameters. See below for module descriptions and features. Patient Side Module E-PSMW Figure 2-4 Module E-PSMW Module keys NIBP connector Temperature connector: 2-channel measurement connector ECG (3/5 lead) and impedance respiration connector Tab for removing the module...
Page 31: Patient Side Module E-Psmpw
System description Patient Side Module E-PSMPW Figure 2-5 Module E-PSMPW Module keys NIBP connector Invasive blood pressure connector: 2-channel measurement Temperature connector: 2-channel measurement connector ECG (3/5 lead) and impedance respiration connector Tab for removing the module Module keys The E-PSM(P)W modules have the following direct function keys: For starting or stopping the NIBP Auto automatic cycling.
Page 32: Extension Module N-Fc
B30 Patient Monitor Extension Module N-FC Figure 2-6 Module N-FC Module insertion guide for attaching an E-PSM(P)W module Sample gas inlet Water trap Gas outlet Tab for removing the module...
Page 33: Extension Module N-Fcrec
System description Extension Module N-FCREC Figure 2-7 Module N-FCREC Recorder Paper compartment lever measurement Water trap Tab for removing the module Sample gas inlet Gas outlet Extension Module N-FREC Figure 2-8 Module N-FREC Recorder Paper compartment lever Tab for removing the module...
Page 34: General Module Description
B30 Patient Monitor General module description The modules are plugged into the monitor. They can be removed or inserted during monitoring. Inserting and removing a module Figure 2-9 Inserting and removing a module To insert a module: Align the module with the insertion guide. E-PSM(P)W and N-Fx modules are all inserted the same way.
Page 35 System description Using two modules Figure 2-10 Using two modules NOTE: You can use one E-PSM(P)W and/or one N-Fx module in the monitor at a time. To install an E-PSM(P)W and an N-Fx module: Insert the N-Fx module first, see ”Inserting and removing a module”...
Page 36: Keyboards
B30 Patient Monitor Keyboards You can control monitoring through the keys on the Command Board and side panel, module. For more information, see section ”Monitoring basic.” Command Board keys Pt.Data Admit/ Invasive Normal NIBP & Trends Discharge Pressures Screen Monitor Print/ Airway Others...
Page 37: Side Panel
System description Side panel Alarm LED indicators, see section ”Alarms.” Silence For silencing the alarms. Alarms Alarms For activating the Alarms Setup menu. Setup Invasi v e Pressu res Zero For zeroing the invasive pressure channels. NOTE: Functional with the E-PSMPW module only. NIBP For starting the NIBP autocycling.
Page 38: Batteries
- Screen Setup - Digit Fields - Battery. You can now see how much charging time is left for each battery separately both in numbers and as symbols, and the total charging time in numbers. WARNING Use only manufacturer approved batteries. Contact GE service if you need to order new batteries. 2-12...
Page 39: Battery Indicators
System description Battery indicators The B30 messages, screen symbols and front panel LED indicators tell the user about the status of the batteries. For screen symbols, see page 2-15. For LED indicators, consult the table below and for messages, see section “Troubleshooting.” Table 2-1 Battery indicators Screen symbol...
Page 40: Replacing The Batteries
B30 Patient Monitor Checking the battery charge when the monitor is turned off When the monitor is turned off, you can check the battery charging level by pressing the test button on the battery as indicated in the drawing on the left. The charging indicator bar (1) lights up and the number of lit segments indicates the charging level: the more lit...
Page 41: Conditioning A Battery
System description WARNING Do not incinerate a battery or store at high temperatures as it will explode. Conditioning a battery Batteries should be conditioned regularly to maintain their useful life. Condition a battery every six months, when its run time becomes noticeably shorter, or when the message ‘Condition Battery x’...
Page 42: Other Symbols
B30 Patient Monitor Type CF (IEC 60601-1) defibrillator-proof protection against electric shock. When displayed in the upper left corner of the screen, indicates that the alarms are silenced. When displayed in the menu or digit fields, indicates that the alarm source has been turned off or alarm does not meet the alarm- specific activation criteria.
Page 43 System description Battery (A) is missing In the front panel: mains or external DC power Submenu. Selecting an alternative marked with this symbol in a menu opens a new menu. The monitor is connected to Network A blinking heart next to the heart rate or pulse rate value indicates the beats detected.
Page 44 B30 Patient Monitor This symbol indicates that the waste of electrical and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately. Please contact an authorized representative of the manufacturer for information concerning the decommissioning of your equipment. The separate collection symbol is affixed to a battery, or its packaging, to advise you that the battery must be recycled or disposed of in accordance with local or country laws.
Page 45: Abbreviations
System description Abbreviations /min beats per minute, breaths per minute °C Celsius degree °F Fahrenheit degree µg microgram arm (describing location) alveolar arterial a/AO arterio-alveolar PO ratio AaDO alveolo-arterial oxygen difference anesthetic agent AAMI Association for the Advancement of Medical Instrumentation arterial blood gases arterial pressure Anesthesia Delivery Unit...
Page 46 B30 Patient Monitor Body body temperature blood pressure Brady bradycardia body surface area burst suppression ratio B-to-B beat-to-beat BTPS body temperature and pressure, saturated gas calculated/derived value chest C(a-v)O arteriovenous oxygen content difference C.C.O. continuous cardiac output cardiac function index C.I.
Page 47 System description central venous pressure decibel double burst stimulation (NMT) delete Delta, De delta frequency band depr. depression desflurane diastolic pressure Diagn diagnostic (ECG filter) DIFF difference S/5 Device Interfacing Solution oxygen delivery oxygen delivery index digital signal converter dynamic estimated electrocardiogram ECG1...
Page 48 B30 Patient Monitor end-systolic volume ESVI end-systolic volume index ET, Et end-tidal concentration EtAA end-tidal anesthetic agent EtBal end-tidal balance gas EtCO end-tidal carbon dioxide end-tidal nitrous oxide end-tidal oxygen ET-tube, ETT endotracheal tube EVLW extravascular lung water EVLWI extravascular lung water index expiratory foot (describing location) Fahrenheit degree...
Page 49 System description Hemo Calcs hemodynamic calculations reduced hemoglobin heat and moisture exchanger HMEF heat and moisture exchanger with filter hectopascal heart rate HRdiff heart rate difference height hardware hertz International Electrotechnical Comission inspiratory-expiratory ratio IABP intra-aortic balloon pump inspiratory capacity intracranial pressure intensive care unit identification...
Page 50 B30 Patient Monitor lateral pound liquid crystal display left cardiac work light emitting diode LVEDP left ventricular end diastolic pressure LVEDV left ventricular end diastolic volume LVSW left ventricular stroke work LVSWI left ventricular stroke work index minimum alveolar concentration maximum mbar millibar...
Page 51 System description NIBP non-invasive blood pressure Ni-Cd nickel-cadmium Ni-MH nickel-metal hydride neuromuscular transmission nitric oxide NTPD normal temperature and pressure, dry gas Num. numerical oxygen oxygen extraction ratio oxygenated hemoglobin operation room oxygenation Oxy Calcs oxygenation calculations partial pressure pressure P(BTPS) pressure in BTPS conditions P(g-a)CO...
Page 52 B30 Patient Monitor arterial pH intramucosal pH (mixed) venous pH patient interface cable Pleth plethysmographic pulse waveform pacemaker PM non-capt. pacemaker non-capturing PM non-funct. pacemaker non-functioning Pmax maximum pressure Pmean mean pressure Pmin minimum pressure Ppeak peak pressure Pplat plateau (pause) pressure pulse rate Prev.
Page 53 System description Room room temperature respiratory quotient respiration rate (total) (measured) rhythm residual volume RVEDV right ventricular end-diastolic volume RVESV right ventricular end-systolic volume right ventricular pressure RVSW right ventricular stroke work RVSWI right ventricular stroke work index second sinoatrial arterial oxygen saturation S.A.R.
Page 54 B30 Patient Monitor software stroke volume variation systolic pressure time (min) temperature tesla T(BTPS) temperature in BTPS conditions first stimulus as % of the reference value (NMT) T1, T2 temperature channel identification on module Tab. tabular Tachy tachycardia Tbl, Tblood blood temperature Tcorr temperature correction...
Page 55 System description V Run ventricular run V Tachy ventricular tachycardia WLAN wireless local area network weight extreme year years * with Fick equation 2-29...
Page 56: Performance
B30 Patient Monitor Performance WARNING Operation of the monitor outside the specified values may cause inaccurate results. Any fluctuations within the specified limits do not affect the performance. NOTE: Information in this section can be especially useful to clinicians. Power supply Rated voltages and frequencies: 100 to 240 V 50/60 Hz Allowed voltage fluctuations:...
Page 57: Hemodynamic Modules E-Psm, E-Psmp
System description Synchronization pulse Pulse width: 10 ms positive pulse Delay: < 35 ms (R-wave peak to leading edge of pulse) Amplitude: CMOS compatible 3.5 V min. at 1 mA sourcing 0.5 V max. at 5 mA sinking Output impedance: 50 ohm Current limit: 10 mA...
Page 58 B30 Patient Monitor Direct current for leads-off detection through a reference electrode: <120 nA The normalized respiration sensing current between RA (R) and LL (F) or RA (R) and LA (L) or LA (L) and LL (L): <5.0 µA Frequency of respiration sensing current: 31.25 kHz Minimizing the effects of the line isolation monitor transients: Crystal controlled oscillator used as the operating frequency source of the patient isolation power...
Page 59 10 to 45 °C (50 to 113 °F) Measurement accuracy: ±0.1 °C (25 to 45 °C) Probe type: Use only GE Healthcare temperature probes or defibrillator-proof YSI 400 series probes. Temperature self-check: At start-up and then every 10 minutes. Time constant of temperature probes:...
Page 60: Modules With Co Measurement, N-Fc And N-Fcrec
B30 Patient Monitor Default alarm limits high Off, low 90% PR high 160, low 40 NOTE: For each SpO accessory, refer to the instructions for use in the accessory package for patient weight limits and accuracy. Modules with CO measurement, N-FC and N-FCREC Sampling rate: 150 ±25 ml/min (sampling line 2 to 3 m, normal conditions) Maximum sampling line length:...
Page 61: Modules With Recorder, N-Frec And N-Fcrec
System description Default alarm limits EtCO high 8%, low 3% FiCO high 3%, low Off Carbon dioxide (CO Measurement range: 0 to 20 vol % Resolution: 0.01% Measurement rise time: < 300 ms with nominal flow Accuracy: 0 to 15 vol% ±...
Page 62 B30 Patient Monitor 2-36...
Page 63 Table of contents Table of contents Monitoring basics Principles ................. 3-1 Modules and module keys .
Page 64 Table of contents...
Page 65: Monitoring Basics
Monitoring basic 3 Monitoring basic Principles You can control monitoring of the B30 patient monitor through the keys on the Command Board, side panel and modules. Module keys and side panel keys control a set of the most often used functions while the Command Board keys give access to all functions.
Page 66: Using Menus
B30 Patient Monitor Using menus A menu is a list of functions or commands displayed on the monitor screen. To display a menu, press one of the Command Board keys. Figure 3-1 Example of a menu Menu header List of menu selections Indicates the present selection Adjustment window with other options Short instructions...
Page 67 Monitoring basic Select items in the menus with the ComWheel. For example, to change what is displayed in the ECG display: Select the desired function by pressing the menu key. Turn the ComWheel to move the highlight down in the menu to the desired selection.
Page 68 B30 Patient Monitor Push the ComWheel to enter an adjustment window or a submenu Turn the ComWheel to choose the desired option or selection in the window. Push the ComWheel to confirm the selection. Normal Screen Press the key to return to normal monitoring display. Submenus are indicated by a symbol .
Page 69: Starting And Ending
Monitoring basic Starting and ending WARNING Always make sure that necessary alarm limits are active and set according to the patient's clinical condition when you start monitoring a patient. WARNING After transferring or reinstalling the monitor, always check that it is properly connected and all parts are securely attached.
Page 70: Entering And Loading Patient Data
B30 Patient Monitor Entering and loading patient data Admit/Discharge Press the key and do one of the following: − Contin. To continue with a patient already admitted on the same monitor, select Previous − Admit Patient To admit a new patient, select The patient admission also happens automatically when the monitor receives vital signs.
Page 71 Table of contents Table of contents Alarms Overview ................. 4-1 Points to note .
Page 72 Table of contents...
Page 73: Alarms
Alarms 4 Alarms Overview When an alarm for the monitored parameter becomes active: Figure 4-1 View of alarms Alarm messages appear in the message field in the order of priority. The measurement value flashes. The color (red, yellow) indicates the alarm category (high priority, medium priority).
Page 74: Points To Note
B30 Patient Monitor Points to note WARNING When the alarms are silenced, observe the patient frequently. WARNING Always make sure that the audio alarm volume level is adequate in your care environment. Alarm indications • When the monitor is turned on, you will hear a beep: this tells you that the alarm audio signal is working.
Page 75: Alarm Categories
Alarms Alarm categories The alarms are classified into three categories according to the priority: HIGH PRIORITY/RED ALARM, MEDIUM PRIORITY/YELLOW ALARM, and LOW PRIORITY/WHITE NOTE (white color). NOTE: Asystole and ventricular fibrillation alarms are always high priority alarms. The priority of an alarm depends primarily on the cause and the duration (generally minimum 20 seconds) of the alarm condition, the priority increasing with the duration and according to the physiological significance.
Page 76: Alarm Led Indicators
B30 Patient Monitor Table 4-3 General pattern Visual Tone pattern Meaning Continuous beep For life threatening situations. High priority alarm. Yellow Double beep every 5 seconds For serious but not life threatening problems. Medium priority alarm. -- 5 -- 5 -- White Single beep Advisory note.
Page 77: Alarms Setup Menu
Alarms Alarms Setup menu You can view and adjust patient alarm limits in the Alarms Setup menu. Alarms Setup List of selections Exit from the alarm limit adjustment area back to Alarms Setup menu Parameter box with high and low limit values and a 10-minute trend showing the current status Adjust Limits Adjusts individual measurement alarm limits.
Page 78 B30 Patient Monitor Alarm Volume Adjusts the volume of the audio alarms. The range is from 1 (soft) to 10 (loud). NOTE: Audible alarms cannot be totally silenced with the Alarm Volume function. Alarm Light Adjusts the brightness of the alarm light if the light has been enabled (default) through Monitor Setup - Install/Service - Installation - Alarm Options - Alarm Light- YES.
Page 79: Adjusting Alarm Limits
Alarms Adjusting alarm limits Adjusting limits Alarms Setup Press the side panel key. Select Adjust Limits. Turn the ComWheel to highlight the measurement. If the desired measurement is not displayed in the window, select Next Page. Push the ComWheel to open an adjustment window. Turn the ComWheel to change the limits and accept them by pushing it.
Page 80: Changing Alarm Sources
B30 Patient Monitor Changing alarm sources For NIBP, P1 and P2 (with E-PSMPW), you can select which measured values trigger the alarm. One or several alarm sources may be active at a time. Parameters Alarm triggered off by Blood pressure Systolic, diastolic and/or mean pressure or off (NIBP, P1, P2) (with off, there is no 10 minute trend on...
Page 81: Silencing Alarms
Alarms Silencing alarms Silencing audible alarms temporarily NOTES: • The bedside alarms can also be silenced and acknowledged from the Central if this feature has been enabled in the Central configuration. In this case, the message 'Alarms silenced from Central' or 'Alarms acknowledged from Central' is displayed on the bedside monitor display.
Page 82: Reactivating Alarms
B30 Patient Monitor NOTES: • The following silencing selections (that is, all other selections than Activate Alarms are Monitor Setup available only if alarm silencing has been enabled ( - Install/Service - Installation - Alarm Options - Show Audio ON/OFF - Yes). By default, it is disabled. You need a password to enter the Install/Service menu.
Page 83: Deactivating Alarms
Alarms Deactivating alarms You can set the alarm limits temporarily to OFF for the following parameters: HR, SpO respiration rate. This way, you can silence a parameter without having to adjust the alarm limits. Alarms Setup Press the key. Adjust Limits Select Turn the ComWheel to highlight the measurement.
Page 84: Showing Alarm History
B30 Patient Monitor Recording time is 30 seconds consisting of 12 seconds recording from the recorder memory and 18 seconds real-time recording. The alarm source is always marked to the alarm recordings. The following alarms start the recording: Alarm Recorded parameters Asystole ECG1 + Art waveforms, 25 mm/s Tachy/Brady...
Page 85: Other Adjustable Features
Alarms Other adjustable features NOTE: This section describes the rest of the adjustable features regarding the alarms. You can adjust each feature if you know the required password for entering the Install/Service menu. If you wish to adjust the settings, we recommend that you contact the person responsible for the entire configuration.
Page 86: Enabling Or Disabling Alarm Silencing
B30 Patient Monitor Enabling or disabling alarm silencing With this selection, you can determine whether the audible alarms can be turned off or not. Monitor Setup Press the key. Select Install/Service and enter the password. Select Installation - Alarm Options. Select Show Audio ON/OFF and YES to enable alarm silencing or NO to disable it.
Page 87: Latching Alarms
Alarms Latching alarms If the Latching Alarms selection is active, the alarm messages stay on the screen even if the initial alarm condition goes away. This enables unattended monitoring. You will also hear a reminder beep every 10 seconds. To clear the message field of the no-longer active alarm messages and to clear the beep, press Silence Alarms key once.
Page 88: Reminder Volume
B30 Patient Monitor Reminder volume Monitor Setup Press the key. Select Install/Service and enter the password. Select Installation - Alarm Options. Select Reminder Volume and adjust the alarm reminder volume with the ComWheel. Monitor Setup Changing the tone pattern The monitor has three choices of alarming tone patterns: ISO, ISO2 and General. To change the tone pattern: Monitor Setup Press the...
Page 89 Table of contents Table of contents Monitor setup Overview ................. 5-1 Configuration and passwords .
Page 90 Table of contents...
Page 91: Monitor Setup
Monitor setup 5 Monitor setup Overview The B30 monitor has numerous setup options for screen, parameters, alarms, etc. There are two types of settings: − User mode settings: Some of the monitor setup options are preconfigured to be effective. The preconfigured default settings, so called factory settings, form six sets of user modes. The monitor starts in the startup mode, which is one of the user modes.
Page 92: Setting Time And Date
B30 Patient Monitor Setting time and date The time is shown in the upper right corner of the screen. Turning off the monitor does not affect the clock. Monitor Setup Press and select Time and date. Monitor Setup Turn and push the ComWheel to set the time and date: −...
Page 93: Changing Monitor Installation Settings
Monitor setup Changing monitor installation settings Monitor Setup Changing units You can change units for height, weight and blood pressure. You can change temperature Others Airway Gas units through - TempSetup and CO units through - CO2 Setup. The changes are permanent. To change the units: Monitor Setup Press the key.
Page 94: Changing Alarm Options
B30 Patient Monitor Changing alarm options Monitor Setup Press the key, select Install/Service and enter the password. Select Installation - Alarm Options. • Select Show limits and YES to show alarm limits in digit fields. NO is the default. • Select Show Audio ON/OFF (default) and YES to enable alarm silencing.
Page 95: Changing The User Modes
Monitor setup Changing the user modes You can change the settings in each user mode to suit your specific needs. User modes are predefined combinations of settings that include both general and measurement specific settings. A user mode defines, for example, what is displayed on the screen and in the trends. General settings can be changed in the Monitor Setup menu, other settings in the parameter setup menus.
Page 96: Changing The User Mode
B30 Patient Monitor Changing the user mode The monitor always starts in startup mode. The startup mode is one of the user modes, and it is chosen during configuration. To change from the startup mode to another mode: Admit/Discharge Press and select Select Mode.
Page 97: Changing The Startup Mode
Monitor setup Changing the startup mode Monitor Setup Select - Install/Service - Save Modes. Enter the password. Select Startup Mode - 1, 2, 3, 4, 5, or 6. Renaming a mode Monitor Setup Select Install/Service - Save Modes. Enter the password. Select the mode, select Name and give a new name.
Page 98: Changing The Normal Screen Layout
B30 Patient Monitor Changing the Normal Screen layout At startup, the screen is arranged according to the startup mode definitions. Parameters that are not used are not displayed and no space is reserved for them. You can decide which waveforms and numerical information are displayed, and where on the screen they are arranged.
Page 99: Modifying Waveform Fields
Monitor setup Modifying waveform fields Monitor Setup Press the key. Select Screen Setup. Select Waveform Field. Up to six waveforms can be displayed at a time. Monitor Setup When waveforms are configured to be displayed, they appear and disappear automatically when modules are connected or disconnected.
Page 100: Modifying Digit Fields
B30 Patient Monitor Modifying digit fields Patient data may be displayed in up to four digit fields, located in the lower part of the screen. The fields are numbered from left to right. Figure 5-2 Digit fields You may change the contents of each field, or turn them off individually. Before modifying the digit fields remember to check that the desired parameter module is plugged in.
Page 101: Modifying Split Screen
Monitor setup Modifying split screen You can split Normal Screen so that one part continuously displays trend data. To select a split screen view: Monitor Setup Press the key. Select Screen Setup. Select Split Screen and choose from the options: Trend or None. Figure 5-3 Split screen view Modifying the minitrend length...
Page 102: Other Adjustable Screen Features
B30 Patient Monitor Other adjustable screen features Changing the display brightness Monitor Setup Press and select Display brightness. Select from 10 to 100 %. Changing sweep speeds You can change the speed of the waveforms on the screen. Selections are Fast (6.25 mm/s) and Slow (0.625 mm/s).
Page 103: Changing The Recorder And Printer Settings
Monitor setup Changing the recorder and printer settings Recorder settings Print/Record Press Select Record Waveforms. • Select Waveform 1 and select a parameter or select OFF. Then select Waveform 2 and 3 and their parameters. You can record up to three waveforms simultaneously. If you wish to record only one waveform, select the other waveform fields OFF.
Page 104: Configuring Trends
B30 Patient Monitor Configuring trends Configuring trend pages You can change the parameters on the trend fields: Monitor Setup Press the key. Select Install/Service and enter the password. Select Trends and select Graphical Trends. Select the trend page that you want to change. Select graphical parameters for each field.
Page 105 Table of contents Table of contents Trends Overview ................. 6-1 Trended parameters .
Page 106 Table of contents...
Page 107: Trends
Trends 6 Trends Overview The monitor displays two types of trend data: graphical and numerical. The monitor collects graphical and numerical trend data automatically from trended variables. You can select the trend time between 20 minutes and 72 hours. Pt.Data & Trends You can view the trends through - Trends, or you can select graphical Monitor Setup...
Page 108: Most Common Tasks
B30 Patient Monitor Most common tasks • Displaying trends and Pt.Data & Trends Press the key and select Trends. activating the Trends menu The most recently displayed trend (graphical or numerical) is displayed together with the Trends menu. Scrolling time with trend cursor 1.
Page 109: Minitrend View
Trends Minitrend view Figure 6-1 Minitrend view You can split the Normal Screen page so that one fourth of the screen, on the left hand side, continuously shows graphical minitrends beside waveforms. Note that the split screen option is available only when the Normal Screen page shows waveforms.
Page 110: Minitrend Length
B30 Patient Monitor To select a split screen view: Monitor Setup Press the key. Select Screen Setup. Select Split Screen and Trend. Monitor Setup Minitrend length You can choose to view trend data from the last five minutes or the last 30 minute period. The five minute minitrend is updated every 10 seconds, the 30 minute minitrend is updated once every minute.
Page 111: Graphical Trend View
Trends Graphical trend view Figure 6-2 Graphical trend page Trends menu Measurement trend field Real time ECG Numeric value of a measurement at the trend cursor point Trend page number Indication of the amount of data gathered and viewed Time and marker field...
Page 112: Symbols
B30 Patient Monitor Symbols Trend bar, parameter scale to the left. The gap shows the blood pressure mean value except in the Paw field where it indicates Pplat. NIBP trend bar Dotted vertical line across the trend field indicates change, such as ST relearning or zeroing of an invasive blood pressure channel/ changing a label.
Page 113: Graphical Trend Pages
Trends Graphical trend pages Graphical trends contain: − Four pages − Six fields on each page Five fields are usually visible. The lowest (sixth) field is replaced by digit fields on the screen. All six fields are printed. Scale, label, unit and color of the parameter follow the real time waveform setting for each parameter.
Page 114: Moving On Graphical Trend Pages
B30 Patient Monitor Moving on graphical trend pages To see more parameters on other pages: • Select Scroll Pages in the Trends menu. Numeric measurement values for trended parameters are displayed next to the cursor. The cursor indicates the time when these values have been measured. To change the cursor location: In the Trends menu, select Cursor.
Page 115: Numerical Trend View
Trends Numerical trend view Figure 6-3 Numerical trend page Trend menu Page name and number Real time ECG Real time digit fields, if the Normal Screen shows waveforms...
Page 116: Numerical Trend Pages
B30 Patient Monitor Numerical trend pages Numerical trends contain: − four pages of maximum 72 hours trend information − real-time ECG on top of each page Resolution is five minutes. Moving between numerical trend pages • Use the ComWheel to scroll the trend in vertical direction. When the highlight reaches the top or the bottom of the view, next five minutes of information appear.
Page 117: Erasing Trend Data
Trends Erasing trend data Trends are erased when you discharge the patient. Admit/Discharge Press the key. Select Discharge. In the opened window, select Yes to erase the trends and to discharge the patient. Admit/ Discharge 6-11...
Page 118 B30 Patient Monitor 6-12...
Page 119 Table of contents Table of contents Patient data management Overview ................. 7-1 Admitting a patient .
Page 120 Table of contents...
Page 121: Patient Data Management
Patient data management 7 Patient data management Overview The monitor continuously saves patient data, such as trends. Saving is activated once the patient is admitted. The monitor saves automatically. − In the monitor memory the most recent patient data up to 72 hours if the network is not in use.
Page 122: Adding Demographics
B30 Patient Monitor Adding demographics Admit/Discharge key. Select Admit Patient - Demographics. Enter patient data: Height is adjustable from 15 to 250 cm (5 in to 8 ft 2 in), Weight is adjustable from 1 to 250 kg (2 to 555 lb). The body surface area, BSA, is calculated automatically by using du Bois formula.
Page 123: Automatic Saving Of Patient Data
Patient data management Automatic saving of patient data The monitor continuously and automatically collects and saves patient data such as trends., Saving is activated once the patient is admitted or the monitor receives vital data. If the monitor is not connected to the network, patient data is saved to the monitor memory. If the monitor is connected to the network patient data is automatically saved to the network.
Page 124 B30 Patient Monitor...
Page 125 Table of contents Table of contents Printing and recording Overview ................. 8-1 Recording .
Page 126 Table of contents...
Page 127: Printing And Recording
Printing and recording 8 Printing and recording Overview You can manage recording and printing via the Print/Record menu. For recordings, you need a module with the built in recorder, N-FCREC or N-FREC, and for printouts you need a laser printer (PCL5 compatible, min. 2 MB memory). The monitor can be connected to a laser printer via network.
Page 128: Recording Waveforms
B30 Patient Monitor Recording waveforms You can record three waveforms to a local recorder: Print/Record Press the monitor key and select Record Waveforms - Record to Local Stop Waveforms. Print/ Record Figure 8-2 Sample of recording Recorder speed Scale Selected waveform Date Time NOTE: Waveform scaling follows the displayed parameter scaling, when applicable.
Page 129: Selecting Waveforms For Recording
Printing and recording Selecting waveforms for recording You can select which waveforms and how many of them you want to record. Print/Record Press the key. Select Record Waveforms. Select Waveform 1 and a parameter for it (see the list below), or select OFF. Select Waveform 2 and 3 and their parameters.
Page 130: Controlling The Recording Time
B30 Patient Monitor Controlling the recording time You can adjust the recording time to be 30 seconds or continuous, which means that the recording continues until the recorder runs out of paper. Print/Record Press the key. Select Record Waveforms. Select Length and choose 30 s or Cont. The default setting for the recording time is 30 seconds.
Page 131: Recording On Alarms
Printing and recording Recording on alarms An automatic strip chart recording is activated when the following alarms reach the red level: Asystole, Tachy, Brady, Art High, Art Low, V Fib, and V Tachy. When recording is activated by alarms, the recording time is always 30 seconds and the delay always 12 seconds. Print/Record Press the key.
Page 132: Recording Trends
B30 Patient Monitor Recording trends To record trends: Print/Record Press the monitor key. Select Record Trends – Record Numerical or Record Graphical. Stop recording by selecting Stop Numerical or Stop Graphical. You can record numerical, graphical or tabular trends. Recording numerical trends Since the contents of the numerical trends are preconfigured, you cannot choose the parameters or change their order.
Page 133: Tabular Trend Format
Printing and recording Selecting the format for the recorded numerical trends You can select the format for the recorded numerical trend to be either Num. (vertical) or Tab. (horizontal): Print/Record Press the key and select Record Trends. Select Num Trend Type and Num. or Tab. Changing resolution To select the resolution of a numerical or tabular trend record: Print/Record...
Page 134: Inserting Recorder Paper
B30 Patient Monitor Inserting recorder paper Figure 8-4 Inserting recorder paper Printing NOTE: Before you start printing, check that the printer is operational. You can print to a laser printer: − Graphical or numerical trends You can print several pages or trend data through the Print/Record menu. Printing currently displayed screen contents To print a trend view Pt.Data &...
Page 135 Table of contents Table of contents Cleaning and care Overview ................. 9-1 Preventive maintenance .
Page 136 Table of contents...
Page 137: Cleaning And Care
Cleaning and care 9 Cleaning and care Overview For safe and reliable function and operation of the monitor, regular care has to be carried out according to the instructions in this manual and to the maintenance procedures described in the "Technical Reference Manual”." WARNING Use only approved accessories, including mounts and batteries, and defibrillator-proof cables and invasive pressure transducers.
Page 138: Regular Checks
B30 Patient Monitor Regular checks When you start monitoring, check that: − The module is firmly in place. − Accessories are intact and properly connected. − You have selected desired parameters to be displayed in the digit and waveform fields. ECG and impedance respiration •...
Page 139: Every Six Months
Cleaning and care Safety checks for software The GE Healthcare software design controls include performance of a risk analysis using methods consistent with ISO 14971 Medical devices - Application of risk management to medical devices. The monitor software employs watchdog timers, self-monitoring activities (memory, communication and sensor checks and so on), and power-on self-diagnostics (for example, memory checksums).
Page 140: Power Interruption
B30 Patient Monitor Power interruption NOTE: Always use the monitor with batteries inserted. Otherwise all trend data and temporary settings are lost if the power cable is detached from the mains. If the monitor is turned off, trend data and the latest user-made settings remain in the monitor memory for 15 minutes even if the mains power is interrupted.
Page 141 Allow the product to dry completely after cleaning. Pulse oximetry sensors The GE Healthcare pulse oximetry sensors are latex-free. Take possible patient allergies into account also when selecting the cleaning agent. Detach the sensor from the patient and the monitor.
Page 142 B30 Patient Monitor • Clean only when necessary. Wash the cuff in mild detergent solution. Do NOT use alcohol. Invasive blood pressure cables • Wipe the cables with sterile alcohol-based detergent. After cleaning rinse surfaces by wiping them with a cloth damped with sterile water. Dry with a dry cloth. Invasive blood pressure transducer WARNING Mechanical shock to the invasive blood pressure transducer may cause...
Page 143: Other Accessories
Cleaning and care Figure 9-1 Emptying the water trap container To remove the water trap, push the trigger above the water trap. The water trap is spring- loaded. The message ‘Check D-fend’ is displayed. • Detach the container from the water trap cartridge by pulling it carefully downward. •...
Page 144 B30 Patient Monitor...
Page 145 Table of contents Table of contents 10 Troubleshooting 10-1 Overview ................10-1 Checklist .
Page 146 Table of contents...
Page 147: 10 Troubleshooting
Troubleshooting 10 Troubleshooting Overview The troubleshooting section consists of two parts which together should help you resolve the most common monitoring problems. The parts are “Checklist” and “Messages”. Checklist Check the following things before monitoring to ensure that you have remembered to make all essential preparations, and if any problems occur during monitoring.
Page 148: Messages
B30 Patient Monitor Messages Table 10-1 Messages Message Explanation What to do • Air leakage Air leak in cuff or hose. NIBP: Check all connections and test tightness using Venous Stasis. • Alarms acknowledged (from Silenced alarms remain silent. New If required, turn on the alarms Central) alarms will have an audible sound.
Page 149 Troubleshooting Message Explanation What to do • Check NIBP NIBP measurement affected by low Check the patient status. blood pressure and pulsation, or a • Check the measurement setup. change in patient's condition. • Check the cuff. • Check sample gas out Sample gas outlet is blocked.
Page 150 B30 Patient Monitor Message Explanation What to do • Lead changed The monitor automatically switches Check the lead. the ECG1 waveform selection to a measurable ECG Lead (I, II, III, aVR, aVL, aVF or V) if the current ECG1 is not measurable.
Page 151 Troubleshooting Message Explanation What to do • RAM error Faulty RAM circuit on the CPU board. Contact authorized service personnel. • Recorder module removed There is no recorder module. Reconnect the N-FREC or N-FCREC module if you need a recorder. •...
Page 152 B30 Patient Monitor Message Explanation What to do • Weak pulsation Weak or unstable oscillation signal Check the patient status. due to improper cuff position or • Check the NIBP cuff position and attachment, weak or abnormal blood attachments. circulation, slow heart rate associated •...
Page 153 Troubleshooting Table 10-4 Other problems related to batteries Symptom Possible cause and solution • Battery operation Condition the batteries according to the instructions in this time is markedly manual. shortened Table 10-5 Other problems related to ECG measurement Symptom Possible cause and solution •...
Page 154: Other Situations
B30 Patient Monitor Table 10-8 Other problems related to NIBP measurement Symptom Possible cause and solution • NIBP Check that cuff tubings are not bent, stretched, compressed or loose. measurement • Prevent motion artifacts. does not work or • values seem Use cuffs of correct size.
Page 155 Table of contents Table of contents 11 ECG 11-1 Overview ................11-1 Module description .
Page 156 Table of contents...
Page 157: 11 Ecg
11 ECG Overview The electrocardiography, ECG, reflects the electrical activity generated by the heart muscle. ECG monitoring is used for a heart rate measurement, for arrhythmia analysis and for detecting pacemaker function and myocardial ischemia. In Normal Screen, when measuring 5-lead ECG, you can simultaneously monitor the waveforms of up to three different ECG leads.
Page 158: Displaying Ecg And Heart Rate
B30 Patient Monitor Displaying ECG and heart rate /min -2.8 Figure 11-2 Display of ECG and HR ECG1 is displayed first ECG2 is displayed below ECG1 ECG3 is displayed below ECG2 Selected lead label ECG gain bar (1 mV reference) Heart rate (HR) label Heart rate/pulse rate source (ECG/Art/ABP/Pleth) HR/PR value...
Page 159: Preparing The Patient And Placing The Electrodes
Preparing the patient and placing the electrodes Preparing the patient • Prepare the skin properly to ensure optimal signal quality. • Shave any hair from the electrode site. Gently rub the skin surface to increase capillary blood flow and remove dead skin cells and oil. •...
Page 160: Lead Measurement
B30 Patient Monitor Patient connection NOTE: Keep the ECG cable, lead set and connectors dry. Avoid excessive use of liquids when cleaning the cables and connectors. R=RED (IEC) L=YELLOW (IEC) R=RED (IEC) L=YELLOW (IEC) RA=WHITE (AAMI) LA=BLACK (AAMI) RA=WHITE (AAMI) LA=BLACK (AAMI) LE AD I R/R A...
Page 161: Color And Letter Coding
Color and letter coding IEC standard 3-lead ECG Position 5-lead ECG Position Position on surface on body on body surface surface R = red right arm R = red right arm right arm L = yellow left arm L = yellow left arm left arm F = green...
Page 162: Ecg Setup Menu
B30 Patient Monitor ECG Setup menu Beat Sound Volume Adjusts the pulse/heart beat sound volume (0 to 10). When the monitor has detected a QRS complex or a pleth or pressure pulse, a beep tone is produced. You can raise, lower or turn off the volume.
Page 163: Selecting A Lead
Diagn (diagnostic) filter is used if more accurate information of the waveform is needed (for example, of the P wave or AV block). The diagnostic filter is more susceptible to both high frequencies and baseline wander than the monitor filter. Pacemaker Selects how to display the pacing spike of cardiac pacemaker.
Page 164: Viewing A Cascaded Ecg
B30 Patient Monitor Viewing a cascaded ECG With a 3 leadwire set, ECG2 and ECG3 leads are automatically shown as cascaded. The same ECG will be displayed in each waveform field. Thus more QRS complexes are displayed at the same time. With a 5 leadwire set either a cascaded ECG or different leads can be displayed.
Page 165: Starting Relearning Manually
Starting relearning manually When the patient’s ECG pattern changes considerably, the monitor should start relearning a new ECG pattern. The pattern changes, for example, when changing the patient’s position. To start relearning manually: Press the key. Select Relearn. Setting heart rate alarm limits To set the heart rate alarm limits: Press the key.
Page 166: Setting Pvc Alarm Limits
B30 Patient Monitor Setting PVC alarm limits To set the PVC alarm limits: Press the key. Select ECG Alarms. Select PVC Alarm - ON. Select Adjust Limits. Alarms Setup You can also adjust the limits through - Adjust Limits. For detailed instructions, see section ”Alarms.”...
Page 167: St Segment Analysis
ST segment analysis Overview The ST value, analyzed by the monitor, shows the difference of electrical activity between ISO and ST points. Myocardial ischemia appears in the ECG as an ST segment deviation from the isoelectric line (ISO point). The ST segment generally rises above the PQ isoelectric line in the presence of transmural ischemia and is pressed below the isoelectric line in the subendocardial ischemia.
Page 168: Setting The St Measurement Points
B30 Patient Monitor Setting the ST measurement points Automatic setting of the J, ST and ISO points The ST algorithm automatically searches for the J and ISO points. The distance between the ST and J point is set according to the heart rate: −...
Page 169: Setting St Alarm Limits
Setting ST alarm limits To set the ST alarm limits: Press the key. Select ECG Alarms. Select ST Alarms. Select Adjust Limits. Alarms Setup You can also adjust the limits through - Adjust Limits. 11-13...
Page 170: Description Of The St Segment Measurement Algorithm
B30 Patient Monitor Description of the ST segment measurement algorithm The ST segment begins at the point where the QRS ends (J point). Diagnostic criteria of ST segment changes are measured at 60 ms after the J point. For monitoring purposes it is important to keep the measurement point fixed during monitoring to notice the ST changes on the respective trends.
Page 171: Monitoring Arrhythmia
Monitoring arrhythmia The Severe arrhythmia analysis mode used by the B30 detects asystole, bradycardia, tachycardia, ventricular fibrillation and ventricular tachycardia. Adjusting arrhythmia alarm settings To open the adjustment menu: Press Select ECG Alarms - Arrh. Alarms. In the adjustment menu, turn and push the ComWheel to select the priority for all alarms except asystole and ventricular fibrillation, which are always red (high priority), and ventricular tachycardia, which cannot be selected OFF.
Page 172: Selecting Leads For The Arrhythmia Analysis
B30 Patient Monitor Selecting leads for the arrhythmia analysis When measuring 5-lead ECG, you can affect the selection of the two ECG leads used for detecting beats and ventricular fibrillation. The selection of user leads (ECG1, ECG2, ECG3) on the monitor affects the leads used for detection. The first lead used for detection is lead I or II. The algorithm uses the lead appearing first in user leads.
Page 173: Monitoring Pacemaker Patients
Gross results for sample-by-sample detection of ventricular fibrillation (AHA) Test Gross VF Sensitivity (duration) VF positive preductive accuracy 100% (episode) The gross results are calculated as overall results of all records. Abbreviations: Ventricular ectopic beat The waveform presented in an ECG during ventricular depolarization Ventricular fibrillation or ventricular flutter Segment of the ECG between the end of the QRS complex and the start of the T-wave.
Page 174: Other Adjustable Features
B30 Patient Monitor Other adjustable features NOTE: This section describes the rest of the adjustable features related to ECG measurement. To adjust the following features, you need a password. If you wish to adjust the settings of the features, we recommend that you contact the person responsible for the entire configuration.
Page 175 Table of contents Table of contents 12 Pulse oximetry 12-1 Overview ................12-1 Module description .
Page 176 Table of contents...
Page 177: 12 Pulse Oximetry
Pulse oximetry 12 Pulse oximetry Overview Oxygen saturation SpO is the percentage of saturated hemoglobin compared to total hemoglobin measured by a two wavelength pulse oximeter (also called functional or In Vivo oxygen saturation. The SpO value is measured by light absorption technique: Red and infrared light is emitted from the emitter side of the sensor.
Page 178: Display Of Pulse Oximetry
B30 Patient Monitor Display of pulse oximetry Figure 12-1 Display of SpO value and pleth waveform Scale of plethysmogram Label Oxygen saturation (SpO ) value Pulse oximetry message field 12-2...
Page 179: Patient Connections
For long term monitoring and during high motion conditions, use GE Healthcare OxyTip+ Adhesive Sensors. For pediatric patients weighing more than 3 kg, use GE Healthcare OxyTip+ Adhesive Sensors or Wrap Sensors. NOTE: For each SpO accessory, refer to the instructions for use in the accessory package for patient weight limits.
Page 180: Connecting The Patient
B30 Patient Monitor Connecting the patient NOTE: Use dry and clean sensors only. Connect the sensor to the blue connector in the module. Clean the application site: Remove nail polish, artificial fingernails, earrings etc., clip long fingernails. Position the sensor correctly. For proper sensor positioning, see the “Instructions for use” accompanying each sensor.
Page 181: Pulse Oximetry Menu
Pulse oximetry Pulse oximetry menu Others Pleth Scale If the pleth scale selection is AUTO, the scale of the plethysmographic waveform display is automatically set during ‘Pulse Search’. The scale is then kept constant throughout the case to enable easy detection of changes in the patient's perfusion. To adjust the pleth scale further, select one of the following: 2, 5, 10, 20, 50, Auto.
Page 182: During Monitoring
B30 Patient Monitor During monitoring WARNING Check the sensor site every four hours (more frequently if the perfusion is poor). Routinely check to ensure adequate circulation distal to the sensor site. Patient condition or prolonged use may require changing the sensor site periodically. Check skin integrity, circulatory status and correct alignment and change sensor site at least every four hours.
Page 183: Measurement Limitations
Pulse oximetry Measurement limitations • The B30 monitors are designed to minimize the interference of electrosurgery. Under some circumstances electrosurgery may cause noise on the screen. Therefore, be careful in interpreting the results, especially the plethysmographic pulse waveform, during electrosurgery. •...
Page 184 B30 Patient Monitor 12-8...
Page 185 Table of contents Table of contents 13 Temperature 13-1 Overview ................13-1 Module description .
Page 186 Table of contents...
Page 187: 13 Temperature
You can simultaneously measure and monitor temperature of two sites by using one of the hemodynamic multiparameter modules E-PSMW or E-PSMPW. As a measuring probe use only GE Healthcare temperature probes or defibrillator-proof YSI 400 series probes. You can measure, for example, esophageal, nasopharyngeal, rectal, and skin temperature.
Page 188: Displaying Temperature
B30 Patient Monitor Displaying temperature Figure 13-2 T1+T2 digit display Labels Temperature measurement value Calculated T2-T1 difference The other options are individual T1 and T2 readings in a digit field. Patient connections Figure 13-3 Temperature measurement setup E-PSMW or E-PSMPW module Adapter cable for temperature probes Reusable temperature probe Adapter cable for disposable temperature probe...
Page 189: Temp Setup Menu
Temperature Temp Setup menu Others T1, 2 Label Allows you to label each temperature measurement site. Unit Allows you to select the units to be either degrees Celsius or degrees Fahrenheit. Allows you to adjust temperature alarm limits for two measurement sites, measured by T1 or T2.
Page 190: Combining Different Temperatures
B30 Patient Monitor Combining different temperatures The monitor displays the difference between different temperatures if they are displayed in the same digit field. differences (T2-T1,) are displayed in the temperature digit field if you choose them in the same digit field. For example, to display T1+T2: Monitor Setup Press the key and select Screen Setup.
Page 191 Table of contents Table of contents 14 Invasive blood pressure 14-1 Overview ................14-1 Module description .
Page 192 Table of contents...
Page 193: 14 Invasive Blood Pressure
Invasive blood pressure 14 Invasive blood pressure Overview You can measure and monitor two invasive blood pressures at the same time using a dual invasive blood pressure cable. To measure invasive blood pressure you need the E-PSMPW module. During the invasive blood pressure measurement, the transducer converts pressure variations into electrical signals.
Page 194: Display Of Invasive Blood Pressure
B30 Patient Monitor Display of invasive blood pressure Figure 14-1 InvBP display Invasive blood pressure waveforms with zero and reference lines Selected pressure label Selected pressure scale Field for messages and alarm limit settings Systolic, diastolic and mean pressure values of invasive blood pressures You can have a combined display of all those waveforms that are selected on the screen.
Page 195 Invasive blood pressure Figure 14-2 Invasive blood pressure setup E-PSMPW module Heparinized fluid bag with pressure infusor Flushing set Disposable catheter Transducer Adapter cable for the InvBP transducer Adapter cable for dual InvBP measurement NOTE: Patient connections made according to the picture above using approved accessories are defibrillator-proof.
Page 196: Starting With Accurate Values
B30 Patient Monitor Starting with accurate values Pressure transducers generally produce a small signal even when no pressure is applied to them. It is necessary to zero the monitor with the transducer to establish an accurate electrical zero point. Also, the position of the transducer effects the accuracy of the measurement. An error of 10 mmHg of static pressure is introduced for every 13.6 cm (5.4 inches) difference in height between the mid-heart and the transducer.
Page 197: Invasive Pressures Menu
Invasive blood pressure Invasive Pressures menu Invasive Pressures Zero Pressures Opens a menu to zero both pressures or one of them. Ventilation Mode Respiration causes artifacts in invasive pressures. At the end of expiration the artifact is at its smallest. Select Spont for spontaneous respiration and Contr for controlled ventilation. Px Setup menu Label Start-up labels are Art and CVP.
Page 198: Labeling Channels
B30 Patient Monitor Determining pressure values visually By moving the horizontal cursor across the pressure waveform, you can get accurate pressure values at selected points. This may be useful, for example, if the patient's breathing pattern is irregular. The cursor is not available for pressures shown with a combined scale. Invasive Pressures Press the key.
Page 199: Cerebral Perfusion Pressure
Invasive blood pressure Table 14-1 Invasive blood pressure labels and descriptions LABEL P1, Art, P2, CVP RAP, LAP Scale mmHg/kPa 200/30 20/3 20/3 20/3 60/8 60/8 Color Blue White White Yellow White Alarm source Mean Digit format Mean Mean Filter (Hz) Response normal normal...
Page 200: Smart Invbp And Flushing
B30 Patient Monitor Smart InvBP and flushing Flushing is performed to keep the lines open. It prevents blood from clotting and occluding the lines and measurements. Infusion that is used for flushing goes through the dome into the patient’s artery. Two types of flushing are used simultaneously: flushing with continuous infusion and manual flushing.
Page 201 Table of contents Table of contents 15 Impedance respiration 15-1 Overview ................15-1 Module description .
Page 202 Table of contents...
Page 203: 15 Impedance Respiration
Impedance respiration 15 Impedance respiration Overview Impedance respiration is measured across the thorax. When the patient is breathing or is ventilated, the volume of air changes in the lungs, resulting in impedance changes between the electrodes Respiration rate is calculated from these impedance changes, and a respiration waveform is displayed on the monitor screen.
Page 204: Module Description
B30 Patient Monitor Module description E-PSMW E-PSMPW ECG and impedance respiration connector Figure 15-1 Modules E-PSMW and E-PSMPW for impedance respiration measurement Respiration detection The respiration rate is the sum of the respirations that have exceeded the detection limit. The dotted lines present the zero line and the detection limit. The signal strength produced by a respiration should thus exceed this minimum limit to be included in the respiration rate calculation.
Page 205: Displaying Impedance Respiration
Impedance respiration To manually select impedance respiration as respiration rate source: Others Press the key. Select Resp Setup. Select Resp Rate Source and select AUTO, CO2 or Imped. Others Displaying impedance respiration Figure 15-3 Impedance respiration waveform and numeric respiration rate value. 15-3...
Page 206: Patient Connections
B30 Patient Monitor Patient connections The setup is the same as for the ECG measurement. For more information, see section “ECG.” NOTE: Impedance respiration measurement is intended for patients over three years old. R=RED (IEC) L=YELLOW (IEC) R=RED (IEC) L=YELLOW (IEC) RA=WHITE (AAMI) LA=BLACK (AAMI) RA=WHITE (AAMI)
Page 207: Activating Measurement
Impedance respiration Activating measurement Select respiration in a waveform or a digit field, otherwise the respiration information is not included in the trends and the alarms are not operative. Monitor Setup Check that the measurement is on: Others Press the key.
Page 208: Improving Waveform Readability
B30 Patient Monitor Improving waveform readability To improve readability, increase the waveform size. Others Press the key. Select Resp Setup. Select Size and adjust the waveform size. Others The bar on the left side of the waveform always indicates a 1 Ω reference. 15-6...
Page 209: Correcting The Respiration Number
Impedance respiration Correcting the respiration number Normally, we recommend the use of the AUTO detection limit. However, in some specific cases you may wish to adjust the limits manually. − When the respirations are weak, you can manually adjust the detection limits (measurement sensitivity) closer to each other to ensure that all respirations are included in the RR value.
Page 210: Measurement Limitations
B30 Patient Monitor Measurement limitations Movement artifacts Changing position, moving the head, moving the arms or shivering may result in movement artifacts. Also the heart may cause noticeable movement and sometimes this may interfere with the respiration measurement. Electrical interference Electrical devices, such as electrosurgery units and infrared heaters, that emit electromagnetic disturbance may cause artifacts or disable the respiration measurement completely.
Page 211: Checklist
Impedance respiration Checklist Check that: • Electrode gel is moist. • Electrodes have good skin contact. • Electrodes are positioned correctly. • Correct leadwire set is selected. • The trunk cable is connected properly. • Leadwire set is properly connected to the trunk cable. •...
Page 212 B30 Patient Monitor 15-10...
Page 213 Table of contents Table of contents 16 Non-invasive blood pressure 16-1 Overview ................16-1 Module description .
Page 214 Table of contents...
Page 215: 16 Non-Invasive Blood Pressure
Non-invasive blood pressure 16 Non-invasive blood pressure Overview The non-invasive blood pressure (NIBP) measurement uses the oscillometric measuring principle. The cuff is inflated with a pressure slightly higher than the presumed systolic pressure, then slowly deflated at a speed based on the patient’s heart rate, collecting data from the oscillations produced by the pulsating artery.
Page 216: Direct Function Keys
B30 Patient Monitor Direct function keys There are two module keys for NIBP on the module and on the monitor side panel: Starts and stops autocycling measurements. Auto On/Off Starts a single measurement, and cancels any measurement. Start Cancel Displaying non-invasive blood pressure NIBP can be displayed in the digit field: Figure 16-2 NIBP digit field display Systolic and diastolic pressure value of non-invasive blood pressure...
Page 217: Patient Connections
Non-invasive blood pressure Patient connections Figure 16-3 Cuff positioning E-PSMW or E-PSMPW module Cuff hose Cuff of correct size Place the arrow (4) over the brachial artery. Check that the index line (5) falls within the range markings on the cuff, and wrap the cuff around the upper arm. For a comprehensive list of accessories, see the “Supplies and Accessories”...
Page 218: Connecting The Cuff Hose
B30 Patient Monitor Connecting the cuff hose Connect the cuff hose to the NIBP cuff by placing the opposite connectors in contact and locking them together. Plug the NIBP cuff hose to the module. NIBP Setup menu NIBP Ready Prompt Ready prompt gives an audible tone when the NIBP measurement is ready. Adjust the volume of the beep tone from 1 (soft) to 10 (loud), or to 0 (OFF.) Inflation Limits When this selection is ‘Auto’, the monitor automatically identifies the cuff hose and selects the right inflation pressure and alarm limits for adults.
Page 219: Starting
Non-invasive blood pressure Starting Note that the measurement unit may be mmHg or kPa. The unit is selected during Monitor Setup configuration through - Install/Service - Installation - Units. You can start the NIBP measurement using either the direct function keys on the module or on NIBP the side panel, or by pressing the key on the Command Board.
Page 220: Autocycling
B30 Patient Monitor Autocycling Auto On/Off key sets automatic NIBP measurement at selected intervals on and off. Autocycling is synchronized to real time so that if the first measurement was at 12.02, the next measurement is at 12.05 and again at 12.10 (5 min. interval.) To start the autocycling, do one of the following: •...
Page 221: Starting A Manual Measurement
Non-invasive blood pressure Starting a manual measurement To start the measurement, do one of the following: • Start/Cancel Press the module or side panel key, or NIBP press the key on the Command Board and select Start Manual. Canceling a measurement To cancel any NIBP measurement, do one of the following: Start/Cancel Press the...
Page 222: Using Venous Stasis
B30 Patient Monitor Using venous stasis Venous Stasis initiates and holds the pressure in the cuff to help venous cannulation. A constant pressure is maintained in the cuff. The value is selected automatically after the inflation limits (infant, child or adult) are set. NIBP To release the pressure before two minutes have expired: •...
Page 223: Automatic Nibp Double Check
Non-invasive blood pressure Automatic NIBP double check If the NIBP value exceeds the alarm limits, a new measurement takes place automatically (immediately, when Manual measurement is selected, and after 30 seconds when Auto measurement is selected.) If the alarm situation persists, an alarm is given. Functioning of NIBP measurement during arrhythmias The functioning of the NIBP measurement has been tested by using Biotek BP Pump W (Non- invasive blood pressure monitor tester with wrist cuff) in the presence of the following...
Page 224 B30 Patient Monitor 16-10...
Page 225 Table of contents Table of contents 17 Airway gas (CO2) 17-1 Overview ................17-1 Module description .
Page 226 Table of contents...
Page 227: Airway Gas (Co2)
Airway gas (CO2) 17 Airway gas (CO2) Overview With the N-FC and N-FCREC modules, you can measure and monitor the gases being delivered to the patient and exhaled by the patient. The modules are equipped with a water separation system and they measure only CO Respiration rate is the frequency of peak (end tidal) CO measurements per minute.
Page 228: Display Of Gases
B30 Patient Monitor Display of gases Figure 17-3 Airway gas waveform display 30 minute trend for CO (selected in the Monitor Setup menu) Gas waveforms Message field for gases Gas label Digit field for ET and FI gas values Respiration rate Scale NOTE: When the measured CO value is outside the specified measurement range, the...
Page 229: Patient Connections
Airway gas (CO2) Patient connections Insert the N-FC or N-FCREC in the monitor. Align the module with the insertion guides and push until it clicks. Check visually that the airway adapter connections are tight and that the adapter is operating properly, then attach it to the patient. Make sure that the water trap container is empty and properly attached.
Page 230: Points To Note
B30 Patient Monitor Points to note • You can connect and disconnect airway modules like any other modules. • For a comprehensive list of accessories, see the "Supplies and Accessories" catalog. • In the monitoring system, use only one module for measuring airway gases. •...
Page 231: Co2 Setup Menu
Airway gas (CO2) setup menu Airway Scale Allows you to select the following scales: scale options for % scale options for kPa scale options for mmHg 0-6% 0 - 6 kPa 0 - 50 mmHg 0-10% 0 - 10 kPa 0 - 80 mmHg 0-15% 0 - 15 kPa...
Page 232: Calibrating
NOTE: Do not wash or disinfect calibration gas sampling lines. The airway module should be calibrated once every six months or whenever there are indications of errors in the gas readings. Calibrate the gas measurement with the GE Healthcare calibration gas. Do not use any other calibration gases. −...
Page 233 Repeat these two steps for each gas. The use of an old regulator with the new aerosol cylinders requires an adapter available from GE Healthcare. For ordering details, see the "Supplies and Accessories" catalog. Normal Screen If the message ‘Zero error’ is displayed, press the key and repeat the calibration procedure.
Page 234: Interfering Gases
B30 Patient Monitor Interfering gases Non-disturbing gases are those with a maximum effect on the CO reading < 0.2 vol%. The effect is valid for specific concentrations shown in parentheses of the non-disturbing gas: Ethanol C OH (<0.3%) Acetone (<0.1%) Methane CH (<0.2%) Nitrogen N...
Page 235: Checklist
Airway gas (CO2) Checklist Check that: • Water trap is locked into the module. • Water trap container is empty. • A new sampling line is used after each patient. • Sampling line is connected to the water trap. • Monitor is turned on and self-check is performed with the sampling line attached.
Page 236 B30 Patient Monitor 17-10...
Page 237 Index Index selecting leads 11-16 Axillary temperature 13-3 Batteries capacity 2-12 charging indicator 2-14 conditioning 2-15 indicators 2-13 Abbreviations 2-19 replacing 2-14 Accessories About-2 test button 2-14 Adjusting Bladder temperature 13-3 alarm light brightness 4-6 Brightness, changing display brightness 5-12 Admitting 7-1 Adults cuff hose detection 9-2...
Page 238 Index Connecting patients 3-5 Core temperature 13-3 Gas calibrating 17-6 Cuff Graphical trends 6-7 cuff hose 16-3 Cursor invasive blood pressure 14-6 Half-annual maintenance 9-3 Heart rate display 11-2 Date setup 5-2 HR Source 11-6 Default user modes 5-6 setting limits 11-9 Digit field Hose modifying 5-10...
Page 239 Index NIBP 9-2 Printing temperature 9-2 numerical trends 6-10 water trap 9-6 Printout Menus 3-2 tabular trend printout 8-7 Messages Problems system 10-2 messages 10-2 Module other situations 10-8 impedance respiration 15-2 Pulse rate invasive blood pressure 14-1 display 11-6 keys 2-5 Monitor installation settings 5-1...
Page 240 Index recording 8-1 Silencing alarms Unit from Central 4-10 changing for different parameters 5-3 Size temperature 13-4 ECG 11-8 User leads 11-7 impedance respiration waveform 15-6 User mode Skin temperature 13-3 default modes 5-6 SpO2 renaming 5-7 patient connections 12-3 display 11-11 monitoring ST segment 11-11 Vapor of water 17-8...
Page 242 Fax:+ 1 414 355 3790 Fax: + 86 21 3877 7451 GE Medical Systems Information Technologies, Inc. 8200 West Tower Avenue Milwaukee, WI 53223 USA GE Medical Systems Information Technologies, a General Electric Company, going to market as GE Healthcare www.gehealthcare.com 0459...

GE Healthcare B30 User's Reference Manual

Table of Contents

Safety Precautions

System Description

B30 Patient Monitor

Alarms

Monitor Setup

Trends

Patient Data Management

B30 Patient Monitor

Cleaning and Care

Troubleshooting

Ecg

Pulse Oximetry

Temperature

Invasive Blood Pressure

Impedance Respiration

B30 Patient Monitor

Quick Links

Chapters

Related Manuals for GE Healthcare B30

Summary of Contents for GE Healthcare B30