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CuffLink NIBP Analyzer

Operators Manual

PN 2242915 December 2007, Rev. 1, 9/09 © 2007, 2009 Fluke Corporation, All rights reserved. Printed in USA. Specifications subject to change without notice. All product names are trademarks of their respective companies.

Warranty and Product Support

Fluke Biomedical warrants this instrument against defects in materials and workmanship for one year from the date of original purchase. During the warranty period, we will repair or at our option replace, at no charge, a product that proves to be defective, provided you return the product, shipping prepaid, to Fluke Biomedical. This warranty covers the original purchaser only and is not transferable. The warranty does not apply if the product has been damaged by accident or misuse or has been serviced or modified by anyone other than an authorized Fluke Biomedical service facility. NO OTHER WARRANTIES, SUCH AS FITNESS FOR A PARTICULAR PURPOSE, ARE EXPRESSED OR IMPLIED. FLUKE SHALL NOT BE LIABLE FOR ANY SPECIAL, INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES OR LOSSES, INCLUDING LOSS OF DATA, ARISING FROM ANY CAUSE OR THEORY. This warranty covers only serialized products and their accessory items that bear a distinct serial number tag. Recalibration of instruments is not covered under the warranty This warranty gives you specific legal rights and you may also have other rights that vary in different jurisdictions. Since some jurisdictions do not allow the exclusion or limitation of an implied warranty or of incidental or consequential damages, this limitation of liability may not apply to you. If any provision of this warranty is held invalid or unenforceable by a court or other decision-maker of competent jurisdiction, such holding will not affect the validity or enforceability of any other provision.

07/07

Notices

All Rights Reserved © Copyright 2007, Fluke Biomedical. No part of this publication may be reproduced, transmitted, transcribed, stored in a retrieval system, or translated into any language without the written permission of Fluke Biomedical.

Copyright Release Fluke Biomedical agrees to a limited copyright release that allows you to reproduce manuals and other printed materials for use in service training programs and other technical publications. If you would like other reproductions or distributions, submit a written request to Fluke Biomedical.

Unpacking and Inspection Follow standard receiving practices upon receipt of the instrument. Check the shipping carton for damage. If damage is found, stop unpacking the instrument. Notify the carrier and ask for an agent to be present while the instrument is unpacked. There are no special unpacking instructions, but be careful not to damage the instrument when unpacking it. Inspect the instrument for physical damage such as bent or broken parts, dents, or scratches.

Technical Support For application support or answers to technical questions, either email [email protected] or call 1-800- 648-7952 or 1-425-446-6945.

Claims Our routine method of shipment is via common carrier, FOB origin. Upon delivery, if physical damage is found, retain all packing materials in their original condition and contact the carrier immediately to file a claim. If the instrument is delivered in good physical condition but does not operate within specifications, or if there are any other problems not caused by shipping damage, please contact Fluke Biomedical or your local sales representative.

Standard Terms and Conditions Refunds and Credits

Please note that only serialized products and their accessory items (i.e., products and items bearing a distinct serial number tag) are eligible for partial refund and/or credit. Nonserialized parts and accessory items (e.g., cables, carrying cases, auxiliary modules, etc.) are not eligible for return or refund. Only products returned within 90 days from the date of original purchase are eligible for refund/credit. In order to receive a partial refund/credit of a product purchase price on a serialized product, the product must not have been damaged by the customer or by the carrier chosen by the customer to return the goods, and the product must be returned complete (meaning with all manuals, cables, accessories, etc.) and in “as new” and resalable condition. Products not returned within 90 days of purchase, or products which are not in “as new” and resalable condition, are not eligible for credit return and will be returned to the customer. The Return Procedure (see below) must be followed to assure prompt refund/credit.

Restocking Charges Products returned within 30 days of original purchase are subject to a minimum restocking fee of 15 %. Products returned in excess of 30 days after purchase, but prior to 90 days, are subject to a minimum restocking fee of 20 %. Additional charges for damage and/or missing parts and accessories will be applied to all returns.

Return Procedure All items being returned (including all warranty-claim shipments) must be sent freight-prepaid to our factory location. When you return an instrument to Fluke Biomedical, we recommend using United Parcel Service, Federal Express, or Air Parcel Post. We also recommend that you insure your shipment for its actual replacement cost. Fluke Biomedical will not be responsible for lost shipments or instruments that are received in damaged condition due to improper packaging or handling. Use the original carton and packaging material for shipment. If they are not available, we recommend the following guide for repackaging:

Use a double-walled carton of sufficient strength for the weight being shipped. Use heavy paper or cardboard to protect all instrument surfaces. Use nonabrasive material around all projecting parts. Use at least four inches of tightly packed, industry-approved, shock-absorbent material around the instrument.

Returns for partial refund/credit: Every product returned for refund/credit must be accompanied by a Return Material Authorization (RMA) number, obtained from our Order Entry Group at 1-800-648-7952 or 1-425-446-6945.

Repair and calibration: To find the nearest service center, go to www.flukebiomedical.com/service, or In the U.S.A.: Cleveland Calibration Lab Tel: 1-800-850-4606 Email: [email protected] Everett Calibration Lab Tel: 1-888-993-5853 Email: [email protected] In Europe, Middle East, and Africa: Eindhoven Calibration Lab Tel: +31-402-675300 Email: [email protected] In Asia: Everett Calibration Lab Tel: +425-446-6945 Email: [email protected]

Certification This instrument was thoroughly tested and inspected. It was found to meet Fluke Biomedical’s manufacturing specifications when it was shipped from the factory. Calibration measurements are traceable to the National Institute of Standards and Technology (NIST). Devices for which there are no NIST calibration standards are measured against in-house performance standards using accepted test procedures.

WARNING Unauthorized user modifications or application beyond the published specifications may result in electrical shock hazards or improper operation. Fluke Biomedical will not be responsible for any injuries sustained due to unauthorized equipment modifications.

Restrictions and Liabilities Information in this document is subject to change and does not represent a commitment by Fluke Biomedical. Changes made to the information in this document will be incorporated in new editions of the publication. No responsibility is assumed by Fluke Biomedical for the use or reliability of software or equipment that is not supplied by Fluke Biomedical, or by its affiliated dealers.

Manufacturing Location The CuffLink NIBP Analyzer is manufactured in Everett, Washington by Fluke Biomedical, 6920 Seaway Blvd., Everett, WA, U.S.A.

i

Table of Contents

Chapter Title Page

1 Introduction and Specifications......................................................... 1-1

Introduction........................................................................................................ 1-3 Standard Features............................................................................................... 1-4 New Features (Firmware Revision 3.0 and Later) ............................................. 1-4

Arrhythmias................................................................................................... 1-4 Pressure Testing............................................................................................. 1-5 Remote Commands ....................................................................................... 1-6

General Safety Considerations........................................................................... 1-6 Symbols ......................................................................................................... 1-6 Warnings and Cautions.................................................................................. 1-7

Instrument Familiarity ....................................................................................... 1-8 Specifications..................................................................................................... 1-12 Accessories ........................................................................................................ 1-16

2 Operation ............................................................................................. 2-1 Powering Up the Analyzer................................................................................. 2-3 Menu Structure and Navigation ......................................................................... 2-3 Preliminary Procedures...................................................................................... 2-6

Assembling Equipment ................................................................................. 2-6 Making Connections...................................................................................... 2-8 Observing Results.......................................................................................... 2-9 Selecting Heart Rate (HtRate) ....................................................................... 2-10 Adjusting the Pressure Envelope (AdjEnv)................................................... 2-11

Simulating Adult Blood Pressure....................................................................... 2-14 Setting Zero Pressure..................................................................................... 2-15 Simulating Other ADAMS Family Target Values ........................................ 2-16 NIBP Monitor Testing Sequence................................................................... 2-16

Simulating Neonatal Blood Pressure ................................................................. 2-17 Simulating Arrhythmias..................................................................................... 2-18 Pressure Testing................................................................................................. 2-19

Leak Testing .................................................................................................. 2-19 Manometer Function ..................................................................................... 2-20 Pop Off Test .................................................................................................. 2-21

Utility Functions ................................................................................................ 2-22

Cufflink Operators Manual

ii

Set Clock ....................................................................................................... 2-22 Pop Time ....................................................................................................... 2-24 Logo............................................................................................................... 2-25 System Functions........................................................................................... 2-25

Establishing Communications ........................................................................... 2-31 Configuring RS232........................................................................................ 2-31 Testing the RS232 Port and Connections ...................................................... 2-32

Using Auto Sequences ....................................................................................... 2-33 Executing an Auto Sequence......................................................................... 2-33 Utilities .......................................................................................................... 2-34

Printing Documents ........................................................................................... 2-37 Printing Blood Pressure Test Results ............................................................ 2-37 Printing Manometer, Leak Test, and Overpressure Test Results .................. 2-38 Printing Auto Sequences ............................................................................... 2-38

3 Remote Operation ............................................................................... 3-1 Introduction........................................................................................................ 3-3 Setting Up the medTester .................................................................................. 3-3 Remote Command Syntax ................................................................................. 3-4

Command Syntax for medTester ................................................................... 3-4 Command Syntax for Computer.................................................................... 3-4 Command Parameters.................................................................................... 3-4 Terminating Characters ................................................................................. 3-5 Error Messages .............................................................................................. 3-5

Command Descriptions...................................................................................... 3-7 BEEP ............................................................................................................. 3-7 CALPUCKPOS ............................................................................................. 3-8 DEFLATE ..................................................................................................... 3-8 DRAWENV................................................................................................... 3-8 DRAWENVNEO .......................................................................................... 3-11 DRAWPULSE............................................................................................... 3-15 GLOBALINIT............................................................................................... 3-17 GOTOLOCAL............................................................................................... 3-18 IDENT ........................................................................................................... 3-18 INFLATE ...................................................................................................... 3-18 KEYTEST ..................................................................................................... 3-19 LEAKTEST................................................................................................... 3-19 MAKEARM .................................................................................................. 3-20 MAKEARMNEO.......................................................................................... 3-23 MANOMETER ............................................................................................. 3-27 MKARM10.................................................................................................... 3-27 MKARM20.................................................................................................... 3-27 MKARM30.................................................................................................... 3-28 MKARM40.................................................................................................... 3-28 MKARM50.................................................................................................... 3-28 MKARM60.................................................................................................... 3-28 MKARM70.................................................................................................... 3-29 MKARMNEO10 ........................................................................................... 3-29 MKARMNEO20 ........................................................................................... 3-29 MKARMNEO30 ........................................................................................... 3-29 MKARMNEO40 ........................................................................................... 3-30 MKARMNEO50 ........................................................................................... 3-30 MKARR_AF ................................................................................................. 3-30 MKARR_MB ................................................................................................ 3-30

Contents (continued)

iii

MKARR_PAC............................................................................................... 3-31 MKARR_PVC............................................................................................... 3-31 MKARR_AS ................................................................................................. 3-31 POPOFF ........................................................................................................ 3-32 PRINTTEST.................................................................................................. 3-32 PSCALE ........................................................................................................ 3-33 PULSE........................................................................................................... 3-34 PUMPPCB..................................................................................................... 3-36 RCUSERENV ............................................................................................... 3-36 RDCLOCK.................................................................................................... 3-36 RDENVGAIN ............................................................................................... 3-36 RDENVSHIFT .............................................................................................. 3-37 RDPEAKDIV................................................................................................ 3-37 RDQCDATE ................................................................................................. 3-37 RDUSERENV ............................................................................................... 3-37 READPRESS ................................................................................................ 3-38 RESET........................................................................................................... 3-38 STUSERENV................................................................................................ 3-39 WRCLOCK ................................................................................................... 3-39 WRPEAKDIV ............................................................................................... 3-40 WRUSERENV .............................................................................................. 3-40 ZEROPRESS................................................................................................. 3-41

Programming with Analyzer Commands........................................................... 3-41 Checklist Generated in BASIC...................................................................... 3-41 Adult BP Checklists and Test Results ........................................................... 3-43 Neonate BP Checklists and Test Results ....................................................... 3-47 Adult Arrhythmic BP Checklists and Test Results........................................ 3-51

Additional Command Descriptions (Firmware Version 3.20)........................... 3-55 PUMPON ...................................................................................................... 3-55 PUMPOFF..................................................................................................... 3-55 VALVEOPEN ............................................................................................... 3-55 VALVECLOSED.......................................................................................... 3-56

4 Maintenance, Service, and Calibration.............................................. 4-1 Maintenance....................................................................................................... 4-3

Avoiding Damage.......................................................................................... 4-3 Cleaning......................................................................................................... 4-3

Service and Calibration...................................................................................... 4-3

Appendices

A Non-Invasive Blood Pressure (NIBP) Monitoring Tutorial ........................ A-1 B Glossary....................................................................................................... B-1


iv

v

List of Tables

Table Title Page

1-1. New RS232 Remote Commands............................................................................ 1-6 1-2. Symbols.................................................................................................................. 1-6 1-3. Analyzer Top and Front Panel Controls and Indicators ......................................... 1-8 1-4. Rear Panel Controls and Indicators ........................................................................ 1-11 1-5. Standard Accessories ............................................................................................. 1-16 2-1. Blood Pressure Parameters Provided by the Select BP Option.............................. 2-6 2-2. Measured Test Parameters ..................................................................................... 2-10 2-3. Arrhythmia Types .................................................................................................. 2-18 2-4. Leak Test Utility Options....................................................................................... 2-20 2-5. Measured Leak Test Parameters ............................................................................ 2-20 2-6. Measured Manometer Parameters .......................................................................... 2-21 2-7. Measured Pop Off Test Parameters........................................................................ 2-22 2-8. Speaker Tests and Adjustments.............................................................................. 2-27 2-9. Display Test Descriptions ...................................................................................... 2-28 2-10. Pop Time and Comm Port Default Values............................................................. 2-29 2-11. Auto Sequence Defaults ......................................................................................... 2-30 2-12. RS232 Settings ....................................................................................................... 2-32 3-1. medTester Remote Configuration Settings ............................................................ 3-3 3-2. Available Error Messages ...................................................................................... 3-6 3-3. Autosequence Defaults........................................................................................... 3-17 3-4. Pop Time and Comm Port Default Values............................................................. 3-17


vi

vii

List of Figures

Figure Title Page

1-1. CuffLink Non-Invasive Blood Pressure Analyzer ................................................. 1-3 1-2. Cuff pressure waveform during blood pressure measurement ............................... 1-4 1-3. Analyzer Top and Front Panel Controls and Indicators ......................................... 1-8 1-4. Rear Panel Controls and Indicators ........................................................................ 1-11 2-1. Analyzer Menu Map .............................................................................................. 2-4 2-2. Adjustments for Adult Cuff Mandrel ..................................................................... 2-7 2-3. Neonate Mandrel .................................................................................................... 2-7 2-4. NIBP Test System Diagram ................................................................................... 2-8 2-5. Makearm Display of Test Results .......................................................................... 2-9 2-6. Sample Printout of Auto Sequence Content........................................................... 2-36 2-7. Sample Printout of Adams Adult Family 120/80 Test Results .............................. 2-38 2-8. Sample Printout of Manometer Test Results.......................................................... 2-38 2-9. Sample Printout of Leak Test Results .................................................................... 2-38 2-10. Sample Printout of Overpressure Test Results....................................................... 2-38 2-11. Sample Printout of Adult Auto Sequence Content................................................. 2-40 2-12. Sample Printout of Adult Auto Sequence Test Results.......................................... 2-41 2-13. Sample Printout of Adult BP with Arrhythmia Auto Sequence Content ............... 2-42 2-14. Sample Printout of Adult BP with Arrhythmia Auto Sequence Test Results ........ 2-43 2-15. Sample Printout of Neonate Auto Sequence Content ............................................ 2-44 2-16. Sample Printout of Neonate Auto Sequence Test Results ..................................... 2-46 3-1. Analyzer Adult Blood Pressure Envelope (BP = 120/80)...................................... 3-8 3-2. Analyzer Neonate Blood Pressure Envelope (BP = 120/80).................................. 3-11 3-3. Analyzer Pressure Pulse #3 .................................................................................... 3-15 3-4. POPOFF Command Display .................................................................................. 3-32 3-5. Scale Pulse Amplitude Display .............................................................................. 3-33 3-6. A BASIC Program using Analyzer Remote Commands........................................ 3-42 3-7. medBase Adult BP Checklist ................................................................................. 3-43 3-8. medBase Adult BP Test Results............................................................................. 3-44 3-9. Sentinel Adult BP Checklist................................................................................... 3-45 3-10. Sentinel Adult BP Test Results .............................................................................. 3-46 3-11. medBase Neonate BP Checklist ............................................................................. 3-47 3-12. medBase Neonate BP Test Results ........................................................................ 3-48 3-13. Sentinel Neonate BP Checklist .............................................................................. 3-49 3-14. Sentinel Neonate BP Test Results .......................................................................... 3-50 3-15. medBase Adult Arrhythmic BP Checklist.............................................................. 3-51


viii

3-16. medBase Adult Arrhythmic BP Test Results ......................................................... 3-52 3-17. Sentinel Adult Arrhythmic BP Checklist ............................................................... 3-53 3-18. Sentinel Adult Arrhythmic BP Test Results........................................................... 3-54

1-1

Chapter 1 Introduction and Specifications

Title Page

Introduction........................................................................................................ 1-3 Standard Features............................................................................................... 1-4 New Features (Firmware Revision 3.0 and Later) ............................................. 1-4

Arrhythmias................................................................................................... 1-4 Pressure Testing............................................................................................. 1-5 Remote Commands ....................................................................................... 1-6

General Safety Considerations........................................................................... 1-6 Symbols ......................................................................................................... 1-6 Warnings and Cautions.................................................................................. 1-7

Instrument Familiarity ....................................................................................... 1-8 Specifications..................................................................................................... 1-12 Accessories ........................................................................................................ 1-16


1-2

Introduction and Specifications Introduction 1

1-3

Introduction The CuffLink Non-Invasive Blood Pressure Analyzer, hereafter referred to as the Analyzer, provides accurate and repeatable dynamic blood pressure (BP) waveforms for evaluation of both semi and fully automated oscillometric non-invasive blood pressure (NIBP) devices. The Analyzer is shown in Figure 1-1.

F1

ESC

ENT

F2F3

F4

F5

CuffLinkNON-INVASIVE BLOOD PRESSURE ANALYZER

CUFFCONNECTCUFF OUTPUTSPULSE

BEEPERVOLUME DISPLAYVIEW

Max

DC

mHg

mmHg

mmHg

Dark

fcv001.eps

Figure 1-1. CuffLink Non-Invasive Blood Pressure Analyzer

To test a device, wrap the BP cuff around the supplied mandrel and insert the cuff adapter in the pressurized line. All tests are conducted with the BP cuff connected to the system. The Analyzer can generate BP waveforms for seven adult (oscillometric), five neonate (oscillometric), and 5 arrhythmias. The different systolic/diastolic pressure gradients simulate a physiological range of normal, hypotensive, and hypertensive adult or neonate patients. Actual patient data was used to design the preprogrammed peripheral pulse waveforms and envelopes. The Analyzer can produce qualitative measurements of BP cuff pressure and inflate / deflate timing, as shown in Figure 1-2.


1-4

CU

FF

PR

ES

SU

RE

SY

S

MA

P

DIA

OSCILLATION AMPLITUDE

TIME

fcv002.eps

Figure 1-2. Cuff pressure waveform during blood pressure measurement

The Analyzer also offers automated leak testing of NIBP monitors. An internal pump pressurizes the NIBP system under test. Press a key to initiate a 60 second leak test once the desired pressure is reached. Use the Analyzer’s digital manometer instead of a mercury column for doing pressure measurements. The Analyzer facilitates overpressure testing of NIBP monitors by automatically detecting and displaying the overpressure point.

Standard Features The Analyzer has the following standard features: • Dynamic oscillometric noninvasive blood pressure simulation • Automated static pressure measurements, leakage testing, and relief-valve testing • Five automated NIBP testing autosequences • Five arrhythmia selections • Adult and neonatal NIBP selections • Direct interface with medTester 5000C • Adjustable heart rate values • Calendar clock with battery backup • Internal PCB expansion slot

New Features (Firmware Revision 3.0 and Later) Firmware revision 3.0 included the following additions and updates, including a set of adult arrhythmias, an internal pump, and additions to pressure testing.

Arrhythmias The Analyzer features five new arrhythmias to test NIBP monitors in the presence of typical patient arrhythmias. These clinically derived simulations are representations of the peripheral pulse, as seen by an oscillometric NIBP monitor. Each arrhythmia is generated on a random basis throughout the entire pressure curve cycle. The variations in pulse timing and amplitude are relatively small.

Introduction and Specifications New Features (Firmware Revision 3.0 and Later) 1

1-5

Premature Atrial Contraction (PAC) The first pulse of the PAC cycle is premature and lower in amplitude than a normal sinus pulse. The next pulse would be back in sync with normal sinus and slightly higher in amplitude. All subsequent pulses are normal.

Premature Ventricular Contraction (PVC) This is a representation of the peripheral pulse similar to PAC

Atrial Fibrillation (AF) The AF cycle has an irregular R to R interval. Its occurrence and properties (early vs. late) are random throughout the pressure curve cycle.

Missed Beat (MB) A complete beat is randomly skipped during the pressure curve cycle. The following beat reverts to normal R to R intervals.

Aberrant Sinus Conduction (AS) The AS cycle inserts one pulse so low that it is virtually non-existent. This causes the Analyzer to skip one diastolic pulse and then return to normal sinus pulses.

Pressure Testing The Analyzer now has the following enhancements to its pressure testing capability.

Internal Pump The Analyzer now has an internal compressor which eliminates the need to manually inflate the cuff for NIBP monitor testing. This automates static pressure measurements, leak testing, and relief valve testing.

Pop Off Added to Press Menu Perform over-pressure tests on NIBP monitors with this addition to the PRESS menu.

Utility Menu Added to Leak Test Select cuff size, turn printing on or off, and choose a target pressure for leak testing.

Manometer The Analyzer simulates a digital manometer with pump capabilities.


1-6

Remote Commands Table 1-1 lists new CuffLink RS232 commands to support new functions.

Table 1-1. New RS232 Remote Commands

Command Function

DEFLATE Releases pressure inside CuffLink

INFLATE Pumps CuffLink to 200 mmHg or specified pressure

KEYTEST Tests CuffLink's keyboard

MKARR_AF Simulates atrial fibrillation

MKARR_MB Simulates a missed beat

MKARR_PAC Simulates premature atrial contraction

MKARR_PVC Simulates premature ventricular contraction

MKARR_AS As Simulates aberrant sinus conduction

POPOFF Tests monitor's overpressure valve

PUMPPCB Determines if pump PCB is installed in CuffLink

General Safety Considerations Read the Users Manual before operating the Analyzer.

Symbols Table 1-2 describes the symbols associated with the Analyzer.

Table 1-2. Symbols

Symbol Description

X Hazardous voltage

W Important information; refer to manual.

Œ Conforms to UL Std 3101-1; certified to CAN/USA Std C22.2 No. 1010.1

P Conforms to European Union directives

~ Do not dispose of this product as unsorted municipal waste. Go to Fluke’s website for recycling information.

Hg Contains mercury. Dispose properly.

Introduction and Specifications General Safety Considerations 1

1-7

Warnings and Cautions A Warning identifies hazardous conditions and actions that could cause bodily harm or death. A Caution identifies conditions and actions that could damage the Analyzer, the equipment under test, or cause permanent loss of data.

XW Warning To avoid possible electrical shock or personal injury, follow these guidelines:

• Use this Analyzer only in the manner specified by the manufacturer.

• Do not use the product if it operates abnormally.

• Do not connect the Analyzer to a patient or equipment connected to a patient. The Analyzer is intended for equipment evaluation only and should never be used in diagnostics, treatment or in any other capacity where the Analyzer would come in contact with a patient.

• Do not use the product in wet locations, around explosive gases or dust.

• Never open the Analyzer's case. Dangerous voltages are present. There are no user replaceable parts in the Analyzer.

• Have the Analyzer serviced only by qualified personnel.

• The Analyzer must be properly earthed. Only use a supply socket that has a protective earth contact. If there is any doubt as to the effectiveness of the supply socket earth, do not connect the Analyzer.

• Do not use a two-conductor adapter or extension cord; this will break the protective ground connection.

W Caution To avoid damage to the Analyzer or adverse affects on its performance, follow these guidelines:

• Do not expose the system to temperature extremes. Ambient temperatures should remain between 0 °C and 50 °C. System performance may be adversely affected if temperatures fluctuate above or below this range.

• Clean the Analyzer only by wiping it down with a clean, lint-free cloth dampened with a mild detergent solution. Do not spray liquid directly on or immerse the unit.


1-8

Instrument Familiarity Figure 1-3 shows the top and front panel controls and indicators of the Analyzer. Table 1-3 lists these components with accompanying descriptions. Figure 1-4 shows the rear panel controls and indicators, and Table 1-4 lists and describes these components.

F1

ESC

ENT

F2F3

F4

F5

CuffLinkNON-INVASIVE BLOOD PRESSURE ANALYZER

CUFFCONNECTCUFF OUTPUTSPULSE

BEEPERVOLUME DISPLAYVIEW

Max

DC

mHg

mmHg

mmHg

Dark

1

2

3

45

67

8

10

11

9

fcv003.eps

Figure 1-3. Analyzer Top and Front Panel Controls and Indicators

Table 1-3. Analyzer Top and Front Panel Controls and Indicators

Label Component Description

A Display The LCD (Liquid Crystal Display) is a full alphanumeric and graphic display. The maximum number of characters able to be on a single line at any given time is 40, and the number of lines from top to bottom is 8, thereby producing a possible 320 character display. The graphics mode of the display is defined by a grid of 64 vertical pixels by 240 horizontal pixels. This mode enables display of the cuff pressure waveform.

Display viewing angle is adjustable, so if the display appears blank (view angle set too low), or dark (view angle set too high) the view angle may need to be adjusted for optimum visibility (see Display View Control Knob).

Introduction and Specifications Instrument Familiarity 1

1-9

Table 1-3. Analyzer Top and Front Panel Controls and Indicators (cont.)


B Esc Key The Esc (escape) key enables the user to exit any menu, exit without saving new data, or abort any function of CuffLink. Continuously holding down the Esc key will return the user to the CuffLink logo display from any menu.

C Function Keys The function keys are labeled Fl through F5. Pressing any one of these keys will execute the function, defined by software, that is displayed above that particular key.

D Cuff Connect A quick disconnect type of port provides the output connection from the pulse producing motor inside Cufflink, to the line connecting the cuff and the BP patient monitor.

E Cuff Output This is a voltage output proportional to cuff pressure (10mv/mmHg). It is always active with a range of -5 V dc to +5 V dc (-500 mmHg to +500 mmHg). The accuracy is specified for positive pressures only.

Example:

1.0 V = 100 mmHg 2.5 V = 250 mmHg

This signal is also useful when connected to a storage oscilloscope or strip recorder to observe the cuff inflate/deflate cycle.

Output impedance is 100 Ω.

F Pulse output This is a voltage output proportional to pulse pressure. It is only active when Cufflink is outputting pressure pulses. The output is at 0 V in the inactive state. The pulse voltage is taken from the pressure transducer and the large static cuff pressure is subtracted. For example, if the cuff is inflated to 150 mmHg and the pulse is 1.2 mmHg in amplitude, only the 1.2 mmHg portion of the signal is presented at this output.

The pulse output voltage is 1 V dc/mmHg and has a range of -5 VDC to +5 VDC (-5 mmHg to +5 mmHg).

Example:

1.0 V = 1.0 mmHg pulse

0.5 V = 0.5 mmHg pulse

When Cufflink is simulating blood pressure it removes the static cuff pressure from the pulse output (forcing it to 0 VDC) at the beginning of each heartbeat. During the heartbeat the amplitude of the pulse is output. As the cuff deflates (or inflates) this process is repeated for each heartbeat.



1-10

Table 1-3. Analyzer Top and Front Panel Controls and Indicators (cont.)


G Sync Output This is a logic level (0 to 5VDC) that outputs a pulse at the start of every heartbeat. When CuffLink is not outputting pressure pulses this output is at OVDC. When CuffLink is outputting pressure pulses the output is high (5VDC) during the pulse and low between the end of one pulse and the start of the next pulse. This output is useful for measuring heart rate and synchronizing a scope trigger for viewing individual pressure pulses on the pulse output.


H Beeper Volume Control Knob The amplitude of the CuffLink audible feedback may be adjusted by turning the beeper volume control knob. Turning the knob clockwise (towards the MAX label next to the knob) will increase the volume of the beeper, while turning the knob counterclockwise will decrease the beeper volume.

I Display View Control Knob The angle at which the display is most visible is adjustable with the display view control knob. Turning the knob clockwise (towards the DARK label next to the knob) will increase the contrast of the display, or make the display darker. Turning the knob counterclockwise will decrease the contrast, making the display lighter.

J Ent Key Pressing the Ent (enter) key will select a highlighted menu, initiate a CuffLink function, or store data in EEROM. In effect, the enter key is the opposite of the Esc key.

K Arrow keys The arrow keys are the cursor control keys. Pressing the up arrow key moves the cursor on the display in a upward direction or increases the highlighted value. Pressing the down arrow key moves the cursor on the display in a downward direction or decreases the highlighted value. The down arrow key is also capable of pulling down the submenus of a highlighted main menu. Pressing the left or right arrow keys will produce cursor movement in the corresponding direction. Holding any arrow key down continuously will cause a repeating of the action of that key.

L Handle The handle for transporting CuffLink is located on the right side of the instrument case.

Introduction and Specifications Instrument Familiarity 1

1-11

I 115

O

FUSE T3.15a 100-115 VAC 50/60HzFUSE T1A 200-230 VAC 50/60Hz INPUT POWER 60 VA

CuffLink sn 3480

FLUKE BIOMEDICAL CORPORATIONCARSON CITY, NEVADA

MADE IN THE U.S.A

PRINTER

SERIAL NUMBER 3480

RS232

2 3 4 51

679 8

fcv004.eps

Figure 1-4. Rear Panel Controls and Indicators

Table 1-4. Rear Panel Controls and Indicators


A Power Cord Input The input for the Cufflink power cord is located next to the power switch. This is the connection for the detachable power cord.

B Power Switch The on position of the power switch is represented by 1 and the off position is labeled 0.

C Fuse Cover The fuse(s) are located behind the fuse cover. The fuse cover may be carefully pried open at 3a.

D Voltage Selector CuffLink is able to operate on two different line voltages. The voltage selector indicates the voltage (either 120V or 240V) at which CuffLink will operate. There are an additional two voltages (100V and 220V) listed on the back panel. These do not apply to CuffLink.

E Fan Intake A hole cut in the rear panel of the case provides ventilation for Cufflink from the fan. Care should be exercised not to block the fan intake or to insert anything into the metal protector.

F RS232 Port This is the connector for the RS-232 serial interface. It is a 25 pin (DB25), male, D shell connector (same pinout as PC compatible computer).

G Printer Port The connector for the parallel printer is a 25 pin (DB25), female, D shell connector. The printer port is Centronics compatible (same pinout as a PC compatible computer).


1-12

Table 1-4. Rear Panel Controls and Indicators


H Serial Port The four digit Cufflink serial number is located above the printer port. The serial number should be documented along with the model number whenever Cufflink is shipped to Dynatech Nevada.

I Fuse Label The fuse label documents the type of fuses needed. Use one 1ASB 250 V ac fuse (DNI part no. 1005-0184) if Cufflink is set for 120 V operation, and two 1/2 A 250 V ac fuses (DNI part no. 1005-0185) if Cufflink is set for 240 V operation.

Replacing Fuses

1. Turn Cufflink's power off and unplug the power cord.

2. Remove the fuse cover with a small blade screwdriver. The plastic fuse holder should pop out of the Cufflink case.

3. Use the screwdriver to pry the old fuse out of the plastic holder.

4. Install the new fuse.

5. Replace the fuse holder by simply pushing the fuse holder back into place.

Specifications The following are general and electrical specifications for the Analyzer.

Physical Dimensions Size ......................................................................... Width 12.5 inches

Height 5.0 inches Length 15.0 inches

Weight..................................................................... 15 pounds

Power Requirements Power ..................................................................... 120/250 V ac

50 Watts average 100 Watts peak 50/60 Hz

Input voltage range...................................................... 60 VA Fuses ...................................................................... T3.15a 110-115 V ac 50/60 Hz

T1A 200-300 V ac 50/60 Hz

Environmental Conditions Operating Temperature........................................... 15 °C to 40 °C Storage Temperature.............................................. -20 °C to +65 °C Relative Humidity .................................................... 90 % max

Introduction and Specifications Specifications 1

1-13

Display Alphanumeric and Graphic LCD Display

Alphanumeric Mode............................................ 8 lines by 40 characters Graphics Mode ................................................... 64 vertical by 240 horizontal dot matrix

Illumination.............................................................. Backlight with Viewing Angle Adjustment Displayed Graphics................................................. Dynamic real-time NIBP cuff-pressure waveform, programmed peripheral pulse and envelope waveforms

Control Keys Function Keys ........................................................ F1 to F5

Enter Escape

Cursor .................................................................... Up Down Left Right

Parameter Selections Menus ..................................................................... Pull down with on-screen help Function keys.......................................................... Software defined, F1 to F5

Storage Environment............................................................ Store in a dry area, temperature range of 32°F to 122°F. Inspection or maintenance during storage.............. None required

Digital Interfaces RS232/Serial........................................................... Baud Rates: 300, 600, 1200, 2400, 4800, 9600

Stop Bits: 1, 2 Parity: Odd, Even, Off Handshake: Xon/Xoff, RTS/CTS, None

Parallel Port (Printer) .............................................. Centronics compatible Pulse Sync .............................................................. 0 to 5 V dc (TTL)

Target Blood Pressure Selections

Select BP Target Value (MAP)

(mmHg) HR

(BPM) Waveform Type

Adult 60/30 (40) 80/50 (62) 100/65 (75) 120/80 (90) 150/100 (115) 200/150 (165) 255/195 (215)

30 40 60 120 160 200 240

Normal Sinus

Neonate 60/30 (40) 80/50 (62) 100/65 (75) 120/80 (90) 150/100 (115)

30 40 60 120 160 200 240

Normal Sinus

Arrhythmias 120/80 (90) 80 Premature Atrial Contraction Premature Ventricular Contraction Atrial Fibrillation Missed Beat Aberrant Sinus Conduction


1-14

Preprogrammed Pulse Envelope Horizontal Axis (cuff pressure) ............................... 0 to 300 mmHg in 1.0 mmHg steps Vertical Axis ............................................................ 2.0 mmHg (nominal)

100% gain with normal adult cuff 0 to 2% selectable

Pulse Amplitude (adult) .......................................... 2.0 mmHg @ MAP 100% gain Repeatability ........................................................... ±1 % of selected target value

Pulse Waveforms

Pulse ID # Pulse Width (ms) Rise Time (ms)

0 800 270

1 500 165

2 250 85

3 720 90

4 230 80

5 280 96

6 350 100

7 480 108

8 980 180

9 1980 460

10 1480 330

Digital Manometer Pressure Range ...................................................... Maximum = 499.75 mmHg Measurement Parameters ...................................... Instantaneous and peak Pump....................................................................... 2.0 liter/minute minimum (free flow)

Automated Leak Testing Start Pressure ......................................................... Maximum = 499.75 mmHg Elapsed Time.......................................................... Fixed at 60 seconds Leak Rate Range.................................................... 0.25 to 499.75 mmHg/minute Pump....................................................................... 2.0 liter/minute minimum (free flow)

Monitor Pop-off Relief Valve Testing Measurement Parameters ...................................... Instantaneous and peak pressure Maximum Pressure ................................................. 499.75 mmHg

Accuracy Dynamic NIBP Response Repeatability (Systolic/Diastalic/Mean)......................................... ±1 % of Target Value Cuff Pressure .......................................................... ±1.0 % of reading (±1 mmHg) Input Overpressure Limit......................................... ±1500 mmHg

Introduction and Specifications Specifications 1

1-15

Ranges for MAKEARM Test Values On Line Cuff Pressure ............................................ 0.0 to 500 mmHg on display

0.0 to 300 mmHg on graph Peak Cuff Pressure................................................. 500 mmHg peak Inflate Time ............................................................. 0.1 to 999.9 seconds Inflate Rate.............................................................. 0.1 to 999.9 mmHg/second Deflate Time............................................................ 0.1 to 999.9 seconds Deflate Rate ............................................................ 0.1 to 999.9 mmHg/second Total Measurement Time........................................ 999.9 seconds maximum Heart Rate............................................................... 30

40 60 80 120 160 200 240

Analog Outputs Cuff Pressure .......................................................... 0 to 499.75 mmHg FS, ±1.0 % of reading,

±±.0 mmHg (cuff) 10 mV/mmHg

Pulse Pressure........................................................ 0 to 5.0 mmHg FS, ±1.0 % of reading 1.0 V/mmHg

Mandrels Adult........................................................................ Five interlocking plastic blocks that produce four circumferences;

a maximum cuff width of 15.25 cm: Large Adult ................................................................ 39.5 cm; use all blocks Adult.................................................................... 33 cm; use 2 curved end blocks and 2 rectangle blocks Small Adult.......................................................... 26.6 cm; use 2 curved end blocks and 1 rectangle block Child.................................................................... 20 cm; use 2 curved end blocks

Neonate .................................................................. One plastic truncated cylinder that accommodates three different circumferences: 14 cm, 10 cm, and 7.6 cm; maximum cuff width of 7.6 cm.


1-16

Accessories Table 1-5 lists standard accessories provided with the Analyzer.

Table 1-5. Standard Accessories

Accessory Part Number

Soft vinyl accessory pouch 2248408

Operators Manual 2242915

Hospital grade power cord set 2198846

Adult cuff mandrel spacer blocks 2392381

Cuff/hose adapters (8)

Male/Female LUER Locking

Female/Mole LUER Non-Locking Taper

5/32" Male/Male Hose Barb

¼” Male/Male Hose Barb

1/8" Male/Male Hose Barb

Male/Female Clippard (Critikon, Siemens)

Colder/CPC (Marquette, Protocol)

OBAC Quick Release (Hewlett Packard)

2242233

2242225

2242257

2242284

2242240

2242190

2242202

2242216

Adult cuff mandrel end blocks (two required) 2230305

External cuff mandrel neonatal (truncated plastic cylinder diameters: 7, 6, 10, and 14 cm)

2392328

2-1

Chapter 2 Operation

Title Page

Powering Up the Analyzer................................................................................. 2-3 Menu Structure and Navigation ......................................................................... 2-3 Preliminary Procedures...................................................................................... 2-6

Assembling Equipment ................................................................................. 2-6 Making Connections...................................................................................... 2-8 Observing Results.......................................................................................... 2-9 Selecting Heart Rate (HtRate) ....................................................................... 2-10 Adjusting the Pressure Envelope (AdjEnv)................................................... 2-11

Simulating Adult Blood Pressure....................................................................... 2-14 Setting Zero Pressure..................................................................................... 2-15 Simulating Other ADAMS Family Target Values ........................................ 2-16 NIBP Monitor Testing Sequence................................................................... 2-16

Simulating Neonatal Blood Pressure ................................................................. 2-17 Simulating Arrhythmias..................................................................................... 2-18 Pressure Testing................................................................................................. 2-19

Leak Testing .................................................................................................. 2-19 Manometer Function ..................................................................................... 2-20 Pop Off Test .................................................................................................. 2-21

Utility Functions ................................................................................................ 2-22 Set Clock ....................................................................................................... 2-22 Pop Time ....................................................................................................... 2-24 Logo............................................................................................................... 2-25 System Functions........................................................................................... 2-25

Establishing Communications ........................................................................... 2-31 Configuring RS232........................................................................................ 2-31 Testing the RS232 Port and Connections ...................................................... 2-32

Using Auto Sequences ....................................................................................... 2-33 Executing an Auto Sequence......................................................................... 2-33 Utilities .......................................................................................................... 2-34

Printing Documents ........................................................................................... 2-37 Printing Blood Pressure Test Results ............................................................ 2-37 Printing Manometer, Leak Test, and Overpressure Test Results .................. 2-38 Printing Auto Sequences ............................................................................... 2-38


2-2

Operation Powering Up the Analyzer 2

2-3

Powering Up the Analyzer To power up the Analyzer, follow these directions: 1. Attach the supplied power cord to the power cord input on the back panel. 2. Plug the unit into a properly rated outlet. 3. Turn the Analyzer on by pushing the power switch on the back panel to the ON

position (marked I). The Analyzer performs a self test and system initialization, during which the logo display is visible for about five seconds:

F1 F2 F3 F4 F5

16:15:36 09/19/07 CuffLink

3.21, Pump

Non-Invasive Blood Pressure Analyzer

fcv101.eps

The current time and date is in the upper right hand corner, and the software revision, along with installed options, appears directly below the Analyzer name. After the five-second logo display, the Main Menu displays:

F1 F2 F3 F4 F5

Select BP Press Util Comm Auto

ADAMS AdultADAMS AdultADAMS NeonateArrythmias

Select adult ADAMS family blood pressure

fcv096.eps

Menu Structure and Navigation The Main Menu options listed across the top of the display are: • Select BP (Select Blood Pressure) • Press (Pressure Tests) • Util (Utilities) • Comm (Communications Ports) • Auto (Auto Sequences) Each of these options has its own submenu. See Figure 2-1 for a complete menu map. Along the bottom of the Main Menu display is a brief description of the contents or purpose of the highlighted menu option. If a pull down menu, or submenu, is visible below the highlighted Main Menu option, the menu description refers to what is available in the highlighted submenu.


2-4

After initialization, ADAMS Adult (in the Select BP submenu) is highlighted as the default. Pressing the Esc key twice returns to the logo display and initialization procedure.

Select BP Press Util Comm Auto

ADAMS Adult Leak Test Set Clock Configure Execute

60/30 (40) Manometer Pop Time Comm Test Utility

80/50 (62) Pop Off Logo Edit

100/65 (75) System View

120/80 (90) Print Test Name

150/100 (115) Key Test Print

200/150 (165) Speaker Test Init

255/195 (215) 440 Print All

HiRate Adjust Play Init All

AdjEnv Adjust Freq

Print Adjust Period

Zero Pressure Sweep

ADAMS Neonate Display Test

60/30 (40) Short

80/50 (62) Long

100/65 (75) Disply QC Date

120/80 (90) ROM Checksums

150/100 (115) U2

HiRate U3

AdjEnv U4

Print Config Init

Zero Pressure User Envelope

Arrhythmias Store User

NSR Recall User

PAC Draw User

PVC Print User

AF Make Arm

MB Pulse

ASC Select

Scale

Draw

Rate

Figure 2-1. Analyzer Menu Map

Operation Menu Structure and Navigation 2

2-5

To navigate the system of menus:

Note Holding any of the keys down results in a repeating action of that key

1. Highlight a Main Menu option by pressing a left or right arrow key.

Note When the desired menu is highlighted and no submenu is shown, press the Down arrow to pull down the submenu.

2. Press either the Up or Down arrow key to move the dark blue rectangle (hereafter referred to as the cursor) up or down in the submenu.

3. When the cursor is at the desired location on any menu, press the Ent (enter) key to select or activate the highlighted option.

4. When finished, take one of the following actions: a. Press the Esc key to return to the previous menu. For example, pressing Esc

when the Set Clock display is visible returns one step back to the Util submenu. b. Hold the Esc key down to return from any menu or submenu back to the logo

display and initialization procedure.


2-6

Preliminary Procedures The analyzer simulates a human arm and produces target value blood pressures for the purpose of testing the accuracy of blood pressure readings on an NIBP monitor. The test is initiated from the Select BP Main Menu option that provides the parameters listed in Table 2-1.

Table 2-1. Blood Pressure Parameters Provided by the Select BP Option

Adult Neonate Adult

Arrhythmias

Blood Pressure (mmHg)

Mean Arterial Pressure (mmHg)

Blood Pressure (mmHg)

Mean Arterial Pressure (mmHg)

60/30 80/50

400/65 120/80

150/100 200/150 255/195

40 62 75 90

115 165 215

60/30 80/50

400/65 120/80

150/100

40 62 75 90 115

Heart Rate Selections

Premature Atrial Contractions

Premature Ventricular Contraction

Atrial fibrillation

Missed Beat

Aberrant Sinus Conductions

Blood Pressure and Heart Rate

30 40 60 80 120 160 200 240

Blood Pressure fixed at 120/80 (90)

Heart Rate fixed at 80 BPM

Assembling Equipment The following equipment is needed to test NIBP monitor blood pressure readings. Figure 2-2 shows the proper way to combine Adult cuff mandrels to simulate various sizes of arms. • NIBP monitor • NIBP Analyzer • Mandrel (supplied with the Analyzer) • BP cuff • Hoses to attach the cuff to the monitor • Cuff adapter for the monitor DUT (device under test) (supplied with the Analyzer)

Operation Preliminary Procedures 2

2-7

Large Adult Use 2 end blocks and3 spacer blocks

Use 2 end blocks and2 spacer blocks

Use 2 end blocks and1 spacer blocks

Use 2 end blocks andno spacer blocks

Adult Cuff Mandrel Sizes:

Adult

Small Adult

Child

fcv011.eps

Figure 2-2. Adjustments for Adult Cuff Mandrel

Figure 2-3 shows the neonate mandrel.

LargeMedium

Small

fcv012.eps

Figure 2-3. Neonate Mandrel


2-8

Making Connections Figure 2-4 is an annotated diagram of the properly-connected test system.

NIBP Monitor

Cuff Connector

“T” ConnectorCuff Adapter

Cuff Mandrel

Cuff Connect Port(front panel)

To connect: Push Cuff Adapterin until a click is heard.To disconnect: push sleeveback to release Cuff Adapter.

Must be connected closerto cuff than monitor

Cufflink

BP Cuff

Wraps around mandrel

Pneumatic Hose(s)

Dual hose systems: connectCuff Adapter to hosemarked “Sense”. If bothhoses are unmarked,connect Cuff Adapter toeither hose.

fcv015.eps

Figure 2-4. NIBP Test System Diagram

To correctly connect the components of the test system: 1. Attach the BP cuff to the NIBP monitor as shown in Figure 2-4. Refer to the monitor

operators manual, as necessary. 2. Wrap the cuff tightly around the appropriate mandrel. See Figures 2-2, and 2-3. 3. Connect the cuff adapter T connector into the line nearest the cuff.

If the NIBP monitor has two pneumatic hoses connected to the cuff, insert the cuff adapter into the hose labeled Sense. If neither hose is labeled, insert the cuff adapter into either hose.

Note Do not connect the cuff adapter to the Analyzer until the Analyzer has warmed up for at least 15 minutes.

4. Power up both the Analyzer and the NIBP monitor.


2-9

The Analyzer is now ready to simulate the human arm and reliably evaluate the accuracy of the NIBP monitor.

Observing Results Results of the analysis are provided by the Analyzer Makearm display, shown in Figure 2-5.

200

160

120

40

0 10

Cuff Pressurein mmHg

Elapsed time in seconds

Heart Rate Indicator(appears during testing)

Current BPTarget Value MAP

Cuff Pressure Waveform(drawn during testing)

Measuredparameters

CuffPresCuffPeakDeflRateDeflTimeInflRateInflTimeTotlTime120/80

01625.1

17.546.73.3

22.0(90) A

20 30

80

fcv016.eps

Figure 2-5. Makearm Display of Test Results

The Makearm display includes a graph, the vertical axis of which indicates the cuff pressure in millimeters of mercury (mmHg). The horizontal axis indicates elapsed time in seconds. The graph is auto-ranging; if the cuff pressure curve values extend beyond the displayed ranges, the entire graph is redrawn on the display to make the curve appear more compact. On the right side of the display are listed the measured test parameters, as defined in Table 2-2.


2-10

Table 2-2. Measured Test Parameters

Abbreviation Parameter Unit of Measurement

CuffPres On-line Cuff Pressure mmHg

CuffPeak Peak Cuff Pressure mmHg

DeflRate Deflate Rate mmHg/second

DeflTime Deflate Time seconds

InflRate Inflate Rate mmHg/second

InflTime Inflate Time seconds

TotlTime Total Measurement Time seconds

The current blood pressure target value is shown just below the list of test parameters on the Makearm display and indicates which BP target value is currently being simulated by the Analyzer.

Selecting Heart Rate (HtRate) To select the heart rate to be tested: 1. From the Select BP submenu, highlight ADAMS Adult (or ADAMS Neonate)

and press the Ent key. The ADAMS Adult Family Target Values screen displays:

F1 F2 F3 F4 F5

*** ADAMS Adult Family *** Target Values 60/30 (40) 150/100 (115) 80/50 (62) 200/150 (165) 100/80 (75)100/80 (75)

HtRate AdjEnv Print ZeroPres

fcv100.eps

2. Highlight the blood pressure target value to be simulated. 3. Press F1 HtRate.

Note The term ADAMS Family refers collectively to Adult and Neonate options.


2-11

The Analyzer displays the available heart rates:

F1 F2 F3 F4 F5

*** Select Heart Rate (BPM) ***

30 40 60 80 120 160 200 240

Use arrow keys to select new heart rate.

fcv017.eps

4. Use the arrow keys to choose a heart rate and then press the Ent key. A popup window briefly displays, confirming the heart rate chosen.

80 BPM

5. When the target value display reappears, press the Ent key to display the Makearm graph. The current heart rate setting is shown in the upper part of the Makearm graph next to CuffPres:


0 162 5.1 17.5 46.7 3.3 22.0(90) A

200

160

120

40

0 10 20 30

80 BPM

Current Heart Rate Setting

80

fcv018.eps

Adjusting the Pressure Envelope (AdjEnv) To modify the gain (amplitude) or shift (BP value) of the blood pressure envelope and to draw the envelope specified: 1. From the Select BP submenu, highlight ADAMS Adult or ADAMS Neonate and

press the Ent key. 2. Highlight the blood pressure target value to be simulated. 3. Press F2 AdjEnv to display the Pressure Curve Adjust screen:


2-12

F1 F2 F3 F4 F5

*** Pressure Curve Adjust ***

120/ 80 (90)

Draw Shift Gain%

fcv111.eps

1. Press F1 Gain% to move the selection box to Gain% and use the Up and Down arrow keys to change the percent of gain. This factor affects the pressure pulse amplitude. The default value is 100 %, and the range is from 1 % to 200 %. A change in the Gain% appears below the heart rate on the Makearm graph:


0 162 5.1 17.5 46.7 3.3 22.0(90) A

200

160

120

40

0 10 20 30

80 BPM

G 50S 12

Envelope Gain%

80

fcv020.eps

2. Press F2 Shift to move the selection box to Shift and use the Up and Down arrow keys to shift the entire blood pressure envelope to the left (- shift, Down arrow) or right (+ shift, Up arrow). If a target value of 120/80 is selected with a shift of +10 mmHg, the actual blood pressure target value simulated changes to 130/90. The default value for a shift is 0 mmHg, and the range is from -100 mmHg to +100 mmHg. The graphs below illustrate a blood pressure envelope with no shift, a negative shift, and a positive shift, respectively:


2-13

Max

Pressure Envelope

1000

Min

mm

1

1.0

0.8

0.6

0.4

0.2

0 40 80 120 160 200

fcv021.eps

Max1000

Min

mm

1

1.0

0.8

0.6

0.4

0.2

0 40 80 120Negative 10 mmHg Shift

120/80/Envelope

160 200

Max1000

Min

mm

1

1.0

0.8

0.6

0.4

0.2

0 40 80 120Positive 10 mmHg Shift

160 200

fcv022.eps

A change in the Shift appears below the Gain% on the Makearm graph:


2-14


0 162 5.1 17.5 46.7 3.3 22.0(90) A

200

160

120

40

0 10 20 30

80 BPM

G 50S 12

Envelope Shift

80

fcv023.eps

3. Press the Esc key to undo any changes. 4. When finished, press the Ent key to save the pressure envelope and return to the

Pressure Curve Adjust screen. 5. When finished, press F3 Draw to view the pressure envelope. 6. Press the Ent key. The user is now ready to start the NIBP monitor, simulate the blood pressure, and take measurements.

Simulating Adult Blood Pressure To simulate the ADAMS Adult 120/80 Blood Pressure target value: 1. From the Select BP submenu, highlight ADAMS Adult and press the Ent key.

Target values and available blood pressures are displayed for the ADAMS Adult Family Target Values screen. The cursor is initially at 120/80. The heart rate is fixed at 80 BPM.

2. Press the Ent key to enter the Makearm function for a blood pressure of 120/80. The Analyzer briefly displays a confirmation, verifying which parameter was chosen:

120/80 (90)

Note The analyzer pop-up windows are not visible if Pop Time is set to 0.00

Operation Simulating Adult Blood Pressure 2

2-15

The Makearm display appears:

200

160

120

40

0 10

Cuff Pressurein mmHg

Elapsed time in seconds

Heart Rate Indicator(appears during testing)

Current BPTarget Value MAP

Cuff Pressure Waveform(drawn during testing)

Measuredparameters


01625.1

17.546.73.3

22.0(90) A

20 30

80

fcv024.eps

Setting Zero Pressure The value for cuff pressure (CuffPres) in the upper right corner of the Makearm display should be zero (0 mmHg) before a test is started.

Note After warm-up, the value for CuffPres becomes stable, making it unnecessary to continually zero the cuff pressure.

To zero the cuff pressure during the 15 - 20 minute warm up period: 1. If the value is not zero, press the Esc key to return to the previous menu.

Note Make sure that nothing is connected to the Analyzer CUFF CONNECT port.

F1 F2 F3 F4 F5

*** ADAMS Adult Family *** Target Values 60/30 (40) 150/100 (115) 80/50 (62) 200/150 (165) 100/80 (75)100/80 (75)


fcv100.eps

2. Press F5 ZeroPres to zero the pressure. A popup message appears, indicating that the cuff pressure has been set to match the atmospheric pressure:

n.nn mmHg removed


2-16

3. Press the Ent key to view the Makearm graph. If the cuff pressure is not set to zero, repeat the above procedure.

Simulating Other ADAMS Family Target Values Simulation of any of the ADAMS Family target values follows the same procedure as that of the 120/80 simulation: 1. From the 120/80 Makearm display, press the Esc key to return to the ADAMS

Family Target Values screen. 2. Choose the desired target value, as indicated in Table 2-1. 3. Press the Ent key. The Makearm display reappears with a new target value listed

below TotlTime.

NIBP Monitor Testing Sequence To test the accuracy of the NIBP monitor: 1. When the cuff pressure is zero, connect the cuff adapter to the Analyzer. 2. Initiate the NIBP monitor testing sequence, referring to the monitor operators manual

as needed. The following sequence occurs: • The cuff inflates around the mandrel. • The analyzer starts the peripheral pulse simulation and draws a curve

representing the cuff pressure (oscillometric technique) as the test progresses. • The analyzer initiates blood pressure simulation when the inflate pressure reaches

8.0 mmHg. • When simulation begins, a small flashing heart becomes visible to the left of

Total Test Time (TotlTime, on right side of graph). This represents the heart rate. Each color change of the heart signifies one heartbeat.

• The analyzer terminates the simulation when the pressure upon deflate reaches 6.0 mmHg.

• The NIBP monitor interprets and displays the measured blood pressure values and heart rate at the completion of the test.

3. Compare the monitor values with the target values displayed on the Makearm display.

Note It is normal for the monitor to have a different reading from the target value displayed on the Makearm display. Readings may also be different when the monitor is in the stat mode rather than the normal (automatic) or manual mode. The objective is that readings be consistent and repeatable. Accuracy for the target values cannot be specified because no standard for blood pressure measurements exists.

Operation Simulating Neonatal Blood Pressure 2

2-17

Simulating Neonatal Blood Pressure Neonatal blood pressure is simulated and the monitor is tested in the same way as for Adult blood pressure, with appropriate cuff and value differences. Target values are also chosen from the Select BP submenu.

Note Use the neonate mandrel with a neonate cuff when simulating neonatal blood pressure.

To simulate neonatal blood pressure: 1. From the Select BP submenu, highlight ADAMS Neonate and press the Ent key.

The ADAMS Neonate Family Target Values screen displays:

F1 F2 F3 F4 F5

*** ADAMS Neonate Family *** Target Values 60/30 (40) 150/100 (115) 80/50 (62) 200/150 (165) 100/80 (75)100/80 (75)


fcv103.eps

2. See Table 2-1 for desired neonate target blood pressure values.

3. Use the same steps as for Simulating Adult Blood Pressure: • Select the heart rate • Adjust the pressure envelope • Set zero pressure • Run the NIBP monitor testing sequence



2-18

Simulating Arrhythmias The analyzer simulates five typical patient arrhythmias to test NIBP monitors. These simulations are a representation of the peripheral pulse as seen by an oscillometric NIBP monitor during arrhythmic activity. Each arrhythmia is generated on a random basis throughout the entire pressure curve cycle. Arrhythmia types are described in Table 2-3.

Table 2-3. Arrhythmia Types

Parameter Description

Premature Atrial Contraction (PAC) The first pulse of the PAC cycle is premature and lower in amplitude than a normal sinus pulse. The next pulse is back in sync with normal sinus and slightly higher in amplitude. All subsequent pulses are normal.

Premature Ventricular Contraction (PVC) This is a representation of the peripheral pulse similar to PAC but with a different amplitude.

Atrial Fibrillation (AF) The AF cycle has an irregular R to R interval. Its occurrence and properties (early vs. late) are random throughout the pressure curve cycle.

Missed Beat (MB) A complete beat is randomly skipped during the pressure curve cycle. The following beat reverts to normal R to R intervals.

Aberrant Sinus Conduction (AS) The AS cycle inserts one pulse so low that is virtually non-existent. This causes the Analyzer to skip one distal pulse and then return to normal sinus pulses.

Testing with Adult Arrhythmias To test the monitor with simulated adult arrhythmias: 1. Connect the Analyzer to the NIBP monitor, as shown in Figure 2-4. Use an adult

mandrel. 2. From the Select BP submenu, highlight Arrhythmias and press the Ent key. The

Arrythmia Selections screen displays:

F1 F2 F3 F4 F5

*** Arrythmia Selections ***

Norm. Sinus (NSR) Atrial Fib. (AF) Atrial (PAC) Missed Beat (MB) Ventricular (PVC) Aberr Sinus (AS)

DrawPrint ZeroPres

fcv102.eps

3. Select an arrhythmia type and press the Ent key. See Table 2-3 for available adult arrhythmia simulation types.

4. If the cuff pressure is not zero, press F5 ZeroPres to return the pressure to zero before testing.

5. Start the NIBP monitor and begin testing.

Operation Pressure Testing 2

2-19

Note The baseline heart rate for all arrhythmias is set to 80 BPM.


7. Press F3 Print to print the arrhythmia test results. 8. Press F4 Draw to display the pressure envelope pulse.

Pressure Testing The analyzer enables the user to test for pressure leaks in the test system, measure general pressure, and evaluate the monitor’s pressure release valve. All three of these functions are accessed from the Press submenu:

F1 F2 F3 F4 F5

fcv099.eps

Leak Testing The Leak Test option allows testing of NIBP equipment, including cuff and tubing, for air leaks.

Note If the NIBP device has an internal system leak test or one that vents the cuff inflation pneumatic circuit to the atmosphere when idle, do not use the Leak Test option. Rather, use the Manometer option to check for internal system leaks. Refer to the NIBP monitor operators manual for the recommended test protocol.

To test for pressure leaks in the NIBP test system: 1. From the Press submenu, highlight Leak Test and press the Ent key. The Leak

Test screen displays:

F1 F2 F3 F4 F5

*** Leak Test ***

Pressure actual (mmHg): -0.75 TargetPressure drop (mmHg): 15.50 200Elapsed time (min:sec): 1: 0Leak rate (mmHg/min): 15.50

Reset Utility Start Pump Release Pressure

fcv027.eps

From the Leak Test screen, several options can be selected. 2. If necessary, set the cuff pressure to zero, as described in Simulating Adult Blood

Pressure: Setting Zero Pressure, above.


2-20

3. Press F5 Utility to display the Utility options, as described in Table 2-4. Use the arrow keys to highlight a desired option and press the Ent key to select it. When finished, press the Esc key once to return to the Leak Test screen.

Table 2-4. Leak Test Utility Options

Option Description

Small, Medium, or Large Cuff Cuff size, or volume, affects the way the Analyzer inflates the cuff for leak testing. Highlight the option and press the Esc key to set the size.

Zero Pressure After pressing the Ent key, the amount of pressure removed (in mmHg) is displayed.

Reset Resets Target Value to 200 mmHg.

Set Target Use the arrow keys to change the Target Value. To save the new value, press Ent. Press Esc to cancel and return to the Leak Test menu.

Print On/Off Use this utility to print Leak Test results.

4. Press F1 Pump to pump air into the system. The pump stops inflating when the actual pressure is equal to the Target value set in the Utility options. This value should be that suggested in the NIBP monitor operators manual.

5. Press F2 Start Test to begin testing for leakage. The Analyzer measures any pressure drop in the system for the duration of one minute. An audible tone sounds at the end of the test period, and measurement stops. Table 2-5 describes the measured parameters.

Table 2-5. Measured Leak Test Parameters


Pressure actual (mmHg) The actual pressure of the BP cuff

Pressure drop (mmHg) The measured drop in cuff pressure as the test progresses

Elapsed time (min:sec) How much time the leak test has taken

Leak rate (mmHg/min) The rate of air leakage at the end of the one-minute test

Target (mmHg) The pressure to which the Analyzer inflates and begins leak testing

6. When finished, press F3 Reset to reset the measurements back to zero.

7. Press the Esc key to exit the Leak Test.

Manometer Function The Manometer option invokes a digital manometer to use for general pressure measurements. To monitor pressure in the NIBP test system with the manometer capability: 1. From the Press submenu, highlight Manometer and press the Ent key. The

Manometer screen displays:

Operation Pressure Testing 2

2-21

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From the Manometer screen, several options can be selected. 2. Press F5 Zero Pressure to zero the pressure if Pressure actual is not zero. 3. Press F1 Pump On/Off to start the pump and inflate the cuff until the NIBP

monitor indicates that the overpressure point has been reached (see the NIBP monitor operators manual).

4. Press F1 Pump On/Off again to stop the pump. The Analyzer displays the pressure in mmHg.

5. Press and hold F2 Release Press to return Pressure actual to zero. If Pressure actual is still not zero, press F5 Zero Pressure.

6. Press F3 Print to print the test results. Table 2-5 describes the measured parameters. 7. Press the Esc key to quit the Manometer mode.

Table 2-6. Measured Manometer Parameters


Pressure actual (mmHg) Pressure in the blood pressure cuff

Pop Off Test The Pop Off test is an overpressure test that evaluates an NIBP monitor's emergency release valve. To monitor pressure in the monitor emergency release valve: 1. From the Press submenu, highlight Pop Off and press the Ent key. The Pop Off

screen displays:

F1 F2 F3 F4 F5

*** Pop Off ***

Pressure actual (mmHg): 2.52Pressure peak (mmHg): 46.32

Print Zero Pressure Reset

Pop Off Pump

Release Pressure

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2. Press F5 Zero Pressure to zero pressure if Pressure actual is not zero. 3. Press F1 Pop Off Pump to start the pump. The Analyzer inflates until the

monitor's release valve activates.


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4. Press F2 Reset to return Pressure actual and Pressure peak to zero. If Pressure actual is still not zero, press F5 Zero Pressure.

5. Press F3 Print to print the test results. Table 2-5 describes the measured parameters.

Table 2-7. Measured Pop Off Test Parameters


Pressure Actual (mmHg) The current pressure in the blood pressure cuff

Pressure Peak (mmHg) The maximum pressure in the system before release of the monitor's emergency valve

6. Press F4 Release Pressure to release all pressure in the system. 7. Press the Esc key to quit the Manometer mode.

Utility Functions The analyzer enables the user to set the clock, adjust pop time, view the logo display, and perform system tests from the Util submenu:

F1 F2 F3 F4 F5

Select BP Press Util Util Comm Auto

Set Clock Set Clock Pop Time Logo System

Set calendar clock

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All of these functions are system tests or adjustments and affect only the Analyzer itself. The NIBP monitor is not affected by the Util options.

Set Clock The Set Clock function allows changes to be made to the clock or calendar, as shown in the upper right corner of the logo display. The time is displayed in an hour, minutes, seconds format, while the date is displayed in the date, day, year format. To set the Analyzer clock: 1. From the Util submenu, highlight Set Clock and press the Ent key. The Set Clock

( labeled Set Time and Date) screen displays:

Operation Utility Functions 2

2-23

F1 F2 F3 F4 F5

*** Set Time and Date ***

Time Date Day Mode ---- ---- --- ----Current: 01:58:35 09/25/07 Tue 12hrAdjust: 01:53:24 09/25/07 Tue 12hr

ESC=Exit, ENT=Store <-> Select, ][ Modify

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The Current row indicates settings for time, date, day, and mode that are currently stored in Random Access Memory (RAM). The Adjust row is where the cursor marks a value to be modified. This is where any changes are made.

Note The Left and Right arrow keys select the time or date value to modify. The Up and Down arrow keys modify the selected value. The arrow key func-tions are shown in the lower right corner of the Set Clock screen. Holding down any key repeats the key's action.

2. Change the hour by putting the cursor on the first two digits in the Time column of the Adjust row, pressing the Up arrow key to increase the value of the number or pressing the Down arrow key to decrease the value of the number.

3. Change the minutes and seconds by moving the cursor to the corresponding position in the Time column and using the arrow keys to change the value.

4. Change the month by putting the cursor on the first two digits in the Date column and using the arrow keys to change the value.

5. Change the day and the year by moving the cursor to the corresponding position in the Date column and using the arrow keys to change the value.

6. Change the mode (a 12-hour or 24-hour clock) by putting the cursor on the first two digits in the Mode column and using the Up and Down arrow keys to toggle the value between the 12-hour and the 24-hour modes. In the 12-hour mode, the clock reads 12:00:00 at midnight. Most clocks display in the 12-hour mode. In the 24-hour mode, the clock reads 24:00:00 at midnight. The 24-hour mode is sometimes referred to as military time.

Note Selecting the 12-hour mode causes an am or pm designator to appear at the end of the Time column

7. To exit the Set Clock function without saving the data, press the Esc key. 8. To save the new data, press the Ent key. New information is stored and available the

next time the Analyzer is powered up. The Analyzer briefly displays a confirmation that the new data has been saved:

Storing DATA


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Pop Time The Pop Time option enables the user to adjust the popup window delay time. When certain functions are chosen from a display (for example, when choosing a blood pressure target value from the Select BP submenu), a message surrounded by a box briefly appears over the information on the display. The box containing this information is called the popup window. The period of time during which the popup window displays is called the pop time. An adjustment in the pop time may be necessary if the popup window flashes on the display too fast to read or if the window stays on the display too long and produces unwanted delays in the testing procedure.

Note The pop up window can be completely eliminated by setting the pop time to 0.00 seconds, a desirable option for the experienced user who does not need such reminders.

To adjust the pop time: 1. From the Util submenu, highlight Pop Time and press the Ent key. The Pop Time

screen displays (actually labeled Adjust Pop Window Delay Time), showing the current pop time (delay time) value in seconds:

F1 F2 F3 F4 F5

*** Adjust Pop Window Delay Time ***

Delay Time (sec): 3.00

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2. Change the pop time by using the Up and Down arrow keys; the cursor is not visible on the Pop Time display. The range of values for Pop Time is from 0.00 seconds to 5.00 seconds and changes by 0.25 second steps. Pressing the Up arrow key once increases the value by 0.25 seconds. Holding the key down quickly increases the displayed value to 5.00 seconds. Pressing the Down arrow key once decreases the value by 0.25 seconds. Holding the key down quickly decreases the pop time to 0.00 seconds.

3. Press the Esc key to discard changes, retaining the current pop time, the Analyzer briefly displays the following confirmation and exits to the Util submenu:

No DATA Stored

4. Press the Ent key to save the modified pop time value. Before exiting to the Util submenu, the Analyzer briefly displays a confirmation that the new value for pop up window delay has been saved:

Storing DATA


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Logo The Logo option shows the Analyzer name, current software revision, time, and date. To view the logo: 1. From the Util submenu, highlight Logo and press the Ent key. The logo is

displayed:

F1 F2 F3 F4 F5

16:15:36 09/19/07 CuffLink

3.21, Pump

Non-Invasive Blood Pressure Analyzer

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2. Press the Esc key to return the display to the Util submenu.

Note No adjustments are possible in the Logo option.

System Functions The System functions, accessed from the Util submenu, are primarily functional self tests, available from the System Utilities screen:

F1 F2 F3 F4 F5

*** System Utilities ***Print Test ROM ChecksumsKey Test Config InitSpeaker Test User EnvelopeDisplay Test Pulse

Send test string to printer

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Print Test The Print Test verifies that the Analyzer can communicate with a connected printer. To carry out the Print Test: 1. Connect the printer to the Analyzer printer port on the rear panel and power on the

printer. 2. On the System Utilities screen, highlight the Print Test option and press the Ent

key. The Analyzer sends a test string through the printer port to the printer. If the Analyzer is communicating correctly, the printer should print the following each time the Ent key is pressed:

Printer test message


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5. If the printer is not connected properly or if there is a fault in the printer system, including the cable, the Analyzer displays:

Printer Not Ready ENT = Retry ESC = Abort

3. Press the Ent key to attempt the print test again or press the Esc key to exit the print test.

Key Test The Key Test verifies that the Analyzer front panel keyboard is functional. To carry out the Key Test: 1. On the System Utilities screen, highlight the Key Test option and press the Ent

key. The Key Test screen displays. 2. Press each key on the keyboard one at a time. A description of each key should

appear after the word Keyboard. If a description of the key that has been pressed does not display, contact the Fluke Biomedical Service Center.

3. Press the Esc key four times to exit the Key Test.

Speaker Test The Speaker Test verifies speaker operation by activating it with signals of various frequencies. Adjustments of frequency (pitch of the sound) and period (length of sound) are also possible. To carry out the Speaker Test: 1. On the System Utilities screen, highlight the Speaker Test option and press the

Ent key. The Speaker Test screen displays. 2. Test the various parameters as desired, according to the instructions in Table 2-8.


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Table 2-8. Speaker Tests and Adjustments

Parameter Procedure

440 Press F1; the speaker produces a 440 hertz, 500 millisecond tone

Adjust Play

Press F2, the speaker produces a tone determined by the settings determined by the Adjust Frequency and Adjust Period values (see below for description) shown in the center of the display.

Adjust Freq

Press F3; the cursor moves to the Adjust Frequency value. When the cursor is at this position, the frequency of the Adjust Play tone may be modified. Use the Up or Down arrow keys to change the value. The Left and Right arrow keys have no effect on this function. Change the value of the frequency and then press F2 (Adjust Play) to hear the difference in the pitch of the tone. As the value of the frequency increases, so does the pitch.

Adjust Period

Press F4; the cursor moves to the Adjust Period value, displayed in milliseconds (ms). When the cursor is at this position, the length of the Adjust Play tone may be modified. Use the Up or Down arrow keys to change the value. The Left and Right arrow keys have no effect on this function. Change the value of the period and press F2 (Adjust Play) to hear the difference in length of the tone. As the value of the period increases, so does the length

Sweep Press F5; the speaker produces a long tone of various frequencies, starting with a low frequency (pitch), gradually increasing to a higher frequency, then returning to the low frequency from which it began.

3. To exit the Speaker Test option, press the Esc key.

Display Test The Display Test verifies the operation of the Analyzer liquid crystal display by writing (displaying) a series of test patterns to the display. Any sections of the display that are not functioning correctly become apparent during this test. To carry out the Display Test: 1. On the System Utilities screen, highlight the Display Test option and press the

Ent key. The Display Test screen displays. 2. Test the various parameters as desired, according to the instructions in Table 2-9.


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Table 2-9. Display Test Descriptions

Test Description

Short Test Press F1 to initiate; this test lasts about 15 seconds and displays two patterns: the Text plane - Character test and the Graphic plane - Solid fill test.

Long Test Press F2 to initiate; this test lasts about 1 minute 10 seconds and displays two patterns: the Text plane - Character test and the Graphic plane - Solid fill test.

Text plane – Character Test

This test shows all of the characters or symbols (character set) that the Analyzer produces, including letters, numbers, and other assorted symbols.

Graphic plane - Solid fill Test

This test evaluates the display's graphic capabilities. The test fills the entire grid of 240 by 64 pixels (the tiny dark squares visible on the display during this test) with a dark blue color. This test demonstrates that all the pixels may be activated correctly.

6. At the end of the Short and Long tests, the Analyzer briefly displays the following

confirmation:

Display test completeHit any key…

7. Press any key to return to the System submenu.

ROM Checksums ROM (Read Only Memory) contains the software that operates the Analyzer. It is located within an Integrated Circuit chip. This type of memory may be read by the Analyzer microprocessor. ROM normally cannot be written to or altered in any way, but information within ROM may occasionally become corrupted for various reasons. The ROM Checksums function performs an evaluation of the ROM installed in the Analyzer system to ensure that the integrity of the ROM is intact. A checksum is a mathematical sum of the code (bytes) in the software program installed in ROM. When the test is finished, a hexadecimal value is displayed that can be verified by contacting the Fluke Biomedical Service Center.

Note ROM Checksums currently can test ROMs U2, U3, and U4, even though U4 has not been installed. Performing a checksum test on ROMs that have not been installed results in an erroneous value.

To carry out the ROM Checksums Test: 1. On the System Utilities screen, highlight the ROM Checksums Test option and

press the Ent key. The ROM Checksums screen displays. This display shows the IC to test, the memory range (in hexadecimal) for the IC, and the calculated checksum value. The checksum values are at xxxx when the ROM Checksum display first appears.

2. Press F1 to select U2. The Analyzer displays the following confirmation for a short period of time while the checksum is taking place:


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Calculating U2

3. Then, a value is displayed for U2 (example: 3B29) :

3B29

4. Verify this number with the Fluke Biomedical Service Center. The checksum value

changes with every Analyzer software revision. 5. Press Esc to exit the ROM Checksums Test and return to the System Utilities

screen.

Config Init The Config Init option reinstalls factory default values for Pop Time, Comm port, and auto sequences, as listed in Tables 2-10 and.2-11

Table 2-10. Pop Time and Comm Port Default Values

Parameter Value

Pop Time 1 second

Communications

Baud Rate 9600

Bits/Character 8

Parity None

Stop Bits 1

Flow Control Xon/Xoff


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Table 2-11. Auto Sequence Defaults

Cycles * BP HR

A1 A2 A3 A4 A5

60/30 (40) Adult 40 1 2 3 4 5

80/50 (62) Adult 60 1 2 3 4 5

100/65 (75) Adult 80 1 2 3 4 5

120/80 (90) Adult 80 1 2 3 4 5

150/100 (115) Adult 120 1 2 3 4 5

200/150 (165) Adult 160 1 2 3 4 5

255/195 (215) Adult 200 1 2 3 4 5

120/80 (80) Adult 80 1 2 3 4 5

Utilities

Pressure Test Yes

Leak Test Yes

Pop Off Test Yes

Print BP Results Yes

* Cycles refer to the number of time that the Analyzer simulates a target value.

To carry out the Config Init function to restore default values: 1. On the System Utilities screen, highlight the Config Init option and press the Ent

key. The Config Init screen displays: 2. If resetting the Analyzer to its default values is not desired, press the Esc key. If

restoration to the default values is desired, press the Ent key. In either case, the Analyzer returns to the System submenu.

User Envelope Factory use only.

Pulse Factory use only.

Operation Establishing Communications 2

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Establishing Communications The Comm function allows the user to modify and test the Analyzer’s RS232 configuration. These functions are accessed from the Comm submenu:

F1 F2 F3 F4 F5

Select BP Press Util Comm Comm Auto

Configure Configure Comm Test

Set baud date, parity and handshake

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Configuring RS232 To configure the RS232 communications settings: 1. From the Comm submenu, highlight Configure and press the Ent key. The

Configure screen displays:

F1 F2 F3 F4 F5

Baud Bits Parity Stop Flow Port 1: Rate Char Mode Bits Control ---- ---- ------ ----- --------Current: 9600 8 none 1 XON/XOFFAdjust: 9600 8 none 1 XON/XOFF

ESC=Exit, ENT=Store <-> Select, ][ Modify

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2. Press the Left and Right arrow keys to select the desired parameter and the Up and Down arrow keys to modify its value. The available settings are listed in Table 2-12.


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Table 2-12. RS232 Settings

Parameter Value

Baud Rate 300

600

1200

2400

4800

9600

Bits/Character 7

8

Parity Mode Even

Odd

None

Stop Bits 1

2


RTS/CTS

None

3. If saving the new values is not desired, press the Esc key. If saving the new values is desired, press the Ent key. In either case, the Analyzer returns to the Comm submenu.

Testing the RS232 Port and Connections To test the RS232 port and its connections: 1. From the Comm submenu, highlight Comm Test and press the Ent key. The

Comm Test screen displays:

F1 F2 F3 F4 F5

*** Comm port test ***Baud, Len, Parity,Stop: 9600,8,none,1 Flow Control: XON/XOFF Transmit Receive Hit F2 to send Hit F4 to clear CuffLink Test this box Transmit Clear

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At the top of the screen are the current settings for the RS232 port. 2. Press F2 Transmit to transmit a signal to whatever is being used as the controller.

The phrase Analyzer Test should appear on the controller's monitor.

Operation Using Auto Sequences 2

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3. Press F4 Clear to clear the receive box on the Analyzer display. When sending data from the controller, information appears in the receive box.

4. Press the Esc key to exit and return to the Comm submenu.

Using Auto Sequences Using auto sequences, the user can simulate any of eight different blood pressures with each of the adult, neonate, and arrhythmias categories, in any combination. In addition, the user can also select the heart rate and cycle count (number of times that the Analyzer simulates a specific blood pressure — from 1 to 99). These functions are accessed from the Auto submenu:

F1 F2 F3 F4 F5

Select BP Press Util Comm AutoAuto

Execute Execute Utility

Execute auto sequences

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Executing an Auto Sequence To execute an auto sequence: 1. From the Auto submenu, highlight Execute and press the Ent key. The Execute

Auto Sequence screen displays:

F1 F2 F3 F4 F5

*** Execute Auto Sequence ***

AUTO-3 AUTO-5 AUTO-2 AUTO-1 AUTO-4

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2. Press the function key below the auto sequence name to start the desired auto sequence.

3. If there is a pressure test, leak test, or pop off test in the auto sequence, press F4 when these tests are done to advance the auto sequence. The Analyzer completes the blood pressure simulations of the auto sequence automatically. If the auto sequence is configured to print, it will do so when the cuff deflates after the last blood pressure test. Otherwise the Analyzer returns to the Execute Auto Sequence display.


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Note If an auto sequence is configured to print and is run before a printer is properly connected to the Analyzer, a Printer Not Ready message displays.If a printout is not desired, select Edit and make sure the Print BP Results line says NO.

Utilities The auto sequence utilities, accessible from the Utility submenu, lets the user edit, view, name, and print auto sequences. To access any of the utilities described below from the Utility submenu (the Auto Sequence Utilities screen), highlight the desired utility option and press the Ent key. The appropriate screen displays.

Edit The Edit utility lets the user change the settings of an auto sequence. To modify the content of an auto sequence: 1. From the Auto Sequence Utilities screen, highlight Edit and select an auto

sequence with the function keys. The three Analyzer auto sequence editing pages are shown below:

F1 F2 F3 F4 F5

Auto-1

Pressure Test. : YESLeak Test..... : YESPop Off Test.. : YESPrint BP Results YES

Store No/Dec PgDn PgUp Yes/Inc

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F1 F2 F3 F4 F5

Auto-1 2 Blood Pressure HR (BPM) CYCLES(1) 60/ 30 ( 40) Adult 40 1(2) 80/ 50 ( 62) Adult 60 1(3) 100/ 55 ( 75) Adult 80 1(4) 120/ 80 ( 90) Adult 80 1


Operation Using Auto Sequences 2

2-35

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F1 F2 F3 F4 F5

Auto-1 3 Blood Pressure HR (BPM) CYCLES(5) 150/100 ( 40) Adult 120 1(6) 120/ 80 (ASC)Arrhyth 80 1(7) 200/150 (165) Adult 160 1(8) 120/ 80 (PVC)Arrhyth 80 1


fcv114.eps

2. Use the Up and Down arrow keys to highlight a test parameter. 3. Press F4 or F5 to increase or decrease the value, respectively. 4. Press F3 Store to save the new data. 5. Press F1 PgUp or F2 PgDn to scroll up or down, respectively, between pages. 6. Select and change parameters on the new page as described in the previous steps. 7. Press the Esc key to quit and return to the Auto Sequence Utilities screen.

View The View utility lets the user see the current configuration of an auto sequence. These displays are view only; to change settings, use the Edit utility. To view the content of an auto sequence: 1. From the Auto Sequence Utilities screen, highlight View and select an auto

sequence with the function keys. 2. Press F1 or F2 to scroll up or down, respectively, between pages. 3. Press the Esc key to quit and return to the Auto Sequence Utilities screen.

Name The Name utility lets the user change the eight character name of an auto sequence. To change the name of an auto sequence: 1. From the Auto Sequence Utilities screen, highlight Name and select an auto

sequence with the function keys. A box with the current auto sequence name appears.

AUTO-1

2. Press the Left and Right arrow keys to move the blinking cursor to the character to be changed; then use the Up and Down arrow keys to scroll through the choices.

3. If saving the new name is not desired, press the Esc key. If saving the new name is desired, press the Ent key. In either case, the Analyzer returns to the Utility submenu.


2-36

Print The Print utility lets the user print the content of the selected auto sequence. For more information about printing auto sequence content and test results, refer to Printing Documents: Printing Auto Sequences, below. To print the content of an auto sequence: From the Auto Sequence Utilities screen, highlight Print and select an auto sequence with the function keys. A Printing Auto Sequence message displays until the document has printed. For example, to print the content of auto sequence #3 (AUTO-3), highlight Print and press F3. Figure 2-6 is a sample printout of auto sequence content.

Cuff Pressure

Description of Terms

Defl Pr Ref = Deflate Pressure ReferenceDefl Time = Deflate TimeDefl Tm Ref = Deflate Time ReferenceInfl Time = Inflate TimePeak Press = Peak Cuff PressurePhyst = Hysterisis PressurePthresh = Threshold PressureTotl Time = Total Time

Peak Press

Defl Pr Ref

Time

Defl Time

Defl Tm RefTotl Time

Pthresh

Pthresh-Physt

Infl Time

Totl Time is variableSet to zero at this point

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Figure 2-6. Sample Printout of Auto Sequence Content

Operation Printing Documents 2

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Init The Init utility lets the user reset an auto sequence to factory default values. To reset an auto sequence to factory default values: 1. From the Auto Sequence Utilities screen, highlight Init and select an auto

sequence with the function keys. The Analyzer warns that the auto sequence is about to be reset.

2. Press the Ent key to reset the values or press the Esc key to return to the Utilities submenu without resetting.

Print All The Print All utility lets the user print the content of all auto sequences. To print the content of all auto sequences: 1. From the Auto Sequence Utilities screen, highlight Print All and press the Ent

key. The Analyzer displays Printing all Auto Sequences while the documents are printing.

Init All The Init All utility lets the user reset all auto sequences to factory defaults. To reset all auto sequences to default values: 1. From the Auto Sequence Utilities screen, highlight Init All and press the Ent

key. The Analyzer warns that all auto sequences are about to be reset. 2. Press the Ent key to reset all values to the default or press the Esc key to return to

the Auto Sequence Utilities screen without resetting. Refer to Figure 2-11 for a list of auto sequence defaults.

Printing Documents Test results can be printed from the Analyzer to any parallel printer suitable for use with a PC-compatible computer. Connect the printer cable to the port labeled Printer on the Analyzer rear panel.

Note If the user tries to print a document when the printer is the wrong type, out of paper, not on line, or not properly connected, the Analyzer displays an error message stating Printer not ready.

Printing Blood Pressure Test Results To print the results of blood pressure tests: 1. Use the arrow keys to choose one of the selections under Select BP on the Analyzer

Main Menu and press the Ent key. 2. Press F3 Print to enable printing. A Printing enabled message displays. 3. Choose the blood pressure value to simulate and press the Ent key. 4. Start the NIBP monitor to begin the test. The Analyzer sends the test results to the

printer when the cuff has completely deflated. Figure 2-7 is a sample printout.


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---------------------------------------------------------------------

***** Make Arm Results *****

Heart Peak Deflate Deflate Inflate Inflate Total

Blood Rate Press Rate Time Rate Time Time

Pressure (BPM) (mmHg) (mmHg/s) (sec) (mmHg/s) (sec) (sec)

---------- ----- ------ -------- ------- -------- ------- -----

___/___(___) ___ 179 7.0 17.9 59.0 2.9 21.5

120/80 ( 90) 80 Gain=100 Shift=0

___/___(___) ___ 159 6.9 15.6 68.6 2.2 18.5

120/80 ( 90) 80 Gain=100 Shift=0

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Figure 2-7. Sample Printout of Adams Adult Family 120/80 Test Results

5. To discontinue printing blood pressure test results, press the Esc key. 6. Return to the Target Values display and press the F3 Print key again. A Printing

disabled message is displayed. At this point, continue with blood pressure simulations; the Analyzer does not print any of the results.

Printing Manometer, Leak Test, and Overpressure Test Results After performing a manometer measurement, leak test, or overpressure test, press F3 Print to print the results. Figures 2-8, 2-9, and 2-10 are sample printouts.

***** Pressure Test *****

Pressure : 108 mmHg

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Figure 2-8. Sample Printout of Manometer Test Results

***** Leak Test *****

Leak Start: 200.00mmHg; Leak Rate:8.75mmHg/m

fcv084.eps

Figure 2-9. Sample Printout of Leak Test Results

***** Over Pressure Test *****

Pop Off: 289.00 mmHg

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Figure 2-10. Sample Printout of Overpressure Test Results

Printing Auto Sequences Auto sequence content (the tests and their order) or auto sequence test results can be printed, as described in this section.

Printing Auto Sequence Content To print auto sequence content:


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1. Highlight Auto on the Main Menu by pressing a Left or Right arrow key. 2. From the Auto submenu, highlight Utility and press the Ent key. 3. Highlight Print and press the function key below the auto sequence to be printed.

For example, to print the content of auto sequence #3, highlight Print and press F3. To print content of all the auto sequences, select Print All and press the Ent key.

Printing Auto Sequence Test Results To print auto sequence test results: 1. Highlight Auto on the Main Menu by pressing a Left or Right arrow key. 2. From the Auto submenu, highlight Utility and press the Ent key. 3. Highlight Edit and press the function key below the auto sequence to be printed. The

Auto-1 screen displays:

F1 F2 F3 F4 F5

Auto-1

Pressure Test. : YESLeak Test..... : YESPop Off Test.. : YESPrint BP Results YES


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4. Use the arrow keys to move the cursor to the Print BP Results line. 5. Press F4 to enter a YES and then press F3 to store the change. 6. If a printout of an auto sequence is not desired, press F5 to enter a NO on this line

and then press F3 to store the change.

Note Before starting an auto sequence that will print, make sure the printer is ready or a Printer not ready message displays, and the auto sequence does not run.


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Sample Auto Sequence Test Printouts Figures 2-11 through 2-16 illustrate sample auto sequence printouts, as described by their captions.

AUTO-3

CuffLink Auto Sequence Test Procedure

04/13/93

Blood Pressure

Blood Pressure

80/ 50( 62) Adult100/ 65( 75) Adult120/ 80( 90) Adult200/150(165) Adult-------- Off --------------- Off --------------- Off --------------- Off -------

40608012012016020080

33333333

Heart Rate (BPM) Cycles

Pressure Test ......YESLeak Test ..........YESPop Off Test .......YESPrint Results ......YES

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Figure 2-11. Sample Printout of Adult Auto Sequence Content


2-41

ADULT3 Page 1Date:09/25/93Time: 08:00

Manufacturer:____________ABC Co XXX 101

A200 CCU

287

0.75

BED 5

3.0

Control#: ____________

Software Rev:____________

Pressure: 287.75 mmHg

Leak Start: 322.75 mmHg


BloodPressure

80/50 (62) 4040

161Gain=100

5.5 27.5 58.8 2.6 30.1Shift=080/50 (62)A

HeartRate(BPM)

PeakPress(mmHg)

DeflateRate(mmHg/s)

DeflateTime(sec)

InflateRate(mmHg/s)

InflateTime(sec)

TotalTime(sec)

UUT Indicates:_____mmHg

Leak Rate: mmHg/m

***** Pressure Test *****

***** Leak Test *****



Model:____________

Dept :____________

Ser:____________

Loc:____________

Notes:________________________________

Cufflink Auto Sequence

202/149 (166) 205200

223Gain=100

8.4 12.5 69.4 3.1 17.0Shift=0

NOTE:Bold type represents data hand-entered by user

200/150 (165)A

202/148 (165) 205200

216Gain=100

8.5 11.6 69.3 3.0 16.0Shift=0200/150 (165)A

200/155 (172) 205200

163Gain=100

7.8 11.6 62.0 2.5 15.2Shift=0200/150 (165)A

116/79 (91) 8080

165Gain=100

7.0 16.1 65.4 2.4 19.1Shift=0120/80 (90)A

116/77 (90) 8080

161Gain=100

7.0 15.5 66.5 2.3 18.3Shift=0120/80 (90)A

116/79 (89) 8080

145Gain=100

6.7 14.0 59.6 2.3 16.8Shift=0120/80 (90)A

100/63 (73) 6060

142Gain=100

6.8 17.9 78.8 1.7 19.6Shift=0100/65 (75)A

99/62 (73) 6060

143Gain=100

6.7 17.6 64.3 2.1 19.7Shift=0100/65 (75)A

98/61 (79) 6060

180Gain=100

6.6 22.0 61.4 2.8 24.8Shift=0100/65 (75)A

80/48 (61) 4040

95Gain=100

3.1 27.1 79.1 1.1 28.2Shift=080/50 (62)A

79/50 (60) 4040

97Gain=100

3.2 27.6 63.6 1.4 29.0Shift=080/50 (62)A

fcv086.eps

Figure 2-12. Sample Printout of Adult Auto Sequence Test Results


2-42

AUTO-1

03/24/93

Blood Pressure

60/ 30( 40) Adult 80/ 50( 62) Adult120/ 80(PAC) Arrhyth120/ 80(PAC) Arrhyth------- Off ------------- Off ------------- Off ------------- Off ------

406080801201608080

11111111


Pressure Test ........YESLeak Test.............YESPop Off Test..........NOPrint Results.........YES

Cufflink Auto Sequence Test Procedure

fcv087.eps

Figure 2-13. Sample Printout of Adult BP with Arrhythmia Auto Sequence Content


2-43

Date:09/25/93Time: 08:41

Manufacturer:_______________

Control#: _______________

Software Rev: _______________

Model:_______________

Dept: ____________

Ser:_______________

Loc: ____________

Notes: ___________________________________

AUTO-1 Page 1Cufflink Auto Sequence

ABC Co

A100

XXX

CCU

00102

BED 5

3.0

BloodPressure

HeartRate(BPM)

PeakPress(mmHg)

DeflateRate(mmHg/s)

DeflateTime(sec)

InflateRate(mmHg/s)

InflateTime(sec)

TotalTime(sec)

* * * * * Make Arm Results * * * * *

66/27 ( 35) 60/30 ( 40)A

77/46 ( 62) 80/50 ( 62)A

113/76 ( 89)120/80 (PAC)AR

119/80 ( 88)120/80 (PVC)AR

NOTE: Bold type represents data hand-entered by user

3940

6060

8080

8080

145Gain=100

97Gain=100

174Gain=100

158Gain=100

2.9Shift=0

3.7Shift=0

4.9Shift=0

5.2Shift=0

47.8

16.3

21.2

16.6

44.2

35.6

19.1

53.6

50.9

19.5

31.3

20.8

3.1

2.5

8.7

2.8

fcv088.eps

Figure 2-14. Sample Printout of Adult BP with Arrhythmia Auto Sequence Test Results


2-44

NEO-2

04/13/93

Blood Pressure

100/ 65( 75) Neonate 80/ 50( 62) Neonate 60/ 30( 40) Neonate100/ 65( 75) Neonate------- Off ------------- Off ------------- Off ------------- Off ------

12012016020040404040

11111111


Pressure Test ........YESLeak Test.............YESPop Off Test..........NOPrint Results.........YES

Cufflink Auto Sequence Test Procedure

fcv089.eps

Figure 2-15. Sample Printout of Neonate Auto Sequence Content


2-45

NEO-2 Page 1Date:09/25/93Time: 08:23

Manufacturer:____________ABC Co YYY 00104

N200 PICU

5.25

BED 2

3.0

Control#: ________

Software Rev:____________

Leak Start: 337.00 mmHg


BloodPressure

100/63 (77) 120120

195Gain=100

6.0 31.1 49.2 3.8 34.9Shift=0100/65 (75)A

HeartRate(BPM)

PeakPress(mmHg)

DeflateRate(mmHg/s)

DeflateTime(sec)

InflateRate(mmHg/s)

InflateTime(sec)

TotalTime(sec)

Leak Rate: mmHg/m

***** Leak Test *****



Model:____________

Dept :___________

Ser:____________

Loc:____________

Notes:________________________________

Cufflink Auto Sequence

98/63 (76) 122120100/65 (75)A

099/63 (79) 122120100/65 (75)A

98/ 64 (76) 205200

141Gain=100

10.1 13.2 51.2 2.6 15.8Shift=0

NOTE:Bold type represents data hand-entered by user

100/ 65 (75)A

100/ 64 (78) 205200

140Gain=100

8.1 10.9 45.5 2.9 15.1Shift=0100/ 65 (75)A

99/ 65 (75) 205200

149Gain=100

10.6 13.2 23.9 5.9 19.1Shift=0100/ 65 (75)A

59/28 (43) 97Gain=100

6.7 13.1 38.7 2.3 15.4Shift=0 60/30 (40)A

59/29 (39) 94Gain=100

6.1 14.1 53.8 1.6 15.7Shift=0 60/30 (40)A

59/29 (39) 122Gain=100

6.5 17.5 42.2 2.7 20.2Shift=0 60/30 (40)A

79/49 (62) 122Gain=100

5.3 16.7 54.3 2.1 19.5Shift=0 80/50 (62)A

80/49 (61) 121Gain=100

6.6 17.4 56.5 2.0 19.4Shift=0 80/50 (62)A

79/48 (59) 120120

135Gain=100

5.8 22.1 45.4 2.8 24.9Shift=0 80/50 (62)A

122120120120

163160163160160160

138Gain=100

5.9 16.7 65.0 2.0 19.9Shift=0

137Gain=100

5.2 18.7 61.4 2.1 22.0Shift=0

fcv090.eps

Figure 2-16. Sample Printout of Neonate Auto Sequence Test Results


2-46

3-1

Chapter 3 Remote Operation

Title Page

Introduction.......................................................................................................... 3-3 Setting Up the medTester .................................................................................... 3-3 Remote Command Syntax ................................................................................... 3-4

Command Syntax for medTester ..................................................................... 3-4 Command Syntax for Computer...................................................................... 3-4 Command Parameters...................................................................................... 3-4 Terminating Characters ................................................................................... 3-5 Error Messages ................................................................................................ 3-5

Command Descriptions........................................................................................ 3-7 BEEP ............................................................................................................... 3-7 CALPUCKPOS ............................................................................................... 3-8 DEFLATE ....................................................................................................... 3-8 DRAWENV..................................................................................................... 3-8 DRAWENVNEO ............................................................................................ 3-11 DRAWPULSE................................................................................................. 3-15 GLOBALINIT................................................................................................. 3-17 GOTOLOCAL................................................................................................. 3-18 IDENT ............................................................................................................. 3-18 INFLATE ........................................................................................................ 3-18 KEYTEST ....................................................................................................... 3-19 LEAKTEST..................................................................................................... 3-19 MAKEARM .................................................................................................... 3-20 MAKEARMNEO............................................................................................ 3-23 MANOMETER ............................................................................................... 3-27 MKARM10...................................................................................................... 3-27 MKARM20...................................................................................................... 3-27 MKARM30...................................................................................................... 3-28 MKARM40...................................................................................................... 3-28 MKARM50...................................................................................................... 3-28 MKARM60...................................................................................................... 3-28 MKARM70...................................................................................................... 3-29 MKARMNEO10 ............................................................................................. 3-29 MKARMNEO20 ............................................................................................. 3-29 MKARMNEO30 ............................................................................................. 3-29 MKARMNEO40 ............................................................................................. 3-30


3-2

MKARMNEO50 ............................................................................................. 3-30 MKARR_AF ................................................................................................... 3-30 MKARR_MB .................................................................................................. 3-30 MKARR_PAC................................................................................................. 3-31 MKARR_PVC................................................................................................. 3-31 MKARR_AS ................................................................................................... 3-31 POPOFF .......................................................................................................... 3-32 PRINTTEST.................................................................................................... 3-32 PSCALE .......................................................................................................... 3-33 PULSE............................................................................................................. 3-34 PUMPPCB....................................................................................................... 3-36 RCUSERENV ................................................................................................. 3-36 RDCLOCK...................................................................................................... 3-36 RDENVGAIN ................................................................................................. 3-36 RDENVSHIFT ................................................................................................ 3-37 RDPEAKDIV.................................................................................................. 3-37 RDQCDATE ................................................................................................... 3-37 RDUSERENV ................................................................................................. 3-37 READPRESS .................................................................................................. 3-38 RESET............................................................................................................. 3-38 STUSERENV.................................................................................................. 3-39 WRCLOCK ..................................................................................................... 3-39 WRPEAKDIV ................................................................................................. 3-40 WRUSERENV ................................................................................................ 3-40 ZEROPRESS................................................................................................... 3-41

Programming with Analyzer Commands............................................................. 3-41 Checklist Generated in BASIC........................................................................ 3-41 Adult BP Checklists and Test Results ............................................................. 3-43 Neonate BP Checklists and Test Results ......................................................... 3-47 Adult Arrhythmic BP Checklists and Test Results.......................................... 3-51

Additional Command Descriptions (Firmware Version 3.20)............................. 3-55 PUMPON ........................................................................................................ 3-55 PUMPOFF....................................................................................................... 3-55 VALVEOPEN ................................................................................................. 3-55 VALVECLOSED............................................................................................ 3-56

Remote Operation Introduction 3

3-3

Introduction Two operating modes—local or remote—control the Analyzer. When the Analyzer is powered on, it initializes in local mode. The Analyzer keyboard is enabled, and the Analyzer can understand information input from its front panel. The remote mode allows communication with the Analyzer, using a serial controller (a computer with an RS232 port or a medTester with medCheck). Connect the Analyzer to the controller with a null modem cable. As soon as the Analyzer receives a remote command from a controller, it goes into the remote mode and recognizes commands from only that controller. The Analyzer keyboard is completely disabled during remote operation, except during some procedures in which the Esc or function keys are needed. To return the Analyzer to the local mode, use the GOTOLOCAL command. Program examples are given at the end of this chapter. There are two types of commands associated with the Analyzer: • Those that instruct the Analyzer to simply perform a procedure • Those that cause the Analyzer to perform a procedure and send test results (data)

back to the controlling device. If the command instructs the Analyzer to do a procedure that generates no data, such as drawing a pressure envelope, the Analyzer completes the procedure, then sends an asterisk (*) to the controller. When the asterisk displays, the Analyzer has received, understood, and carried out a command. The following sections on remote commands include instructions on writing commands, an error message list, a section of detailed command descriptions, and examples of how to use the Analyzer commands in a computer program.

Setting Up the medTester Before the Analyzer can communicate with a medTester, the medTester must be configured, using the values listed in Table 3-1.

Table 3-1. medTester Remote Configuration Settings

medTester RS232 Setting

Com1 Off

Com2 On

Connect null modem cable from the Analyzer to Com2.

Baud Rate 9600

Stop bits 1

Parity Off

CTS Off

.


3-4

Remote Command Syntax A computer or a medTester with medCheck can be used to control the Analyzer. For both controllers, start remote commands with a command verb and add optional parameters (values that further define the remote command). Remote commands are not case sensitive; either upper or lower case letters can be used anywhere in the command, and the Analyzer understands it. The differences in syntax for each controller are explained below (n represents the parameter value).

Command Syntax for medTester When the Analyzer is controlled with a medTester, separate the command verb from the parameter list with a colon and separate each parameter with a semicolon. Do not put spaces anywhere in the command line. The syntax is: CommandVerb:parameter=n;parameter=n Example: makearm:hr=60,envshift=50

Command Syntax for Computer When the Analyzer is controlled with a computer, separate the command verb from the parameter list with a space or a colon. Separate the parameters with a comma or semicolon. The syntax is: CommandVerb parameter=n,parameter--r- Example: makearm hr=60,envshift=50 or CommandVerb:parameter=n;parameter=n Example: makearm:hr=60;envshift=50

Command Parameters Command parameters are values specified to further define remote commands. For example, different heart rates can be specified for the makearm command. If no command parameters are specified, the Analyzer uses current values. Current values are either the default values or the values used in a previous command. Parameters for each command are described in the Command Descriptions section later in this chapter.

Default Values Default values are reassigned to all remote commands each time the Analyzer is powered up. The Analyzer uses default values for the first command given to it if no parameters have been specified. For example, the command makearm has no parameters defining it, so the Analyzer uses default values. However, if "malcearm:hr=30" were specified as a parameter that sets the heart rate at 30 BPM, the Analyzer would use that value instead of the 80 BPM default value.

Remote Operation Remote Command Syntax 3

3-5

Exercise at the Controlling Device The RESET command can be used to set values to default. The following exercise shows how the Analyzer retains current parameter values until new values are assigned: 1. Enter the command makeann:bp=adams-150/100. This simulates a blood pressure of

150/100. The Analyzer uses default values for all other parameters. 2. Enter the command makearm. Blood pressure is still set at 150/100 from the previous

command. 3. Enter the command makearm:bp=adams-80/50. A new blood pressure of 80/50

replaces the blood pressure of 150/100. 4. Enter the command reset. The Analyzer is reset to default values. All succeeding

commands will have parameters set to the default until other values are specified.

Terminating Characters When writing programs to control the Analyzer, place a terminating character after the command line to mark the end of the command line. Terminate commands with any of the following characters. • CR – Carriage Return • LF – Line Feed • CR LF – Carriage Return and Line Feed • LF CR – Line Feed and Carriage Return If the Analyzer receives a terminating character that is not preceded by a remote command, it sends a question mark (?) back to the controller. Use this feature to do a communication check and verify that the Analyzer is properly connected to the controller. After sending the terminating character to the Analyzer, wait five seconds for the Analyzer to send a "?" back to the controller. If, after the third time, a question mark does not appear on the controller's display, assume that the Analyzer is not correctly connected to the controller, a cable wiring error exists, or the setup (baud rate, parity, etc.) is wrong. After selecting a terminating character, use the same one to terminate all commands. For example, do not start writing a program using LF as the terminating character and then switch to CR. If starting with LF, use it throughout the entire program.

Error Messages The Analyzer evaluates all remote commands for validity. If a command generates an error, an error message displays. Table 3-2 lists available error messages.


3-6

Table 3-2. Available Error Messages

Error Number Description

0 * - Successful command

1 Illegal parameter

2 Unknown command

3 Missing parameter(s)

4 Illegal beep frequency

5 Illegal beep period

6 Illegal time string, must be 22 chars

7 Parallel printer fault

8 Illegal ROM number

9 General failure

10 Illegal heart rate

11 Illegal pulse ID number

12 Pulse width exceeds heart rate period

13 Pulse amplitude too high

14 Pulse amplitude too low

15 Illegal motion command

16 Maximum motor velocity exceeded

17 Pressure engine motion fault

18 Illegal motor direction

19 Illegal motor step count

20 Illegal blood pressure

21 Pressure envelope gain too high

22 Pressure envelope gain too low

23 Pressure envelope shift too high

24 Pressure envelope shift too low

25 Target pressure too high

26 Target, pressure too low

27 Illegal cal memory type

28 Illegal cal gain value

29 Illegal microphone value

30 Illegal Pop Time

31 Illegal display test number

Remote Operation Command Descriptions 3

3-7

Command Descriptions This alphabetized section contains detailed descriptions of the Analyzer's remote commands. Examples for each command show exactly how to type the command, the results, and the data returned to the controller, as it appears on the controller's display. Commands in the Examples sections were written in command syntax for computers. For information on medTester syntax, refer to Command Syntax for medTester.

Note Different results from those shown in the examples may be obtained. Except for asterisks, the Returned Data listed in the following examples is varied, depending on the Analyzer and the parameter values assigned to the command.

BEEP Use this command to test Cufflink's speaker and modify the frequency (pitch) and period (length of the beep). Because the speaker is more difficult to hear at very low and very high frequencies, be sure the Beeper Volume control on the front panel is set high enough. Parameters for this command are described below.

Parameter Definition Range Default

FREQ Frequency (Hertz) 76 to 10,000 Hz 440 Hz

PERIOD Period (milliseconds) 50 to 32,000 ms 500 ms

Example

Beep the speaker using Cufflink's default values.

Command beep

Results A 440 Hz tone sounds for 500 milliseconds.

Returned Data *

Example

Beep the speaker at a frequency of 300 Hz for 800 milliseconds.

Command beep freq=300,period=800

Results A 440 Hz tone sounds for 500 milliseconds.

Returned Data *


3-8

CALPUCKPOS Use this command to calibrate puck position. This procedure positions the puck at a known location or reference point from which subsequent puck movement is calculated. During this procedure, the Analyzer moves the puck in a downward direction until it extends to its full range of movement (to the chamber bottom). Then the puck moves up and stops as soon as it is detected by an opto sensor. The Analyzer records the number of motor steps necessary to move the puck this distance and stores the number in EEROM. There are no parameters for this command.

Example

Calibrate the puck position.

Command calpuckpos

Results The Analyzer calibrates the puck. Returned data is the value that the Analyzer stores in EEROM

Returned Data 5681; varies with each Analyzer

DEFLATE Use this command to release all pressure inside the Analyzer. There are no parameters for this command.

Example

Eliminate the pressure inside the Analyzer.

Command deflate

Results The Analyzer releases pressure.

Returned Data *

DRAWENV Use this command to draw an ADAMS Adult pressure envelope on the Analyzer display, as shown in Figure 3-1. Envelope gain, shift, and pulse width can be modified.

Max

Pressure Envelope

1000

Min

mm

1

1.0

0.8

0.6

0.4

0.2

0 40 80 120 160 200

fcv037.eps

Figure 3-1. Analyzer Adult Blood Pressure Envelope (BP = 120/80)


3-9

Parameters for this command are described below.

Parameter Definition Range Default Description

HR Heart Rate (Beats/Minute)

30 BPM to 240 BPM in 1 BPM Steps

80 BPM 1 BPM resolution

BP Blood Pressure (mmHg)

ADAMS-60/30

ADAMS-80/50

ADAMS-100/65

ADAMS-120/80

ADAMS-150/100

ADAMS-200/150

ADAMS-255/195

ADAMS-120/80

PULSEID Pulse Identification (milliseconds)

ID# / WIDTH

0 / 800 ms

1 / 500 ms

2 / 250 ms

3 / 720 ms

4 / 230 ms

5 / 280 ms

6 / 350 ms

7 / 480 ms

8 / 980 ms

9 / 1980 ms

10 / 1480 ms

ID# 3 (720 ms)

Pulse width affects the rise time of pulse

ENVGAIN Pressure Envelope Gain

1 to 200% (10 to 2000 RVDUs)

100% is a typical valuefor adult cuffs.

Affects pulse strength or amplitude

ENVSHIFT Pressure Envelope Shift

-100 to +100 mmHg

0 mmHg Modifies existing pressure envelope to simulate another BP

Example: 0 +10 mmHg shift causes 120/80 to read 130/90 on most monitors.

Example

Draw a pressure envelope showing a BP of 80/50 with a heart rate of 60 BPM

Command drawenv hx=60,bp=adams-80/50

Results The specified pressure envelope is drawn on the Analyzer display:


3-10

Max

BP = 80/50, HR = 60 BPM

1000

Min

mm

7

1.0

0.8

0.6

0.4

0.2

0 40 80 120 160 200

fcv038.eps

Returned Data *

Example

Draw a pressure envelope with a heart rate of 30 BPM, a blood pressure of 200/150, a 50% gain, and a shift of 20 mmHg.

Command drawenv hr---30,bp=adams200/150,envgain=50,envshift=20


Max

BP = 200/150, HR = 30 BPM, gain = 50%, shift = 20 mmHg

500

Min

mm

63

1.0

0.8

0.6

0.4

0.2

0 120 160 200 240 280

fcv039.eps

Returned Data *


3-11

DRAWENVNEO Use this command to draw an ADAMS Neonate pressure envelope on the Analyzer display, as shown in Figure 3-2. Envelope gain, shift, and pulse width can be modified.

Max

Pressure Envelope

1000

Min

mm

1

1.0

0.8

0.6

0.4

0.2

0 40 80 120 160 200

fcv040.eps

Figure 3-2. Analyzer Neonate Blood Pressure Envelope (BP = 120/80)


3-12






BP Blood Pressure(mmHg)

ADAMSNEO-60/30 ADAMSNEO-80/50 ADAMSNEO-100/65 ADAMSNEO-120/80 ADAMSNEO-150/100

ADAMSNEO-120/80


ID# / WIDTH

0 / 800 ms 1 / 500 ms 2 / 250 ms 3 / 720 ms 4 / 230 ms 5 / 280 ms 6 / 350 ms 7 / 480 ms 8 / 980 ms 9 / 1980 ms 10 / 1480 ms

ID# 3 (720 ms)



1 to 200% (10 to 2000 RVDUs)

100% is a typical value for neonate cuffs.



-100 to +100 mmHg 0 mmHg Modifies existing pressure envelope to simulate another BP



3-13

Example

Draw a neonatal pressure envelope with a BP of 80/50 with a heart rate of 60 BPM.

Command drawenvneo hr=60,bp=adamsneo-80/50


Max

BP = 80/50, HR = 60 BPM

1000

Min

mm

7

1.0

0.8

0.6

0.4

0.2

0 40 80 120 160 200

fcv041.eps

Returned Data *

Example

Draw a neonatal pressure envelope with a heart rate of 30 BPM, a blood pressure of 150/100, a 50% gain, and a shift of 20 mmHg.

Command drawenvneo hr=30,bp=adamsneo-150/100,envgain=50,envshift=-20



3-14

Max

BP = 150/100, HR = 30 BPM, gain = 50%, shift = 20 mmHg

500

Min

mm

68

1.0

0.8

0.6

0.4

0.2

20 60 100 140 180 220

fcv042.eps

Returned Data *


3-15

DRAWPULSE Use this command to draw an individual pressure pulse, as shown in Figure . Different pulse widths can be specified for this command.

msec

Pulse # 3 (720 milliseconds)

716

sec

1.0

0.8

0.6

0.4

0.2

0 0.2 0.4 0.6 0.8 1.0

fcv043.eps

Figure 3-3. Analyzer Pressure Pulse #3




ID# / WIDTH

0 / 800 ms

1 / 500 ms

2 / 250 ms

3 / 720 ms

4 / 230 ms

5 / 280 ms

6 / 350 ms

7 / 480 ms

8 / 980 ms

9 / 1980 ms

10 / 1480 ms

ID# 3 (720 ms)



3-16

Example

Draw a 720 millisecond wide pressure pulse.

Command drawpulse

Results The 720 millisecond wide pressure pulse (default value) is drawn on the Analyzer display:

msec


716

sec

1.0

0.8

0.6

0.4

0.2

0 0.2 0.4 0.6 0.8 1.0

fcv043.eps

Returned Data *

Example

Draw a 480 millisecond wide pressure pulse (pulse number 7).

Command drawpulse pulseid=7

Results The specified pressure pulse is drawn on the Analyzer display:

msec


476

sec

1.0

0.8

0.6

0.4

0.2

0 0.1 0.2 0.3 0.4 0.5

fcv045.eps

Returned Data *


3-17

GLOBALINIT Use this command to reset the Analyzer to factory defaults. There are no parameters for this command. The default values are listed below.

Table 3-3. Autosequence Defaults

Cycles * BP HR

A1 A2 A3 A4 A5

60/30 (40) Adult 40 1 2 3 4 5

80/50 (62) Adult 60 1 2 3 4 5

100/65 (75) Adult 80 1 2 3 4 5

120/80 (90) Adult 80 1 2 3 4 5

150/100 (115) Adult 120 1 2 3 4 5

200/150 (165) Adult 160 1 2 3 4 5

255/195 (215) Adult 200 1 2 3 4 5

120/80 (80) Adult 80 1 2 3 4 5

Utilities

Pressure Test Yes

Leak Test Yes

Pop Off Test Yes

Print BP Results Yes

* Cycles refer to the number of time that the Analyzer simulates a target value.

Table 3-4. Pop Time and Comm Port Default Values

Parameter Value

Pop Time 1 second

Communications

Baud Rate 9600

Bits/Character 8

Parity None

Stop Bits 1



3-18

Example

Do a global initialization.

Command globalinit

Results All user modifications for Pop Time, RS232 port, and autosequences are reset to factory defaults.

Returned Data *

GOTOLOCAL Use this command to switch control of the Analyzer fro a serial controller to the Analyzer keyboard. There are no parameters for this command.

Example

Return the Analyzer control to its front panel.

Command gotolocal

Results The Analyzer logo displays, and it returns to the local mode. The front panel keyboard is now active.

Returned Data *

IDENT Use this command to show the Analyzer name and firmware version on the controller display. There are no parameters for this command.

Example

Identify the Analyzer and firmware version.

Command ident

Results Display of Analyzer identification and firmware version

Returned Data CuffLink, 3.00, Pump; varies with each Analyzer, depending on the installed firmware and options

INFLATE Use this command to pump up the pressure inside the Analyzer. Parameters for this command are described below.


PRESSURE Pressure (mmHg) 0 to 499.75 mmHg 200 mmHg

Example

Pump Analyzer pressure up to 275 mmHg.

Command Inflate pressure=275

Results The Analyzer internal pump increases pressure to 275 mmHg.

Returned Data *


3-19

Example

Pump Analyzer pressure up to 200 mmHg.

Command inflate

Results The Analyzer internal pump increases pressure to 200 mmHg.

Returned Data *

KEYTEST Use this command to test the Analyzer keyboard. There are no parameters for this command.

Example

Test the keyboard.

Command keytest

Results The Analyzer echoes the key pressed. To exit the keytest, press Esc four times.

Returned Data F1

LEAKTEST Use this command to put the Analyzer in the leak test mode. The keys on the Analyzer front panel become active during this test so a user can zero pressure, perform the leak test, do a reset, or print the test results. To exit the leak test mode, simply issue to the Analyzer another remote command. There are no parameters for this command.

Example

Enter the Analyzer leak test mode.

Command leaktest

Results The Analyzer enters the leak test mode and shows the Leak Test display. Press F1 on the keyboard to begin the leak test. The leak test runs for one minute and then displays the leak rate in mmHg/min.

F1 F2 F3 F4 F5

fcv046.eps

Returned Data *


3-20

MAKEARM Use this command to simulate blood pressures from the ADAMS Adult Family target values. Heart rate, BP, and pressure envelope gain and shift can be modified. Parameters for this command are described below.





BP Blood Pressure(mmHg)

ADAMS-60/30

ADAMS-80/50

ADAMS-100/65

ADAMS-120/80

ADAMS-150/100

ADAMS-200/150

ADAMS-255/195

ADAMS-120/80


ID# / WIDTH

0 / 800 ms

1 / 500 ms

2 / 250 ms

3 / 720 ms

4 / 230 ms

5 / 280 ms

6 / 350 ms

7 / 480 ms

8 / 980 ms

9 / 1980 ms

10 / 1480 ms

ID# 3 (720 ms)



1 to 200% (10 to 2000 RVDUs)

100% is a typical value for adult cuffs.



-100 to +100 mmHg




3-21

Make all necessary connections from the Analyzer to the NIBP monitor before sending a makearm command to the Analyzer. When the Analyzer receives the makearm command, it displays a graph where the pressure envelope will be drawn.

Start the NIBP monitor; the Analyzer begins BP simulation and draws the pressure envelope. When the blood pressure cycle is complete, the following are displayed on the computer monitor:

• Peak pressure

• Deflate time

• Deflate rate

• Inflate time

• Inflate rate

• Total time

Returned Data

The NIBP monitor can run as many times as needed or until a new command is issued to the Analyzer. The Analyzer sends the makearm data (format shown below) to the com-puter in six different fields separated by commas. If the data is positive, it is preceded by a space; if the data is negative, it is preceded by a minus sign (-).

Data Field Number Field Length Field Content

peak pressure 1 4 characters [sign n n n)

deflate time 2 6 characters [sign n n n .n)

deflate rate 3 6 characters [sign n n n .n]

inflate time 4 6 characters [sign n n n .n]

inflate rate 5 6 characters [sign n n n .n]

total time 6 6 characters [sign n n n .n]

The following example is a data string of positive values as it might appear on the controller display. The peak pressure of 79 mmHg is in field 1, and the total time of 3.3 minutes is in field 6.


3-22

Peak Pressure (mmHg)

(mmHg/min)

(minutes)

(minutes)

(mmHg/min)

(minutes)

Deflate Time

Deflate Rate

Inflate Time

Inflate Rate

Total Time

79, 4.0, 2.0, 78.9, 0.9, 3.3

fcv047.eps

Example

Simulate a blood pressure of 100/65 with a heart rate of 60 BPM.

Command makearm bp=adams-100/65,hr=60

Results The Analyzer draws the makearm graph and begins arm simulation when the NIBP monitor starts inflating the cuff. Test results are sent to the controller when the cuff deflates.


0 197 4.9 39.1 39.4 4.8 43.8(75) A

200

160

120

40

0 20 40 60

60 BPM

80

fcv048.eps

Returned Data 197, 4.9, 39.1, 39.4, 4.8, 43.8; varies, depending on parameter values


3-23

Example

Simulate a blood pressure of 120/80 with a heart rate of 30 BPM, a gain of 50%, and a shift of 12 mmHg.

Command makearm bp=adams-120/80,hr=30, envgain=50,envshift=12

Results The Analyzer draws the makearm graph and begins arm simulation when the NIBP monitor starts inflating the cuff. Test results are sent to the controller when the cuff deflates.


0 142 3.1 45.1 43.2 3.1 48.1(90) A

200

160

120

40

0 20 40 60

30 BPM

G 50S 12

80

fcv049.eps


MAKEARMNEO Use this command to simulate blood pressures from the ADAMS Neonate Family target values. Heart rate, BP, and pressure envelope gain and shift can be modified. Parameters for this command are described below.





BP Blood Pressure (mmHg)

ADAMSNEO-60/30

ADAMSNEO-80/50

ADAMSNEO-100/65

ADAMSNEO-120/80

ADAMSNEO-150/100

ADAMSNEO-200/150

ADAMSNEO-255/195

ADAMSNEO-120/80


3-24


ID# / WIDTH

0 / 800 ms

1 / 500 ms

2 / 250 ms

3 / 720 ms

4 / 230 ms

5 / 280 ms

6 / 350 ms

7 / 480 ms

8 / 980 ms

9 / 1980 ms

10 / 1480 ms

ID# 3 (720 ms)



1 to 200% (10 to 2000 RVDUs)

100% is a typical value for adult cuffs.



-100 to +100 mmHg



Make all necessary connections from the Analyzer to the NIBP monitor before sending a makearmneo command to the Analyzer. When the Analyzer receives the makearmneo command, it displays a graph where the pressure envelope will be drawn.

Start the NIBP monitor; the Analyzer begins BP simulation and draws the pressure envelope. When the blood pressure cycle is complete, the following are displayed on the computer monitor:

• Peak pressure

• Deflate time

• Deflate rate

• Inflate time

• Inflate rate

• Total time


3-25

Returned Data

The NIBP monitor can run as many times as needed or until a new command is issued to the Analyzer. The Analyzer sends the makearmneo data (format shown below) to the computer in six different fields separated by commas. If the data is positive, it is preceded by a space; if the data is negative, it is preceded by a minus sign (-).

Data Field Number Field Length Field Content

peak pressure 1 4 characters [sign n n n)

deflate time 2 6 characters [sign n n n .n)

deflate rate 3 6 characters [sign n n n .n]

inflate time 4 6 characters [sign n n n .n]

inflate rate 5 6 characters [sign n n n .n]

total time 6 6 characters [sign n n n .n]

The following example is a data string of positive values as it might appear on the controller display. The peak pressure of 79 mmHg is in field 1, and the total time of 3.3 minutes is in field 6.

Peak Pressure (mmHg)

(mmHg/min)

(minutes)

(minutes)

(mmHg/min)

(minutes)

Deflate Time

Deflate Rate

Inflate Time

Inflate Rate

Total Time

79, 4.0, 2.0, 78.9, 0.9, 3.3

fcv053.eps

Example

Simulate a neonatal arm with a heart rate of 40 BPM.

Command makearmneo hr=40

Results The Analyzer draws the makearmneo graph and begins arm simulation when the NIBP monitor starts inflating the cuff. In this case, default values are used for all parameters except heart rate. Test results are sent to the controller when the cuff deflates.


3-26


0 194 3.5 53.2 45.4 4.1 57.3(90) N

200

160

120

40

0 20 40 60

40 BPM

80

fcv054.eps


Example

Simulate a neonatal arm with a blood pressure of 120/80 , a heart rate of 30 BPM, a gain of 50%, and a +12 mmHg shift.

Command makearmneo bp=adamsneo-120/80,hr=160, pulseid--=8,envgain=50,envshift--12

Results The Analyzer draws the makearmneo graph and begins arm simulation when the NIBP monitor starts inflating the cuff and results are sent to the controller when the cuff deflates.


0 142 3.1 45.1 43.2 3.1 48.1(90) N

200

160

120

40

0 20 40 60

30 BPM

G 50S 12

80

fcv055.eps



3-27

MANOMETER Use this command to put the Analyzer into the manometer mode. The keys on the Analyzer front panel become active during this test so a user can zero pressure, do a reset, or print test results. Press F1 to start measurements. See also: Pop Off Test. There are no parameters for this command.

Example

Put CuffLink into the manometer mode.

Command manometer

Results The Analyzer enters the manometer test mode and shows the Manometer display. Press Fl on the Analyzer keyboard to begin.

fcv056.eps

Returned Data *

MKARM10 Use this command to set blood pressure simulation to Adams Adult 60/30, with a heart rate of 40 BPM. There are no parameters for this command.

Example

Simulate a specific adult BP of 60/30 at 40 BPM.

Command Mkarm10

Results The Analyzer runs the Adams Adult 60/30, heart rate is set to 40 BPM.

Returned Data *


Example


Command Mkarm20


Returned Data *


3-28


Example


Command Mkarm30


Returned Data *


Example


Command Mkarm40


Returned Data *


Example


Command Mkarm50


Returned Data *


Example


Command Mkarm60


Returned Data *


3-29


Example


Command Mkarm70


Returned Data *

MKARMNEO10 Use this command to set blood pressure simulation to Adams Neonate 60/30, with a heart rate of 40 BPM. There are no parameters for this command.

Example

Simulate a specific neonate BP of 60/30 at 40 BPM.

Command mkarmneo10

Results The Analyzer runs the Adams Neonate 60/30, heart rate is set to 40 BPM.

Returned Data *


Example


Command mkarmneo20


Returned Data *


Example


Command mkarmneo30


Returned Data *


3-30


Example


Command mkarmneo40


Returned Data *


Example


Command mkarmneo50


Returned Data *

MKARR_AF Use this command to set blood pressure simulation to the Atrial Fibrillation Arrhythmia at the fixed BP and heart rate of 120/80 and 80 BPM. There are no parameters for this command.

Example

Simulate an atrial fibrillation.

Command mlcarr_af

Results The Analyzer runs atrial fibrillation at 120/80 with the heart rate set to 80 BPM.

Returned Data *

MKARR_MB Use this command to set blood pressure simulation to the Missed Beat Arrhythmia at the fixed BP and heart rate of 120/80 and 80 BPM. There are no parameters for this command.

Example

Simulate a missed beat.

Command mitarr_mb

Results The Analyzer runs missed beat at 120/80 with the heart rate set to 80 BPM.

Returned Data *


3-31

MKARR_PAC Use this command to set blood pressure simulation to the Premature Atrial Contraction Arrhythmia at the fixed BP and heart rate of 120/80 and 80 BPM. There are no parameters for this command.

Example

Simulate a premature atrial contraction.

Command mkarr_pac

Results The Analyzer runs premature atrial contraction at 120/80 with the heart rate set to 80 BPM

Returned Data *

MKARR_PVC Use this command to set blood pressure simulation to the Premature Ventricular Contraction Arrhythmia at the fixed BP and heart rate of 120/80 and 80 BPM. There are no parameters for this command.

Example

Simulate premature ventricular contraction.

Command mkarr_pvc

Results The Analyzer runs premature ventricular contraction at 120/80 with the heart rate set to 80 BPM.

Returned Data *

.

MKARR_AS Use this command to set blood pressure simulation to the Aberrant Sinus Conduction Arrhythmia at the fixed BP and heart rate of 120/80 and 80 BPM. There are no parameters for this command.

Example

Simulate aberrant sinus conduction.

Command mkarr_as

Results The Analyzer runs premature aberrant sinus conduction at 120/80 with the heart rate set to 80 BPM.

Returned Data *


3-32

POPOFF Use this command to test the NIBP monitor's emergency release valve via the Pop Off display shown in Figure 3-4. Although the Esc key is disabled during this test, the function keys remain enabled. This characteristic is useful when using the Analyzer with the medTester in the checklist mode. There are no parameters for this command.

F1 F2 F3 F4 F5

*** Pop Off ***

Pressure actual (mmHg): 2.52Pressure peak (mmHg): 46.32

Print Zero Pressure Reset

Pop Off Pump

Release Pressure

fcv057.eps

Figure 3-4.

Example

Test the overpressure valve

Command popoff

Results The Analyzer tests the overpressure valve.

Returned Data *

PRINTTEST Use this command to test the parallel printer. The Analyzer sends a data string that says Printer test message. If this message prints, the printer is connected and working properly. If the printer is not ready to print (unconnected, turned off), the Analyzer displays a Printer Not Ready message. In response to this message, press the Ent key on the keyboard to try again or the Esc key to quit.

Example

Do a print test.

Command printtest

Results The printer prints Printer test message.

Returned Data *


3-33

PSCALE Use this command to produce a constant pulse amplitude that is independent of pressure, via the Scale Pulse Amplitude display shown in Figure 3-5. This signal is present at all Analyzer front panel outputs; the signal can be monitored at the PULSE output. The Analyzer keyboard is enabled during this test. Heart rate, pulse width, pulse amplitude, and puck motion can be modified.

F1 F2 F3 F4 F5

*** Scale Pulse Amplitude ***

Motion : Stopped Enter togglesAmplitude : 1000 motion start/Pressure : 0.00 stopRate (BPM) 80

Rate Shape 250 500 1000

fcv058.eps

Figure 3-5. Scale Pulse Amplitude Display



HR Heart Rote (Beats/Minute)



PULSEAMP Pulse Amplitude (RVDU)

1 to 1000 RVDUs 1000 RVDUs

MOTION Puck Motion On Off

On

PULSEID Pulse Identification ID# / WIDTH


Pulse #3 (720 ms)

*RVDU = Relative Volume Displacement Unit, or the volume display when the pressure engine moves one increment (one microstep).


3-34

Example

Output the default pulse.

Command pscale

Results Pulse is output at PULSE output jack on the Analyzer.

F1 F2 F3 F4 F5


Motion : Running Enter togglesAmplitude : 1000 motion start/Pressure : 0.00 stopRate (BPM) 80

Rate Shape 250 500 1000

fcv059.eps

Returned Data *

Example

Output a 28 millisecond pulse at 40 BPM with an amplitude of 500 RVDUs.

Command pscale hr=40,pulseid=5,pulseamp=500

Results Pulse is output at PULSE output jack on the Analyzer.

F1 F2 F3 F4 F5


Motion : Running Enter togglesAmplitude : 500 motion start/Pressure : 0.00 stopRate (BPM) 40

Rate Shape 250 500 1000

fcv060.eps

Returned Data *

PULSE Use this command to output a single, specific pressure pulse. If parameters are not specified, the Analyzer uses a current value for pulse width and calculates pulse amplitude. The Analyzer calculates pulse amplitude by reading the cuff pressure and applying it to the active pressure envelope. This command is useful for synchronizing Analyzer pulse output to another device and for custom pressure envelopes with random pulse selection. Parameters for this command are described below.


3-35


PULSEAMP Pulse Amplitude (RVDU)

1 to 1000 RVDUs 1000 RVDUs

PULSEID Pulse Identification ID# / WIDTH


Pulse #3 (720 ms)

Pulse width affects the rise time of the pulse.

*RVDU = Relative Volume Displacement Unit, or the volume display when the pressure engine moves one increment (one microstep).

Example

Output a pulse using the active pressure envelope and pulse width (ID).

Command pulse

Results No parameters were specified in this example, so Cufflink determines amplitude by reading cuff pressure and applies it to the active pressure envelope. Cufflink also uses the current pulse width and drives the motor to output a single pulse and then stop. Pulse is output at PULSE output jack on the Cufflink front panel.

Returned Data *

Example

Output a pulse that is 231 steps in amplitude and 23 ms wide.

Command pulse pulseamp=231,pulseid=4

Results Pulse #4 becomes the active pulse. If another pulse command is issued without specifying parameters, the Analyzer uses pulseid #4. Pulse is output at the PULSE output jack on the Analyzer front panel.

Returned Data *


3-36

PUMPPCB Use this command to determine if a pump circuit board is installed in the Analyzer. There are no parameters for this command.

Example

Check for pump PCB.

Command pumppcb

Results The analyzer scans for the board.

Returned Data Pump PCB installed or Pump PCB not installed

RCUSERENV Use this command to copy the user envelope data from EEROM to RAM. There are no parameters for this command.

Example

Recall user envelope data.

Command rcuserenv

Results Cufflink writes the user envelope data stored in EEROM to RAM.

Returned Data *

RDCLOCK Use this command to display the current time, day, and date. The data returned to the controller is configured as hour:min:sec mo/date/yr day (0 = Sunday, 6 = Saturday). There are no parameters for this command.

Example

Display the time and date for Monday, December 5th.

Command rdclock

Results The Analyzer reads the clock information.

Returned Data 13:14:12 12/05/91 1; varies, depending on the current date

RDENVGAIN Use this command to show the pressure envelope gain value (displayed in %) on the controller's display. There are no parameters for this command.

Example

Display the envelope gain value.

Command rdenvgain

Results reads the envelope gain value from ROM.

Returned Data 101; varies, depending on the current setting for envelope gain


3-37

RDENVSHIFT Use this command to show the pressure envelope shift value (in mmHg) on the controller's display. The range for envelope shift is from -100 mmHg to +100 mmHg. There are no parameters for this command.

Example

Display the pressure envelope shift value.

Command rdenvshift

Results The Analyzer reads the pressure envelope shift value stored in RAM.

Returned Data 42; varies, depending on the current setting for envelope shift

RDPEAKDIV Use this command to display the peak divide ratio on the controller's display. Peak divide ratio is the variable used to detect the point of rapid cuff deflate or when to stop blood pressure simulation, during the makearm process. There are no parameters for this command.

Example

Read the peak divide ratio.

Command rdpeakdiv

Results The Analyzer reads the peak divide ratio stored in EEROM and sends this value to the computer.

Returned Data 8.8; varies, depending on the current setting for peak divide ratio

RDQCDATE Use this command to display the last date on which the Analyzer was calibrated at the factory. There are no parameters for this command.

Example

Read the QC (Quality Control) date.

Command rdqcdate

Results The Analyzer reads the QC date stored in EEROM.

Returned Data 02/04/91; varies, depending on the last time the Analyzer was at the factory.

RDUSERENV Use this command to transmit the user pressure envelope array data. The array is a series of values 300 lines long and consists of two fields: one for the line number and one for the pressure envelope data. These fields are separated by a colon. The end of the array transmission is marked with a star character (*). The Analyzer stores the user envelope array in RAM to retrieve it when a rduserenv command is issued. This data may be different from what is stored in EEROM. When the Analyzer is powered on, it writes the user envelope stored in EEROM to RAM. As soon as new user envelope information is sent via the RS232 port, the user envelope in RAM is different from EEROM. To read the EEROM user envelope data instead of that stored in RAM, issue the rcuserenv command followed by a rduserenv command. There are no parameters for this command.


3-38

Example

Read the user envelope

Command rduserenv

Results The Analyzer takes data for the user envelope in RAM and sends it out the RS232 port.

Returned Data 1:100. 2:100, 3:100, 4:105, 5:110 …. 298:150, 299:140, 300:130, *

READPRESS Use this command to show a value (in 0.25 mmHg increments) on the controller's display for the Analyzer pressure transducer. There are no parameters for this command.

Example

Read the pressure transducer value.

Command readpress

Results The Analyzer reads the pressure transducer value stored in EEROM.

Returned Data 123.25; varies for each Analyzer

RESET Use this command to reset the Analyzer back to factory default values. This affects the parameters listed below. There are no parameters for this command.

Parameter Default Value

Pulse ID number 3

Heart Rate 80 BPM

Pressure Curve ID number A120 80

Pressure Curve Vertical Gain 100%

Pressure Curve Horizontal Shift 0 mmHg

Example

Reset CuffLink to default values

Command Reset

Results The Analyzer resets to factory values.

Returned Data *


3-39

STUSERENV Use this command to store the user envelope data from RAM to EEROM. This command is useful for loading new user envelope data into EEROM, where it will be permanently stored until changed again. There are no parameters for this command.

Example

Store new user envelope information permanently in EEROM.

Command stuserenv

Results The Analyzer writes a new user envelope (in RAM) to EEROM.

Returned Data *

WRCLOCK Use this command to write data to the Analyzer clock. The data string sent must be complete, as partial strings cause errors in the clock. Issue to the Analyzer an rdclock command to verify that the correct information was written to the clock. Use the following format when sending a clock information data string to the analyzer.

08:23:33pm 12/15/89 6


Parameter Description String Positions

0 hour 10s digit

1 hour 1s digit

TIME Time and Date data string

2 :

3 minute 10s digit

4 minute 1s digit

5 :

6 seconds 10s digit

7 seconds 1s digit

8 space, a, or p

9 space or m

10 space

11 space

12 month 10s digit

13 month 1s digit

14 /

15 day 10s digit

16 day 1s digit

17 /

18 year 10s digit

19 year 1s digit

20 space

21 day of week (0 - sun, 6 = sat)

22 null (0 x 00)


3-40

Example

Send a clock information data string to the Analyzer.

Command wrclock

Results A data string is sent to the Analyzer.

Returned Data *

WRPEAKDIV Use this command to store a new peak divide ratio in EEROM. Peak divide ratio is the variable used to detect the point of rapid cuff deflate or when to stop blood pressure simulation during the makearm process. Set a divide ratio factor for this command. Parameters for this command are described below.

Parameter Default Value Range

DIV Divide Ratio Factor 2.0 to 20.0

Example

Set the peak divide ratio to 8.8.

Command wrpeakdiv div=8.8

Results The Analyzer stores a value of 8.8 in RAM for peak divide ratio.

Returned Data *

WRUSERENV Use this command to write new user envelope data from Cufflink's RS232 port to RAM. This action overwrites user envelope data already in RAM. Information can be written to RAM (not to EEROM) only by using the wruserenv command. To write data to EEROM, which is permanent, use the stuserenv command. When the Analyzer receives a wruserenv command, it acknowledges that it is ready to receive data by sending a star character (*) back to the controller. The controller can begin sending the data, one line at a time, until all 300 lines have been received by the Analyzer. The Analyzer marks the end of the transmission with another star character. A PC utility program (PC3CUFF) is available that transfers the array text file from a 1PC to the Analyzer. There are no parameters for this command.

Example

Write a new user envelope to RAM.

Command wruserenv

Results The Analyzer writes new user envelope data from its RS232 port to RAM.

Returned Data 1:100. 2:100, 3:100, 4:105, 5:110 …. 298:150, 299:140, 300:130, *

Remote Operation Programming with Analyzer Commands 3

3-41

ZEROPRESS Use this command to zero the pressure transducer. This removes any offset errors during a pressure measurement. To get an idea of how often pressure should be zeroed, periodically make a pressure measurement with nothing connected to the Cuff Connect output to see if the reading is zero. If it is not zero, issue to the Analyzer a zeropress command. There are no parameters for this command.

Example

Zero the pressure transducer.

Command zeropress

Results The Analyzer removes any offset occurring at the pressure transducer and sets it to zero.

Returned Data *

Programming with Analyzer Commands With the Analyzer remote commands, custom programs can be created that automate calibration and testing protocols. This section contains samples of BASIC code, checklists, and test results.

Checklist Generated in BASIC The BASIC program shown in Figure 3-6 tells the Analyzer to display its firmware version, simulate an adult blood pressure, display the test results on the computer's display, and return to local mode.


3-42

10 REM Demonstration program for Cufflinks RS-232 Communications.20 REM The system used for this demonstration has a mouse on COM130 REM so COM2 is used.40 CLOSE #2 ‘Ensures that #2 file is closed.50 CLS ’Clears the screen. 60 OPEN “COM2:9600,N,8,1,CDO,CSO,DSO,OPO,RS,TB2048,RB2048” FOR RANDOM AS #270 REM OPEN “COM2:9600,N,8,1,CDO,CSO,DSO,OPO,RS,TB2048,RB2048”80 ‘Opens communications channel 2 in90 ‘random-access mode at speed of100 ‘9600 baud with no parity bit, 8 data bits110 ‘ and 1 stop bit. The program can now 120 ‘access channel 2 as file number 2.130 ‘____________________140 CUFFOUT$= “IDENT” ‘Displays the current firmware version.150 PRINT #2, CUFFOUT$ ‘Sends command to the Cufflink.160 ’170 INDATA$ = INOUT$(13, #2) ‘Gets return data from the Cufflink.180 REM The return from the Cufflink is “Cufflink, 3.20, Ausc, Pump”190 REM that is 25 characters for the input string. For shorter strings,200 REM the number must be smaller and longer strings will carry over to 210 REM the next input string.211 REM220 PRINT “Press any key to continue”: a$ = INPUT$(1)230 PRINT INDATA$ ‘Prints data on screen240 ‘250 ’____________________260 ‘The next command shows a MAKEARM command with parameters.’270 ‘280 CUFFOUT$ = “MAKEARM HR=60,BP=ADAMS-150/.100,PULSEID=3”290 PRINT #2, CUFFOUT$ ‘Sends command to the Cufflink.300 ’310 CLOSE #2320 OPEN “COM2:9600,N,8,1,CDO,CSO,DSO,OPO,RS,TB2048,RB2048” FOR RANDOM AS #2330 REM The two previous lines close and clear the communications buffer340 REM that is used. This wipes extra characters that list options and350 REM the “*” returns when Cufflink receives the MAKEARM command.351 REM360 PRINT “press any key when test is completed”: a$ = INPUT$(1)370 INDATA$ = INPUT$(39,#2) ‘Gets return data from the Cufflink.380 REM Again the length of the returned string affects the Input$.390 REM If the string is longer than the Input$, the system will hang up.391 REM400 PRINT INDATA$410 PRINT “Press any key to return Cufflink to LOCAL” : a$ = INPUT$(!)420 CUFFOUT$ = “GOTOLOCAL”430 PRINT #2, CUFFOUT$440 CLOSE #2450 END

fcv061.eps

Figure 3-6. A BASIC Program using Analyzer Remote Commands


3-43

Adult BP Checklists and Test Results Figures 3-7 shows a medBase Adult BP checklist that creates results like those shown in Figure 3-8. Figure 3-9 shows a Sentinel Adult BP checklist that creates results like those shown in Figure 3-10.

DATE: 06/05/1993

CHECKLIST NUMBER: 18 (start)

Ln

123456789

101112131415161718192021222380

12

3767

1315383940414243736162636465665051

----->25

\P GENERAL CONDITION OF EQUIPMENT \P LINE CORD/STRAIN RELIEF\M TRPN (POWER ON)\P INDICATORS/DISPLAYS\P CONTROLS/SWITCHES\P TUBES/HOSES\P FITTINGS/CONNECTORS\M IDENT\M LEAKTEST\P LEAK TEST: APPLY 200 NMHG (<10/MIN)\M MANOMETER\P STATIC PRESSURE CHECK: APPLY 200 MMHG\P STATIC PRESSURE CHECK: APPLY 100 MMHG\P POP OFF/RELIEF VALVE: APPLY >250 MMHG\M MAKEARM:HR=100;BP=ADAMS-120/80\P ADULT 120/80 AT 100 BPM\M MAKEARM:HR=80;BP=ADAMS-150/100\P ADULT 150/100 AT 80 BPM\M MAKEARM:HR=60;BP=ADAMS-200/150\P ADULT 200/150 AT 60 BPM\M GOTOLOCAL\M GTOLthrough line 79 - unused --l4

GEN/PHYSGEN/MECHREMOTEGEN/ELECGEN/ELECGEN/PLMBGEN/PHYSCLCLCLCLCLCLCLCLCLCLCLCLCLCLCL

AUTO SEQ

Item Check Item Type

CHECKLIST DESCRIPTION: ADULT*NIBP

CHECKLIST CONTENTS PAGE: 3

--- end of checklist #18 --

fcv062.eps

Figure 3-7. medBase Adult BP Checklist


3-44

MedTester REC # 15

SEQUENCE: 4

OP CODE: TEO

DEVICE INFORMATION

PHYSICAL INSPECTION

LINE VOLTAGES

GROUND RESISTANCE: .002 OHMS

LEAKAGE TESTS, EQUIPMENT PWR OFFCASE EXT LEAD NORM POL CLSD GND .0 µAMPS RMSCASE EXT LEAD NORM POL OPEN GND .0 µAMPS RMSCASE EXT LEAD REV POL OPEN GND .0 µAMPS RMS

LEAKAGE TESTS, EQUIPMENT PWR ON

EUT CURRENT DRAWN: .5 amps

COMMENTS:NEXT TEST DUE DATE:USER TIME:ELAPSED TEST TIME: 62 SECONDS

CASE EXT LEAD REV POL OPEN GND .0 µAMPS RMSCASE EXT LEAD NORM POL OPEN GND .0 µAMPS RMSCASE EXT LEAD NORM POL CLSD GND .0 µAMPS RMS

TYPE: ADULT*NIBPMODEL:

120.5 120.5 VOLTS RMS.4L1-L2 L1-GND L2-GND

MANF:SN:

LOC:DNICN: ADULT*NIBP

DATE: 6/05/93 TIME: 15:38:28

fcv063.eps

Figure 3-8. medBase Adult BP Test Results


3-45

DEMO ROOM

Page: 1Date: 06/05/93Time: 12:32 AM

Proc. Name

SENT*ADULT

Description

GENERAL CONDITION OF EQUIPMENTLINE CORD/STRAIN RELIEFTRPN (POWER ON)INDICATORS/DISPLAYSCONTROLS/SWITCHESTUBES/HOSESFITTINGS/CONNECTORSIDENTLEAKTESTLEAK TEST: APPLY 200 MMHG (<10/MIN)MANOMETERSTATIC PRESSURE CHECK: APPLY 200 MMHGSTATIC PRESSURE CHECK: APPLY 100 MMHGPOP OFF/RELIEF VALVE: APPLY >250 MMHGMAKEARM:HR=100;BP=ADAMS-120/80ADULT 120/80 AT 100 BPMMAKEARM:HR=80;BP=ADAMS-150/100ADULT 150/100 AT 80 BPMMAKEARM:HR=60;BP=ADAMS-200/150ADULT 200/150 AT 60 BPMGOTOLOCALGTOL5

GEN/PHYSGEN/MECHREMOTEGEN/ELECGEN/ELECGEN/PLMBGEN/PHYSCLCLCLCLCLCLCLCLCLCLCLCLCLCLCLAUTO SEQ

Pass/FailPass/FailmedTester remote commandPass/FailPass/FailPass/FailPass/FailmedTester remote commandmedTester remote commandPass/FailmedTester remote commandPass/FailPass/FailPass/FailmedTester remote commandPass/FailmedTester remote commandPass/FailmedTester remote commandPass/FailmedTester remote commandmedTester remote commandmedTester autosequence

Type medTester Control

0.00

PM Labor Time

Relational Checklist ReportListed In Order Of Relational Procedure

fcv067.eps

Figure 3-9. Sentinel Adult BP Checklist


3-46

MedTester REC # 16

CHECKLIST: ADULT*NIBP

OP CODE:TEO

DEVICE INFORMATION

PHYSICAL INSPECTION

COMMENTS:NEXT TEST DUE DATE:USER TIME:ELAPSED TEST TIME: 209 SECS

GENERAL CONDITION OF EQUIPMENT........PASSLINE CORD/STRAIN RELIEF...............PASSTRPN (POWER ON).......................REMOTE CMD, NO DATAINDICATORS/DISPLAYS...................PASSCONTROLS/SWITCHES.....................PASSTUBES/HOSES...........................PASSFITTINGS/CONNECTORS...................PASSIDENT.................................CUFFLINK,3.00,AUSC,PUMPLEAKTEST..............................*LEAK TEST: APPLY 200 MMHG (<10/MIN)...PASSMANOMETER.............................*STATIC PRESSURE CHECK: APPLY 200 MMHG.PASSSTATIC PRESSURE CHECK: APPLY 100 MMHG.PASSPOP OFF/RELIEF VALVE: APPLY >250 MMHG.PASSMAKEARM:HR=100;BP=ADAMS-120/80........*ADULT 120/80 AT 100 BPM...............PASSMAKEARM:HR=80;BP=ADAMS-150/100........*ADULT 150/100 AT 80 BPM...............PASSMAKEARM:HR=60;BP=ADAMS-200/150........*ADULT 200/150 AT 60 BPM...............PASSGOTOLOCAL.............................*GTOL..................................REMOTE CMD, NO DATA

TYPE: ADULT*NIBPMODEL:

MANF:SN:

LOC: DNICN: ADULT*NIBP

DATE: 6/05/93 TIME: 15:39:31

fcv064.eps

Figure 3-10. Sentinel Adult BP Test Results


3-47

Neonate BP Checklists and Test Results Figure 3-11 shows a medBase Neonate BP checklist that creates results like those shown in Figure 3-12. Figure 3-13 shows a Sentinel Neonate BP checklist that creates results like those shown in Figure 3-14.

DATE: 06/05/1993


Ln

123456789

101112131415161718192021222380

12

3767

1315383940414243736768697071725051

----->25

\P GENERAL CONDITION OF EQUIPMENT \P LINE CORD/STRAIN RELIEF\M TRPN (POWER ON)\P INDICATORS/DISPLAYS\P CONTROLS/SWITCHES\P TUBES/HOSES\P FITTINGS/CONNECTORS\M IDENT\M LEAKTEST\P LEAK TEST: APPLY 200 NMHG (<10/MIN)\M MANOMETER\P STATIC PRESSURE CHECK: APPLY 200 MMHG\P STATIC PRESSURE CHECK: APPLY 100 MMHG\P POP OFF/RELIEF VALVE: APPLY >250 MMHG\M MAKEARMNEO:HR=60;BP=ADAMSNEO-150/100\P ADAMS NEONATE 150/100 AT 60 BPM\M MAKEARMNEO:HR=120;BP=ADAMSNEO-100/65\P ADAMS NEONATE 100/650 AT 120 BPM\M MAKEARMNEO:HR=200;BP=ADAMSNEO-60/30\P ADAMS NEONATE 60/30 AT 200 BPM\M GOTOLOCAL\M GTOL through line 79 - unused --A 4


AUTO SEQ


CHECKLIST DESCRIPTION: NIBP*NEO



fcv068.eps

Figure 3-11. medBase Neonate BP Checklist


3-48

MedTester REC # 17

SEQUENCE: 4

OP CODE: TEO

DEVICE INFORMATION

PHYSICAL INSPECTION

LINE VOLTAGES







TYPE: NIBP*NEOMODEL:


MANF:SN:

LOC:DNICN: NIBP*NEO

DATE: 6/05/93 TIME: 15:43:29

fcv069.eps

Figure 3-12. medBase Neonate BP Test Results


3-49

DEMO ROOM


Proc. Name

SENT*NEO

Description

GENERAL CONDITION OF EQUIPMENTLINE CORD/STRAIN RELIEFTRPN (POWER ON)INDICATORS/DISPLAYSCONTROLS/SWITCHESTUBES/HOSESFITTINGS/CONNECTORSIDENTLEAKTESTLEAK TEST: APPLY 200 MMHG (<10/MIN)MANOMETERSTATIC PRESSURE CHECK: APPLY 200 MMHGSTATIC PRESSURE CHECK: APPLY 100 MMHGPOP OFF/RELIEF VALVE: APPLY >250 MMHGMAKEARMNEO:HR=60;BP=ADAMSNEO-150/100ADAMS NEONATE 150/100 AT 60 BPMMAKEARMNEO:HR=120;BP=ADAMSNEO-100/65ADAMS NEONATE 100/65 AT 120 BPMMAKEARMNEO:HR=200;BP=ADAMSNEO-60/30ADAMS NEONATE 60/30 AT 200 BPMGOTOLOCALGTOL5




0.00

PM Labor Time


fcv073.eps

Figure 3-13. Sentinel Neonate BP Checklist


3-50

MedTester REC # 18

CHECKLIST: NIBP*NEO

OP CODE: TEO

DEVICE INFORMATION

PHYSICAL INSPECTION


GENERAL CONDITION OF EQUIPMENT........PASSLINE CORD/STRAIN RELIEF...............PASSTRPN (POWER ON).......................REMOTE CMD, NO DATAINDICATORS/DISPLAYS...................PASSCONTROLS/SWITCHES.....................PASSTUBES/HOSES...........................PASSFITTINGS/CONNECTORS...................PASSIDENT.................................CUFFLINK,3.00,AUSC,PUMPLEAKTEST..............................*LEAK TEST: APPLY 200 MMHG (<10/MIN)...PASSMANOMETER.............................*STATIC PRESSURE CHECK: APPLY 200 MMHG.PASSSTATIC PRESSURE CHECK: APPLY 100 MMHG.PASSPOP OFF/RELIEF VALVE: APPLY >250 MMHG.PASSMAKEARMNEO:HR=60;BP=ADAMSNEO-150/100.....*ADAMS NEONATE 150/100 AT 60 BPM.......PASSMAKEARMNEO:HR=120;BP=ADAMSNEO-100/65..*ADAMS NEONATE 100/65 AT 120 BPM.......PASSMAKEARMNEO:HR=200;BP=ADAMSNEO-60/30...*ADAMS NEONATE 60/30 AT 200 BPM........PASSGOTOLOCAL.............................*GTOL..................................REMOTE CMD, NO DATA

TYPE: NIBP*NEOMODEL:

MANF:SN:

LOC: DNICN: NIBP*NEO

DATE: 6/05/93 TIME: 15:44:19

fcv071.eps

Figure 3-14. Sentinel Neonate BP Test Results


3-51

Adult Arrhythmic BP Checklists and Test Results Figure 3-15 shows a medBase Adult BP Arrhythmic checklist that creates results like those shown in Figure 3-16. Figure 3-17 shows a Sentinel Adult Arrhythmic BP checklist that creates results like those shown in Figure 3-18.

DATE: 06/05/1993


Ln

123456789

101112131415161718192021222380

1237671315383940414243734445464748495051

----->25

\P GENERAL CONDITION OF EQUIPMENT \P LINE CORD/STRAIN RELIEF\M TRPN (POWER ON)\P INDICATORS/DISPLAYS\P CONTROLS/SWITCHES\P TUBES/HOSES\P FITTINGS/CONNECTORS\M IDENT\M LEAKTEST\P LEAK TEST: APPLY 200 NMHG (<10/MIN)\M MANOMETER\P STATIC PRESSURE CHECK: APPLY 200 MMHG\P STATIC PRESSURE CHECK: APPLY 100 MMHG\P POP OFF/RELIEF VALVE: APPLY >250 MMHG\M MKARR_PAC PRE. ATRIAL CONTRACTION\P ARRHYTHMIA PAC 120/80 @ 80 BPM\M MKARR_PVC PRE. VENTRICULAR CONTRACTION\P ARRHYTHMIA PVC 120/80 @ 80 BPM\M MKARR_AF ATRIAL FIBRILLATION\P ARRHYTHMIA ATRIAL FIB 120/80 @ 80 BPM\M GOTOLOCAL\M GTOLthrough line 79 - unused --A4


AUTO SEQ


CHECKLIST DESCRIPTION: NIBP*ARR



fcv074.eps

Figure 3-15. medBase Adult Arrhythmic BP Checklist


3-52

MedTester REC # 19

SEQUENCE: 4

OP CODE: TEO

DEVICE INFORMATION

PHYSICAL INSPECTION

LINE VOLTAGES







TYPE: NIBP*ARRMODEL:


MANF:SN:

LOC:DNICN: NIBP*ARR

DATE: 6/05/93 TIME: 15:49:00

fcv076.eps

Figure 3-16. medBase Adult Arrhythmic BP Test Results


3-53

DEMO ROOM


Proc. Name

SENT*ARR

Description

GENERAL CONDITION OF EQUIPMENTLINE CORD/STRAIN RELIEFTRPN (POWER ON)INDICATORS/DISPLAYSCONTROLS/SWITCHESTUBES/HOSESFITTINGS/CONNECTORSIDENTLEAKTESTLEAKTEST: APPLY 200 MMHG (<10/MIN)MANOMETERSTATIC PRESSURE CHECK: APPLY 200 MMHGSTATIC PRESSURE CHECK: APPLY 100 MMHGPOP OFF/RELIEF VALVE: APPLY >250 MMHGMKARR_PAC PRE. ATRIAL CONTRACTIONAARRHYTHMIA PAC 120/80 AT 80 BPMMKARR_PVC PRE VENTRICULAR CONTRACTIONAARRHYTHMIA PVC 120/80 AT 80 BPMMKARR_AF ATRIAL FIBRILLATIONAARRHYTHMIA ATRIAL FIB 120/80 AT 80 BPMGOTOLOCALGTOL5




0.00

PM Labor Time


fcv079.eps

Figure 3-17. Sentinel Adult Arrhythmic BP Checklist


3-54

MedTester REC # 20

CHECKLIST: NIBP*ARR

OP CODE: TEO

DEVICE INFORMATION

PHYSICAL INSPECTION


GENERAL CONDITION OF EQUIPMENT........PASSLINE CORD/STRAIN RELIEF...............PASSTRPN (POWER ON).......................REMOTE CMD, NO DATAINDICATORS/DISPLAYS...................PASSCONTROLS/SWITCHES.....................PASSTUBES/HOSES...........................PASSFITTINGS/CONNECTORS...................PASSIDENT.................................CUFFLINK,3.00,AUSC,PUMPLEAKTEST..............................*LEAK TEST: APPLY 200 MMHG (<10/MIN)...PASSMANOMETER.............................*STATIC PRESSURE CHECK: APPLY 200 MMHG.PASSSTATIC PRESSURE CHECK: APPLY 100 MMHG.PASSPOP OFF/RELIEF VALVE: APPLY >250 MMHG.PASSMKARR_PAC PRE. ATRIAL CONTRACTION.....*ARRHYTHMIA PAC 120/80 @ 80 BPM........PASSMKARR_PVC PRE VENTRICULAR CONTRACTION*ARRHYTHMIA PAC 120/80 @ 80 BPM........PASSMKARR_AF ATRIAL FIBRILLATION..........*ARRHYTHMIA ATRIAL FIB 120/80 @ 80 BPM.PASSGOTOLOCAL.............................REMOTE CMD, NO DATAGTOL..................................REMOTE CMD, NO DATA

TYPE: NIBP*ARRMODEL:

MANF:SN:

LOC: DNICN: NIBP*ARR

DATE: 6/05/93 TIME: 15:49:44

fcv077.eps

Figure 3-18. Sentinel Adult Arrhythmic BP Test Results

Remote Operation Additional Command Descriptions (Firmware Version 3.20) 3

3-55

Additional Command Descriptions (Firmware Version 3.20) The remote commands described in this section were added with firmware version 3.20.

PUMPON Use this command to turn the pump on and close the release valve. The pump runs until it is turned off or the default parameters are reached. Parameters for this command are described below.


TIME On time for the pump

1 to 900 seconds 900 seconds The time that the pump is on

PRESSURE Target pressure for pump operation

0 to 499 mmHg 200 mmHg The pump runs when pressure is below this point.

Example

Send a command for the pump to run for two minutes or a pressure of 50 mmHg.

Command pumpon time=120,pressure=50

Results XXXX.XX, YY:YY; XXXX.XX is the Analyzer system pressure; YY:YY is the time the pump was running.

Returned Data *

PUMPOFF Use this command to turn the pump off. There are no parameters for this command.

Example

Turn the pump off.

Command pumpoff

Results The Analyzer turns the pump off.

Returned Data *

VALVEOPEN Use this command to turn the pump off and open the release valve. There are no parameters for this command.

Example

Turn the pump off and open the release valve.

Command valveopen

Results The Analyzer turns the pump off and opens the release valve.

Returned Data *


3-56

VALVECLOSED Use this command to close the release valve. There are no parameters for this command.

Example

Close the release valve.

Command Valveclosed

Results The Analyzer closes the release valve.

Returned Data *

4-1

Chapter 4 Maintenance, Service, and Calibration

Title Page

Maintenance....................................................................................................... 4-3 Avoiding Damage.......................................................................................... 4-3 Cleaning......................................................................................................... 4-3

Service and Calibration...................................................................................... 4-3


4-2

Maintenance, Service, and Calibration Maintenance 4

4-3

Maintenance The Analyzer requires little maintenance or special care; however, it is a calibrated measuring instrument and should be treated as such. The optional carry case is recommended for storage. It is further recommended that the storage environment be free from vibration.

Avoiding Damage Do not drop the instrument or subject it to any mechanical abuse that could cause a shift in the calibrated settings.

W Caution To avoid damage to the Analyzer or adverse affects on its performance, do not expose the system to temperature extremes. Ambient temperatures should remain between 0 °C and 50 °C.

Cleaning Clean the exterior of the Analyzer occasionally with a cloth dampened with a mild detergent solution.

W Caution To avoid damage to the Analyzer or adverse affects on its performance, do not spray liquid directly on or immerse the unit.

Service and Calibration If your new Analyzer fails to operate successfully or if it needs a recommended yearly calibration, please contact the Fluke Biomedical Service Center immediately, as indicated under Warranty and Product Support.

W Caution To avoid damage to the Analyzer or adverse affects on its performance, allow only qualified technical personnel to service the Analyzer.

Packing If repairs or calibration are required, return the Analyzer to the factory or the nearest service center. 1. Before returning the Analyzer for factory service, contact Fluke Biomedical Service

Center for a required Return Authorization Number. 2. Provide the following information: 3. The Analyzer serial number 4. The specific steps that reproduce your problem 5. A daytime phone number 6. Your name / company 7. A fax number (if available)


4-4

8. Pack the instrument carefully, using the original shipping container and packing materials supplied by Fluke Biomedical. If the original packing materials are not available, refer to Return Procedures for a list of preferred materials or contact Fluke Biomedical for replacement packing.

Note Failure to pack the instrument properly could void the warranty.

Shipping 1. Place the Return Authorization Number in a prominent place on the outside of the

packing box, and refer to the number in any correspondence with Fluke Biomedical Service.

2. Enclose your return address and Return Authorization Number. 3. Insure the unit for full retail value and ship to the nearest Fluke Biomedical Service

Center.

Appendices

Appendix Title Page

A Non-Invasive Blood Pressure (NIBP) Monitoring Tutorial ................................ A-1 B Glossary............................................................................................................... B-1

A-1

Appendix A Non-Invasive Blood Pressure (NIBP)

Monitoring Tutorial

Introduction Manufacturers of NIBP monitors that use the oscillometric technique have performed clinical trials to determine the correlation between both auscultatory techniques and invasive (arterial line) methods of measuring blood pressure to the oscillometric technique. Various interpretations have emerged from these manufacturers with varying degrees of agreement. Because no regulatory agency has put forth a standard as to how pulse amplitudes should be interpreted to determine blood pressure, the accuracy and repeatability of these monitors is difficult to determine. Because the Analyzer produces a stable live subject response to the cuff during the measurement cycle, it is possible to determine the repeatability and agreement of these monitors. The Analyzer produces the same response, independent of the inflate/deflate cycle or the algorithm used by the monitor; therefore, we offer the term Target Value as an approximation of the patient's actual blood pressure. Absolute dynamic accuracy cannot be assigned to MAP, diastolic, and systolic target values at this time because no standard exists. Should any public standards emerge, the Analyzer can be programmed to implement them and test blood pressure monitor accuracy.

NIBP Monitoring Blood pressure can be measured using a variety of techniques. They can be classified into two major categories. They are known as invasive and non-invasive. The invasive approach inserts a catheter into an artery of a test subject. The catheter may contain a pressure transducer at its tip or it may be fluid filled and couple the blood pressure thru the fluid to an external transducer. The change of fluid pressure (blood pressure) in the subject's artery is said to be measured invasively. This technique is also referred to as a direct measurement, because the parameter being measured is directly coupled to the transducer. The non-invasive technique can be realized several ways. It usually involves the use of an inflatable cuff wrapped around the limb of a test subject. The cuff is inflated and deflated at a controlled rate and physical parameters are observed. The auscultatory and


A-2

oscillometric techniques are well known non-invasive methods. These methods are indirect because they do not couple directly to the artery.

Auscultatory Technique (not available in Analyzer) The auscultatory technique is based on the sounds caused by the blood flow through the artery that is surrounded by the cuff. These sounds are known as Korotkoff (K) sounds. In manual blood pressure measurement these sounds are detected by a human observer using a stethoscope. Automated blood pressure monitors use an audio transducer (e.g. microphone) to convert the K sounds into electric signals. The cuff is inflated to a point that occludes the artery. The pressure in the cuff is lowered. The cuff pressure at which the K sounds are first detected is the systolic pressure. The monitor continues to decrease the cuff pressure until the K sounds disappear. The cuff pressure at this point is called diastolic pressure

Oscillometric Technique The oscillometric technique does not use K sounds to determine blood pressure. The oscillometric technique monitors the changes in cuff pressure caused by the flow of blood thru the artery. The monitor inflates the cuff to a pressure that occludes the artery. Even when the artery is occluded, the pumping of the heart against the artery can cause small pressure pulses in the cuff baseline pressure. The monitor lowers cuff pressure at a controlled rate. As the cuff pressure goes down, blood starts to flow thru the artery. The increasing blood flow causes the amplitude of the pressure pulses in the cuff to increase. These pressure pulses continue to increase in amplitude with decreasing cuff pressure until they reach a maximum amplitude at which point they begin to decrease with decreasing cuff pressure. The cuff pressure at which the pulse amplitude is the greatest is known as Mean Arterial Pressure (MAP). The manner in which the pulse amplitudes vary is often referred to as a pulse envelope. The envelope is an imaginary line that connects the peak of each pressure pulse and forms an outline. The shape of the envelope is observed by the monitor using a variety of techniques to determine the diastolic and systolic blood pressures.

Auscultatory vs. Oscillometric Techniques The auscultatory response is based on the sounds heard with a microphone. The cuff is inflated to a pressure much higher than systole. As the cuff is deflated the observer (or automated monitor) listens for the onset of K sounds. The cuff pressure at which the K sounds are first detected is treated as systolic pressure. In Figure A-1, some smaller K sounds are shown to appear before the systolic point. In many cases there is a threshold point. The point at which the sounds jump from some very low level to a much larger level is more typical with live subjects. The K sound amplitude does not change much as the cuff continues to deflate until the point of diastole is reached. At this point, there is an abrupt drop in K sound amplitude.

Appendices Non-Invasive Blood Pressure (NIBP) Monitoring Tutorial A

A-3

Oscillometric Response(Pressure Pulses)

Auscultatory Response(Korotkoff Sounds)

Cuff Pressure

MAP

MAP

Distole

Distole

Systole

Systole

Time

Time

Time

fcv006.eps

Figure A-1. Auscultatory vs. Oscillometric Techniques

Also in Figure A-1, the oscillometric pulse amplitudes are depicted as constantly changing. There is no point where the pulses abruptly change in amplitude, but there is a point where the pulse amplitude reaches a peak. It is generally agreed that the cuff pressure at peak pulse amplitude is the MAP, a value not easily identified using the auscultatory method.


A-4

Pulse Amplitude The amplitude of the oscillometric pulses (hereafter referred to as pulses) is quite small when compared to the static pressure in the cuff. As shown in Figure A-2, these pulses appear as very small spikes on the cuff pressure waveform. They are depicted in amplified form with the cuff pressure stripped off to reveal how the amplitude varies as a function of cuff pressure. The peak pulse amplitude is 2 mmHg at a cuff pressure of 115 mmHg in the example shown.

mmHg

Pul

se A

mpl

itude

Cuf

f Pre

ssur

e

mmHg

PulseEnvelope

200

Cuff Pressure

Time

1002.0

1.0

fcv007.eps

Figure A-2. Pulse Amplitude and Cuff Pressure vs. Time: Linear Deflate

In general, the peak pulse amplitude is 1-3 % of the cuff pressure at which it occurs. Therefore, the monitor must be able to strip off the large static cuff pressure to measure the individual pulse. Because the pulses are so small, it is possible for artifact conditions to obscure the pulse. Patient motion and respiration are common artifacts that the monitor must reject. When the cuff pressure is quite high the pulse amplitude is small. As the cuff deflates, the pulse amplitudes increase to a maximum and then decrease to a minimum.


A-5

Cuff Deflation The linear deflate method is also known as continuous bleed. This is the method a nurse typically uses when measuring blood pressure manually. If the deflate is slow, accuracy is improved. For example, if the bleed rate is 1 mmHg/sec and the heart rate is 60 BPM, the cuff pressure changes 1 mmHg per heart beat. Therefore, the error due to change in cuff pressure is limited to 1 mmHg. If the bleed rate is 10 mmHg/sec, then the cuff pressure changes 10 mmHg per heartbeat, and the potential error due to change in cuff pressure is 10 mmHg. This error is in addition to the error of the method being used to determine blood pressure. The tradeoff is accuracy versus patient discomfort.

Note If someone taking a subject’s blood pressure deflates the cuff faster than 3 mmHg/sec, an appreciable error in the ability to measure blood pressure may be introduced. For example, if the cuff is inflated to 180 mmHg and then deflated to 60 mmHg, it should take 40 seconds at a deflation rate of 3 mmHg/second.

Automated monitors employ algorithms to interpret the measurement points to minimize error due to rapid deflate. A typical deflate method used by automated monitors is known as a step or stepwise deflate, as shown in Figure A-3.

150

100

Amplified PulsesmmHg

mmHg

Step Deflate

Pulse Pair

50 2.0

1.0

Time

Cuf

f Pre

ssur

e

Pul

se A

plitu

de

Rapid Deflate

fcv008.eps

Figure A-3. Cuff Pressure and Pulse Amplitude vs. Time: Commercial Monitor

The cuff is inflated to a pressure much greater than systole and deflated in discrete steps. Typical step deflate size is from 4 to 10 mmHg depending on the monitor and cuff size being used. After the deflate, the monitor measures some number of pulses before


A-6

deflating again. The number of pulses gathered depends on the monitor software and the algorithm used. In a stat mode, it is common to gather only one pulse per step. In normal mode, it is common to gather pulses until at least two pulses are within some tolerance of each other in amplitude for artifact rejection. When a monitor step deflates in large steps, it must interpolate the shape of the pulse envelope. The larger the step size the larger the potential for error when interpolating. If the step size is small, the potential for error is reduced. Much effort has been spent by manufacturers to maximize step size and minimize error with varying degrees of success. With the introduction of the Analyzer, it is now possible to compare normal mode to stat mode and observe the repeatability of the monitor as a function of step size and pulse pair matching. The end of the measurement cycle is defined as the point at which diastolic pressure has been determined. At this time the cuff is rapidly deflated to further minimize patient discomfort.

BP Determination The manner in which oscillometric pulses vary as a function of cuff pressure is open to interpretation. Height-based and slope-based algorithms are used to determine blood pressure based on pulse amplitudes. Figure A-4 shows the same pulse envelope interpreted by these two different methods.

Pulse Amplitude

Map %

Distole %

Distole

Height Interpretation Slope Interpretation

Systole %

Systole

CuffPressure

Pulse Amplitude

DistoleMap

Systole

CuffPressure

fcv009.eps

Figure A-4. Height/Slope Interpretations for Determining BP from Pulse Amplitude Data

Height Method The peak pulse amplitude is treated as MAP and normalized to a value of 100%. The cuff pressure at MAP is the MAP pressure. Systole and diastole are fixed percentages based on MAP. The cuff pressure under diastole is the diastolic pressure and the cuff pressure under systole is the systolic pressure. There is no standard to suggest what the percentages for systole and diastole should be or even that they should be fixed percentages. Manufacturers using height-based algorithms have performed their own clinical trials and drawn their own conclusions about what the percentages should be and whether they are fixed as a function of MAP pressure.


A-7

Slope Method There are many methods employed to determine how many slopes should be drawn and what conclusions can be made about their intersection. As shown in Figure A-4, the cuff pressure under the intersection of the slopes is treated as the systolic and diastolic pressures. There is no standard for slope algorithms, just as there is no standard for height algorithms.


A-8

B-1

Appendix B Glossary

ADAMS Adult Family Set of Analyzer target values designed to simulate adult blood pressure

ADAMS Neonate Family Set of Analyzer target values designed to simulate neonatal blood pressure

AdjEnv Adjust Envelope is a selection on Analyzer ADAMS Adult or ADAMS Neonate menus from which one can adjust envelope gain and shift or draw the pressure envelope.

A to D (or A/D) converter Analog to Digital Converter. This is an electronic device or circuit that converts analog input voltage to a number of equivalent digital output levels.

arrhythmia Alteration in time or force of the normal heartbeat rhythm

auscultatory blood pressure measurement

Blood pressure measurement done by interpreting sounds of blood flow (K sounds) through an artery that is surrounded by the cuff

baud rate Rate of serial transmission measured in bits per second.

bits/character The number of bits needed to define one keyboard character

blood pressure Pressure in the brachial artery at heart level.

blood pressure cycle

One Analyzer blood pressure simulation, completed by deflation of the BP cuff

BPM Beats per minute

Checklist A set of instructions performed on a piece of equipment

Checklists are generated by the Sentinel or medBase programs and can include any medTester remote commands for the Analyzer.

Controller A device capable of controlling Analyzer operations

A medTester with Checklist or a computer with a serial port


B-2

Cuff adapter Specialized connecting hose (consists of T connector, plastic tubing,

and quick release connector) that provides the link from the Analyzer to the NIBP system

There are several different types of cuff adapters available to accommodate many different types of NIBP monitors.

CuffPeak Cuff Peak

Value on the makearm display that indicates peak cuff pressure reached during the blood pressure cycle

CuffPress Cuff Pressure

Value on the makearm display that indicates current cuff pressure during the blood pressure cycle

Cuff pressure Pressure inside the sphygmomanometer cuff

Cursor Dark blue rectangle on the Analyzer display that indicates a current selection

Cycle See blood pressure cycle.

data string A serial data transmission

In this case, the data is values that the Analyzer sends to the controller.

Default values Values assigned to remote commands each time the Analyzer is powered on

DeflRate Deflate Rate

Value on the makearm display that indicates the rate of cuff deflation (in mmHg/sec) at the end of the blood pressure cycle

Demme Deflate Time

Value on the makearm display that indicates how long (in seconds) it took for the cuff to deflate at the end of the blood pressure cycle

Diastole Relaxation of the heart during the cardiac cycle

diastolic blood pressure

The blood pressure that occurs during the relaxation period of the cardiac cycle

Display test

Analyzer self test

A series of patterns shown on the display to verify correct display operation

EEROM Electrically Erasable Read Only Memory; a memory device pro-grammed with high voltage signals and erased electrically

In the Analyzer, all user modifications are stored in EEROM.

Flow control The handshaking method used by peripherals and microprocessors to inform each other when data is available to be sent or received

This is useful when the microprocessor is faster than the peripheral device (printer, etc.). The Analyzer microprocessor can fill the output buffer, go on to other tasks, and resume sending data to the peripheral when it needs more data.

Appendices Glossary B

B-3

Gain Amplitude, voltage

Gain affects the Analyzer pressure pulse amplitude

HtRate Heart Rate adjustable from the Analyzer Target Values menu for both ADAMS Adult and ADAMS Neonate.

Hz hertz

impedance Resistance or opposition to AC (sinusoidal) current (W)

Expressed in Ω.

inflRate Inflate Rate

Value on the makearm display that indicates the rate of cuff inflation (in mmHg/second) during the blood pressure cycle

inflTime Inflate Time

Value on the makearm display that indicates how long (in seconds) it took for the cuff to inflate during the blood pressure cycle

Korotkoff sounds The sounds that blood creates when moving through vessels partially occluded by a sphygmomanometer cuff

For blood pressure determination, systolic pressure is at the point where Korotkoff sounds are first heard as the cuff begins to deflate. Diastolic pressure is at the point where the Korotkoff sounds become muffled.

K sounds Korotkoff sounds

LCD Liquid Crystal Display

leak test Test in which an NIBP device is evaluated for leaks in the cuff or hose connections caused by incorrect or broken connections, cracks in the cuff, 0 ring deterioration, etc. Maximum leak rates are documented in the manual for each NIBP device.

local mode The Analyzer operating mode controlled with the keys on its front panel

makearm Name for the Analyzer blood pressure simulation process.

mandrel Adjustable plastic form (supplied with the Analyzer) that replaces the human arm inside the sphygmomanometer cuff

The complete adult mandrel assembly consists of 2 end blocks and 3 spacer blocks. The optional auscultatory mandrel assembly contains the auscultatory puck and connects to the adult mandrel. The neonate mandrel is a single plastic cylinder that has 3 different diameters (mandrel size is determined by cuff position).

manometer Device for measuring pressure

MAP Mean Arterial Pressure

The minimum cuff pressure at which pulse amplitude is the greatest.

The maximum perfusion (transfer) of oxygen from the arterial blood supply to the surrounding tissue also occurs at MAP

millisecond One thousandth of a second.


B-4

mmHg Millimeters of mercury

Standard unit of pressure measurement

neonatal Of or relating to a newborn

NIBP Non-invasive Blood Pressure

A blood pressure measurement that involves no direct contact with the artery

Ω ohm

opto sensor Electronic device that acts as a switch

When the Analyzer puck moves down far enough to break the light beam of this device, the switch turns off. When the light beam is not broken, the switch is on.

oscillometric blood pressure measurement

A measurement of blood pressure by monitoring changes in cuff pressure caused by the flow of blood through the artery

overpressure test Test in which an NIBP device's overpressure point is exceeded, or the point at which cuff pressure is great enough to cause emergency deflation

parallel communications Data transmission in which all bits are received or transmitted at the same time

parallel printer port Connection for a parallel, Centronics compatible printer

parameter Additional values that further define the Analyzer remote commands

One can specify many different parameters for remote commands.

parity The number of (binary) ones in a serial data stream

Even parity means the data stream has an even number of ones. Odd parity means the data stream has an odd number of ones. Different peripheral devices may need different types of parity. It is necessary to configure the Analyzer to be compatible with whatever parity the peripheral device requires (Odd, Even, or Off).

peak divide ratio The value that the Analyzer uses to calculate the point of rapid cuff deflate at the end of the blood pressure cycle

peak pressure Maximum cuff pressure attained during the blood pressure cycle

pixel When referring to monitors or displays, the small elements (seen as small squares on the Analyzer display) that comprise the display

Pixels are arranged in a horizontal and vertical grid pixel number is directly related to display resolution. The greater the number of pixels in the display, the greater the resolution will be.

pop off test See overpressure test.

PopTime The amount of time the Analyzer displays pop-up windows; adjustable from 0 to 5 seconds

Pop-Up Window Informational boxes that appear momentarily on the Analyzer display

Pop-up windows appear to confirm a choice made or an action the Analyzer has performed.

Appendices Glossary B

B-5

pressure cycle See blood pressure cycle.

pressure envelope Graphic representation of cuff pressure as a function of time during a blood pressure cycle

pressure envelope gain Increase or decrease in pressure envelope amplitude

pressure envelope shift Change of blood pressure envelope position along the pressure axis

pressure pulse Pulse, or temporary increase in blood pressure caused by the intermittent rush of blood in the arteries due to the heart's pumping action

pressure transducer Electronic device that converts pressure to a proportional voltage signal

print test Test that the Analyzer performs to check printer operation

puck Small, moveable disk that creates positive and negative pressures inside a chamber when moved by the Analyzer pressure engine

The action of the puck moving up and down within the puck chamber produces the Analyzer oscillometric blood pressure simulations. The puck inside the auscultatory mandrel simulates auscultatory blood pressure.

pulse amplitude Height of the peripheral pulse

pulse envelope Imaginary line that connects the peak of each pressure pulse to form an outline

NIBP monitors use pulse envelope shape to determine diastolic and systolic blood pressures.

RAM Random Access Memory

remote mode Analyzer operating mode mediated with a controller (a medTester with Checklist or a PC with an RS232 port)

returned data Information (values) sent to a controller from the Analyzer as a result of a remote command

These values can be test results, information stored in the Analyzer memory, or, if the remote command does not generate data, an asterisk.

ROM Read Only Memory

The software program that operates the Analyzer is located in ROM

ROM checksum The mathematical sum of the software program code (in bytes) stored in ROM

The code in ROM should never change once programmed at the factory, and a ROM checksum value indicates the integrity of the code when analyzed by a qualified service technician.

RS232 Electronics industry standard for serial communications

RTS/CTS Request To Send/Clear To Send

Handshaking protocol in which an RTS signal generated by the Analyzer indicates there is data to send and a CTS signal generated by the peripheral device indicates it is ready to receive data from the Analyzer


B-6

RVDU Relative Volume Displacement Unit

The volume displaced inside the puck chamber when the Analyzer pressure engine moves one increment (one micro step)

Sentinel Equipment management system (available from Dynatech Nevada) that tracks items such as preventative maintenance and plant operations

serial communication Transmission or reception of data in a bit stream, one bit at a time

shift See pressure envelope shift.

stop bit The last bit added to the bit stream by the transmitting hardware that indicates the end of the bit stream to the receiving hardware

One can specify either 1 or 2 stop bits for the Analyzer.

systole Contraction of the heart during the cardiac cycle

systolic blood pressure The blood pressure that occurs during the cardiac cycle when the heart contracts

target value A blood pressure defined by specific systolic, diastolic, and MAP values that can be simulated by Analyzer

terminating character Character that, when entered from a controller's keyboard, informs the Analyzer where the end of a serial transmission (remote command) is

TotITime Total Time

Value on the makearm display that indicates how long (in seconds) it took for the complete blood pressure cycle

Xon/Xoff Transmit On/Transmit Off

A handshaking protocol in which a transmit on signal generated indicates data may be received

zero pressure Analyzer feature that allows one to zero the pressure transducer and remove any offset errors during pressure measurements