2009-01-28-Dash V6 QRG

Finished card size is: 7.25 inches x 7.25 inches .25 inch bleedBLEED

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GE HealthcareTechnologies

Dash Series V6Quick Reference Guide

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Table of Contents

Dash 3000/4000/5000 V6Table of Contents

01.0 Equipment OverviewPages 01.01 - 01.09

02.0 Basic Use - Admit/DischargePages 02.1 - 02.1202.01 The Basics02.03 Monitoring Admit Modes02.03 Standard02.06 Rover02.08 Combo02.10 Rover-Combo02.11 Silence Alarm

03.0 ECG/PacePages 03.01 - 03.1203.05 Pace

04.0 12-Lead ECG/ST AnalysisPages 04.01 - 04.0804.01 12-Lead ECG04.04 ST Analysis

05.0 NBPPages 05.01 - 05.07

06.0 SPO2Pages 06.01 - 06.0806.05 Masimo SET

06.06 Nellcor OxiMAX

06.07 GE Ohmeda

07.0 Respiration/TemperaturePages 07.01 - 07.04

08.0 Invasive Pressure/PAPages 08.01 - 08.1208.07 IABP08.08 PA Insert/Wedge

09.0 Cardiac OutputPages 09.01 - 09.04

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Table of Contents

Dash 3000/4000/5000 V6Table of Contents

10.0 Alarm ControlPages 10.01 - 10.0810.01 Alarm Structure10.05 Arrhythmia Alarm Level10.06 Parameter Alarm Level

11.0 Patient DataPages 11.01 - 11.0611.01 Alarm History11.02 Vital Signs11.03 Graphic Trends11.04 Dose Calculations11.05 TitrationTable

12.0 Monitor SetupPages 12.01 - 12.0612.01 Waveforms On/Off12.02 Parameters On/Off12.03 Graphic Setup12.06 Display

13.0 View Other Patients/AVOAPages 13.01 - 13.04

14.0 Dash Port 2 Docking StationPages 14.01 - 14.05

15.0 Capnoflex LFCO2Pages 15.01 - 15.04

16.0 Mainstream ETCO2Pages 16.01 - 16.02

17.0 BISxPages 17.01 - 17.04

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Dash Series V6Quick Function KeyIcons

PowerPress once to turnthe monitor On orOff.

Silence Alarm/AdmitPress Silence Alarmto control audiblealarms. Also servesas a Quick Admitkey.

Zero AllPress once to zeroall invasivepressures lineswhich are open tothe atmosphere.

NBP Go/StopPress once to startthe noninvasiveblood pressuremeasurement.Press again to stopthe measurement.

Graph Go/Stop(3000/4000)Print(5000)Press once to printpatient data or aninformation window.Press again to stopthe print job.

Standby(5000 only)Press once to enterthe Standby mode.Press again toreturn to the normalmode.

Admit/Discharge(5000 only)Press once to admitthe patient . Pressagain to dischargean admitted patient.

NBP Auto(5000 only)Press once to viewthe NBP Auto menu.Select one of the 13pre-defined timeintervals or selectCUSTOM to create anew automaticmeasurementinterval cycle for thepatient.

Trend(5000 only)Press once todisplay patienttrends. The type oftrend displayeddepends on thefactory or customdefault setting.

Main View(5000 only)Press once to closeall open menus andinformationwindows and returnto the main display.

Equipment Overview

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Dash 3000 Control Panel

Quick function keys Provides direct action to

certain options. Trim Knob: Turn and

push.

Equipment Overview

GRAPH GO/STOP

SILENCE ALARM

TRIM KNOB

ZERO ALL

NBP GO/STOP

POWER

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push.

POWER GRAPHGO/STOP

NBP GO/STOP ZERO ALL SILENCEALARM

TRIM KNOB

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push.

SILENCEALARM

TRENDNBPAUTO

POWER TRIMKNOB

ZEROALL

STANDBY

PRINTADMIT/DISCHARGE

NBPGO/STOP

MAINVIEW

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Operations Trim Knob: The Trim Knob

is found on the monitor orremote control and is usedfor highlighting andselecting menu options. Turn the Trim Knob to

highlight desired menuoptions.

Once you havehighlighted the menuoption, press to select.

Indicators Alarm Light: This is an

optional light indicator builtinto the handle or displaybezel that indicates analarm condition.

Power Indicator: AC poweror battery power source ofmonitor.

Charging Status: Chargingstatus of internal batteries. Yellow: Battery charging. Green: Fully charged No Light: Battery not

installed, not charging, orasleep. Monitor may alsobe using the battery forpower.

TrimKnob

PowerIndicator

ChargingStatus

AlarmLight

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Patient CableConnectors All patient cable connectors

are located on the side ofthe monitor.

Enabled Option Labels Identifies the options

enabled on the monitor.

Definition of Terms Hardwire: This means that

the ECG signal is beingacquired from a cableattached to the patient andconnected to a bedsidemonitor.

Telemetry: This meansthat the ECG signal is beingacquired from a telemetrytransmitter/transceiver.This patient is able toambulate without beinglimited by a cable.

TTX: Refers to a telemetrytransmitter/transceiver.

GREEN:ECG

EnabledOptionLabels

BROWN:CO / Temp

BLUE:SPO2

RED:Invasive

Pressures

BLACK:NBP

YELLOW:CO2

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Built-In Writer Prints on two-inch wide

paper.

Battery Doors Holds up to two batteries to

provide power duringpatient transport orwhenever AC power isinterrupted.

Built-InWriter

BatteryDoors

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Speaker Provides an audible

announcement of patientand system status alarms.

Defib Sync Connector Provides analog output

signals to other equipment.

Aux Connector Provides serial connection

to compatible auxilliarydevices, including: Remote control Tram-Rac housing Remote display Nellcor 395 pulse

oximeter Aspect BISx module

Ethernet Connector Provides network

connections to othermonitors and devices usedin the patient monitoringnetwork.

DC Power

Product Code Label Identifies product code for

identification and serviceneeds.

EthernetConnector

Speaker

Defib SyncConnector

AuxConnector

ProductCode

DCPower

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11

The Basics Display

1 Time and Date

2 Factory orCustomDefault Name

3 Care UnitName

4 Bed Number

5 Patient Name

6 ParameterWindows

7 Battery Gauge

8 Optional LargeClock/Date

9 More Menus

10 Message Line

11 Waveforms

Basic Use Admit / Discharge

1 2 3 4

8

5

10 9 7 6

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Basic Use Admit / Discharge

The Basics Parameter Window

1 Digital Values

2 Parameter Window Label

3 Alarm Limits

4 Units of Measurement

1

2

3

4

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MonitoringAdmit ModesThe bedside monitor can be usedin four different ways dependingon hospital need. Differencesbetween each application will beapparent in the monitors admitmenu.

StandardThis application uses a monitormounted in a room. It has onlyhardwire capability and does notaccommodate telemetry.

To Admit a Patient Select MORE MENUS. Select ADMIT MENU. Select ADMIT PATIENT.

NOTE: Dash 5000:

The Admit/Discharge key onthe front of the monitor canalso be used to Admit orDischarge the monitor.

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Standard (continued) To Discharge a Patient

Remove all ECG leads fromthe patient.

Select MORE MENUS. Select ADMIT MENU. Select DISCHARGE

PATIENT. Turn the Trim Knob to move

the cursor in front ofDischarge and press toselect.

A messageDISCHARGEDandALL ALARMS OFFwill appear on thedisplay when themonitor is in adischarged mode.

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How to EnterDemographicInformation Select MORE MENUS. Select ADMIT MENU. Select CHANGE ADMIT

INFO. An informationwindow with menu optionsis displayed.

Rotate the Trim Knobcontrol to move thepointer (>); repeat the press,turn, press process to entercharacters or makeselections.

Select RETURN after allinformation is entered.

Select desired option:SAVE CHANGES or DONOT SAVE CHANGES.

NOTE: If the monitor is connected toa CIC, the Name and ID Number maybe entered from the CIC instead ofthe bedside. All other informationmust be entered at the bedsidemonitor.

Recall Defaults This menu allows the

clinician to recall previouslynamed monitor defaultswhile monitoring anadmitted patient.

Up to five sets of defaultscan be programmed.

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RoverThis application allows themonitor to be moved or rovedto the patients bedside. It hasonly hardwire capability anddoes not accommodatetelemetry.

To Admit a Patient Connect the AC Power

source. Connect the Network cable.

NOTE: Network cable is not requiredwhen using wireless Dash.

Push the Power button toactivate the display.

Select MORE MENUS. Select ADMIT MENU. Select SET UNIT NAME. From the information

window, move cursor infront of the desired unit.

Select SET BED NUMBER. From the information

window, move cursor infront of the desired bednumber.

Select ADMIT PATIENT.NOTE: The Unit Name and BedNumber windows should appearautomatically. If not, check that thenetwork cable is connected.

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Rover (continued) To Discharge a Patient




the cursor in front ofDischarge and press toselect.

A message DISCHARGEDand ALL ALARMS OFF willappear on the display whenthe monitor is in adischarged mode.

Push the Power button toturn the display off.

Store the monitor with ACpower cord plugged in anddisplay off.

NOTE: It is recommended to leavethe network cable plugged in andthe Dash display on for two minutesfollowing discharge (if applicable).

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ComboThis application uses a monitormounted in a room, but the ECGdata can be acquired from eitherthe monitor or a telemetrytransmitter/transceiver.

To Admit a Patient toHardwire (the monitor) Select MORE MENUS. Select ADMIT MENU. Select ECG SOURCE. Turn the Trim Knob to move

the cursor in front of thedesired telemetrytransmitter/transceiveror MONITOR and press toselect.

Select ADMIT PATIENT.

NOTE: If the Telemetry transmitter/transceiver is being used for the ECGsignal, the TTX number will appear inthe ECG parameter box.

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Combo (continued) To Discharge a Patient




the cursor in front of thedesired discharge optionand press to select. Return: Cancels the

action and exits to MainMenu.

Monitor: Discharges onlythe bedside monitor.

Telemetry: Dischargespatient from telemetry.

Both: Discharges boththe monitor andtelemetry.


NOTE: When discharging ONLY thebedside monitor, all stored vital signdata will be deleted. The only datawhich remain available will be: HR,ST, PVC, and Alarm Histories.

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Rover-ComboThis application combines themobility feature of Rovermonitoring with the telemetrycapabilities of Combomonitoring.

To Admit a Patient Connect the AC Power

source and Network cable.NOTE: Network cable is not requiredwhen using wireless Dash.

Push the Power button toactivate the display.

Select MORE MENUS. Select ADMIT MENU. Select SET UNIT NAME. Move cursor in front of the

desired unit. Select SET BED NUMBER. Move cursor in front of the

desired bed number.

Select ECG SOURCE. Move cursor in front of the

desired transmitter/transceiver or MONITORand press to select.

Select ADMIT PATIENT.NOTE: If the Unit Name, Bed Numberor ECG Source windows do notappear, check that the network cableis connected.

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Rover-Combo (continued) To Discharge a Patient

Remove all ECG leadsfrom the patient.



the cursor in front of thedesired discharge optionand press to select: Return: Cancels the

action and exits to MainMenu.

Monitor: Discharges onlythe bedside monitor.

Telemetry: Dischargespatient from telemetry.

Both: Discharges boththe monitor andtelemetry.


Push the Display On/Offbutton to turn the displayoff.

Store the monitor with theAC power cord plugged inand the display off.

NOTE: When discharging ONLY thebedside monitor, all stored vital signdata will be deleted. The only datawhich remain available will be: HR,ST, PVC, and Alarm Histories.

NOTE: It is recommended to leavethe Network cable plugged in andthe Dash display on for two minutesfollowing discharge.

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Silence Alarm Pressing the Silence Alarm

key once will silence anactive alarm for oneminute. The messageSILENCED will appear onthe display. Any new alarmat an equal or greaterpriority will sound.

Pressing the Silence Alarmkey twice if an alarm issounding will start anALARM PAUSE. The lengthof pause will varydepending on the monitorsmode. The messageALARM PAUSE will appearon the display.

Alarms will reactivate if theSilence Alarm key ispressed again.

An Alarm Pause willimmediately be activated ifthe Silence Alarm key ispushed in the absence ofan alarm. NOTE: Alarm Pause Lengths:

Adult ICU Mode:5 minutes.

Neonatal ICU Mode:3 minutes.

Operating Room Mode:5 minutes. 15 minutes,Alarm Paused(permanent pause).

ALARM PAUSED 4 min

SILENCED

NOTE: If Crisis Alarm Breakthroughis set in defaults, all crisis alarms willbreak through Alarm Silence andAlarm Pause.

Silence Alarm Key

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ECG / Pace

ST Measurement Point

PVC Count(Full Arrhythmia Only)

Heart Rate

Heart RateAlarm Limits

ST Analysis Data

Pace DetectionIndicators

QRSIndicator

ECG Skin Preparation and

Lead PlacementThe quality of the signalreceived from the electrodesis a direct result of skinpreparation and leadplacement. Clip or shave hair from

application sites. Gently rub the area with a

gauze pad to remove deadskin cells.

Cleanse site with alcohol ormild soap and water.

Dry skin completely. Apply electrodes according

to manufacturersrecommendations.

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ECG / Pace

Display LeadTop or first leaddisplayed on thebedside and graphedwith alarms and manualprints.

SizeChanges the size ofall ECG waveformsdisplayed and graphed.1X is the standard size.

NOTE: At least a 0.5 millivolt QRScomplex at standard size is neededfor beat detection.

To Change theDisplay Lead: Select ECG. Select DISPLAY

LEAD II. A popup menu

opens. Move the cursor in

front of the desireddisplay lead andpress to select.

Select MAIN MENUto exit.

To Adjust ECG Size: Select ECG. Select ECG SIZE. Turn the Trim Knob

to highlight desiredselection and pressto select.

Select MAIN MENUto exit.

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Detect PaceTurns pacemakerdetection On/Off. Two different options of

pacemaker modes areavailable. The clinicianmust judge which mode isbest for each patient.Pace 2 is the recommendedpacemaker detection mode.Pace 1 should be used ifPace 2 does not adequatelydetect pacemaker spikes.

To Activate orDeactivate thePacemaker Mode: Select ECG. Select DETECT PACE. Turn the Trim Knob in

front of the desiredpacemaker mode andpress to select.

Select MAIN MENU toexit.

NOTE: A P appears in the ECGparameter window when pacedetection is enabled. An * willappear if a paced beat is detected.

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Pace 2 ModeAnalyzes waveformswith the addedcapability of minimizingthe chance of countingsevere residualpacemaker energy as aQRS complex. Pace 2may not adequatelydetect all QRSmorphologies.Arrhythmia calls such asAsystole or Pause maybe made with heart rateidentified as less thanactual.

NOTE: Pacemaker patients shouldbe kept under close observation.

Pace 1 ModeAnalyzes the presence ofpacer spikes, assessesthe waveform forresidual pacemakerenergy and determinesthe presence of anR-wave following thepacemaker spike.

If an event occurs duringthe first few millisecondsfollowing the spike, it willbe counted as a pacedspike.

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Guidelines forSuccessful PacemakerMonitoring Multi-vector pace detection

is determined bysimultaneous analysis ofthe displayed ECG Lead andthe Vector Lead.

Adequate pacemakerdetection is directlydependant on the quality ofthe ECG waveform. Properskin preparation andelectrode placement areessential.

Ensure that the pacedetection mode isactivated.

All detected pacemakerspikes will appear upright,uniform and white on thedisplay screen.

If the monitor is notadequately detectingpacemaker spikes as evidenced by heart ratedouble counting,pacemaker spikes notdetected, alarms for lowheart rate or asystole it is recommended that youchange the electrodeplacement to arecommendedconfiguration.

After changing electrodeplacement, alwaysRELEARN the ECGwaveform. If adjusting theelectrode placement doesnot resolve the detectionissue, change the pacedetection mode to Pace 1and RELEARN.

Recommended Alternative Lead Placements

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Limits To Change the ECG

Alarm Limit: Select ECG. Select ECG LIMITS. Select desired alarm limit . Turn the Trim Knob to the

desired alarm limit andpress to select.


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View All ECGAllows six leads of ECG tobe viewed on thedisplay. To View All ECG:

Select ECG. Select VIEW ALL ECG. Six waveforms will be

displayed.

Press GRAPH GO/STOP toprint displayed leads.

Press the Trim Knob toremove displayed leads.


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ArrhythmiaArrhythmia processingcan be manuallychanged to one of thefollowing conditions: Full: Expands detection

to all arrhythmia conditionsdefined by the softwarelevel.

Lethal: Arrhythmiaprocessing is limited toAsystole, VFib/VTac andVTach.

Off: Disables all arrhythmiaalarms. Parameter alarmsremain active.

To Change theArrhythmia ProcessingMode: Select ECG. Select ARRHYTHMIA. Turn the Trim Knob to

move the cursor in frontof the desired arrhythmiaprocessing mode andpress to select.

Select MAIN MENU toexit. NOTE: A minimum arrhythmia

processing mode can be set up inthe monitor defaults.

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RelearnDuring ECG monitoring, itmay be necessary torelearn the ECGwaveform if a change inthe patients normal ECGpattern has occurred, orthe electrode placementhas changed. A change in the ECG

pattern could result in: Incorrect arrhythmia

calls. Loss of ST measurement. Inaccurate heart rate

detection. To Relearn the ECG

Waveform: Select ECG. Select RELEARN. The ECG parameter

window will replace theHR with an X and themessage Learning willappear above the displaylead.


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Single Lead vs.Multi-LeadThis option examinesECG leads utilized forarrhythmia analysis. Multi-Lead Analysis

examines ECG leadsI, II, III and V to helpeliminate false alarmsand improve the abilityof the system to: Detect beats that occur

isoelectric to a singlechest lead.

Discriminate artifact thatappears in one leadcompared to other leadvectors.

Provides a Smart LeadFail feature where thefailed lead is identifiedand, if available, anotherlead is provided fordisplay.

Continue arrhythmiaprocessing after a leadchange.

Single Lead Analysis usesonly the top displayed leadto process heart rate andarrhythmia information.

Single Lead Analysis canbe beneficial whentroubleshooting heart rateand arrhythmia alarms.

To Change to SingleLead Analysis: Select ECG. Select LD ANALYSIS:

MULTI-LEAD. Move the cursor in front

of Single Lead and pressto select.


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IntelliRateThis option utilizesinformation contained inmultiple physiologicsignals (e.g., ECG, arterialblood pressure, andpulse oximetry) toimprove the accuracy ofthe heart ratecalculation.After assessing theinformation extractedfrom each of thephysiologic signals, theIntelliRate algorithmapplies rule-based logicto determine whichheart rate source hasthe highest liklihood ofbeing accurate.By reporting the mostaccurate rate, thetrended heart rate ismore accurate, andoccurrances of falseheart rate limit violationalarms are greatlyreduced.

ECG Menu

More ECG Menu

Examples of ECG Parameter Windows with the source of the IntelliRate comingfrom SPO2 and ART

NOTE: If the heart rate source isECG, IntelliRate assumes the ECGheart rate and does not apply to thesource..

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ECG Menu

More ECG Menu

Beat Pause IntervalThis feature allows theclinician to select themaximum pausebetween consecutiveheart beats before analarm sounds. Selections available

are from one to fiveseconds in one-halfsecond intervals.

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12-Lead ECG / ST Analysis

12-Lead ECG Analysis To Obtain a 12-Lead on

a Patient Place patient in a supine

position. Correctly identify and apply

all 10 electrodes. Select the ECG Parameter

Window. Select 12-LEAD ECG

ANALYSIS.NOTE: For the most accurate serialcomparison, use the same electrodeconfiguration used on previousanalysis.

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Lead Electrode LocationV1 Fourth intercostal space at the right

sternal border, right chest.V2 Fourth intercostal space at the left

sternal margin border left chest.V3 Midway between locations V2 and V4

left chest.V4 Mid-clavicular line in the fifth intercostal

space, left chest.

V5 Anterior axillary on the same horizontallevel as V4 level, left chest.

V6 Mid-axillary line on the same horizontallevel as V4 and V5, left chest.

LA Resting ECG: Left deltoid or left wrist.RA Resting ECG: Right deltoid or rightwrist.LL Resting ECG: Left thigh or left ankle.RL Resting ECG: Right thigh or right ankle.

V3R Midway between locations V1 and V4R,right chest.

V4R Mid-clavicular line at the fifth intercostalspace, right chest.

V5R Anterior axillary line on the samehorizontal level as V4R, right chest.

V6R Mid axillary line on the same horizontallevel as V4R and V5R, right chest.

Lead Electrode LocationV7R Right posterior axillary line, V6R level.V8R Under right mid-scapular line, V6Rlevel.V9R Right paraspinal border, V6R level.V7 Left posterior axillary line, V6 level.V8 Under left mid-scapular line, V6 level.V9 Left paraspinal border, V6 level.

V4V3

V1V3R

V2

V4R V6

RA

LLRL

V5V5RV6R

LA

V9V7 V9RV8 V8R V7R

LLRL

LARA


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Select 12-LEAD ECG NOW.Message appears:PERFORMING ANALYSIS.Please wait After 30seconds, an unconfirmed12-Lead ECG Analysiswindow will appear.

Select One of thefollowing Transmissionand/or printing options: Return: Exit to 12-Lead

menu. Transmit: Send

12-lead for storage toMUSE. No printed copyon unit.

Print: Print copy to laserprinter on unit. No 12-Lead stored at MUSE.

TransmitPrint: Send12-Lead for storage toMUSE and print copy tolaser printer.

Delete: Erase theanalysis without storingor printing.

12-Lead is completed.The last 12-Lead analysiswindow is available for reviewunder REVIEW 12 LEAD ECG TOTRANSMIT OR PRINT.

12-Lead ECG / ST Analysis

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To Enter PatientDemographics Select ADMIT INFO. Select CHANGE ADMIT

INFO. Enter Information:

First Name Last Name Patient ID: Facility

Specific, (i.e., MedicalRecord Number, SocialSecurity Number, etc.)

Sex Birth Date Age: Correct age impacts

the analysis.

Height Weight Location ID: Identifies

origin of 12-Lead toMUSE for transmission.(Set in defaults. For rovermodes, set in admitmenu).

Site Number: Identifieshospital to MUSE fortransmission.(Set in defaults).

NOTE: Accurate demographics mustbe entered to ensure properanalysis.

When monitoring ECG,entering the sex and ageof the patient willprovide informationneeded for using the12SL Algorithm withGender-Specific Analysis(or the ACI-TIPIalgorhythm). The 12SL Algorithm with

Gender-Specific Analysisimproves the detection ofacute myocardialinfarctions (AMI) for adultwomen under the age of60.

If the date of birth is notentered, the system will setthe date of birth to thecurrent month and day, butthe year will be set to 1948.

ACI-TIPI analysis cannot beperformed on patients lessthan 16 years of age.

NOTE: If ACI-TIPI is enabled,other fields may be required; i.e.,Technician ID, Optional Field, OrderNumber.

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ST Analysis ST Menu Options

ST information with trendsand complexes may appearin a waveform position.

ST by lead data mayappear in the ECGParameter window.

The lead with the mostdeviation from theisoelectric line appears inthe ECG Parameter window.The ST value is updatedregularly and changes tothe alarming lead whenlimits are exceeded.

NOTE: ST options may varydepending on monitor defaultconfiguration.

NOTE: The accuracy of the STAnalysis is dependent on theplacement of the electrodes.

ST Trends andComplexes The monitor has an ST

display which consists ofthree, 30-minute ST trendsand three ECG complexes.

The reference complexis in back of thecurrent complex

Data is outside ofthe displayed scale

A reference complex foreach of the selected leadscan be displayed for visualreference purposes whenST is on.

The current complex issuperimposed (green) overthe reference complex(gray).

ST MeasurementPoint

PVC Count(Full Arrhythmia Only)

Heart Rate

Heart RateAlarm Limits

ST AnalysisData

Pace DetectionIndicators

QRSIndicator

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Turn ST ON/OFFTurns ST Analysis off andreturns to the mainmenu. To Turn ST Analysis

Program Off: Select ECG. Select ST ANALYSIS. Select TURN ST OFF. Display automatically

returns to the Main Menu. To Turn ST Analysis

Program On: Select ECG. Select ST ANALYSIS. ST complexes and

numerics automaticallyappear on the display.

Select MAIN MENU toexit. Store New References

Displays a new set ofreference complexes onthe screen to use as avisual reference. To store new references:

Select ECG. Select ST ANALYSIS. Select STORE NEW

REFERENCES.

Select YES from thepopup menu.The reference complexesshown on the display willnow reflect the currentcomplexes.


NOTE: Selecting STORE NEWREFERENCE does not affect actualST processing, it is for visualreference only.

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ST LimitsDisplays a menu andinformation window toset and adjust STdeviation limits. To Adjust All ST Limits:

Select ECG. Select ST ANALYSIS. Select ADJUST ALL

LIMITS. Turn the Trim Knob to the

+ / desired limit andpress to select.

All limits areautomatically adjusted inthe information window.

The monitor adjusts thelow and high limitsaround the current valueof the lead(s).


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Identify V LeadIdentifies the V Lead beingused for ECG and ST Analysis.

To Change the V Lead: Select ECG. Select ST ANALYSIS. Select IDENTIFY V LEAD. Move the cursor in front

of the desired V Lead andpress to select.


NOTE: With a 5-leadwire cable,the V Lead is used in ST Analysis andarrhythmia analysis.

Changing this label changes thelabel on the V-lead trend andcomplex.

NOTE: With a 10-leadwire cable,the V Lead is used for arrhythmiaanalysis only. Changing this labelDOES NOT change the label on theST display. Use the ST display menuto change the label.

Identify Leads

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ST DisplayChanges the leads forthe trends andcomplexes display. To Change the

Displayed ST Leads: Select ECG. Select ST ANALYSIS. Select ST DISPLAY. Turn the Trim Knob to

deselect one of the threeselections beforeselecting another.


NOTE: A maximum of three choicescan be selected for the ST Display.

ST Display

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Pulse RateValue

NBP

NBP Non-Invasive Blood

Pressure (NBP)Non-invasive blood pressureis measured using theoscillometric method.The cuff is inflated to occludethe artery and then releasedin increments. The monitordetermines the point ofmaximum pulsation, which isthe mean arterial bloodpressure. The systolic anddiastolic pressures are thendetermined.

NOTE: Countdown Timer: AUTO isdisplayed instead of the minutes ifa time interval greater than 60minutes is selected.

Pulse Rate ValueThis can be turned On or Offto display pulse rate values inthe parameter window.The monitor must be set inthe individual threewaveforms display mode.The pulse rate value does notdisplay in any other displaymode.

Time of LastMeasurementand Cuff Size

Diastolic Value

Limitsand

Units

Systolic Value

Mean ValueCountdownTimer

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NBP Go/StopThe NBP quick functionkey on the monitor startsor stops a bloodpressure measurement.

NBP AutoThis option allows themonitor to beprogrammed to takeNBP readingsautomatically at specifictime intervals or createyour own custom seriesof automaticmeasurements.

To Program NBP for theAuto Mode: Select NBP. Select NBP AUTO. A popup menu appears. Choose the appropriate

time interval or chooseCUSTOM.


NBP

NOTE: The NBP measurement forthe auto option is set in the monitordefaults and can be timed in twodifferent ways:

1. Regular Timing:NBP measurement is taken at aspecific time interval regardless ofthe actual clock times.

2. Clock Sync Timing:NBP measurement is synchronizedto specific clock times.

NOTE: Turning the Auto mode Off,then On, restarts the timing cycle.

NBP Go/Stop Key

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Custom Auto SetupYou can select up to fourindividual series with aspecific time intervalbetween measurementsand the number ofmeasurements toperform. To Program Custom

Auto NBP: Select NBP AUTO. A popup menu appears. Select CUSTOM. Turn the Trim Knob to

change the series intervaland repetitions if desired.

Select START CUSTOMAUTO at the end and themenu will automaticallyreturn to the main screen.

NOTE: You can also go directly toyour CUSTOM AUTO SETUP menu inthe NBP menu.

NOTE: Dash 5000 The NBP Autokey will take you directly to theCUSTOM AUTO SETUP menu.

NBP Auto Key

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Review NBPThe monitor can store upto 96 NBP readings forreview. To Review NBP

Readings: Select NBP. Select REVIEW NBP. An information window is

displayed.

Select VIEW NEWER/VIEW OLDER from themenu options to obtainall data.

Press the GRAPH GO/STOP button on themonitor to print displayedvital signs.


NOTE: Dash 5000 You can easilyaccess NBP readings by choosingthe trend key on the front of themonitor.

NBP LimitsAllows NBPalarm limits tobe adjusted. To Change

NBP Limits: Select NBP. Select NBP

LIMITS. Select the

desired NBPlimit.

Turn the TrimKnob to thedesired limitand press toselect.

Select MAINMENU to exit .

NOTE: The above stepsapply to changes madeto systolic, diastolic andmean NBP limits.

Trend Key

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Cuff SizeThe Cuff Size optiondetermines the initialinflation pressure. Thisoption sets the monitorfor the appropriate cuffinflation. Three optionsare available: Adult: 160 mmHg. Pediatric: 140 mmHg. Neonatal: 125 mmHg.With additional bloodpressure measurements thecuff inflation pressure is30 mmHg for Adults and25 mmHg for Pediatric/Neonatal over the last systolicblood pressures. To Change the Cuff Size:

Select NBP. Select CUFF SIZE. Move the cursor in front

of the desired cuff sizeand press to select .


NOTE: The Cuff Size is automaticallyset if the patients age is entered inthe Admit Menu.

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Clear NBP ReadingThis option removes thecurrent NBP readingfrom the parameterwindow and vital signshistory. An X willreplace the numericvalues in the parameterwindow. To Clear NBP Reading in

the Parameter Window: Select NBP. Select CLEAR NBP

READING. Xs will be placed in the

parameter window. Select MAIN MENU to

exit.NOTE: Clearing the NBP reading alsoremoves the value from the vitalsigns history.

NOTE: The NBP values change to Xsif no NBP monitor has taken place fortwo hours in the Adult ICU mode, 15minutes in Operating Room modeand 12 hours in Neonatal ICU mode.

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SpO2

SpO2 SpO2 monitoring is a

non-invasive techniqueused to measure theamount of oxygenatedhemoglobin and pulserate by measuringabsorption of selectedwavelengths of light.

To activate SpO2monitoring, securelyconnect the SpO2 cableinto the appropriate blueport on the Dashmonitor. The SpO2parameter window willautomatically appearonce the SpO2 sensor isconnected to the cableand plugged into themonitor.

To discontinue SpO2monitoring, remove thecable from the monitoror disconnect the SpO2sensor from the cable.The SpO2 window will beremoved from thedisplay.

Pulse RateValue

SpO2Value

Limitsand Units

SignalStrengthIndicator

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SpO2

There are threeindications from themonitor that verify thequality of the data beingdisplayed Signal Strength

Indicators: Consists of 0, 1, 2, or 3

asterisks, 3 being thestrongest.

Proper environmentalconditions and sensorattachment will helpensure a strong signal.

NOTE: When monitoring SpO2 usingNellcor OxiSmart technology andthe SAT-Seconds feature is active,the signal strength asterisks may notbe displayed. If they are notdisplayed, signal strength may bedetermined by the amplitude of theSpO2 waveform.

Quality of the SpO2Waveform: Noise or artifact may be

due to poor sensorplacement or patientmovement.

Frequent, erratic changesin the value or waveformmay indicate a poorsignal.

NOTE: When using Masimo SETtechnology, the waveform cannot beutilized as a quality indicator due tothe fact that the motion artifact isfiltered.

Waveform

The Stability of theSpO2 Values: Compare the pulse rate in

the SpO2 parameterwindow with a manualpulse, or the ECG heartrate in the ECGparameter window.

NOTE: It is critical to observe allthree indicators at the same time.

Example of a GoodQuality SpO2 Waveform

Signal Strength Indicator

PulseRateValue

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Patient Preparation forSpO2 Monitoring Choose the sensor that is

best suited for yourpatients needs: ear, finger,disposable, reusable, etc.

Clean the surface of thesensor before and aftereach use except whenusing disposable sensors.

Following the instructionsprovided with the sensor,correctly position andattach the sensor to yourpatient.

When a Masimo sensor isrepositioned at any time,disconnect the cable fromthe sensor beforerepositioning.

Reconnect the sensor to thecable after proper patientpreparation and placement.

It is Important to beAware of the Followingwhen Monitoring SpO2 A poor SpO2 signal may

result if the sensor detectoris exposed to strongambient light.

When securing the sensor,ensure nothing is blockingthe sensor light detector.

Prolonged monitoring mayrequire changing the sensorsite periodically. Move thesensor if there is any sign ofskin irritation or impairedcirculation.

Change the sensor site atleast EVERY FOUR HOURSto prevent skin breakdown.

Do not use SpO2 sensorsduring MRI scanning.Induced current couldpotentially cause burns.

Neonates and Infants When using pulse oximetry

on neonates and infants,always observe thefollowing precautions: The peripheral pulse rate

(PPR), as determined bythe SpO2 function, mustbe within 10% of theheart rate.

The SpO2 signal strengthin indicator must havetwo or three asterisksdisplayed.

You may need to changethe sensor site at leastEVERY TWO HOURSto prevent skinbreakdown.

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The Dash monitorincorporates severaldifferent technologyoptions for interpretingSpO2 values: Masimo SET Nellcor OxiMAX GE OhmedaTo determine the optionenabled on the monitor, lookon the right side of themonitor, next to the patientconnectors.

All SpO2 technologiesinclude the followingmenu options Size: Adjusts the size of the

displayed SpO2 waveform.The default size is 1X.

To Change the Size: Select SpO2. Select SIZE. Turn the Trim Knob to

highlight the desired sizeand press to select .


Rate: A pulse rate is derivedfrom the SpO2 signal and isdisplayed in the parameterwindow.

This can be turned Onor Off.

Rate Volume: The ratevolume turns on a tone thatsounds each time an SpO2pulse is detected. This is avariable pitch tone whichchanges as the patientssaturation level changes.A drop in saturation resultsin a change in pitch of thetone.

NOTE: Turning the SpO2 rate volumeon automatically turns the QRSvolume off and vice-versa.

NOTE: When two SpO2 sites arebeing monitored, the rate volumecan only be turned on for one site ata time.

SpO2 Limits: Allows SpO2percent and rate alarmlimits to be adjusted.

To Change SpO2 Limits: Select SpO2. Select SpO2 LIMITS. Select the desired SpO2

limit .

Turn the Trim Knob to thedesired SpO2 limit andpress to select.


Persistent SpO2 allowsthe SpO2 parameter box toremain on the display afterthe SpO2 cable has beendisconnected. Theparameter box displaysPROBE OFF PATIENT and analarm sounds at both themonitor and central station.This option may be turnedon or off in the SpO2 menuif enabled in the defaults.

Speed: This represents thesweep speed of thewaveforms.

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SpO2 Menu Masimo SET

SpO2 Masimo SETallows the sensitivity andaveraging times to beadjusted: Sensitivity options

include: Normal, for routine

patient monitoringpurposes.

Maximum for improvedlow perfusionperformance and forfaster tracking of SpO2changes.

Averaging MenuOptions: Determines how many

seconds the collectedSpO2 information isaveraged.

Options for averagingtimes are: 2, 4, 8, 10, 12,14, or 16 seconds.

The signal strengthindicator denotesperfusion quality. Zero asterisks means

no signal. Three asterisks indicates

high perfusion level.NOTE: With motion, the SpO2waveform is often distorted. WithMasimo SET technology, the SpO2waveform is not an indication ofsignal quality or validity.

Rejuvenating theAdhesive Properties ofthe DisposableSaturation Sensor: Rejuvenate the sensor at

least once per shift andPRN.

Rub the adhesive sides ofthe sensor with an alcoholpreparation pad.

After the sensor has driedfor at least one minute,replace it on the site.

NOTE: It is recommended that theadhesive tapes be changed withevery site change. Adhesive tapecan not be rejuvenated.

Perfusion(Signal Strength)

Indicators

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SpO2 Nellcor OxiMAXTechnologyThe following guidelinesapply: Response: The time

period for acquiringmeasurement averageis adjustable. Normal: Report changes

within four to six seconds.

Fast: Report changes inless than four seconds.

Sat-Seconds: Controlsthe amount of timethat SpO2 saturationmay be outside the setlimit before an alarmsounds. This helpsdecrease the likelihoodof false alarms causedby motion artifact.

NOTE: When the Sat-Secondsfeature is active, the signal strengthasterisks may not be displayed. Tohelp determine signal strength, usethe amplitude of the SpO2 waveform.

SpO2 Menu Nellcor OxiMAX

Sat-seconds Display: When an SpO2

saturation valueexceeds an alarm limit,a pie chart in theparameter windowbegins to fill in aclockwise direction.

As the seconds passand the value iscompared against thealarm limits, the Sat-Seconds setting in thechart fillsproportionally.

When the pie chart iscompletely filled,indicating theSat-Seconds limit hasbeen reached, an alarmsounds. When theSpO2 value is within theset limits, theSat-Seconds pie chartempties in acounter-clockwisedirection.

NOTE: When three or more limitviolations occur within 60 seconds,an alarm sounds even if thesat-seconds limit has not beenreached.

Sat-SecondsPie Chart

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SpO2 GE OhmedaTechnologyThe following guidelinesapply: Adult Measurements:

Averaged over asix-second time period.

NeonateMeasurements: Averaged over a

12-second time period.The longer averagingtime decreases falsealarms from patientmotion artifact .

NOTE: Ohmeda OxyTip+ sensors andNellcor R-Cal technology compatiblesensors are supported.

SpO2 Menu GE Ohmeda

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Respiration / Temperature

Respiratory Rate Respirations are

detected by measuringthoracic impedance.Respirations can bemonitored in Lead I forchest breathers orLead II for abdominalbreathers. To Change the

Respiratory Lead: Select RESPIRATION. Select LEAD. This option switches

between Lead I andLead II.


NOTE: Changing the leadsautomatically starts the relearningprocess.

Lead Monitored

Respiration Rate

Limitsand Units

Breath Indicator

Upper Chest Breathers Lead I Abdominal Breathers Lead II

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Relearn RespirationThis option may benecessary if the patientsbreathing pattern haschanged or the monitoris not calculating therespiratory ratecorrectly. This processtakes eight breaths tocomplete. To Relearn the

Respiration: Select RESPIRATION. Select RELEARN

RESPIRATION. A learning message will

appear in the respirationsparameter window.


Example of a Good Respiratory Waveform

Expiration MarkerInspiration Marker

Respiration / Temperature

Relearn Respiration

Respiratory Limits Information Window

Respiration Limits To Change the

Respiration Limits: Select RESPIRATIONS. Select RESPIRATION

LIMITS. Select the desired

respiratory rate limit orapnea limit.

Turn the Trim Knob to thedesired respiratory rateand press to select .


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SensitivityThe monitorautomatically sets thedetection sensitivity at40% of the averageamplitude.The sensitivity may needto be changed due tovarying amplitudes orartifact. The lower thepercentage, the greaterthe detection sensitivity. To Change the

Sensitivity: Select RESPIRATIONS. Select SENSITIVITY. Turn the Trim Knob to the

desired percent and pressto select.


NOTE: The RELEARN option willreturn the sensitivity to 40%.

NOTE: As you change the sensitivitypercentage, the markers will moveon the waveform. The adjustmentoccurs immediately

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Temperature Temperature monitoring

can be done usingmultiple sites withinternal or externaltemperature sensors.The temperature sitesare identified in theparameter window as T1and T2. Only numericinformation is displayedin the temperatureparameter window. Temp Sites and Units

Temp Limitsfor One Site

Temperature menuoptions include: T1: This turns monitoring

ON or OFF at temperaturesite 1.

T2: This turns monitoringON or OFF at temperaturesite 2.

Units: Switches the unitsof measure betweenCelsius and Fahrenheit.

To Change theTemperature Limits: Select TEMPERATURE. Select T1 or T2. Turn the Trim Knob to the

desired temperature limitand press to select .


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Temp Value


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PABP 2

ARTBP 1

Invasive Pressure / PA

Invasive Pressures The invasive pressure

labels are displayed onthe monitor with anumber (1 4). Thesenumbers identify thelocation in the Dashmonitor.A maximum of sixwaveforms and eightparameters can bedisplayed on the monitorwhen using individualscale mode.

Invasive Pressure Insertion. To activate invasive

pressure monitoring,securely connect thetransducer cable into theappropriate red port onthe side of the Dashmonitor. The invasive parameter

window willautomatically appearonce the cable is pluggedinto the Dash monitor.

To discontinue invasivemonitoring, remove thecable from the monitor.The parameter windowwill be removed fromthe display.

Preset names are assignedto each pressure port: BP 1: Arterial Line BP 2: PA Line

NOTE: Up to two additional InvasivePressures can be monitored whenusing bifurcated cable plugged intothe invasive ports. If plugged intoBP1, it is labeled BP1/BP3. If it isplugged into BP2, it is labeledBP2/BP4.

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Inavsive Pressure / PA

Pressure Menu Options Invasive Pressures

ZeroingIn order to obtainaccurate pressuremeasurements, it isimportant to zero thetransducers.Transducers can bezeroed all at once orindividually. To Zero Pressure

Transducers: Open the transducers to

air. Press the ZERO ALL key

on the monitor. Verify the zero reference

is established. Close the transducer to

air. Once the transduceris closed, the pressurenumerics will bedisplayed.

NOTE: Transducers can be zeroedindividually under the appropriateparameter window menu optionlabeled ZERO.

All Pressure MenusInclude the FollowingOptions

Scales Cursor Clear Cursor Limits Change Name Zero BP Filter Calibrate Transduce Speed

Zero All Key

The only difference is thesite name. For example,CVP cursor, PA cursor,ART limits, PA limits, etc.

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Invasive Pressures Scales To Change the Scale of

the Pressure Waveform: Select the desired

pressure parameterwindow.

Select SCALES. A popup menu opens

indicating the availableoptions.

Move the cursor in frontof the desired scale andpress to select.


NOTE: Selecting AUTO will calculatea scale based on the patientscurrent pressure.

NOTE: AUTO is an option only if thepressure has been zeroed.Auto-scaled waveforms graphdifferently than displayed.

Invasive Pressures Cursor The cursor option places a

moveable, dashed,horizontal line across thepressure waveform to giveaccurate values at selectedpoints on the pressurewaveform. Numeric data isdisplayed to the right of thecursor.

To Remove the Cursorfrom the Waveform: Select CLEAR CURSOR. This is a direct action

menu option. Select MAIN MENU to

exit.

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Invasive Pressures Change Names Having the invasive

pressure port namedproperly is important forproper waveformprocessing and scaling.

To Change the Name: Select the desired

pressure parameterwindow.

Select CHANGE NAME. A popup menu opens,

indicating the availableoptions.

Turn the cursor in front ofthe desired name andpress to select.


Changing Pressure Limits

Invasive Pressures Limits To Change Invasive Line

Pressure Limits: Select the appropriate

parameter window. Select LIMITS.

Select the appropriatelimit (systolic, diastolic ormean).

Turn the Trim Knob to thedesired limit and press toselect.


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Invasive Pressures Smart BP Smart BP is a feature found

in the ART and FEMpressure menus thatreduces nuisance alarmsassociated with zeroing thetransducer, fast flushingand drawing blood.

To Turn Smart BPOn or Off: Select ART or FEM

parameter window. Select SMART BP and

press to select. On/Off status is noted in

the menu option. Select MAIN MENU to

exit.NOTE: The user is allowed 14seconds for zeroing and two minutesfor drawing blood before alarms areactivated.

Smart BP

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Disconnect Alarm A feature found in the ART

and FEM pressure menus. If the mean pressure falls

below 25 mmHg and thedisconnect alarm is on, aWarning Alarm sounds andthe messageDISCONNECTED isdisplayed in the parameterwindow.

Check the patientimmediately in the eventthe catheter has dislodged.

Disconnect Alarm

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Invasive Pressures IABP The IABP program

compensates for theirregularities in the pressurewaveform caused by theuse of an intra-aorticballoon pump.

To ensure that the triggersignal is compatible with allmodes of the IABP, thesignal source used totrigger an intra-aorticballoon pump should be thepump itself.

If the trigger is from themonitor, be certain that themanufacturer is compatiblewith the GE Healthcareanalog output signal.

If the trigger is off of theR-Wave, review thepatients ECG leads andplace the one with thegreatest amplitude in thedisplay (top) lead position.

If blood pressure is used totrigger the balloon, the firstred pressure port labeledART will be used.

Cable the balloon pump tothe monitor through theDefib Sync connector onthe back of the monitor.

The Parameter WindowDisplays: Systolic Value = Highest

pressure in one cardiaccycle.

Diastolic Value = Lowestpressure in one cardiaccycle.

Mean Value = Averagepressure in one cardiaccycle.

NOTE: The values displayed willdiffer depending on the timing of thepump.

To Turn the IABPProgram On: Select ART 1. Select IABP. On/Off status is noted in

the menu option. Select MAIN MENU to

exit.

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PAPA Insert/Wedge is afeature found in the PAInvasive Pressures Menu.There are two modes fordoing a PA Wedgemeasurement: Auto andManual.When PA INSERT/WEDGEis selected, the displaychanges to the Full Gridmode and the primary ECGwaveform is duplicated inthe second waveform slot .All BP waveforms, exceptthe PA waveform, areremoved from the Full Gridregion.

The Auto Mode allows aPA Wedge measurementto be performed withouthaving to touch themonitor after startingthe program.The Manual Modedefaults when the PAInsert/Wedge menuoption is selected.

PA Insert/Wedge

NOTE: The monitor must detect a30% change in the waveform tomeasure a Wedge. If the waveformdoes not change accordingly, the

Wedge Processing message will notappear and you must use themanual mode for Wedgemeasurements.

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To Complete an Auto PAWedge: Select PA. Select PA

INSERT/WEDGE. Select MODE:MANUAL

(this changes the mode toAuto).

An INFLATE BALLOONmessage appears in thePA parameter window.

Inflate the balloonaccording to your unitspolicy and procedures.

The message WEDGEPROCESSING displays.

Deflate the balloon after3 to 4 respiratory cycles(no more than tenseconds).

PA Insert/Wedge

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PA Wedge ReviewInformation window isautomatically displayed.

To change the PA value,select MOVE WEDGECURSOR.

Turn the Trim Knob tomove the cursor to thedesired position andpress to select.

Press the GRAPHGO/STOP button on themonitor to print window.


NOTE: The last PAW with a timestamp will be displayed in the PAparameter window.

PA Wedge Review

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The Manual Modeoverrides the Auto Modeand requires additionalsteps at the monitor tocomplete themeasurement.Under certain patientconditions (valvulardisease or respiratoryvariation in PA reading),the monitor is unable todetect a change in thewaveform. To Complete a Manual

PA Wedge: Select PA. Select PA

INSERT/WEDGE. Verify that the

MODE:MANUAL isdisplayed.

The message MANUALWEDGE appears in the PAparameter window.

Inflate the balloon. Watch PA waveform for

wedging. Deflate the balloon. Select REVIEW WEDGE. The PA Wedge Review

Information window isdisplayed.

Select MOVE WEDGECURSOR.

Turn the Trim Knob tomove the cursor to thedesired position andpress to select.

Press the GRAPHGO/STOP button on themonitor to print window.

Select Main Menu to exit.

NOTE: The monitor must detect a30% change in the waveform tomeasure a Wedge. If the waveformdoes not change accordingly, theWedge Processing message will notappear and you must use themanual mode for Wedgemeasurements.NOTE: The last PAW with a timestamp will be displayed in the PAwindow.

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Graph BP InvasiveThis allows you to selectthe available invasivewaveforms for graphing.Waveforms will begraphed on one scaleusing the full grid space.This feature is found inthe PA Insert/Wedgemenu and the MonitorSetup window. To Graph Waveforms

(without ECG lead): Select MORE MENUS. Select MONITOR SETUP. Select GRAPH SETUP. Select GRAPH BP

INVASIVE. Highlight desired

waveforms to begraphed.

Highlight GRAPH. Select MAIN MENU to

exit. Press the GRAPH

GO/STOP button on themonitor to stop thegraph.

Graph BP Waveforms

NOTE: Skip the first threesteps above if you are in thePA Insert/Wedge menu.

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Cardiac Output

Cardiac Output The Cardiac Output

Program measurescardiac output by use ofa thermodilutioncatheter.

To activate monitoring,securely connect thecardiac output patientcable into the Temp/COconnector port on theside of the Dash monitor.The CO parameterwindow willautomatically appearonce the cable isplugged into the monitor.The parameter windowdisplays the patientsblood temperature.

To discontinue COmonitoring, remove thecable from the monitor.The parameter windowwill be removed from thedisplay.

To Obtain a CardiacOutput (CO) Using theAuto Mode: Select CARDIAC OUTPUT

or CO. Verify Menu options:

- Use PAW, PAD, or LA forcardiac calculations.

- Catheter type.- Injection Temp.- Size of catheter.- Injectate volume.- Computation Constant.

NOTE: If a Baxter, Abbott, Ohmedaor Arrow catheter is being used, thesoftware will automatically enter aComputation Constant. If OTHER isselected as the catheter type, themonitor will prompt the user to enterthe Computation Constant manuallybased on the manufacturersrecommendations. If the cathetertype is changed, the user isprompted to verify all other options.NOTE: The Computation Constantwill read 0.000 when the cable is firstconnected and prior to the firstinjection.NOTE: When the ComputationConstant is manually entered, theother menu options (type, temp andsize) are not needed. These menuoptions may be changed but willhave no effect on the software.

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When the INJECT WHENREADY is displayed,proceed with injection.

Seconds after injecting,COMPUTING CO isdisplayed.

CO COMPLETE is displayedwith the CO value uponcompletion and the data isplaced in the trial window.

NOTE: Up to four trials are displayedin the trial window, the fifth trialautomatically deletes the first. Alltrials are averaged and the data isstored in the cardiac calcs.

Select DELETE CO TRIALS. Move the cursor in front of

the trial that is to be deletedand press to highlight.

Move the cursor to RETURNand press to select.

NOTE: Trials are deletedpermanently.

Select CARDIAC CALCS. Select CHANGE VALUE to

edit or add unmonitoredparameter values.


Select SAVE CALCS. Select REVIEW CALCS. Select MAIN MENU to

exit.

NOTE: The last average CO value,along with a time stamp, will bedisplayed in the parameter window.

Cardiac Output

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A Manual CardiacOutput may bepreferred for patientswith extreme bloodtemperaturefluctuations. To Obtain a Cardiac

Output (CO) Using theManual Mode:

Select CARDIAC OUTPUTNOW from the CardiacOutput menu.

Watch for the INJECT NOWmessage and inject desiredfluid volume.

NOTE: With this option, it isparticularly important to injectimmediately upon seeing the INJECTNOW message. If too much timeelapses, the monitor will cycle itselfand the message PUSH CO NOW ORTURN AUTO ON is displayed.

A COMPUTING CO messageis displayed and thewashout curve begins tomove across the display.

The message COCOMPLETE is displayedwith the CO value.

NOTE: Up to four trials are displayedin the trial window. The fifth trialautomatically deletes the first. Alltrials are averaged and the data isstored in the cardiac calcs.

Select CARDIAC CALCS. Select CHANGE VALUE to

exit or add unmonitoredparameter values.


Select SAVE CALC. Select REVIEW CALCS. Select MAIN MENU to exit .

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Parameter Label Units Formula

Body Surface Area BSA m2 HT0.725 WT0.425 0.007185

Cardiac Index CI L/min/m2 CO/BSA

Stroke Volume SV mL/beat CO/HR 1000

Systemic Vascular Resistance SVR dyn sec cm-5 [(MAPCVP) 79.92] / CO

Systemic Vascular Resistance Index SVRI dyn sec cm-5 m2 SVR BSA

Pulmonary Vascular Resistance PVR dyn sec cm-5 [(PAMPAW) 79.92] / CO

Pulmonary Vascular Resistance Index PVRI dyn sec cm-5 m2 PVR BSA

Left Ventricular Stroke Work Index LVSWI g m/m-5 [SV (MAPPAW) 0.0136] / BSA*

Right Ventricular Stroke Work Index RVSWI g m/m-5 [SV (PAMCVP) 0.0136] / BSA*

* If using pulmonary artery diastolic (PAD) pressure or left atrial (LA pressure), PAW will be substituted with PAD or LA.

Calculated Parameters

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Alarm Control

Alarms Alarm Structure

The monitors alarmstructure is divided intotwo classifications: Patient Status Alarms:

Triggered by a patientcondition that exceeds aparameter limit or by anarrhythmia condition.

System Status Alarms:Triggered by mechanical orelectrical problems.They are of lesser prioritythan Patient Status Alarms.

Patient Status AlarmsThere are four levels ofPatient Status Alarms:

CRISIS:Life-threatening events.CRISIS alarms sound untilsilenced by the user.

WARNING:Serious, but not life-threatening events.WARNING alarms sounduntil the condition isresolved.

ADVISORY:Events that requiremonitoring, but are notserious or life-threatening.ADVISORY alarms sounduntil the condition isresolved.

MESSAGE:Additional information only.

System Status AlarmsThere are three levels ofSystem Status Alarms:

WARNING:Serious mechanical orelectrical problems.

ADVISORY:Mechanical or electricalproblems.

MESSAGE:Additional information only.

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Alarm Control

System Status AlarmsIndicator WARNING ADVISORY MESSAGE

Alarm Tone Repeating foghorn Single foghorn No

Alarm Light Yellow No No

On-Screen Message Yes Yes Yes

Alarm Broadcast Yes No No

Remote Alarm Terminal Yes No No

Patient Status AlarmsIndicator CRISIS WARNING ADVISORY MESSAGE

Alarm Tone Three beeps Two beeps One beep No

Alarm Light Red Yellow No No

On-Screen Message Yes Yes Yes Yes

Automatic Print Yes Yes No No

Alarm History Yes Yes Yes No

Alarm Broadcast Yes Yes Yes No

Remote Alarm Terminal Yes Yes Yes No

NOTE: You cannot change System Status Alarm levels and limits.

WARNING: After an interruption of the electric power supply,verify the alarm processing is active and verify that no arrhythmia occurred.

NOTE: You can change Patient Status Alarm levels and limits. Each level applies to Parameter Alarms andArrhythmia Alarms. The only difference between them is that the Parameter Alarms do not store in Alarm History.

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Alarm PauseBreakthroughThe Alarm PauseBreakthrough featureallows any crisis alarmto Break Through orinterrupt an alarm pausewith an audible alarm.When a crisis alarmbreaks through, thealarms will sound andthe event will print, butno storage of that eventwill be found in theAlarm History. Thisoption is set up in themonitor defaults.

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Alarm Control Menu All Limits:

This information windowshows all the high andlow alarm limits for allparameters that arecurrently beingmonitored.

You can adjust theparameter limits here, butit is much easier to adjustthem in the individualparameter windows.

NOTE: Any changes made with theParameter Alarm Level menu optionsare temporary and return to thedefault settings upon patientdischarge.

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Arrhythmia AlarmLevel:This option allows thearrhythmia alarm levelsto be viewed andchanged.

To Adjust ArrhythmiaAlarm Levels: Select MORE MENUS. Select ALARM CONTROL. Select ARRHYTHMIA

ALARM LEVEL. An information window is

displayed.

Turn the Trim Knob to thedesired alarm level (Crisis,Warning, Advisory orMessage), and press toselect.

Move the cursor in frontof RETURN and press toselect, and close thewindow.


NOTE: Any changes made with theArrhythmia Alarm Level menuoptions are temporary and return tothe default settings upon patientdischarge.

NOTE: Asystole and VFib/VTachcannot be moved from a Crisis alarmlevel in the Adult ICU and Neonatalmodes.

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Parameter Alarm Level:This option allows theparameter alarm levelsto be viewed orreassigned to otherlevels if desired.

To Adjust ParameterAlarm Levels: Select MORE MENUS. Select ALARM CONTROL. Select PARAMETER

ALARM LEVEL. An information window is

displayed. Move the cursor in front

of the Parameter to bechanged and press tohighlight.

Turn the Trim Knob to thedesired level (Crisis,Warning, Advisory orMessage), and press toselect.

Move the cursor in frontof RETURN and press toselect, and close thewindow.

Select MAIN MENU toexit. NOTE: Any changes made with the

Parameter Alarm Level menu optionsare temporary and return to thedefault settings upon patientdischarge.

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Alarm Volume:The Alarm Volume can beadjusted at the bedside.

NOTE: The Alarm Volume at thebedside monitor does not affect theAlarm Volume at the central station.

NOTE: A minimum Alarm Volumecan be set up in the monitor defaults.

Clear Alarms:Allows for any alarminformation displayed inthe alarm parameterwindow to be clearedfrom the display. Information from the

alarm parameter windowis removed.

NOTE: Arrhythmia alarms are notdeleted and can be found in theAlarm History.

Alarm History:This information is foundunder the Alarm Controlmenu as well as thePatient Data menu.

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Display Off/AlarmPause:This option allows theuser to disconnect thepatient from the monitorfor an extended periodof time.There are several alarmpause choices available: Monitor/Central Pause:

This option turns off thebedside monitor andpauses the alarms atboth the bedside and thecentral station for anindefinite period of time.

Monitor Pause:This option turns off thebedside monitor, butallows alarm notificationto remain active at thecentral station.

NOTE: Pressing the Power Buttonwill turn the Dash display off andstop communication with the CentralStation. Depending on yourconfiguration, a NO COMM alarmmay sound.

To Activate the DisplayOff/Alarm PauseFeature: Select MORE MENUS. Select ALARM CONTROL. Select DISPLAY OFF/

ALARM PAUSE.

Move the cursor in frontof the desired alarmpause choice and pressto select.

The display screen is nowpaused.

Press the Power buttonon the monitor toreactivate the display andalarms.

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Patient Data

Patient Data Alarm History

Allows storage of up to36 arrhythmiawaveforms and 10 STevents (includingreference) that are setin a Crisis, Warning, orAdvisory alarm level. To Retrieve Alarm

History Information: Select MORE MENUS. Select PATIENT DATA. Select ALARM HISTORY. An information window is

displayed. Move the cursor in front

of the desired event to beviewed.

Press the Trim Knob toview a 10-secondcondensed window of thearrhythmia.

Press GRAPH GO/STOPon the monitor to printthe displayed arrhythmia.

Select MAIN MENU toreturn.

NOTE: Ten seconds of three ECGleads or two ECG leads and the ARTwaveform are displayed in acompressed format.

NOTE: Alarm History informationcan also be reviewed under AlarmControl.

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Patient Data

Vital SignsProvides 24 hours ofstored parameter data,including the last 20cardiac calculationsand 10 pulmonarycalculations. To Retrieve Vital Sign

Information: Select MORE MENUS. Select PATIENT DATA. Select VITAL SIGNS. An information window is

displayed. Menu options include:

- View Older/Newer- Time Interval: Select

the time interval for thepatient data display.

- Specific Time: Select aspecific time period ofcollected data to view.

- Sort Data: Allows youto sort collected patientdata in a specific order.

- Page Up/Page Down Press GRAPH GO/STOP

on the monitor to printdisplayed vital signs.


Dash 5000The Trendskey can becustomized soyou can viewa specific trend type: Tabular All: Displays Vital

Signs window whenpressed.

Tabular NBP: DisplaysVital Signs window sortedby NBP first .

Graphic: DisplaysGraphic Trends windowwhen pressed.

CRG: Displays CRGTrends window whenpressed.

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Graphic TrendsAllows graphicrepresentation of dataover a specified period oftime. To Retrieve Graphical

Trended Information: Select MORE MENUS. Select PATIENT DATA. Select GRAPHIC TRENDS. An information window is

displayed with thegraphic trends that werelast selected.


Menu Options Preset Trends:

Select one of the presetparameter groups totrend.

View Older/View Newer: Moves the trends window

backward or forward intime.

Time Period: Allows you to select a

time period for viewingthe displayed trends.

Select Parameters: Allows you to choose up

to three parameters totrend.

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Dose CalculationsProvides a method ofdetermining drug dosages.Different monitor modesutilize different drug libraries.The Adult Monitoring Modeoffers 21 different drugs andfour unspecified drugs, whilethe Neonatal MonitoringMode offers 14 different drugsand four unspecified drugs.

To Obtain DoseCalculations: Select MORE MENUS. Select PATIENT DATA. Select DOSE CALCS. Select the CHANGE

VALUES option. Move the cursor to DRUG

NAME and press toselect.

Scroll to the desired drugand press to select .

Repeat the aboveprocedure to enter thefollowing values:- Weight- Solution volume- Drug quantity

NOTE: When using the option ofDrug A, B, C, D (unspecified drugs), besure to select the proper drugadministration units for themedication

Select the appropriatedrug units for themedication.

Scroll to the desired doseand press to select .

The infusion rate will beautomatically calculatedand displayed.

Press the GRAPHGO/STOP button on themonitor to print thedisplayed calculation.

Move the cursor in frontof RETURN and press toselect.

Select SAVE CALC to storedose calculation in themonitor (optional).


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Titration TableA Titration Table can beaccessed aftercompleting a dosecalculation. To Obtain Drug Titration

Table: Complete drug dose

calculation. Select Titration Table and

an information windowwill appear.

The calculated doseappears in the center ofthe table. To change thetable range, repeat thedrug dose calculationprocedure and enter adifferent dose to becalculated.

Press the GRAPHGO/STOP button on themonitor to print thedisplayed titration table.


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Cardiac CalculationsThe 20 most currentCardiac Calculations arestored. To Review Stored

Cardiac Calculations: Select MORE MENUS. Select PATIENT DATA. Select CARDIAC CALCS. Review Cardiac

Calculations. Press the GRAPH

GO/STOP button on themonitor to print thedisplayed calculations.


NOTE: This is the Vital Signsinformation window, but the data issorted so Cardiac Calculations (CO)appears first in the list .

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Monitor Setup

Monitor Setup Waveforms On/Off

Reassigns waveformpositions on the display. To Turn Waveforms

On/Off: Select MORE MENUS. Select MONITOR SETUP. Select WAVEFORMS

ON/OFF. Select the desired

waveform: 1 thru 6. Turn Trim Knob to move

the cursor in front of thedesired waveform andpress to select.

Select ALIGNWAVEFORMS to alignwith parameter windows.


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Monitor Setup

Parameters On/OffAdds or removesparameter windows. To Turn Parameters

On/Off: Select MORE MENUS. Select MONITOR SETUP. Select PARAMETERS

ON/OFF. An information window

appears with availableoptions.

Turn Trim Knob to movethe cursor in front of thedesired parameter andpress to select.

Select RETURN to closewindow.


NOTE: The ECG parameter can beturned off. When the ECG parameteris turned off, the SPO2 parameter isthe primary parameter formonitoring a patient. The SPO2 andSPO2 Rate parameter alarms defaultautomatically to a warning.

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Graph/Print SetupAll Printing Options Graph/Print Go/Stop

To Print a WaveformStrip: Press the GRAPH/PRINT

GO/STOP button on thefront of the monitor.

To print an informationwindow: Press the GRAPH/PRINT

GO/STOP button on thefront of the monitor.

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Changing Graphing/Printing WaveformLeads To Change the Leads

that are being Graphed/Printed: Select MORE MENUS. Select MONITOR SETUP. Select GRAPH/PRINT

SETUP.

Select waveform 2, 3, or 4to change graphing/printing waveforms.

Turn Trim Knob to movethe cursor in front of thedesired waveform andpress to select.


NOTE: In the Dash 5000 menus, allthe words graph are replaced withprint.


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BP Waveform To Graph/Print

Waveforms(without ECG lead): Select MORE MENUS. Select MONITOR SETUP. Select GRAPH/PRINT

SETUP. Select GRAPH/PRINT

BP INVASIVE. Highlight desired

waveforms to begraphed/printed.

Highlight GRAPH/PRINT. Select MAIN MENU to

exit. Press the GRAPH PRINT

GO/STOP button on themonitor to stop thegraph.

NOTE: This option is also available inthe PA Insert/Wedge menu.

Graph/Print Location To Change the Graph/

Print Locations: Select MORE MENUS. Select MONITOR SETUP. Select GRAPH/PRINT

SETUP. Select GRAPH/PRINT

LOCATION.

Select MANUAL, ALARMor PRINT WINDOWGRAPH/PRINTLOCATION.An information window isdisplayed with a list ofavailable writers.

Turn Trim Knob to movethe cursor to select thespecific writer and pressto select.


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Timed Graph/Print To Change a Timed

Graph/Print: Select MORE MENUS. Select MONITOR SETUP. Select GRAPH/PRINT

SETUP. Select TIMED GRAPH/

PRINT. Highlight desired

waveforms to begraphed.

Highlight GRAPH/PRINT. Turn Trim Knob to move

the cursor to select thedesired time and press toselect.


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Display ModeThis option controls theview of the display. Individual 3 Waveform:

When monitoring up tothree waveformparameters, the threeindividual waveformdisplay options may beselected. This will doublethe size of displayedparameters andautomatically alignwaveforms with theirrespective parameterwindows. A maximum ofsix parameters and threewaveforms can be viewedin this mode.

NOTE: A pulse rate value can bedisplayed in the NBP parameterwindow when Individual 3 Waveformmode is initialized.

To Change from SixIndividual Waveformsto Three: Select MORE MENUS. Select MONITOR SETUP. Select DISPLAY. From popup menu,

select INDIVIDUAL 3WAVEFORMS.

NOTE: If additional waveformparameters are added, the displaymust be changed back toINDIVIDUAL 6 WAVEFORM in orderto view all waveforms on the display.

Individual 6 Display:A maximum of sixwaveforms and eightparameter windows can bedisplayed with eachwaveform having anindependent scale.

Full Display:A maximum of fivewaveforms can bedisplayed. The first two areindividual scale, the nexttwo are common scale, andthe final is individual scale.

Full Grid Display:This option allows for thedisplay to be on a full orcommon scale withgraticules displayed on thescreen.

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View Other Patients / AVOA

View Other Patients Allows patient data to be

viewed from anotherpatients bedside. To View Another Patient:

Select MORE MENUS. Select VIEW OTHER

PATIENTS. Select a bed to view. Turn the Trim Knob to

move the cursor in frontof the desired bed andpress to select

The display will be dividedinto two with the ViewedPatient on the left ,(the message VIEWEDPATIENT will be displayedon the bottom) and thecurrent monitored bed onthe right.

Select a Bed to View Display

Viewed Patient Display

To Remove theViewed Patient: Select MORE

MENUS. Select VIEW OTHER

PATIENTS. Select a bed to

view. Note that the

cursor is in front ofthe Viewed Patientand press to select.

The Viewed Patientwill be removedand only thecurrent monitoredbed will bedisplayed.

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View Other Patients / AVOA

AVOA When the Auto View On

Alarm (AVOA) feature isactivated, selected bedsin alarm willautomatically pop up.A split screen on the hostmonitor, shows real-timeinformation along with apopup menu related tothe alarm bed.The user can graph thealarm, silence the alarm,pull up vital signs orgraphic trends from thepopup menu. To Set Up AVOA XM at

the Host Monitor: Select MORE MENUS. Select VIEW OTHER

PATIENTS. Select VIEW ON ALARM

OPTIONS..

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The Following ChoicesWill Appear in the Menu: VIEW OTHER BEDS ON

ALARM allows you toturn the feature on or offat the host monitor.

SEND AUTO VIEWSturns On/Off the hostbeds broadcast ofalarms to other beds onthe network.

ALERT TONE selects theaudio alert at On, Off, orRepeating Tones.

CONFIGURE AUTOVIEW ON ALARM allowsyou to select the careunit and beds to viewautomatically on alarm.It also allows selection ofalarm levels to triggerthis function.

CURRENTCONFIGURATIONSdisplays the currentAVOA settings for thehost monitor whichbeds are selected toview on alarm and atwhich alarm levels.

When Viewing an AlarmBed: MAIN MENU closes the

split patient view andreturns to the maindisplay.

RETURN closes the splitpatient view and returnsto the VIEW OTHERPATIENTS menu.

GRAPH 20 SEC starts a20-second graph strip ofthe viewed patient data.

SILENCE silences theviewed alarm bed for 60seconds.

LAST EVENT retrievesthe last arrhythmiaevent from the viewedalarm bed. Select OK toreturn to the VIEWOTHER PATIENTS menu.

VITAL SIGNS displaysthe vital signs for thealarming bed.

GRAPHIC TRENDSdisplays the graphictrends for the viewedalarm bed.

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Equipment Overview Front View1 Security Lever

Slide left to lock the monitoronto the docking station, thenslide right to unlock themonitor.

2 AC Main Power IndicatorIlluminates green when ACpower is applied to thedocking station.

UNLOCK LOCK

Dash Port 2 Docking Station

The docking station is aquick mount/dismountbase for a Dash patientmonitor.It gives the monitor easyconnect/disconnect accessto AC power, the UnityNetwork, to a remotedisplay, and to auxiliarydevices.The docking station can beused with ALL Dashmonitors (3000, 4000,5000). However, someDash monitors DO NOTsupport the dockingstations Ethernet Network,auxiliary 1, auxiliary 2, orremote displaycommunication links. SeeDash Port 2 DockingStation operationinstructions for moredetailed information.

3 Communication IndicatorGreen LED: A steady green color

indicates the dockingstation has establishedcommunication with themonitor.

Amber LED: A flashing amber color

indicates that thedocking station and theDash monitor are notcompatible.

32

1

2

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Dash Port 2 Docking Station

Equipment Overview Back View1 Ethernet Connector

Connect to the UnityNetwork.

2 Video Out ConnectorConnect to a compatibleremote display. The remotedisplay al

Documents

2009-01-28-Dash V6 QRG