Welch Allyn 621NP - Manual

v Warnings, Cautions, and Notes All operating personnel should be familiarized with the general safety information in this summary. Specific warnings and cautions will also be found throughout the operator’s manual. Such specific warnings and cautions may not appear here in this summary. C US This d...

vi Warnings • The Welch Allyn Atlas Monitor is designed for use by medical clinicians. Although this manual may illustrate medical monitoring techniques, this system should only be used by a trained clinician who knows how to take and interpret a patient’s vital signs. • Do not operate this product ...

vii • If an electrosurgical unit is used, place the ECG cable and wires as far as possible from the site of the surgery and from the electrosurgical cables. This will minimize interference and the risk of burns to the patient. Ensure that the electrosurgical return cable (neutral) is well attached a...

viii • Make frequent electrical and visual checks on cables and electrode wires. • Ensure the AC rating for the device is correct for the AC voltage at your installation site before using the monitor. The AC rating is shown on the back of the instrument. If the rating is not correct, do not use the ...

ix Allyn or an authorized distributor, agent, or service representative. This warranty does not include breakage or failure due to tampering, misuse, neglect, accidents, modification or shipping. This warranty is also void if the instrument is not used in accordance with manufacturer’s recommendatio...

xi European contact for regulatory compliance: European Regulator Manager Welch Allyn LTD. Navan, Co. Meath Republic of Ireland Phone 353-46-67700 Fax: 353-46-27128 Service Information: Service Manual / Spare Parts A service manual is available by request to qualified electronics personnel. The serv...

1 1 How This Manual Works This manual is arranged so that everything about one topic is found in a single section. The statement immediately below the chapter title (like this one) appears in italics and presents the important points of the topic. Most topics include an illustration or a table. The ...

2 1.1 A Quick Tour of the Welch Allyn Atlas Monitor When you turn on the power, the monitor starts with preset or default alarm levels. Waveforms are displayed on the screen. Readings are displayed on the screen and on LEDs. You can perform the most common operations — set and silence alarms, displa...

4 2 Monitoring the Patient The patient’s vital measurements are displayed as numeric readings and as waveforms. You can set the measurement limit alarm levels, silence the alarms for a short period, and suspend individual alarms. You can print waveforms and current measurements, or print all the sto...

5 Trend Lead Select Print AC 70 23% 12 RR (bpm) HI F C LO HI LO HI LO SpO 2 % PULSE TEMP Diastolic Systolic (mmHg) (mmHg) Power Silence Trend Print (bpm) HI F C LO LO HI LO SpO 2 % PULSE TEMP Diastolic Systolic (mmHg) (mmHg) Trend Print NIBP Sp0 2 CO2 mmHg RR F Alarm SuspendButtons BP ALARMS 2:10 68...

6 2.1 Monitoring Blood Pressure Blood pressure can be measured at timed intervals which you set, or you can start the blood pressure measuring cycle manually. Systolic and Diastolic readings are shown on the LEDs at the upper right of the monitor. You can set the high and low alarm limits for both t...

7 CO 2 / RESP ALARMS Trend Lead Select Print AC Select Set Off Off Select Set PG 2-5 Blood Pressure Connector Atlas Monitor showing NIBP displays, controls and tubing connector Setting alarm limits - To set the Systolic and Diastolic alarm limits, use the Select and Set buttons on the right side of ...

8 2.1.1 MAP (Mean Arterial Pressure) Mean Arterial Pressure is calculated from the systolic and diastolic measurements. MAP may be optionally displayed by selecting it on the Advanced Configuration menu. MAP is displayed in the upper left corner of the screen. MAP - (Mean Arterial Pressure) display ...

9 HR ALARMS CO 2 / RESP ALARMS Trend Lead Select Print AC Select 70 Set Off Off Off BP ALARMS MAP 96 Map Blood Pressure Connector Blood Pressure Alarm Off Silence Set Select Atlas Monitor waveform display showing location of MAP reading

11 kPa – If the blood pressure is displayed in kPa on the screen, the blood pressure readings will be in kPa in the trend data and in the current readings of the waveform printout. Note: To set the blood pressure limits in kPa, you will need to use the Select and Set buttons on the right side of the...

12 2.2 Monitoring SpO 2 , Pulse Rate and the SpO 2 Waveform The oximetry and pulse rate measurements are generally taken with the reusable fingerclip sensor (provided), however a wide variety of SpO 2 sensors are available as accessory items. The oximetry pulse volume is displayed as a vertical bar ...

13 Trend Lead Select Print AC 12/ min SpO 2 ALARMS Select Set Off Off (bpm) LO SpO 2 % SpO 2 SpO 2 CO 2 PULSE BP ALARMS - + SpO 2 Pulse Tone Volume Pulse Rate Select Set SpO 2 Connector Signal Strength Oximetry Measurement SpO 2 Alarms Off Silence Atlas Monitor showing SpO 2 displays, controls, and ...

15 2.3 Monitoring Heart Rate and the ECG Waveform The trace displays one of the ECG leads. This lead is indicated above the right end of the trace, near the ♥ symbol and heart rate value. Choose the lead with the Lead Select button. Heart rate is displayed at the right. ECG displays – The ECG wavefo...

16 lower the alarm limit. (When you come to the end of the range, the numbers will stop changing). • Press the Select button again to go to the next limit, or press it several times until none of the measurements flash and no HI or LO indicators are lit. The instrument is now in its normal measureme...

17 HR ALARMS CO 2 / RESP ALARMS Trend Lead Select Print AC Select 80 Se Off Off ECG Connector Lead Select Heart Rate Selected Lead Atlas Monitor showing ECG waveform display, controls, and ECG connector

21 2.5 Monitoring Temperature (Models 622xx & 623xx) The Temperature, measured on the skin surface with a skin sensor, is displayed in ° F or ° C, as chosen in Advanced Configuration. There are no audible alarms for Temperature. An invalid temperature reading is indicated by dashes “---” in the ...

22 F C TEMP Temperature Units Temperature Connector Atlas Monitor showing Temperature display and connector

23 2.6 Monitoring CO 2 , Respiration Rate, and the ETCO 2 Waveform (Model 623xx) The lower trace displays the ETCO 2 waveform, although you can display Impedance Respiration, ECG, or SpO 2 in its place if desired. The CO 2 measurement is shown above the right end of the trace, and Respiration Rate a...

26 suspended alarms will not alert the nurse station, nor will alarms that occur during a silence period, until the period is over. See the Technical Service Manual for details on the Nurse Call relay. Warning : it is the user’s responsibility to implement the interface between the Nurse Call system...

27 Alarm Conditions Alarm type Normal operation Silenced Suspended Patient Alarm; a vital sign measurement is outside limits Numbers flash Audible alarm – medium pitched tone once per second Print On Alarm if configured. Numbers flash No audible alarm No Print On Alarm Numbers flash No audible alarm...

28 HR ALARMS CO 2 / RESP ALARMS Trend Lead Select Print AC Select 170 12 RR 23 % Set SpO 2 ALARMS Select Set Off Off Off (bpm) HI LO BP Start/Canc SpO 2 % SpO 2 PULSE TEMP Diastolic Systolic - + - + PG 3-6 HR ALARMS CO 2 / RESP ALARMS Print AC Select 70 23 % Set SpO 2 ALARMS Select Set Off Off Off O...

29 3.1 Patient Alarms Patient alarms sound when one of the patient’s vital measurements is registering outside the limits you have set. You can set high and low alarm limits for most of the measurements. Setting and checking the alarm limits can be easily done from the front panel. The alarm setting...

30 Suspending Alarms “Off” button label Suspends alarms HR ALARMS Heart Rate CO 2 /RESP ALARMS (RESP ALARMS) ETCO 2 and Respiration Rate SpO 2 ALARMS Oximetry and Pulse Rate BP ALARMS Systolic, Diastolic and MAP Press the appropriate ALARMS Off button to suspend the audible alarm for a selected meas...

31 3.2 Measurement Invalid Alarms Invalid measurements could be caused by problems such as an ECG lead detaching from the patient or by a kinked ETCO 2 sample line. Such conditions sound an alarm with a tone and pattern distinct from the other alarms. You can quiet these with the Silence button, and...

32 3.3 Instrument Problem Alarms Instrument Problem Alarms, although they rarely occur, are of three types: 1) the Atlas Monitor detected an internal fault during power-on self test; 2) the Atlas Monitor detected an internal fault during use; 3) the Atlas Monitor reports that it lost power while in ...

33 3.4 Battery Alarms (Models 622xx & 623xx) Battery Alarms indicate that there are 10 or fewer minutes of battery life remaining. When one minute of battery life remains, a final alarm tone indicates that the Atlas Monitor is about to shut down, and a Trend report is automatically printed. Batt...

34 Message Location Atlas Monitor showing location of system message

35 4 Capturing and Displaying Trend Data Trend data is captured at every Blood Pressure cycle, whether it is automatically timed or manually initiated. If automatic BP timing is turned off, trend data will be captured every 15 minutes. Display the data by pressing Trend . Then press Print to print i...

36 Trend 2:10 68 121/85(--) 94 35 10 97.6 2:20 70 120/80(--) 95 38 12 98.6 2:30 67 120/78(--) 96 37 12 97.5 2:40 66 118/80(--) 95 38 10 98.6 2:50 70 120/86(--) 98 33 14 98.6 3:00 72 122/85(--) 90 38 12 95.6 3:10 74 128/86(--) 97 40 16 98.7 3:20 70 120/82(--) 95 36 12 96.2 3:30 70 119/88(--) 92 33 10...

37 5 Using Print and Waveform Freeze Pressing the Print button prints the waveforms (and current measurements) if the waveforms are displayed. If a screen of trend data is displayed, all the trend data is printed. Atlas Monitors without printers have a Freeze button that halts the waveform display f...

38 Trend Print Lead Select 20 RR 23% (bpm) HI LO SpO 2 % PULSE TEM Print RespirationRate 3 Dec 1998 23:40:01 86 75.1 F RR SpO 2 m m H g CO 2 CO 2 5mm/mV 25 0 .05 - 40Hz 25mm/s ECG Lead ECG Scale ECG Bandwidth Print Speed Respiration Scale CO 2 CO 2 Waveform 21 31 97 BP / ( ) 120 8 0 9 2 Atlas Monito...

39 5.1 The Printer – Loading Paper and Troubleshooting The printer has an easy loading feature that doesn’t require threading the paper strip. The lid is popped open, the thermal paper roll placed into the well with the correct surface towards the front, and the lid is shut. The printer - If your At...

41 6 Connecting to the Patient The main patient connections are for NIBP, SpO 2 , and ECG. Atlas Monitor models 622xx and 623xx additionally provide temperature measurement, and the model 623xx adds ETCO 2 . If you do not use all the measurement capabilities of the monitor, you will not have alarms ...

42 SpO2 BP ECG Temp CO2 Atlas Monitor showing hookup of patient sensors

43 6.1 Connecting the NIBP Cuff Select the proper cuff size (Small, Adult, Large Adult, or Extra Large Adult). Place cuff on patient, correctly oriented. Connect the tubing to the cuff and to the monitor. Blood pressure measurements can be taken automatically or manually. BP cuff sizes - For accurat...

44 RANGE ADULT ART ER Y INDEX 3 1 .5 c m M A X S IZ E ;; ;;;; ;;; ;;; ; ; ;;; ;;; ;;;; ; ; ;;; ;;;; ;;; ; ; ; ; ; ;;;; ;;; ; ; ; ; ; ;;; ;;; ; ; ; ; ; ; ; ; ; ; ; ; ; ;; ; ;;;;;; ;; ; ;;;;;; ;;;;;;;; ;;;;;;;; ;; ; ;;;;; ;;;;;;;; ; ;;;;;;;; ;;;;;; ;; ; ; ;;;; ; ; ; ; ; ; ; ; ; Correct placement of NI...

45 Blood pressure measurements – Blood pressure cycling can be scheduled automatically or started manually, as determined by the choice selected by the Auto button. When you turn on the monitor, the Auto setting defaults to “ X” , but it remembers the previous setting. Press the Auto button once to ...

46 6.2 Connecting the SpO 2 Fingerclip Sensor The SpO 2 fingerclip sensor provides the means to take the oximetry and pulse readings. Clip the fingerclip sensor to the patient, making sure it is in the correct orientation. Connect the sensor to the monitor. The sensors come in sizes for adult and ch...

48 6.3 Connecting the ECG Electrodes Prepare the patient’s skin, attach the leads to the electrodes, place the electrodes in the three (or five) correct locations, and plug the ECG cable into the monitor. The heart rate alarm usually operates in conjunction with the ECG measurement. Connecting - Con...

49 ECG ECG V1 RA RL LL LA V6 One of six V Lead electrode placementsites for the fifth lead. V5 V4 V3 V2 RA LA LL LL Correct placement of 3 wire and 5 wire ECG electrodes

50 V-Lead Placement – The brown V-lead connector can be placed at one of six standard locations: • V1 –Right Sternal border, fourth intercostal space. • V2 – Left sternal border, fourth intercostal space. • V3 –Between V2 and V4, midpoint between the two, in a line that joins all three. • V4 – Mid-c...

51 ECG RA LA LL LL Alternate ECG electrode placement for Impedance Respiration

52 6.4 Connecting the Temperature Probe (Models 622xx & 623xx) The Temperature measurement comes from a skin probe. Atlas Monitor models 622xx and 623xx can measure skin temperature with the supplied surface probe. Follow the package instructions for probe placement. Fahrenheit or Celsius - Temp...

53 6.5 Connecting the End Tidal CO 2 Sample Tube (Model 623xx) ETCO 2 is measured with a sample tube using a nasal cannula adapted for sidestream CO 2 measurement. Attach the cannula to the patient’s nose. Connect the sample tube to the watertrap and plug the watertrap into the monitor. – The watert...

54 7 Using The Menus Two menus are provided for configuring the Atlas Monitor. The items on these menus are choices that you might make to configure the Atlas Monitor to your needs when you first place it into service. You may change the date/time setting for Daylight Savings/Standard time, or when ...

55 Trend Lead Select Print AC Select Language 60 seconds English automatic5 wire25mm/sMonitor160 mm/hgYesCO 2 F12.5 mm/smmHg Alarm silence duration ECG gain ECG lead set ECG sweep speed ECG bandwidth Initial cuff pressure Monitor MAP Second trace selection Temperature units Respiration sweep speed A...

56 7.2 The Advanced Configuration Menu The Advanced Configuration menu provides options to configure monitoring settings for your specific needs. Access Advanced Configuration by pressing the Date/Time button, then the Trend button. What’s it for? - This menu allows the user to choose other options ...

57 Advanced Configuration Menu Settings Advanced Configuration Item Possible settings Factory default Language English, French, Canadian French, Spanish, German, Portuguese, Italian, Chinese, Japanese English Silence duration 60, 90, or 120 seconds 90 seconds ECG gain automatic, or 10mm/mV automatic...

58 7.2.1 Advanced Configuration Menu Settings The Advanced Configuration menu offers settings to customize the Atlas Monitor to suit your needs. Not all options are available on all models. Language - Factory default will be set for the dominant language used in your country. Of course, if you are m...

59 CO 2 units – The concentration of Carbon Dioxide can be expressed in millimeters of mercury ( mmHg ), percent ( % ), or kiloPascals ( kPa ). The values displayed for percentage and kiloPascals are calculated from the mmHg partial pressure based upon current barometric conditions. Print On Alarm -...

60 8 Cleaning and Maintaining the Atlas Monitor No harsh chemicals should be used for cleaning the monitor. A mild detergent solution works well. Care should be taken to keep liquids away from the monitor and its connecting parts. Servicing should be performed by a qualified technician at 6, 12, and...

61 • The system will report that it is Sampling. • The system will then report Reset Complete. • Remove the watertrap/Scrubber from the watertrap socket. • Detach the Scrubber from the watertrap and reattach the tubing. • Replace the watertrap in the watertrap socket. • Press Trend to return to the ...

62 9 Unpacking and Installing the Atlas Monitor When you first unpack the monitor, you should check it for shipping damage. Then verify that you have all the accessories, documentation, and supplies. Unpacking – As you carefully unpack the monitor, inspect it for damage from shipping. If you find an...

64 10 Appendix A: Technical Specifications for the Atlas Monitor A.1 General Specifications: Size 33 x 24 x 23 cm (13 x 9.5 x 8.75 inches) Weight 4.3 kg (9.5 lb.) (model 621xx) 6 kg (13.2 lb.) (models 622xx & 623xx) Display Type Cathode Ray Tube / LED Display Size 275 x 125 mm (10.8 x 4.9 inches...

74 13 Appendix D: Accessories for the Welch Allyn Atlas Monitor Part number Description Blood Pressure Accessories 5200-01 Adult Cuff Assembly (cuff, latex-free bladder and connectors) 5200-02 Large Adult Cuff Assembly (cuff, latex-free bladder and connectors) 5200-03 Small Cuff Assembly (cuff, late...

75 Power Cord Accessories 5200-110 Line Cord (US / Canada / Japan version) 5200-111 Line Cord (European version) 5200-112 Line Cord (United Kingdom version) 5200-113 Line Cord (Australian version) 5200-114 Line Cord (Swiss version) 5200-115 Line Cord (South American version) Mounting Accessories 620...

76 ETCO 2 Accessories 6200-20 ETCO 2 Water Trap (package of 5) 6200-21 ETCO 2 Scrubber 6200-22 ETCO 2 Adult Nasal Sample Line 6200-23 ETCO 2 Adult Nasal Sample Line (package of 10) 6200-24 ETCO 2 Sample Line 6200-25 ETCO 2 Divided Cannula (ETCO 2 sample line plus O2 delivery) 6200-120 ETCO 2 Dryer S...

77 14 Appendix E: Troubleshooting E.1 Diagnosing Atlas Monitor Problems E.1.1 Blood Pressure PROBLEM: Blood pressure readings are inaccurate. RECOMMENDED ACTIONS: Squeeze all air out of cuff and repeat measurement. Check the cuff for correct size for the patient – check that the index mark falls wit...

78 PROBLEM: Blood pressure automatic timing stops. RECOMMENDED ACTIONS: Safety mechanisms automatically stop the timed blood pressure measurements when the Atlas Monitor repeatedly fails to make a measurement within 3 minutes ; Determine the reason that the measurements are failing and restart the t...

81 PROBLEM: ECG waveform, heart rate corrupted by Electrosurgery or Electrocautery. RECOMMENDED ACTIONS: Monitor is specified to return to Clinical Utility within 8 seconds of discontinuance of electrosurgery; Heart Rate display may require up to 20 seconds to stabilize. Verify that electrosurgery n...

82 Check for good contact of electrodes to patient – shave, clean if necessary. PROBLEM: Impedance respiration waveforms are not displayed immediately. RECOMMENDED ACTIONS: Some impedance respiration signals will cause a delay of up to two minutes to properly display the waveform. This time is requi...

83 Reduce the frequency of blood pressure measurements or printouts if practical. Charge Atlas for 24 hours and time battery life in use as specified above; if less than the specified battery life is provided, the battery must be replaced. E.1.7 Printer PROBLEM: Printer does not print RECOMMENDED AC...

85 PROBLEM: Temperature display is inaccurate RECOMMENDED ACTIONS: Skin probe: Verify proper placement on patient. Eliminate drafts or other airflow near probe – cover with tape. Oral, rectal, skin probe: Replace probe. Have unit repaired. E.2 Atlas Monitor Error Messages MESSAGE: Altitude too high ...

86 MESSAGE: Blood pressure failure, service required MEANING: Atlas Monitor has detected a malfunction of the Blood Pressure system. RECOMMENDED ACTIONS: A mechanical or electrical fault has been detected in the Blood Pressure system. Remove the Atlas Monitor from service. The unit must be repaired....

88 MESSAGE: CO 2 watertrap not detected MEANING: The Atlas Monitor has CO 2 selected as the Second trace selection , has been monitoring CO 2 , and can now no longer detect the watertrap. This message will not occur unless the Atlas Monitor has been successfully monitoring CO 2 and has subsequently ...

89 Check the attachment of the leads to the snap electrodes. Check the attachment of the electrodes to the patient. Check for good contact. Shave hair or clean skin if necessary. Check the proper placement of the electrodes on the patient. MESSAGE: Low battery power - shutdown in less than 10 minute...

91 RECOMMENDED ACTIONS: An electrical fault has been detected in the Temperature system. You can continue to use the Atlas Monitor until it is convenient to perform repairs, if it acceptable to operate without Temperature sensing. The unit must be repaired. MESSAGE: Unexpected forward flow - CO 2 un...