Midmark Multi-parameter Monitors User guide

For Veterinary Use Only

003-2407-00 (Rev A)

Cardell® 9500HD

Veterinary Vital Signs Monitor

User’s Manual

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Cardell® 9500HD Series User’s Manual

1

Table of Contents

SECTION 1 - PREFACE ............................................................................................ 3

1.1 General ................................................................................................................................................... 3

1.2 Product Support ..................................................................................................................................... 3

1.3 Important Information ............................................................................................................................ 4

SECTION 2 - SAFETY ............................................................................................... 5

2.1 Safety Notice .......................................................................................................................................... 5

2.2 Safety Requirements ............................................................................................................................ 6

2.3 Safety Symbols ...................................................................................................................................... 7

SECTION 3 - CONTROLS AND CONNECTORS ...................................................... 8

3.1 Installation and Connection .................................................................................................................. 8

3.2 Before Monitoring .................................................................................................................................. 9

3.3 Front Panel ........................................................................................................................................... 10

3.4 Rear Panel ............................................................................................................................................ 12

3.5 Side Panels .......................................................................................................................................... 13

3.6 Power ................................................................................................................................................... 13

3.7 Keys and Buttons ................................................................................................................................ 14

3.8 Menu Setup .......................................................................................................................................... 15

3.9 Printing .................................................................................................................................................. 15

3.10 Display Screen ................................................................................................................................... 16

SECTION 4 - ALARM SETUP ................................................................................. 20

4.1 General Information ............................................................................................................................ 20

4.2 Alarm ON/OFF ..................................................................................................................................... 20

4.3 Alarm Setup .......................................................................................................................................... 21

SECTION 5 - SETTING UP THE MONITOR............................................................ 24

5.1 Display Setup ....................................................................................................................................... 24

5.2 Trend Display ....................................................................................................................................... 24

5.3 Demo Mode .......................................................................................................................................... 25

5.4 Printing Setup....................................................................................................................................... 25

5.6 System Setup ....................................................................................................................................... 26

5.7 Volume and Brightness Setup ........................................................................................................... 27

5.8 Big Font ................................................................................................................................................. 28

SECTION 6 - ECG MONITORING ........................................................................... 29

6.1 General Information ............................................................................................................................ 29

6.2 Patient Cable ........................................................................................................................................ 29

6.3 Animal Preparation and Lead Contact ............................................................................................. 29

6.4 Attaching ECG Electrodes ....................................................................................................... 30

6.4.3 Positioning Anesthetized Patients ................................................................................................. 31

6.4.4 Positioning Conscious Patients ...................................................................................................... 31

6.5 ECG Setup ........................................................................................................................................... 31

6.6 Alarm Setup .......................................................................................................................................... 33

6.7 Precautions........................................................................................................................................... 34

6.8 Cleaning and Maintenance ................................................................................................................ 34

6.9 Troubleshooting ..................................................................................................................... 35

SECTION 7 - NIBP MONITORING .......................................................................... 36

7.1 General Information ............................................................................................................................ 36

7.2 Cuff Placement .................................................................................................................................... 36

2

7.3 NIBP Setup ........................................................................................................................................... 39

7.4 Precautions........................................................................................................................................... 42

7.5 Preparations ......................................................................................................................................... 42

7.6 Maintenance ......................................................................................................................................... 42

SECTION 8 - SPO

2

MONITORING .......................................................................... 44

8.1 General Information ............................................................................................................................ 44

8.2 Sensor Placement ............................................................................................................................... 44

8.3 Menu Setup .......................................................................................................................................... 46

8.4 Alarm Setup .......................................................................................................................................... 47

8.5 Preparation for Monitoring .................................................................................................................. 48

8.6 Precautions........................................................................................................................................... 49

8.6 Cleaning and Maintenance ................................................................................................................ 49

8.7 Troubleshooting ................................................................................................................................... 50

SECTION 9 - RESPIRATION AND TEMPERATURE MONITORING ..................... 51

9.1 General Information ............................................................................................................................ 51

9.2 Temperature Monitoring ..................................................................................................................... 51

9.3 Respiration Monitoring ........................................................................................................................ 52

9.4 Menu Setup: ......................................................................................................................................... 53

9.5 Alarm Setup:......................................................................................................................................... 54

SECTION 10 – CO

2

MONITORING (OPTIONAL) ................................................... 55

10.1 General Information .......................................................................................................................... 55

10.2 Capnostat

®

Sensor .......................................................................................................................... 55

10.3 LoFlo CO

2

Sensor - Sidestream ...................................................................................................... 57

10.4 Menu Setup ........................................................................................................................................ 58

10.5 Alarm Setup ....................................................................................................................................... 59

10.6 Cleaning & Maintenance .................................................................................................................. 59

SECTION 11 - CLEANING AND MAINTENANCE .................................................. 60

11.1 Cleaning ................................................................................................................................. 60

11.2 System Calibration ................................................................................................................. 62

APPENDIX 1 - SPECIFICATIONS ........................................................................... 63

I. Safety: ........................................................................................................................................................ 63

II. Power Supply Requirements: ................................................................................................................... 63

III. Performances: ......................................................................................................................................... 63

IV. Display: .................................................................................................................................................. 65

V. Recorder: .................................................................................................................................................. 65

VI. Physical Specifications: .......................................................................................................................... 65

VII. Environmental Requirements: ............................................................................................................... 65

APPENDIX 2 – BP REFERENCE VALUES ............................................................ 66

APPENDIX 3 – DEAD SPACE ................................................................................ 68

APPENDIX 4 - ACCESSORIES............................................................................... 70

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Cardell® 9500HD Series User’s Manual

3

SECTION 1 - PREFACE

1.1 General

Welcome and thank you for choosing the Cardell

®

Model 9500HD portable multi-parameter

veterinary monitor. The 9500HD continuously monitors and displays the following

physiological parameters: ECG waveforms, arterial blood oxygen saturation of arterial

hemoglobin (SpO

2

), pulse rate, respiration rate, systolic (SYS), diastolic (DIA) and mean

arterial pressure (MAP) and temperature. With the addition of the optional Capnostat

Mainstream CO

2

probe, one can also measure end-tidal CO

2

as well as inspired CO

2

.

This operator’s manual contains detailed information about the performance specifications,

operation and maintenance of 9500HD. It is designed for use by qualified veterinary

personnel. Before using the patient monitor, please read this manual carefully and thoroughly

in order to use the monitor safely and correctly.

This manual is an integral part of the product and describes its intended use. It should always

be kept close to the equipment. Observance of the manual is a prerequisite for proper product

performance and correct operation and ensures patient and operator safety.

1.2 Product Support

1.2.1 Warranty

Please fill in the product warranty card carefully and mail it to our service center. We will

keep it for future reference. After unpacking the system, keep the packing materials for future

return for service if necessary. The manufacturer shall be responsible for the safety,

reliability, and performance of the monitor. The warranty applies if the product is used

according to the operator’s manual instruction.

The warranty does not apply if the product:

has been damaged from improper operation (misuse).

has been damaged because of improper connection to other equipment.

has been damaged by accident.

has been modified without written authorization of the Company.

has had the serial number removed or defaced.

1.2.2 After-sale service

To obtain service or product support, please contact Midmark in Tampa, Florida at 800-643-

6275 or visit the website at www.Midmark.com. Have the following information available:

model and serial number of the equipment

date of purchase and distributor name

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1.3 Important Information

The manufacturer’s quality management system complies with the international standards

ISO 9001 and EN 46001 and has the certificate issued by TUVps.

Manufacturer address: Midmark, 10008 N. Dale Mabry Hwy, Suite 110, Tampa, FL

33618.

• Phone: 800-643-6275 Fax: 813-264-6218

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Cardell® 9500HD Series User’s Manual

5

SECTION 2 - SAFETY

2.1 Safety Notice

2.1.1 Intended Use

The Cardell

®

9500HD series monitor is used to provide continuous monitoring, display and

recording of physiological parameters, such as: ECG, non-invasive blood pressure, SpO

2

,

CO

2

, respiration, and temperature.

2.1.2 Application Environment

This device is for use by trained veterinary personnel in veterinary centers. The device is to

be used on one patient at a time.

2.1.3 Operator Requirements

Only veterinary personnel who have read the Operator’s Manual should use this monitor.

2.1.4 Terminology

The terms danger, warning, and caution are used throughout this manual to point out hazards

and to designate a degree or level of seriousness. Familiarize yourself with their definitions

and significance.

DANGER is defined as a source of potential injury to a person.

WARNING indicates a potential hazard or unsafe practice which, if not avoided, could result

in death or serious injury.

CAUTION indicates a potential hazard or unsafe practice which, if not avoided, could result

in minor personal injury or product /property damage.

NOTE provides application tips or other useful information to assure that you get the most

from your equipment.

2.1.5 Monitor Safety

The safety statements presented in this chapter refer to the equipment in general and in most

cases, apply to all aspects of the monitor. There are additional safety statements in the

parameter chapters, which are specific to that monitored parameter.

The order in which safety statements are presented in no way implies order of importance.

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6

There are no dangers that refer to the equipment in general. Specific “Danger” statements

may be given in the respective sections of this manual.

2.2 Safety Requirements

The following warnings and cautions must be read and understood before operation of the

patient monitor.

2.2.1 WARNINGS:

9500 HD veterinary monitor is not intended to be used as an apnea monitor.

9500 HD veterinary monitor is not intended to be used during MRI or CT scan.

Please do not rely on the alarm functions of the patient monitor. The alarm limits may

have been improperly set or the alarm may have been disabled.

Alarm functions of the patient monitor must be checked regularly.

Before putting the system into operation, visually inspect all connecting cables for signs

of damage. Damaged cables and connectors must be replaced immediately.

When several devices are used on the same patient, leakage current may increase and lead

to danger to the patient. Before using, please consult a professional to do a leakage

current test and make sure the leakage current is within safety limits.

When a defibrillator is used, make sure patient will not touch the ground, metal or other

conductor or device. During defibrillation, never touch the patient, table or the device.

Before using on another patient, make sure previous monitoring data is cleared.

2.2.2 CAUTION:

Use properly grounded power sockets and ensure adequate grounding. If there is any

doubt about the grounding, please use battery operation.

Check accessories on regular basis and discard damaged accessories properly.

To ensure patient’s safety and performance of the product, use only the manufacturer

recommended accessories.

Service parts must be in conformity with IEC 60601 standards. The system configuration

of monitor must be in conformity with IEC 60601-1-1 medical electric standard,

otherwise, it will reduce the safety of monitor.

Even while not being used, the battery may also discharge. Check battery level every

month.

The ECG cable socket is for connecting ECG lead wires only. Please do not connect it to

any other signal source. Pay attention to the color label and marks of ECG lead wires.

Please clean the monitor and accessories according to instructions. Always unplug the

power cord before cleaning.

EMC — The device is in conformity with the requirements of IEC 60601-1-2 and related

EMC standards. But when electromagnetic power is extremely high, it may cause

interference. Please ensure any device close to the monitor meets the related EMC

requirements. Do not use cell phone or personal telecommunication devices next to the

monitor.

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Cardell® 9500HD Series User’s Manual

7

Unknown EMI may be caused by radio transmitters or TVs. Please remove the patient

monitor or add shielding materials.

INSTRUCTIONS FOR USE – For continued safe use of this equipment, it is necessary

that the instructions are followed. However, instructions listed in this manual in no way

supersede established medical practices concerning patient care.

Loss of data — When the device accidentally loses data, please keep patient under close

attention until the device returns to normal.

Other devices connecting to the device should meet IEC standards (for example, data

processing device should meet IEC 950 and medical device should meet IEC60601-1)

and the whole system should meet the latest version of IEC60601-1-1 standards.

Plastic bags and other packaging materials should be disposed of in accordance with

related regulations.

After the device or the accessories are at the end of their life cycle, please dispose of them

according to local laws and regulations.

2.3 Safety Symbols

NOTE: Some symbols may not appear on all equipment.

Type BF Applied Part: F-type applied part (floating/insulated) complying with the specified

requirements of IEC 60601-1 Medical Standards to provide a higher degree of protection

against electric shock than that provided by Type B applied parts.

Type CF Applied Part: F-type applied part (floating/insulated) complying with the

specified requirements of IEC 60601-1 Medical Standards to provide a higher degree of

protection against electric shock than that provided by Type BF applied parts.

Attention: Consult accompanying documents

Equipotentiality

Power ON/OFF

Alternating Current

Earth connector

Fuse

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8

SECTION 3 - CONTROLS AND CONNECTORS

3.1 Installation and Connection

Environment Requirements:

To ensure electric installation safety, the environment should be reasonably dust free, without

corrosive or combustible gas, or extreme temperature or humidity.

Keep a space for the patient monitor at least 5cm from the wall to ensure good air ventilation.

If the patient monitor is installed in a cabinet, please make sure there is enough space to

facilitate service.

Extreme temperature can affect the accuracy of the monitor and damage accessories or

circuits.

Please ensure that water does not condense in the patient monitor when using the device. For

instance, when the monitor is transferred between buildings, there is a risk of condensation

because of exposure to humidity and combined with a difference in temperature.

WARNING: Never use the veterinary monitor in an environment with combustible

anesthetic gases.

Power Supply Requirements:

Power Supply Input: AC 110-230V,50/60Hz

Input Power: ≤90VA

Shock Protection:

The 9500HD multi-parameter monitor is a Class I device in conformity with

IEC60601/EN60601 requirements with protective grounding (through three pin power plug).

WARNING: To turn off the AC power, please unplug the power cord from power socket or

unplug the power cord from the AC power receptacle on the monitor.

The On/Off button will not turn off the AC power of the patient monitor.

Patient Grounding:

The equipotential or grounding cable may be yellow or yellow and green.

During heart or head check, in order to eliminate the potential difference between different

equipment, the monitor has a special cable to connect to the grounding system. The

grounding cable should be used when using high electrical output equipment such as a

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Cardell® 9500HD Series User’s Manual

9

defibrillator or electric cautery or any equipment that may cause interference with the

monitor.

Connect the small end of the grounding cable to the grounding connector on the monitor.

This is the small metal peg on the back of the monitor. The large end of the grounding cable

should be connected to any metal surface or copper pipes.

Combination of Equipment:

Both medical and non-medical equipment must comply with IEC60601-1-1 standard.

CAUTION: The use of several machines together can increase the current leakage which

risks injury to patient and medical personnel.

Unpacking:

After confirming the outside packing is intact, please open the box and inspect the contents:

Patient Monitor Main Unit

Power Cord

Operator’s Manual

In addition, you should have all the accessories and optional parts (See Appendix 4).

If any damage is found during shipping, please keep the package and contact Midmark

immediately.

3.2 Before Monitoring

Before monitoring patient, please check the following:

Check if there is any mechanical damage.

Check the external connections.

Check if the patient monitor is in good working condition.

WARNING: If anything is found abnormal or mechanical damage is suspected, please do

not use the monitor, and contact Midmark as soon as possible.

Step 1: Turn the monitor on, and the system will start a self-test. If the self-test is successful,

you can start monitoring the patient. If changes are to be made in the operation or settings,

see the operation procedures in the Operator’s Manual.

Step 2: Make sure the monitor is connected to the patient with the appropriate accessories.

Step 3: After connections are in place, there should be waveform or data on the screen,

otherwise:

a. Check the connections to the patient.

b. Check the connections to the monitor.

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3.3 Front Panel

The front panel of 9500HD multi-parameter patient monitor is as shown in fig.3-1:

Fig. 3-1 9500HD Front Panel

(1) Power Switch: When the monitor is connected to the wall socket or

there is enough battery power, press this button, and the patient monitor

will turn on or off. After the patient monitor is turned off, the battery

continues to charge.

.

(2) Power indicator: AC indicator. When the monitor is connected to the

wall socket, whether the patient monitor is turned on or not, the yellow

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Cardell® 9500HD Series User’s Manual

11

indicator will remain on. When the patient monitor is turned on and

working, the indicator becomes green.

(3) Freeze/Restore: When the waveform is sweeping across the screen,

press this button to freeze the waveform. Press the button again to unfreeze

the waveform sweep.

(4) Start/Stop BP: Press this button to start blood pressure measurement;

press it again to stop blood pressure measurement.

(5) Silence: Press this button to enable /disable the alarm sound.

(6) Start/Stop Printing: Press this button to start printing. Press it again to

stop printing. If not pressed after being activated, the monitor will print 90

seconds and automatically stop (except when using the alarm-triggered

print setting).

(7) ECG Menu: Press this button to enter the ECG menu.

.

(8) Knob:

To access the menu, rotate the knob and the required item will appear at the

bottom of the screen. When the cursor points to a certain function, press the

knob to select it. Then rotate the knob to change the item. When finished,

press the knob again to confirm the selection.

(9) Display Screen: Color TFT LCD, displaying waveforms, menus, alarm

status and physiological measurement data.

(10) Alarm Indicator: Red/Yellow dual-color alarm indicator.

 The red LED flashes during an emergency alarm (life is endangered).

 The yellow LED flashes during a warning alarm.

 The yellow LED stays on during an alerting alarm.

(11) Handle

BP

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3.4 Rear Panel

The rear panel of 9500HD multi-parameter patient monitor is as shown in Fig.3.2:

9500HD patient monitor rear panel (Fig. 3.2).

1. Fan (for heat dissipation)

2. Reserved

3. Reserved

4. RS422 (for connecting to PC or central station monitoring system – Model 9503 only).

5. FUSE 1

6. FUSE 2

7. Equipotentiality

8. Power inlet

9. Label (Contact information)

10. Label (Model + Serial No.)

WARNING: Other equipment connected to the device should be certified according to IEC

standards (i.e. IEC 950 for data-processing equipment, IEC 60601-1 for medical equipment

and IEC 60601-1-1 for whole system).

1

4

5

6

7

8

10

3

2

3

9

3

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Cardell® 9500HD Series User’s Manual

13

3.5 Side Panels

Side panels

(Fig.3-4)

1. TEMP1/2: Receptacles for temperature probe extension cables

2. ET CO

2

: Receptacle for optional Capnostat Mainstream CO

2

probe

3. SpO

2

: Receptacle for SpO

2

extension cable

4. ECG/RESP: Receptacle for ECG cable

5. NIBP: Receptacle for NIBP inflation hose

6. Cardell

®

Blue Racing Stripe

7. Built-in 3-channel printer

8. Rechargeable Battery compartment

3.6 Power

AC Power:

When AC power is used, the 9500HD may be turned on at any time. Before plugging it into

AC power, compare the resident power output with the requirements of the device. On the

rear panel, you can see the power supply requirements.

After confirming all cables are properly connected, press the power button on the front panel.

The system will start a self-test which lasts about 15 seconds. If the power indicator on the

front panel is green, it indicates that the device is in normal working condition and can be

used for vital signs monitoring, communication, and battery charging.

When the device is plugged in to AC power and turned off, the power indicator on the front

panel is yellow, showing the monitor is in standby condition and the battery is being charged.

1

2

4

5

3

6

7

8

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14

Battery Power:

When AC power is shut off, the 9500HD monitor can still work with the internal battery.

Before use, the battery must be charged. Whenever the device is plugged into AC power, the

battery will automatically be charged. The battery should be charged for at least for 8 hours

before it becomes full. To ensure battery is fully charged, it is recommended to plug the

device in AC power even when the device is not used.

A fully charged battery can support the device continuously working for 1.5-2 hours. The

frequency of NIBP measurement and printing may accelerate the consumption of battery

power. When the battery power is almost depleted, the battery mark at the lower right corner

of the screen will flash, an audible alarm is emitted. This alerts the user to plug the device

into AC power as soon as possible.

WARNING:

Even when the device is not working, the battery power will be discharged slowly.

When the device is being stored for a long time, make sure the battery is full.

Check the battery status and recharge at least once a month.

3.7 Keys and Buttons

The buttons of the device are divided into two types:

Function keys:

Waveform freeze/unfreeze key

Start/Stop blood pressure measurement

Alarm Silence

Printer Start/Stop

ECG menu key

Knob: Located at the lower right of the front panel, it can be used to

move left or right through a menu, to change menu selections, and to

confirm the selection by pressing it.

BP

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Cardell® 9500HD Series User’s Manual

15

3.8 Menu Setup

(1) Rotate the knob to highlight the menu item and press the knob to confirm the selection

and enter the sub-menu.

(2) After entering the sub-menu, rotate the knob to highlight the selected menu and press the

knob to confirm the selection.

(3) Then rotate the knob again to select the desired item.

(4) When finished, press the knob to confirm the selection and validate the setup.

(5) Rotate the knob to point to the BACK icon and press the knob to return to the original

screen.

NOTE: After 30 seconds of inactivity, the menu on the screen will disappear, and the full

screen monitoring interface will resume.

3.9 Printing

Recorder

The device uses a built-in 3-channel thermal array recorder

Manually controlled printing

Press the printing start/stop key on the front panel to print the physiological parameters,

history data and monitoring waveforms. Press the key again to stop printing.

Alarm triggered printing:

While the alarm triggered printing function is turned ON, whenever there is an alarm, the

recorder will automatically print the data and waveform of 2 seconds or 5 seconds before the

alarm. The user may also set the print duration to last 8 seconds, 16 seconds or 32 seconds

after the alarm. Alternatively, the user may press the print start/stop key to stop

printing .

Print Header:

The Report header includes date, time, printing speed, and parameter values. Each time a

waveform is printed, the above contents will also be printed.

Printing Paper:

The printing paper width is 50mm. The paper should be kept in a cool and dry place, away

from direct sunlight, high temperature and humidity. For long-term storage (>5 yrs), it is

recommended to make a photocopy.

Installing Paper:

To install the paper roll in the printer first lift the smoke-colored latch on the printer

compartment. Place the roll of paper between the two round tabs of the paper holder with the

paper coming off of the bottom of the roll. Pull enough paper from the roll so it hangs over

the door when closed (Do not thread paper under black bar). You are now ready to print.

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16

3.10 Display Screen

(Fig.3-5)

In the figure above, we can see the waveforms of ECG 1, ET CO

2

, SpO

2

, RESP and the data

for ECG1, SpO

2

, NIBP, RESP, and TEMP. Press the knob to enter the tabular history screen

in Fig.3-6.

(Fig.3-6)

In the figure above, we can see columns for a date/time stamp, and corresponding parameter

values, including systolic blood pressure, diastolic blood pressure, SpO

2

%, HR/PR,

respiration rate, temperature 1, temperature 2, end-tidal CO

2

, and inspired CO

2

.

The system stores up to 600 sets of history data. On each screen there are 10 sets of data. On

the right side of the readings, there is a scroll bar indicating the current location of

observation.

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Cardell® 9500HD Series User’s Manual

17

Menu Box

(Fig.3-7)

The Menu box uses dynamic popup and exit modes.

When there is no menu on the screen, rotate the knob or press the ECG menu button to

activate the menu display. When the menu is displayed on the screen, press the ECG menu

button to exit from the menu. When there is no activity for 30 seconds, the menu will

disappear automatically and return to the original monitoring screen.

Parameter Box

(Fig.3-8)

The monitor displays the following parameter values in real time: heart rate/pulse rate,

SpO

2

%, Diastolic/Systolic/Mean non-invasive blood pressure (NIBP), ET CO

2

, IN CO

2

,

respiration rate, temperature 1&2, and the temperature difference.

ECG measurement includes 3 modes: “Monitoring/Surgical/Diagnosis”. The user may select

different modes for different applications. The ECG mode label is displayed on the display

channel in small font.

The NIBP unit can be displayed as either mmHg or kPa. The NIBP area will display the cuff

setting as “Small or Large”, referring to whether the vinyl small animal cuffs are being used

or if the nylon (SV8 or SV10) large animal cuffs are being used.

The NIBP measurement mode can be selected between “Manual/Auto/Stat”, which is

displayed on the right side of screen.

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18

Status Box

(Fig.3-9)

In the Status Box, you can see battery power status, alarm status and patient ID number.

(1) Alarm status: A symbol is used to indicate the alarm status.

(2) Battery power status: The more the segments in the battery symbol, the more the power in

the battery.

a) When the battery power is low, the battery symbol will flash. Please connect the

patient monitor to AC power as soon as possible.

b) When there is no segment in the battery indicator, the symbol will become red,

indicating that the battery power is used up. If the patient monitor is not connected to

AC power within 3 minutes, the monitor will be turned off automatically.

c) When the battery symbol changes to “~”, it indicates the device is connected to AC

power.

(3) ID: shows patient’s ID number.

Waveform Status

(Fig.3-10)

Waveform speed: The waveform displayed is physiological waveform and the speed unit

is mm/s. The waveform can be displayed in speeds of 12.5, 25 or 50mm/s.

ECG Leads: I, II, III, V, avL, avR, avF

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Midmark Multi-parameter Monitors User guide

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