IFU - PM Philips Goldway GS20 - Revisi A.1 August 2019

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GS20
Patient Monitor
Release A.01
English
Instructions for Use

GS20
Patient Monitor
Instructions for Use
English
Product Information
Product Model: GS20
Product Name: Patient Monitor
Manufacturer
Philips Goldway (Shenzhen) Industrial Inc.
Registered/Production address: No.2 Keji North 3rd Road, Nanshan District, Shenzhen, P.R.
China 518057
Tel: +86 755 26980999
Fax: +86 755 26980222
Edition
 Revision A
 August 2019
All rights reserved.
Explanation of Symbols
The following symbols appear on the monitor and its packaging.
Table 1 Monitor and Packaging Symbols
Symbol Description Symbol Description

Defibrillation-proof type Defibrillation-proof
CF applied part type BF applied part
On/Standby key Audio Pause key
Alarm Pause key Waveform Freeze key
NBP key Print key
Fragile, handle with

Recyclable
care
Recovery Keep upright
Humidity limitation Maximum stacking
Caution, consult
Temperature limitation accompanying
documents
Atmospheric pressure
Keep dry
limitations
ii GS20 Patient Monitor Instructions for Use
NBP cuff hose
Main Menu key NBP
connector
SpO2 SpO2 probe connector ECG/RESP ECG/RESP connector
TEMP1 TEMP1 connector TEMP2 TEMP2 connector
Date of manufacture Power LED
Equipotential grounding Charging LED
Non-ionizing radiation On/Off LED
Nurse call connector Manufacturer address
Refer to instruction
Dangerous Voltage
manual/booklet
ECG analog output
Protective grade
port
Protective grounding Ethernet port
Compliance to WEEE Compliance to WEEE

standard standard
USB port Serial number
Catalogue number Configuration number
Lot number Key code
Safety Standards
The following table describes the safety standards of the GS20 Patient Monitor.
Table 2 Safety Standards
Parameter Specification
Class I, anti-shock, externally and internally
Protection class
powered equipment.
Degree of protection Type CF applied part
Mode of operation Continuous
Degree of noxious-liquid proof IPX1
Degree of safety of application in the presence The equipment is not suitable for use in the
of a flammable anesthetic mixture with air or presence of a flammable anesthetic mixture with
with oxygen or nitrous oxide air or with oxygen or nitrous oxide.
Sterilization and disinfection As recommended by manufacturer.
Management class Class II
GS20 Patient Monitor Instructions for Use iii

Product Support and Warranty Information
The company warranties the GS20 Patient Monitor for one year.
Keep the packing case for transport, storage, or maintenance.
The company is responsible for the safety, reliability and performance of the monitor when the:
 Product is assembled, upgraded, altered, or maintained by authorized service representatives.
 Location where the product is placed is that of a typical hospital environment.
 Product is used according to this guide.
 The company is not responsible for damage to the monitor when the:
 Damage is caused by:
– Improper operation.
– Improper connection of the monitor to other devices.
– Accidental impact.
 Monitor is altered without written authorization from the company.
 Serial number of the monitor is removed or becomes illegible.
After-Sales Service
When you need product support, contact Philips Customer Care Center or your local representative.
Before calling for service, note the following information:
 Model and serial number of the monitor
 Monitor problem
Conventions
This section describes the conventions used in this guide.
Text Formatting
The following typographical conventions are used in this guide:
Typeface Usage Example

Bold System keys Press the Main Screen key.
Special bold User interface text Open the System Menu.
Italic Variables, document titles  <product name>-<hardware
configuration>-<software version>.cfg
 Service Guide
Decimal Points
Because the GS20 monitors use a period (.) to indicate a decimal point in decimal numbers (for example,
10.0), all decimal numbers in this manual use a period as a decimal point. Commas are not used as a decimal
point.
Notes, Cautions, and Warnings
The manual uses the following conventions for Notes, Cautions, and Warnings.
Note — A Note calls attention to an important point in the text.
iv GS20 Patient Monitor Instructions for Use

Caution A Caution calls attention to a condition or possible situation that could damage or
destroy the product or the user’s work.
Warning A Warning calls attention to a condition or possible situation that could cause
injury to the user and/or patient.
Safety Requirements
This monitor is suitable for a case in which electro-surgery unit is used. Properly connect the electro-surgery
circuit to prevent burns and life risk therefrom.
When using in conjunction with high-frequency electro-surgery unit, the monitor restores to the previous
operation mode within 10s after the elimination of high-frequency signal and electromagnetic field, without
losing any permanently stored data.
For safe grounding of the monitor, the hospital must provide live wire, zero-line, and fully protected power
socket. If any external protective grounding conductor is in doubt during installation or wiring, the monitor
must be powered by an internal battery.
Ensure that the patient monitor is in good working condition before use. If there is a problem with the
accuracy of any measurement item, use alternative method to check the patient's vital signs first, and then
check the monitor with the results therefrom to see if the monitor is operating properly.
Equipment connected to the monitor through signal input/output port should comply with the corresponding
standards (for example, data processing equipment should comply with GB4943 and medical devices with
GB9706.1). Do not connect any permanently installed equipment to the signal input/output ports of the
monitor, please consult the manufacturer for correct usage if you still have questions.
Other equipment connected to the monitor should comply with the corresponding standards (for example, data
processing equipment should comply with GB4943 and medical devices with GB9706.1). The entire system
should comply with the latest and valid standards in GB9706.15. Do not connect components not specified in
this manual to the system.
If multiple devices are connected to a patient, the sum of the leakage currents may cause a dangerous situation.
Therefore, qualified service representatives should always perform current leakage tests before setting up the
connections. This ensures that leakage is within limits and prevents personal injury and environmental damage.
If any question remains, consult the manufacturer for correct usage.
Warning The monitor is not for home use. It is expected to be used exclusively by
healthcare professionals. The monitor may cause wireless interference or disrupt
the operation of nearby equipment. Mitigation measures may be necessary, such
as reorienting or relocating the monitor, or shielding the corresponding site.
The monitor is only for use on one patient at a time.
The monitor is not an apnea monitor.
This monitor is not suitable for use in the presence of a flammable anesthetic
mixture with air or with oxygen or nitrous oxide. In the absence of other oxidants,
the oxygen concentration must be less than 25% and the partial oxygen pressure
must be less than 27.5 kPa.
Never use the monitor and the SpO2 probe during MRIs or CT scans, to avoid burns
to the patient. The monitor may affect the MRI image, and the MRI unit may affect
the accuracy of the monitor’s measurements.
Do not connect the monitor to any other equipment or device not clearly listed in
this manual.
Do not open the monitor case, to prevent electric shock. The device does not
contain user-serviceable parts.
Use the power modules and application parts manufactured or recommended by
the Company. Otherwise, personal injury and machine failure can occur.
To avoid personal injury, use only accessories and parts produced or
recommended by the company. Otherwise, damage to the patient, operator or
monitor can occur.
GS20 Patient Monitor Instructions for Use v
The monitor is resistant to electromagnetic interference. Interference takes place
when electromagnetic energy is extremely high. Ensure that nearby instruments
are also in compliance with EMC standards. Never turn on or use portable
communication devices like mobile phones or portable dual-channel radios near a
monitor. If there is an unknown EMI, check the location of the monitor to
determine the source of interference and take measures for elimination.
To reduce the hazard of burns in high-frequency surgical neutral connections, the
leads and connectors must be located away from the surgical site. Keep cables
away from other devices.
Never rely exclusively on the alarm system for patient monitoring. You must
periodically check that monitor alarms are working properly. The most reliable
method of patient monitoring combines close, personal surveillance along with
the correct operation of the monitor.
Never dispose of this product (or any part thereof) as industrial or domestic waste.
The system may contain hazardous substances that cause serious pollution to the
environment. The system also contains private information. Philips recommends
that you contact Philips Service Organization before disposal.
To avoid contamination or infection with personnel, the environment, or other
equipment, please disinfect and clean the monitor before disposal in accordance
with the laws of the country/region where you locate.
Caution Immediately stop using the monitor if it becomes wet by chance, and ask a
qualified professional to conduct safety test. Use the monitor again unless it
passes the safety test.
Never simultaneously touch the patient and the input or output of the monitor.
Carefully place power cords and other cables to prevent patient contact, tangling
or electrical interference.
Periodically check all reusable accessories for damage. Replace damaged
accessories when necessary.
Measurement accuracy may decrease temporarily while performing
electro-surgery or defibrillation. This does not affect patient or equipment safety.
The monitor restores to normal measurement within 10s after the electro-surgery
or defibrillation is completed.
Clean and sterilize the monitor and accessories according to Philips requirements.
Turn off the monitor and disconnect the power cords before cleaning or
sterilization.
It is not recommended to sterilize the monitor and its accessories and
consumables, unless it is specified in the Instructions for Use of such
accessories and consumables.
The monitor should be calibrated and maintained regularly by a qualified
professional.
Keep all monitor packing materials away from children, or dispose of them in
accordance with your local environmental regulations.
Ensure that no water condenses into or on the monitor. Condensation can occur
from changes in temperature or exposure to humidity.
The device and accessories are to be disposed of according to local regulations
after their service life. Dispose of batteries according to your local regulations.
Never incinerate batteries or expose to high temperatures. If in doubt, please
contact Philips headquarter or local office.
vi GS20 Patient Monitor Instructions for Use

Table of Contents
Chapter 1 Overview .............................................................................................................. 1-1
1.1 Indications for Use..................................................................................................................... 1-1
1.2 Intended Use .............................................................................................................................. 1-1
1.3 Contraindications ....................................................................................................................... 1-1
1.4 Major Parts ................................................................................................................................ 1-2
1.4.1 The Front Panel .................................................................................................................... 1-2
1.4.2 The Rear Panel ..................................................................................................................... 1-3
1.4.3 The Side Panels .................................................................................................................... 1-4
1.4.4 The Bottom........................................................................................................................... 1-5
Chapter 2 Basic Operation ................................................................................................... 2-1

2.1 Unpacking the Equipment ......................................................................................................... 2-1
2.2 Configuring the Monitor ............................................................................................................ 2-1
2.3 Inspecting the Monitor............................................................................................................... 2-2
2.4 Powering the Monitor ................................................................................................................ 2-2
2.4.1 Powered by AC .................................................................................................................... 2-2
2.4.2 Powered by Battery .............................................................................................................. 2-3
2.4.3 Conditioning the Battery ...................................................................................................... 2-3
2.4.4 Replacing the Battery ........................................................................................................... 2-4
2.4.5 Disposing of a Battery .......................................................................................................... 2-4
2.4.6 Disconnecting Power............................................................................................................ 2-4
2.5 Work Modes .............................................................................................................................. 2-4
2.5.1 On/Standby Modes ............................................................................................................... 2-4
2.5.2 Sleep Mode........................................................................................................................... 2-5
2.6 Screen Display ........................................................................................................................... 2-5
2.6.1 Using the Monitor Menus .................................................................................................... 2-7
2.7 Changing Screen Layout ........................................................................................................... 2-7
2.7.1 Displaying Normal Layout ................................................................................................... 2-8
2.7.2 Displaying Big Number Layout ........................................................................................... 2-8
2.7.3 Displaying 7 ECG Layout .................................................................................................... 2-8
2.7.4 Displaying Other Bed View ................................................................................................. 2-8
2.7.5 Configuring Layout ............................................................................................................ 2-10
2.8 Changing Waveform Settings .................................................................................................. 2-11
2.8.1 Changing Waveform Position............................................................................................. 2-11
2.8.2 Changing the Waveform Speed .......................................................................................... 2-11
2.8.3 Changing the Waveform Color ........................................................................................... 2-12
2.8.4 Freezing the Waveforms ..................................................................................................... 2-12
2.9 Configuring Volume and Brightness........................................................................................ 2-12
2.9.1 Adjusting Alarm Tone Volume ........................................................................................... 2-12
GS20 Patient Monitor Instructions for Use Contents - 1
2.9.2 Adjusting HR Volume ........................................................................................................ 2-13
2.9.3 Adjusting Screen Brightness .............................................................................................. 2-13
2.9.4 Using Night Mode .............................................................................................................. 2-13
2.9.5 Enabling or disabling Key Tone ......................................................................................... 2-14
2.9.6 Configuring HR Sound/PR Sound Priority ........................................................................ 2-14
2.10 Using On-Screen Keyboard ..................................................................................................... 2-14
2.11 Managing Patients ................................................................................................................... 2-14
2.11.1 Admitting a New Patient .................................................................................................... 2-15
2.11.2 Editing a Patient ................................................................................................................. 2-15
2.11.3 Discharging a Patient ......................................................................................................... 2-16
2.12 Using the Timer ....................................................................................................................... 2-16
2.13 Manually Marking an Event .................................................................................................... 2-16
2.14 Networking Capabilities .......................................................................................................... 2-17
2.15 Checking System Settings ....................................................................................................... 2-17
Chapter 3 Alarms .................................................................................................................. 3-1

3.1 Alarm Types............................................................................................................................... 3-1
3.2 Alarm Levels ............................................................................................................................. 3-1
3.3 Latched and Non-Latched Alarms ............................................................................................. 3-1
3.4 Visual Alarms ............................................................................................................................ 3-1
3.4.1 Alarm LEDs ......................................................................................................................... 3-2
3.4.2 Flashing Numeric Values...................................................................................................... 3-2
3.4.3 Alarm Messages ................................................................................................................... 3-2
3.4.4 Prompting Messages ............................................................................................................ 3-2
3.4.5 Alarm Icons .......................................................................................................................... 3-3
3.5 Audible Alarms .......................................................................................................................... 3-3
3.6 Suspending Audible Alarms ...................................................................................................... 3-4
3.6.1 Resetting Alarms .................................................................................................................. 3-4
3.7 Suspending or Closing Alarms .................................................................................................. 3-4
3.8 Changing Alarm Limits ............................................................................................................. 3-5
3.9 Configuring System Alarms ...................................................................................................... 3-5
3.9.1 Showing or Hiding Current Alarm Limits ............................................................................ 3-5
3.9.2 Enabling or Disabling Alarms .............................................................................................. 3-6
3.9.3 Configuring Automatic Alarm Limit .................................................................................... 3-6
3.9.4 Restoring Default Alarm Limits ........................................................................................... 3-6
3.9.5 Enabling or Disabling Nurse Call ........................................................................................ 3-7
3.10 Viewing All Effective Alarm Events ......................................................................................... 3-7
3.11 Alarm Safety Information .......................................................................................................... 3-8
Chapter 4 Monitoring ECG ................................................................................................. 4-1

4.1 Preparing the Skin ..................................................................................................................... 4-1
Contents - 2 GS20 Patient Monitor Instructions for Use

4.2 Connecting ECG Cables ............................................................................................................ 4-1
4.3 About ECG Leads ...................................................................................................................... 4-1
4.3.1 Choosing a Lead Mode ........................................................................................................ 4-2
4.3.2 Choosing a ECG Lead .......................................................................................................... 4-2
4.3.3 Placing ECG Leads .............................................................................................................. 4-2
4.4 Monitoring Patients with Pacemakers ....................................................................................... 4-3
4.5 The ECG Display....................................................................................................................... 4-4
4.6 Configuring ECG Waveform ..................................................................................................... 4-4
4.6.1 Changing ECG Waveform Size ............................................................................................ 4-4
4.6.2 Adjusting ECG Waveform Baseline ..................................................................................... 4-5
4.6.3 Changing ECG Waveform Speed ......................................................................................... 4-5
4.6.4 Changing ECG Waveform Color.......................................................................................... 4-5
4.7 Choosing Heart Rate Source ...................................................................................................... 4-5
4.8 Choosing ECG Mode................................................................................................................. 4-6
4.9 Enabling or Disabling Filter ...................................................................................................... 4-6
4.10 Enabling or Disabling ECG Analog Signal Output ................................................................... 4-6
4.11 Configuring ECG Alarms .......................................................................................................... 4-7
4.12 ECG Safety Information ............................................................................................................ 4-7
Chapter 5 Monitoring Respiration ...................................................................................... 5-1

5.1 Lead Placement for Monitoring Respiration ............................................................................. 5-1
5.2 Enabling or Disabling RESP ..................................................................................................... 5-1
5.3 The Respiration Display ............................................................................................................ 5-1
5.4 Selecting a RESP Detection Mode ............................................................................................ 5-2
5.4.1 Using Manual Detection Mode ............................................................................................ 5-2
5.4.2 Using Auto Detection Mode ................................................................................................. 5-2
5.4.3 Respiration Detection Mode and Cardiac Overlay ............................................................... 5-3
5.5 Configuring RESP Waveform .................................................................................................... 5-3
5.5.1 Changing RESP Waveform Size .......................................................................................... 5-3
5.5.2 Changing RESP Waveform Speed ....................................................................................... 5-4
5.5.3 Enabling or Disabling Waveform Fill .................................................................................. 5-4
5.5.4 Changing RESP Waveform Color ........................................................................................ 5-4
5.6 Configuring RESP Alarms ......................................................................................................... 5-4
5.7 Configuring Apnea Alarm.......................................................................................................... 5-4
5.8 RESP Safety Information........................................................................................................... 5-5
Chapter 6 Monitoring SpO2 ................................................................................................. 6-1

6.1 Selecting and Applying an SpO2 Sensor .................................................................................... 6-1
6.2 Connecting SpO2 Cables ........................................................................................................... 6-1
6.3 SpO2 Display ............................................................................................................................. 6-2
6.4 Configuring SpO2 Waveforms ................................................................................................... 6-2

6.4.1 Changing SpO2 Waveform Speed ........................................................................................ 6-2
6.4.2 Changing SpO2 Waveform Color ......................................................................................... 6-2
6.5 Enabling or Disabling SpO2 Pulse Rate..................................................................................... 6-3
6.6 Changing SpO2 Response Mode ................................................................................................ 6-3
6.7 Assessing Suspicious SpO2 Readings ........................................................................................ 6-3
6.8 Configuring SpO2 Alarms .......................................................................................................... 6-3
6.8.1 Desatuation Alarm (Desat) ................................................................................................... 6-4
6.9 Configuring SpO2 Pulse Rate Alarms ........................................................................................ 6-4
6.10 SpO2 Safety Information ........................................................................................................... 6-4
Chapter 7 Monitoring NBP .................................................................................................. 7-1

7.1 Selecting and Applying an NBP Cuff ........................................................................................ 7-1
7.2 Connecting the NBP Cuff and Hose .......................................................................................... 7-1
7.3 Measuring NBP ......................................................................................................................... 7-1
7.3.1 Measurement Limitations ..................................................................................................... 7-1
7.3.2 Selecting an NBP Measurement Mode................................................................................. 7-2
7.4 NBP Display .............................................................................................................................. 7-2
7.5 Configuring NBP ....................................................................................................................... 7-2
7.5.1 Selecting a Fading Time Interval.......................................................................................... 7-3
7.5.2 Changing Alarm Limits Display........................................................................................... 7-3
7.5.3 Selecting NBP Measurement Interval .................................................................................. 7-3
7.5.4 Starting NBP Stat Measurements ......................................................................................... 7-4
7.6 Enabling or Disabling NBP Pulse Rate ..................................................................................... 7-4
7.7 Viewing NBP Measurement Results .......................................................................................... 7-4
7.8 Configuring NBP Alarms........................................................................................................... 7-5
7.9 Configuring NBP PR Alarms ..................................................................................................... 7-5
7.10 Calibrating NBP ........................................................................................................................ 7-5
7.11 NBP Safety Information ............................................................................................................ 7-5
Chapter 8 Monitoring Temperature .................................................................................... 8-1

8.1 Selecting and Connecting Temperature Probes ......................................................................... 8-1
8.2 Temperature Display .................................................................................................................. 8-2
8.3 Enabling or Disabling Temperature Monitoring ........................................................................ 8-2
8.4 Configuring TEMP Alarms ........................................................................................................ 8-2
8.5 TEMP Safety Information ......................................................................................................... 8-2
Chapter 9 Viewing Trend Data ............................................................................................ 9-1

9.1 Trend Data Overview ................................................................................................................ 9-1
9.2 Viewing ECG Waveforms ......................................................................................................... 9-1
9.2.1 Viewing ECG Waveforms of a Segment .............................................................................. 9-1
9.2.2 Analyzing ECG Waveform of a Segment............................................................................. 9-2
9.3 Analyzing HR Variation ............................................................................................................ 9-3

9.4 Viewing Graphical Trends ......................................................................................................... 9-3
9.4.1 Changing Graphical Trend Data Resolution ........................................................................ 9-4
9.4.2 Checking Graphical Trend by Scrolling ............................................................................... 9-5
9.5 Viewing Tabular Trends ............................................................................................................. 9-5
9.5.1 Changing Displayed Parameters .......................................................................................... 9-5
9.5.2 Checking Tabular Trend by Scrolling................................................................................... 9-6
9.6 Viewing and Analyzing NBP History Data ............................................................................... 9-6
9.6.1 Viewing NBP History Data .................................................................................................. 9-6
9.6.2 Monitoring Dynamic Blood Pressure ................................................................................... 9-6
9.7 Viewing Alarm/Event History ................................................................................................... 9-7
9.7.1 Viewing Trends Associated with Physiological Alarms ....................................................... 9-7
9.8 Viewing the Data Manager ........................................................................................................ 9-7
9.8.1 Recalling 120 Minutes of ECG Waveforms ......................................................................... 9-7
9.8.2 Recalling 50 days of Graphical Trend Data ......................................................................... 9-8
9.9 Exporting Patient Data............................................................................................................... 9-8
Chapter 10 Calculation ....................................................................................................... 10-1

10.1 Drug Calculation...................................................................................................................... 10-1
10.1.1 Calculating Drug Concentration......................................................................................... 10-1
10.1.2 Calculating Infusion Rate, Titration Rate and Medication Time ........................................ 10-2
10.1.3 Using the Titration Chart .................................................................................................... 10-2
10.2 Calculating Oxygenation ......................................................................................................... 10-3
10.3 Calculating Ventilation ............................................................................................................ 10-3
10.4 Calculating Hemodynamics ..................................................................................................... 10-4
Chapter 11 Using the Recorder .......................................................................................... 11-1

11.1 Loading the Recorder Paper .................................................................................................... 11-1
11.2 Printing Real-Time Waveforms ............................................................................................... 11-2
11.2.1 Changing Timed Printing Interval ...................................................................................... 11-2
11.2.2 Changing Print Speed ......................................................................................................... 11-3
11.2.3 Choosing Real-Time Printing Waveforms.......................................................................... 11-3
11.3 Enabling Print on Physiological Alarm ................................................................................... 11-3
11.3.1 Choosing Alarm Print Mode .............................................................................................. 11-4
11.4 Changing Print Time ................................................................................................................ 11-4
11.5 Configuring Advance Time...................................................................................................... 11-4
11.6 Printing ECG Recall Waveforms ............................................................................................. 11-5
11.7 Printing Tabular Trends ........................................................................................................... 11-5
11.8 Printing NBP History Data ...................................................................................................... 11-5
11.9 Printing Calculation Results .................................................................................................... 11-5
11.10 Removing the Recorder ........................................................................................................... 11-5
11.11 Storing the Recorder Papers .................................................................................................... 11-6

Chapter 12 Cleaning and Care .......................................................................................... 12-1
12.1 General Guidelines .................................................................................................................. 12-1
12.2 Cleaning ................................................................................................................................... 12-1
12.2.1 Cleaning the Monitor ......................................................................................................... 12-1
12.2.2 Cleaning the Cables............................................................................................................ 12-2
12.2.3 Cleaning the SpO2 Sensor .................................................................................................. 12-2
12.2.4 Cleaning the NBP Cuff....................................................................................................... 12-2
12.2.5 Cleaning the Temperature Probe ........................................................................................ 12-2
12.2.6 Cleaning the Recorder ........................................................................................................ 12-3
12.3 Disinfection ............................................................................................................................. 12-3
12.3.1 Disinfecting the Monitor .................................................................................................... 12-3
12.4 Sterilizing the Monitor ............................................................................................................. 12-3
12.5 Routine Inspection ................................................................................................................... 12-3
12.6 Maintenance ............................................................................................................................ 12-4
12.7 Troubleshooting ....................................................................................................................... 12-4
Chapter 13 Accessories ....................................................................................................... 13-1

13.1 ECG Cables ............................................................................................................................. 13-1
13.2 SpO2 Sensors ........................................................................................................................... 13-1
13.3 NBP Cuffs and Interconnect Tubes.......................................................................................... 13-2
13.4 Temperature Probes ................................................................................................................. 13-2
13.5 Accessories .............................................................................................................................. 13-2
Chapter 14 Specifications ................................................................................................... 14-1

14.1 ECG Specifications.................................................................................................................. 14-1
14.2 SpO2 Specifications ................................................................................................................. 14-3
14.3 RESP Specifications ................................................................................................................ 14-4
14.4 TEMP Specifications ............................................................................................................... 14-4
14.5 NBP Specifications .................................................................................................................. 14-4
14.6 Display Specifications ............................................................................................................. 14-5
14.7 Interface Specifications ........................................................................................................... 14-5
14.8 Power Specifications ............................................................................................................... 14-6
14.9 Recorder Specifications ........................................................................................................... 14-6
14.10 Physical Specifications ............................................................................................................ 14-6
14.11 Environmental Specifications .................................................................................................. 14-6
Appendix A Alarm Specifications ....................................................................................... A-1

A.1 Physiological Alarms ................................................................................................................ A-1
A.2 Technical Alarms ...................................................................................................................... A-2
A.3 Default Alarm Limits ................................................................................................................ A-3
A.4 Auto Set Alarms........................................................................................................................ A-4
Appendix B Electromagnetic Compatibility (EMC) ......................................................... B-1

B.1 Instructions for Use .................................................................................................................. B-1
B.2 Guidance and Manufacturer's EMC Declaration ...................................................................... B-2
B.2.1 Electromagnetic Emissions for All Equipment and Systems .............................................. B-2
B.2.2 Electromagnetic Immunity for All Equipment and Systems ............................................... B-3
B.2.3 Electromagnetic Immunity for Equipment and Systems not Life-Supporting .................... B-4
B.2.4 Recommended Separation Distances .................................................................................. B-5

Overview
Chapter 1 Overview
The GS20 Patient Monitor (hereinafter referred to as the “Monitor”) automatically recognizes the
physiological monitoring units and monitors the physiological parameters of patients. You can display,
review, store and print the measured data.
Figure 1-1 GS20 Patient Monitor

This document provides detailed instructions on the performance of the monitor and how to use and
maintain it. Keep the document next to the monitor for reference. In addition, read carefully before
installing and using the monitor, for correct usage and meeting its performance indicators, as well as
the specified safety standards.
This guide describes all of the monitor features and options. Your monitor may not have all of them.
What you see on the screen, how the menus appear and so forth, depends on the way it has been
configured for your hospital.
1.1 Indications for Use

The GS20 patient monitor is indicated for use by healthcare professionals and in healthcare facility.
1.2 Intended Use

The GS20 patient monitors is intended for monitoring, analysis, recording, and alarming of multiple
physiological parameters in healthcare environments for patients.
1.3 Contraindications
NBP measurement should not be performed on patients with sickle-cell disease, or any condition
where skin damage has occurred or is expected to occur. When measuring IBP,
 Avoid subclavian puncture on patients with severe coagulation disorder.
 Choose a different puncture site for patients with local skin infection.
 Avoid internal jugular and subclavian puncture on patients with hemopneumothorax.
GS20 Patient Monitor Instructions for Use 1-1

Overview
1.4 Major Parts

This section describes the major parts of the GS20 Patient Monitor.
1.4.1 The Front Panel

The following figure shows the front panel of the monitor.
Figure 1-2 GS20 Front Panel

The following table describes the controls on front panel of the monitor.
Table 1-1 Monitor Controls on Front Panel
Item
Icon Meaning Description
Number
On/Standby
1 Press this key to turn the monitor on or off.
key
On/Off indicator (green)
2 On/Off LED On: Lit
Off: Off
Please refer to 2.4.2 “
3 Charging LED
Powered by Battery”.
AC indicator (green)
4 AC LED AC connected: Lit
AC disconnected: Off
Audio Pause
5 Please refer to 3.6 “Suspending Audible Alarms”.
key
Alarm Pause
6 Please refer to 3.9.2 “Enabling or Disabling Alarms”.
key
1-2 GS20 Patient Monitor Instructions for Use

Overview
Item
Icon Meaning Description
Number
Press to freeze the waveforms when monitoring a
Waveform patient.
7 Freeze key
Press again to unfreeze the waveforms.
8 NBP key Press to start or stop an NBP measurement.
9 Print key Press to start or stop printing.
Main Menu
10 Press to display or exit the Main Menu.
key
Navigation
11 None Used for selecting on the screen.
wheel
12 None Alarm LED Please refer to 3.4.1 “Alarm LEDs”.
13 None Handle Used for lifting up the monitor.
1.4.2 The Rear Panel

The following figure shows the rear panel of the monitor.
Figure 1-3 GS20 Rear Panel

The following table describes each item on the rear panel.
Table 1-2 Items on Rear Panel
Item
Icon Name Description
Number
1 Nurse call connector Connects to the nurse call system.
Used for software upgrades and patient
2 USB ports
data export.
3 Ethernet port Standard network connector.

Overview
4 ECG analog output port Connects to ECG analog output cable
5 None AC power socket Used for connecting to AC power cord.

AC power cord lock
6 None To secure the AC power cord.
catch
7 Equipotential grounding Connects to the grounding system
8 None Heat outlet Heat outlet of the monitor.
Warning — Never block the monitor’s heat outtake during operation.
1.4.3 The Side Panels

The following figure shows the side panels of the monitor.
Figure 1-4 Side Panels

Table 1-3 Side Panel Symbols
Item
Symbol Name Description
Number
1 ECG/RESP ECG/RESP cable connector Connects to ECG cable
2 SpO2 SpO2 probe connector Connects to SpO2 probe.
3 NBP NBP connector Connects to NBP cuff
4 TEMP1 TEMP1 connector Connects to TEMP probe
5 TEMP2 TEMP2 connector Connects to TEMP probe
6 None Battery compartment door Access to battery compartment

The monitor sound comes out
7 None Speaker outlet
from here.
8 None Recorder Built-in thermal recorder.

Overview
1.4.4 The Bottom

The following figure shows the bottom view of the monitor.
Battery Compartment
Door Latch
Figure 1-5 Bottom View

Overview

Basic Operation
Chapter 2 Basic Operation

This chapter describes how to set up and begin using the GS20 Patient Monitor.
2.1 Unpacking the Equipment

Unpack the equipment and ensure that you have the following items. If anything from the packing
list is missing, immediately contact Philips or delivery agent.
Items included:
 A patient monitor main unit
 A documentation CD
 A quick guide
 An AC power cord
 A set of accessories
Keep the packing case of the monitor and accessories for future transport or storage.
Examine the monitor and ensure that:
 The housing is not cracked or broken.
 Power plugs and cords are in good condition and plug pins are not moving.
 The accessory cables are intact.
Caution If the equipment, accessories, or their packaging show signs of damage,
do not use the equipment.
2.2 Configuring the Monitor

Caution Place and use the monitor in an appropriate location that conforms to the
environmental specifications in this manual. Otherwise, the system may
not meet the claimed performance and specifications.
Locate the monitor in an area that:
 Is convenient for observation and operation.
 Is free from movement, dust, corrosive or explosive gases.
 Has a 5cm space around to ensure good ventilation and smooth heat dissipation.
You can put the monitor on a flat surface or mount it with the following mounting accessories:
 Roll stand
 Wall mount
Warning Never attempt to open the monitor case. Only qualified personnel should service
the monitor.

Basic Operation
2.3 Inspecting the Monitor

Warning Only connect the monitor to a power outlet with correct protective grounding. If
no grounded power is available, only use the monitor with internal batteries.
To remove AC power, disconnect the plug of the power cord from the outlet or
the monitor.
If the monitor fails the inspection, stop using the monitor and contact the
biomedical engineer in your facility or your supplier.
Before you start using the monitor, ensure that:

1. There is no damage to the monitor or external leads, sockets and accessories.
2. AC power is in conformity with standards. Use the power cord that is shipped with the
monitor, plug one end into an AC power outlet with a protection-grounded wire. Plug the
other end into the power connector on the monitor. Once AC power is connected, check if the
power LED on front panel illuminates green. If the monitor is powered by battery, verify that
adequate power remains.
3. The monitor is properly grounded. Plug one end of the grounding cable to the equipotential
grounding on the rear panel of the monitor and the other end to the grounding system.
4. When you press the On/Standby key on the front panel to start the monitor, the On/Off LED
on the front panel illuminates green. After a self-checking, the monitor goes into normal
monitoring and can be used for monitoring vital signs, data processing and communication.
Note — When the monitor is turned on and not connected to any patient for the first time, it
does not display any alarm information. When connected to the patient and an alarm event
occurs, the Monitor will display related alarm information.
5. Verify that the alarm system of the monitor is in good working condition. The method is that,
when disconnecting the SpO2 probe from the monitor, whether the Alarm/Event window on
the screen displays "!! SPO2: Probe Off", the monitor makes an alarm sound and the alarm
light indicates correctly. For further testing of individual measurement alarms, perform the
measurement on yourself or use a simulator. Adjust the alarm limits and ensure that you
observe the appropriate alarm behavior.
2.4 Powering the Monitor

You can power the monitor with either an AC power source or its internal battery.
Note — Use only the batteries specified by the company. Otherwise monitor damage or
patient injury may occur.
When storing the monitor for long time, make sure that it is fully charged. Check the battery
status and recharge it at least once a month.
Remove the battery during transport of the monitor.
If powered by battery, ensure that adequate power remains.
2.4.1 Powered by AC
To connect to AC power supply:
1. Plug the power cord to the power socket on the back of the monitor. Push it into position and
lower the power cord lock catch to secure it.

Basic Operation
2. Make sure power socket is properly grounded and provides specified voltage and frequency.
When the power LED on front panel illuminates green, it indicates that AC power is
connected.
When the monitor is powered by AC, the battery status pane on the screen shows it’s
powered by AC. When AC is disconnected, the monitor automatically switches to be powered by
battery.
Note — To ensure that the monitor can be powered by the battery at any time when the AC
power is disconnected, we recommend you to keep the monitor plugged in to AC power
when it is not in use.
2.4.2 Powered by Battery
The battery pane on the screen indicates battery status. More bars in the pane indicate more
charge remains on the battery.
When the battery power is low, the monitor gives battery alarm:
 When there are only two bars in the battery pane, the monitor gives low power alarm. The
battery pane flashes, indicating that the battery power is low. If you don’t charge it within 20
minutes, the monitor will shut down automatically.
 When there is only one bar in the battery pane, the monitor gives extreme low power alarm.
The battery pane turns red and flashes, indicating that the battery power is very low. If you
don’t charge it within 5 minutes, the monitor will shut down automatically.
Any time the monitor is connected to AC power, the battery is being charged, and no extra adapter
is needed. The charging LED on front panel shows the status of the current charge.
The charging LED shows:
 Off, when no battery is installed.
 Yellow, when the battery is being charged.
 Green, when the battery is fully charged.
2.4.3 Conditioning the Battery

When you first use the battery, make sure that the battery has gone through at least two complete
conditioning circles. A complete conditioning circle includes: continuous charging and then
discharging until the monitor shuts down.
Condition the battery on regular base to maintain the battery life during use. We recommend you to
condition the battery every two-month usage or storage, or when the battery running time is
dramatically shortened.
Note — The service life of battery depends on the frequency and time of use. If the serving
time of battery is obviously lower than that is claimed in the specifications, replace it or
contact your service representatives.
Keep the battery out of reach of children, preferably in the original box for use.
Under extreme conditions, battery unit leakage may occur. The leaked liquid is corrosive to
the eyes and skin. If the battery leaks into your eyes or skin, rinse immediately with water
and seek medical attention.

Basic Operation
2.4.4 Replacing the Battery

Warning Only authorized service representatives should install and replace the monitor
battery.
Ensure that the battery compartment door is firmly closed. Serious injury could
cause to patients if it falls out of the monitor.
To replace the battery:

1. Shut down the monitor and disconnect the AC power cord and other connection lines.
2. On the bottom of the monitor, insert a flat-head screw driver into the battery compartment
latch and gently pry open the battery compartment door.
3. Press down the batter latch and pull the strip on the battery to take it out.
4. Place the new battery into the compartment. When the battery is in position, a sound will be
heard.
5. Close the compartment door.
2.4.5 Disposing of a Battery

When a battery displays signs of damage or when it no longer charges, replace it. Dispose of the used
battery in accordance with local laws and regulations.
Warning Do not throw the battery into fire or short it. Burning, exploding or leaking
batteries can cause personal injury.
2.4.6 Disconnecting Power

Pressing the On/Standby key on the front panel does not cut the power. You need to disconnect the
AC power cord and remove the internal battery (or use up the battery charge) to disconnect the
power.
2.5 Work Modes

The monitor provides the following work modes:
 On: normal monitoring, battery charging and indicating.
 Standby: monitoring stops, screen goes blank, and power consumption stays at minimum
level. The monitor restarts rapidly when it is turned on. The monitor enters On mode within 5
seconds after the On/Standby key is pressed.
 Sleep: monitoring stops, screen goes blank, and power consumption stays at minimum level.
The monitor does not restart rapidly when it is turned on.
 Power off: power is off, the monitor cannot start. Please refer to 2.4.6 “Disconnecting Power”.
2.5.1 On/Standby Modes

The monitor goes from On mode to Standby mode when:
 You press the On/Standby key, if the monitor is powered by AC power.
 You press the On/Standby key, if the monitor is powered by internal battery only and the
battery charge is higher than 20%.

Basic Operation
Note — If you do not connect any patient or perform any operation to the monitor for 30
minutes, a message appears on the bottom of the screen, indicating that no monitoring is
going on, you should press the On/Standby key to enter Standby mode.
When you press the On/Standby key in the Standby mode, the monitor enters On mode. The
screen displays Patient Information window. You can start monitoring a patient. See 2.11.1
“Admitting a New Patient”.
2.5.2 Sleep Mode

The monitor goes from On mode to Sleep mode when:
 You press and hold the On/Standby key for at least 5 seconds.
 The monitor is powered by internal battery only and the battery charge is lower than 10%.
 You press the On/Standby key, if the monitor is powered by internal battery only and the
battery charge is lower than 20%
If you do not startup the monitor when it is in Standby mode (powered by AC power) for more
than 48 hours, the monitor enters Sleep mode automatically.
When you connect AC power to the monitor and press the On/Standby key in the Sleep mode, the
monitor enters On mode. The screen displays Patient Information window. You can start
monitoring a patient. See 2.11.1 “Admitting a New Patient”.
2.6 Screen Display

All elements of the monitor are displayed on the screen, each of which is almost interactive. The
screen elements include measured waveform, values and menu.
You can select elements on the screen by:
 Using the navigation wheel.
This section describes the elements on the screen, taking the Normal layout as an example, as
shown below.

Basic Operation
Figure 2-1 Screen Display (Normal Layout as an Example)

The following table describes the screen display.
Table 2-1 Screen Display Description
Item Name Description

Number
Indicates the power source, refer to 2.4 “Powering the
1 Power pane
Monitor” for details.
2 Network pane Indicates the connection to the Central Monitoring System.
3 Alarm icon pane Indicates the alarm status.
4 Patient pane Shows patient type and ID.
Shows the current system date and time, can also be used as
5 Date/Time pane
timer.
6 Alarm/Event pane Shows the alarm/event record
7 Waveform panes Show waveforms for the measurements.
8 Numeric panes Display measurements as numeric values.
9 Tool bar Shows icons for quick operation, see Table 2-5.

Basic Operation
The following table provides a brief description of each button in the tool bar.
Table 2-2 Buttons in the Tool bar
Icon Button Name Select to...
Mark an event that can later be viewed in the

Manual Event
Alarm/Event tab of the trend display.
Change alarm limit settings for all parameters in one

Alarm Setup
screen.
View trend data, including alarm history, for the

Trends
patient.
Layout Change the layout of the main screen.
Print Setup Record patient data.
Vol / Light Change volume or brightness of the monitor.
Calculator Open the Calculate menu.
Configure system settings and view information about

System
the monitor.
The screen display depends on the configuration you choose, refer to 2.7 “Changing Screen
Layout”.
2.6.1 Using the Monitor Menus

You can configure the monitor system and measurement settings with the monitor menus. Several
functions can be accessed in different ways. This instruction describes how to access functions in
the most typical manner.
Press the Main Menu key on the front panel to open the Main Menu. Items in the Main Menu
are configurable by the system administrator (password-protected). In the Main Menu, you can
change the setting of the monitor quickly.
Select the Close icon on top right corner of the menu to exit.
2.7 Changing Screen Layout
Select the Layout button to open the Layout Menu window.

In the Layout Menu window, you can:
 Display normal layout

Basic Operation
 Display big number layout

 Display 7 ECG layout
 Display other bed view layout
 Configure the display
2.7.1 Displaying Normal Layout

The Normal layout displays the monitoring waveforms and corresponding parameters. It is useful
for monitoring a patient for normal purpose.
To display the Normal layout:
1. Open the Layout Menu window.
2. Select the Normal tab. The preview of this layout is shown under the tab.
3. Select OK. The Normal layout takes effect.
2.7.2 Displaying Big Number Layout

The Big Number layout allows you to see vital signs from a distance. It contains numeric panes
and the corresponding waveform below each numeric pane.
To display the Big Number layout:
2. Select the Big Number tab. The preview of this layout is shown under the tab.
3. Select OK. The Big Number layout takes effect.
2.7.3 Displaying 7 ECG Layout

The 7 ECG layout displays 7 ECG waveforms simultaneously and heart rate (HR) values in the
block of ECG parameters.
To display the 7 ECG layout:
2. Select the 7 ECG tab. The preview of this layout is shown under the tab.
3. Select OK. The 7 ECG layout takes effect.
2.7.4 Displaying Other Bed View

The Other Bed View allows you to view the data of another bed in the same LAN.
To display the Other Bed View layout:
2. Select the Others tab. The preview of this layout is shown under the tab.
3. In the last channel on the bottom of the preview, select Other Bed View.
4. Select OK. The Other Bed View layout takes effect.
2.7.4.1 Display Other Bed Data
To display data of another bed:

1. Open the Other Bed View window.

Basic Operation
2. Select the Other Bed Monitoring window to open the Other Bed View Setup menu.
3. Select Monitor Other Bed ID, choose the ID of the bed that you want to view.
4. Close the Other Bed View Setup menu.
The following illustration shows data of another bed in the Other Bed View window.
Figure 2-2 Other Bed View Window

When an alarm occurs on another bed, the alarm message will be shown in the alarm pane of
another bed area. On the bottom right corner of the window, the bed ID color changes according to
the alarm level. The color of the bed ID is described in the following table.
Table 2-3 Other Bed ID Color
Alarm Status of Other Bed Color of Other Bed ID

No alarm is active Green
High priority alarm Red
Medium priority alarm Yellow
Low priority alarm Cyan
2.7.4.2 Changing the Displayed Other Bed Waveforms
You can change the waveforms of the other bed shown in the Other Bed View window.
To change the displayed the other bed waveforms:
2. Select the Other Bed View window to open the Other Bed View Setup menu.
3. Select Channel 2 to display the contents of channel 2.
4. Select what you want to display in channel 2.
5. Close the Other Bed View Setup menu.
2.7.4.3 Controlling Other Bed View Monitoring
Besides viewing another bed on your monitor, you can control whether other beds can view the
data on your monitor.
To control Other Bed View monitoring of your monitor:
2. Select the Other Bed View window to open the Other Bed View Setup menu.

Basic Operation
3. Select the Monitored check box to select the desired setting:

– Check Monitored, your monitor can be viewed by other beds.
– Uncheck Monitored, your monitor cannot be viewed by other beds.
4. If you allow other beds to view your monitor, select an ID from Monitored ID to identify
your monitor. Select OK to confirm.
2.7.5 Configuring Layout

In the Configure tab of Layout Menu, you can:
 Enable or disable enhanced waveform
 Enable or disable dynamic trend
 Load customized layout
To open the Configure tab of Layout Menu:
1. Open the Layout Menu.
2. Select the Configure tab.
2.7.5.1 Enabling or Disabling Enhanced Waveform
The Monitor displays waveforms in single and/or bold lines. By default, waveforms are in a single
line. You can choose to display a waveform as a bold line.
To enable or disable enhanced waveform:
1. Open the Configure tab.
2. Select the Enhanced Waveform check box to select the desired setting:
– Check Enhanced Waveform, the waveforms are drawn in a bold line.
– Uncheck Enhanced Waveform, the waveforms are drawn in a single line.
3. Select OK. The settings take effect right away.
4. Close the menu.
2.7.5.2 Enabling or Disabling Dynamic Trend
In the dynamic trend view, the monitor displays the most recent trends (1h, 2h or 4h).The
parameter values are plotted vertically along the y-axis of the graphical display. You can set a time
range in the Dyn Trend Time menu and that range appears along the horizontal x-axis. The most
recent measurements appear on the right side of the graph and the data scrolls to the left, so the
oldest data appears on the far left side of the graph.
To enable or disable the dynamic trend:
2. Select the Dyn Trend On/Off check box to select the desired setting.
– Check Dyn Trend, dynamic trend is enabled.
– Uncheck Dyn Trend, dynamic trend is disabled.
3. If you want to change the time range of the dynamic trend, select one of the options:
– 1 hour
– 2 hours
– 4 hours

Basic Operation
4. Select OK. The settings take effect right away.

5. Close the menu.
2.7.5.3 Loading User Display
The monitor is preloaded with 4 user customized displays in its System (password-protected). You
can load one of them.
To load a user display:
2. Select Load User Display, select one of the options:
– Layout 1
– Layout 2
– Layout 3
– Layout 4
3. The new layout is loaded.
2.8 Changing Waveform Settings

In order to observe the waveforms, you can:
 Change position of waveforms
 Change speed of waveforms
 Change color of waveforms
 Freeze waveforms
2.8.1 Changing Waveform Position

You can choose the order of the waveforms on the screen.
To change the waveform position:
1. Select the Layout button to open Layout Menu. Each tab of Layout Menu shows preview of
this layout.
2. Select the channel that you want to change, the Channel Selection menu opens. The menu
includes a list of all available waveforms, which depends on configuration of your monitor.
Note — If a measurement is not chosen in layout preview, the monitor does not enable this
measurement. For instance, if TEMP is not shown in the layout preview, the monitor does
not monitor temperature.
3. Select one of the following options:
– A parameter, to change its waveform position.
Note — If the selected parameter is already shown in another channel, after you change
the waveform position, waveforms in the two channels switch their positions.
– Blank, deselect this channel. The monitor will reassign channel height.
2.8.2 Changing the Waveform Speed

You can configure the speed at which physiological waveforms are displayed. Increasing the
waveform speed spreads out the waveform scale in the channel for more detailed observation.

Basic Operation
Reducing the waveform speed compresses the waveform display so that waveform segments
display for longer periods of time.
To change the waveform speed:
1. Select the waveform channel that you want to change the speed to open the setup menu for
this parameter.
2. Select Waveform Speed to open the Waveform Speed menu.
3. Select a waveform speed. Select OK to confirm.
4. Close the setup menu.
2.8.3 Changing the Waveform Color

For the same type of measurement, the waveform color and numerical color displayed on the
screen are the same. You can configure the color of each waveform. When you change the
waveform color, the corresponding numeric values also change.
To change the color of a waveform:
1. Select the waveform channel that you want to change the color to open the setup menu for this
parameter.
2. Select Color Setup to open the color setup menu. All available colors are displayed.
– One of the colors in the menu, the color of this waveform changes.
– Default, the default color setup for this waveform is restored.
2.8.4 Freezing the Waveforms

You can freeze the real-time waveforms to check measurements more closely.
When monitoring a patient, press the Waveform Freeze key on the front panel to freeze
waveforms. After 30 seconds, the waveforms automatically unfreeze and the monitor returns to the
previous screen.
To unfreeze waveforms before 30 seconds, press the Waveform Freeze key on the front panel.
2.9 Configuring Volume and Brightness
Select the Vol/Light button in the tool bar to open the Vol/Light menu.
In the Vol/Light menu, you can:
 Adjust alarm tone volume
 Adjust heart rate volume
 Adjust screen brightness
 Enter night mode
 Enable or disable key sound
 Set up HR sound/PR sound priority
2.9.1 Adjusting Alarm Tone Volume

To adjust the alarm tone volume:
1. Open the Vol/Light menu.

Basic Operation
2. Select Alarm Volume and then choose a volume. The maximum volume you can choose is 7.
By default the minimum volume is 1.
3. Select OK to confirm.
4. Close the menu.
2.9.2 Adjusting HR Volume

You can adjust HR volume as needed, which are selectable from 1-7.
To adjust the HR volume:
2. Select HR Volume and then choose the volume: 1 - 7. 1 is the minimum volume and 7 is the
maximum.
4. Close the menu.
2.9.3 Adjusting Screen Brightness

You can adjust the screen brightness of the monitor (1-7). 1 is the darkest setting and 7 is the
brightest.
To adjust the screen brightness:
2. Select Brightness and then choose the brightness: 1 - 7. 1 is the darkest setting and 7 is the
brightest.
4. Close the menu.
2.9.4 Using Night Mode

Warning Before using Night Mode, carefully consider a patient's condition. The screen is
dimmer when Night Mode is on and all audible tones, including PR sound and
HR sound, are off.
Note — To avoid misoperation, you cannot enable Night Mode when an alarm is active.
To enable night mode:
2. Select the Night Mode check box to select the desired setting:
– Check Night Mode to enter Night Mode.
– Uncheck Night Mode to exit Night Mode.
The monitor exits Night Mode automatically when
 You press any key one the front panel (except the On/Standby key)
 An alarm event occurs.

Basic Operation
2.9.5 Enabling or disabling Key Tone

If the key tone is enabled, the monitor gives a tone when you press the key on the front panel or a
button on the screen.
To enable or disable the key tone:
2. Select the Key Tone check box to select the desired setting:
– Check Key Tone, the monitor gives a tone to every key operation.
– Uncheck Key Tone, the monitor does not give a tone to key operation.
2.9.6 Configuring HR Sound/PR Sound Priority

When the monitor detects both HR and PR (from SpO2), the monitor gives the sound of the source
that you choose here.
To configure HR sound/PR sound priority:
2. Select HR/PR Priority to open the HR/PR Priority menu.
3. Select one of the options:
– ECG
– SpO2
5. Close the menu.
2.10 Using On-Screen Keyboard

Use the on-screen keyboard like a conventional keyboard. Enter information by selecting one
character after another.
2.11 Managing Patients

Patient information must be properly administered and documented. It is important to properly
admit a patient, so you can clearly identify this patient on records.
In the Patient pane on the screen, the current patient type and ID are displayed. The patient type
icons are:
Adult
Pediatric (Pedi.)
Neonatal (Neo.)
Once you input a new patient ID or change the patient type, the alarm settings are restored to the
default values for the specified patient type, and all trend data will be cleared.
Select the Patient pane on the screen to open the Patient Setup menu. Use the Patient Setup
menu to:
 Admit a patient

Basic Operation
 Edit a patient
 Discharge a patient
2.11.1 Admitting a New Patient

You do not have to enter a patient ID before you begin monitoring. If you choose not to enter an ID,
the text ID Unknown appears in the patient pane.
Note — Prior to monitoring, make sure you choose the correct patient type. The default
alarm limits depends on the patient type that you choose.
The monitor automatically saves patient information when there is a power loss.
To admit a new patient:
1. Open the Patient Setup menu.
2. Select Add New Patient to open the Patient Setup window.
3. Enter the information:
– MRN
– Transaction ID
– First Name
– Middle Name
– Last Name
– Location ID
– Patient Type
– Gender
– Date of Birth
– Height
– Weight
– Pacemaker Det
4. Use the navigation wheel to:
– If there is an On-screen keyboard, use it to input patient information, select OK to
confirm.
– Select the desired option to input.
– OK, a new patient is admitted.
– Cancel, the operation is cancelled.
2.11.2 Editing a Patient

To edit a patient:
2. Select Edit Patient to open the Edit Patient window.
3. Use the navigation wheel to select the patient information you want to change:
– If there is an On-screen keyboard, use it to change patient information, select OK to
confirm.
– Select the desired option to input.
4. Select OK. The patient information is changed.

Basic Operation
Note — If you change the pace detection setting when editing a patient, the ECG algorithm
will relearn.
2.11.3 Discharging a Patient

For those patients who do not need to be monitored, you can discharge them.
To discharge a patient:
2. Select Discharge Patient to open the Discharge Patient window.
3. Select OK. This patient is discharged from the monitor.
Note — Discharging a patient clears all trend data for the current patient, and resets all
profile settings to their default values.
2.12 Using the Timer

You can use the system time as a timer. It will alert you after a certain period of time set.
Note — Do not use the timer to arrange any monitoring tasks that are associated with a
patient with server condition.
To use the timer:
1. Select the Date/Time pane on the screen to open the Timer window.
2. Select a time length for the timer:
– 5
– 10
– 15
– 20
– 30
3. Select OK. The timer begins.
4. The remaining time is shown in the Date/Time pane on the screen. When the timer ends, the
ending message will still be shown for another 10 seconds before closing the timer, and the
date and time information resumes.
Note — If you select the Date/Time pane when the timer is working, the monitor closes the
timer automatically.
2.13 Manually Marking an Event

An event is the electronic record of a patient’s condition in a time segment, you can mark it
manually.
When an event occurs, the profile in a predetermined period of time is stored by the system. This is
the event segment. It includes information from a period of time before the marking signal (called
the pre-event time). The time segment after the event is called post-event time.
Select the Manual Event button in the tool bar to mark an event. Once an event is marked, the
system saves a 10-second record before the event occurs.
To view the Alarm/Event, refer to Chapter 9 “Viewing Trend Data”.

Basic Operation
2.14 Networking Capabilities

The GS20E Patient Monitor can be connected to Philips CMS200 Central Monitoring System
(B.02 or above) via LAN, to create a central monitoring system that allows remote monitoring.
The delay between the monitor and the central monitoring system is no longer than 3 seconds.
When connecting the monitor in a LAN, the Network Connection pane on the screen indicates
networking status:
LAN network connected.
LAN network disconnected.

More information about connecting to a network, please refer to GS20 Patient Monitor Service
Guide.
More information about the central monitoring system, please refer to its Instructions for Use.
2.15 Checking System Settings
Select the System button in the tool bar to open the System menu.
Note — Please contact your system administrator if you need to use the User
Configuration (password protected) in the System menu. The User Maintenance
(password protected) in the System menu is not intended for use by the user.
To check the software version:
1. Open the System menu.
2. Select About..., the software version is shown.
3. Close the menu.

Basic Operation

Alarms
Chapter 3 Alarms
Alarms sound when the monitor senses an irregular condition either in monitor operation or alarm
limits.
Alarms include:
 Visual alarms
 Audible alarms
3.1 Alarm Types

Alarms consist of physiological alarms and technical alarms.
Physiological alarms are triggered by physiological values exceeding the limits or by a patient's
abnormalities.
Technical alarms are triggered by equipment malfunction or improper equipment use. When a
technical alarm occurs, there might be problems with readability of patient data; however
measurements are not interrupted.
3.2 Alarm Levels

Both physiological alarms and technical alarms are classified by priority:
 High: indicates a potentially life-threatening or other serious situation. These alarms require
an immediate response from the clinician.
 Medium: indicates a physiological condition or equipment malfunction that requires timely
handling. Most medium priority alarms are triggered by values exceeding alarm limits.
 Low: indicates equipment malfunctions. These alarms require less immediate handling.
3.3 Latched and Non-Latched Alarms

When a Non-Latched Alarm occurs, the alarm stops when the condition that triggered the alarm
ends. On the other hand, a Latched Alarm continues even after the condition that caused the alarm
has resolved itself or been acknowledged by the clinician.
Note — Your administrator can enable the Alarm Lock Option feature
(password-protected).
For a non-latched parameter, if a technical alarm occurs when its physiological alarm is active, the
physiological alarm is cleared. However, for a latched parameter, its technical alarms do not clear
the physiological alarms.
3.4 Visual Alarms

The monitor uses the following visual alarm indicators: alarm LEDs, flashing numeric panes,
alarm messages and alarm icons.

3.5 Alarm LEDs
Note — On the Normal screen, your distance from the monitor should be no farther than 2
meters, in order to distinguish the visual message signals and alarm signals correctly.
The following table describes the alarm LED colors:
Table 3-1 Alarm LED Colors
Alarm Priority Color

High Flashing red every 0.5 second.
Medium Flashing yellow every 2 seconds.
Low Steady cyan
3.5.1 Flashing Numeric Values

When a parameter value exceeds the preset alarm limits, the corresponding numeric pane flashes
calling the user's attention to the measurement parameters.
3.5.2 Alarm Messages

All active alarm messages appear in the Alarm/Event pane on the screen. Besides that, technical
alarm messages also appear in the waveform channel of this measurement item.
The Alarm/Event pane is divided into 3 sections: the left section displays high priority alarm
messages, middle section displays medium priority alarm messages and right section displays low
priority alarm messages. When more than one alarm of the same priority is active, an icon "↓"
appear in the corresponding section, indicating that multiple alarms occur.
You can tell the priority of the alarm messages in the Alarm/Event pane by the number of the
exclamatory mark: 3 exclamatory marks (!!!) indicate high priority, 2 exclamatory marks (!!)
indicate medium priority and 1 exclamatory mark (!) indicates low priority.
To view all currently active alarms, refer to 3.10 “Viewing All Effective Alarm Events”.
3.5.3 Prompting Messages

When the following cases occur, the monitor displays prompting messages in the middle section of
the Alarm/Event pane:
 DEMO mode is enabled
 Detecting (SpO2)
 Self-testing (TEMP)
When the following cases occur, the monitor not only displays prompting messages in the middle
section of the Alarm/Event pane, but also gives a beep sound:
 NBP measurement completes

Alarms
3.5.4 Alarm Icons

The following table describes the alarm icons.
Table 3-2 Alarm Icons
Alarm
Description
Icon
Audio Pause icon (white icon with black background), indicating that audio
signal of the alarm is suspended for 60 seconds.
Alarm Pause icon (red icon with white background), indicating that the alarm
of the monitor is suspended for a specified period.
Alarm Off icon (white icon with red background), the alarm icon with solid
lines indicates that this alarm is disabled.
3.6 Audible Alarms

The following table describes the audible alarm signals and their features.
Table 3-3 Audible Alarm Signals and Features
Signal Alarm Sound Pulse Pulse Group Interval Pitch

High priority alarm 2 sets of 5 beeps 10 seconds High
signal
Medium priority 1 set of 3 beeps 25 seconds Medium
alarm signal
Low priority alarm 1 set of 2 beeps 30 seconds Low
signal
The auditory alarm signal sound pressure is in the range from 45dB to 85dB. The sound pressure
for medium priority alarms is the highest and that for the low priority alarms lowest. If alarms of
more than one priority are triggered, the monitor sounds the most severe.
The reminder signal sounds 1 set of 2 beeps every 60 seconds at a low pitch, in order to be
distinguishable from those of the alarm signals.
You can change:
 Alarm volume - increase or decrease the alarm volume. Refer to 2.9.1 “Adjusting Alarm Tone
Volume”.
 Alarm tones - the monitor offers two sets of alarm tones. Only your administrator can change
the alarm tone (password protected).
 Suspend alarm tones - refer to 3.6 “Suspending Audible Alarms”.
Note — Do not rely exclusively on the audible alarm system for patient monitoring.
Changing the alarm volume to a low level or turning it off during patient monitoring could
result in patient danger. The most reliable method of patient monitoring combines close
personal surveillance with correct operation of monitoring equipment.
Set the alarm volume based on the environment and ambient noise levels. Alarm volume
should be tested and verified during installation. The alarm volume should be loud enough
to be heard in the intended environment.

3.7 Suspending Audible Alarms
Press the Audio Pause key on the front panel, the audible alarm signal is suspended for 60 seconds.
During this period, if you press the Audio Pause key again, the audible alarm signal is reactivated.
During the 60-second silence period, the monitor does not give alarm sound. The Audio Pause
icon and remaining time are shown in the alarm icon pane on the screen. If an alarm is still active
when the alarm pause timer ends, the monitor gives alarm sound again.
3.8 Suspending or Closing Alarms

When you press the Alarm Pause key on the front panel, the alarms are suspended for a specified
period. The duration is password-protected and configurable by your administrator. To exit the
alarm pause mode, press the Alarm Pause key again.
If enabled in the password-protected User Maintenance menu, you can also disable the alarms
permanently. See 3.10.2 “Enabling or Disabling Alarms”.
When the alarms are suspended or disabled, the monitor:
 Displays alarm pause icon and remaining time (in minute and second) in the alarm icon pane,
if alarms are suspended.
01:51
 Displays alarm off icon and the text “OFF” in the alarm icon pane, and gives the reminder
sound if the alarm off reminder is on, if alarms are disabled.
OFF
Note — The alarm off reminder is configurable in the password-protected User
Maintenance menu.
 Disables audible alarm and alarm indicators, but still displays alarm messages for all technical
alarms.
 Disables all alarm signals (both audible and visible) for physiological alarms, does not save
the alarm messages or transfer them to central monitoring system or nurse call system.
 Does not break alarm pause or alarm off even when a new alarm event occurs.
If an alarm is still active when the alarm pause or alarm off ends, the monitor gives normal alarm
indicators.
3.9 Resetting Alarms

Press the Main Menu key on the front panel and then select the Alarm Reset icon to reset the
alarms. Press the Alarm Reset icon on the front panel to reset the alarms.
 For all NBP alarms (both physiological and technical alarms)
Clear all audible and visible alarm signals (sound, indicator and message)
 The rest technical alarms
Clear audible and visible signals (sound, indicator and message) for these alarms: Monitoring
Resumed, SpO2 No Sensor, IBP1 No Sensor and IBP2 No Sensor.
Clear audible signal (sound) but keep visible signals (indicator and message) for the rest
alarms.
 The rest physiological alarms
Clear the latched audible and visible signals (sound, indicator and message) for the alarms

Alarms
that are no longer active.

Clear audible signal (sound) but keep visible signals (indicator and message) for the
nonlatched alarms.
If a new alarm occurs after the alarm is reset, the monitor gives alarm signals again.
3.10 Changing Alarm Limits

Alarm limits are the basis for the monitor to determine whether the monitoring parameters of the
patient are normal. Alarm limits determine the conditions that trigger alarms based on the high and
low limits set.
To set the alarm limits:
1. Select the Alarm Setup button to open the Alarm Setup menu.
2. Select the tab of the parameter you want to set.
3. Select the upper limit and lower limit for the parameter.
4. If you want to disable audible alarm for this parameter, select the Alarm Sound check box to
select the desired setting:
– Check Alarm Sound, alarm sound is enabled for this parameter.
– Uncheck Alarm Sound, alarm sound is disabled for this parameter.
Note — When the one or more alarm sounds are disabled for a parameter, the icon “ ”
appears in its numeric pane.
5. If you want to apply the auto set alarm limits for this parameter, select Auto Alarm Limit.
Select OK to apply the auto alarm limits, select Cancel to cancel the operation.
6. Close the menu.
Note — Alarm limits remain in the monitor until you change them next time, even after shut
down or a power loss.
3.11 Configuring System Alarms

The General tab in the Alarm Setup menu is used to:
 Show or hide current alarm limits
 Enable or disable alarms
 Enable auto alarm limits for all parameters
 Restore default alarm limits
 Enable or disable Nurse Call
To open the General tab:
1. Select the Alarm Setup button or the measurement numeric pane to open the Alarm Setup
menu.
2. Select the General tab.
3.11.1 Showing or Hiding Current Alarm Limits

You can choose to show or hide the alarm limits displayed in each numeric pane in all layouts.
To show or hide the current alarm limit:
1. Open the General tab.

2. Select the Alarm Limit Display check box to select the desired setting:
– √, the current alarm limit will be displayed.
– No √, the current alarm limit will be hidden.
3. Close the menu.
3.11.2 Enabling or Disabling Alarms

When alarms are disabled, the monitor enters the alarm off mode. For more details about the alarm
off mode please refer to 3.7 “Suspending or Closing Alarms”.
To enable or disable alarms:
1. Open the General tab.
2. Select Alarm. Select the desired setting:
– On, alarms are enabled.
– Off, to disable the alarms. A window prompts. Select OK to confirm, or select Cancel to
cancel the operation.
3. Close the menu.
3.11.3 Configuring Automatic Alarm Limit

You can quickly set alarm limits that are based on an individual patient’s vital signs measurements.
After you take an initial set of measurements, the monitor calculates an offset and applies it to each
value to generate new upper and lower alarm limit.
For formula used to calculate the automatic alarm limit, please refer to A.4 “Auto Set Alarms”.
To set automatic alarm limit for all parameters:
1. To establish a baseline, take an initial set of vital signs measurements on the patient.
2. Open the General tab in the Alarm Setup menu.
3. Select the Auto Alarm Limit button. A message asks if you are sure you want to change the
alarm limits. Select OK to set automatic alarm limits for all parameters, or select Cancel to
cancel the operation.
4. Close the menu.
If you want to set automatic alarm limits for individual parameter, refer to 3.9 “Changing Alarm
Limits”.
Note — If the calculated offset value exceeds the alarm limit range, the system does not
change the upper and lower alarm limits.
The alarm limits change for existing measurements only; the alarm limits do not change if a
parameter was not measured.
3.11.4 Restoring Default Alarm Limits

You can also reset the monitor's alarm limits to the factory default settings for easy adjustment of
the parameter's alarm limits. When you start monitoring a new patient or change the patient type,
the monitor resets all the alarm limits to default value.
To restore the default alarm limits:

Alarms
2. Select Default Alarm Setup. A message asks if you are sure to restore default alarm limits.
Select OK to confirm, or select Cancel to cancel the operation.
3. Close the menu.
For more information on default alarm limits, see A.3 “Default Alarm Limits”.
3.11.5 Enabling or Disabling Nurse Call

A nurse call signal reflects the audio output of the monitor: if the monitor is sounding an alarm, the
nurse call system is signaling.
You can connect the nurse call system and the monitor with a nurse call cable.
To enable or disable the nurse call function:
2. Select Nurse Call Switch.
– On, the nurse call system is on.
– Off, the nurse call system is off.
3. Close the menu.
Features of the nurse call system are password-protected, only your administrator can change them.
3.12 Viewing All Effective Alarm Events

The Alarm/Event window lists all the alarm/event records of the monitor, including 4 tabs:
 Active Alarm — This tab lists all the active alarm records.
 Physiology Alarm — This tab lists all the physiological alarm records.
 Technical Alarm — This tab lists all the technical alarm records.
 Manual Event — This tab lists all the manual event records.
Each alarm/event entry includes the following information:
 The date and time the alarm/event occurred.
 Alarm description (priority level and alarm message. Alarm priority is indicated by the
number of the exclamatory mark: !!! for high priority, !! for medium priority and ! for low
priority. For an alarm with limits, the value of parameter at that moment is also shown).
To view all effective alarm records:
1. Perform one of the following:
– Select the Alarm/Event pane on the screen to open the Alarm Record window.
– Select the Trend button in the tool bar to open the Trend window. Select Alarm/Event.
2. Select the Active Alarm tab. All the active alarm records are listed.
3. Select Scroll to turn the page and view more records.
4. Close the window.
If you want to view the alarm/event records of one patient, refer to Chapter 9 “Viewing Trend
Data”.

3.13 Alarm Safety Information
The alarms introduced in this chapter are applicable to all the measurement parameters of the
monitor. Specific alarms for some parameters, e.g. Apnea, will be introduced in the later chapters
about the parameter measurement.
Note — The monitor detects and responds almost immediately to most out-of-limits
conditions, except when averaging of the physiological signal is required to reduce
unwanted noise signals. Examples of averaging include respiration rates and
measurements derived from SpO2 signals.
The alarm volume should be loud enough to be heard within a room or through a door. Set
the volume based on the environment and ambient noise levels.
When using the monitor in an independent area (e.g. ICU or cardiac surgery room), make
sure all monitors use the same alarm settings to avoid confusion.
After a power loss for no more than 30 seconds, the alarm settings before the power loss
will be restored.
After a power loss (AC and/or battery) for more than 30s, the alarm/event records remain
in the monitor.

Monitoring ECG
Chapter 4 Monitoring ECG

An electrocardiogram (ECG) monitors the electrical activity of the heart. The patient monitor
processes these electrical signals and displays the ECG waveforms on the screen. The monitor can
also:
 Display 7 ECG waveforms on the same screen
 Compute and display heart rate (HR) values
 Detect and filter pacemaker-generated signals
4.1 Preparing the Skin

The quality of the ECG information displayed by the monitor depends on the quality of the
electrical signal taken from the ECG electrode. To obtain valid signals, the patient skin must be
cleaned before applying any electrodes.
To prepare the skin:
 Shave hair from sites as necessary.
 Wash sites thoroughly with soap and water, leaving no residue. (Do not use ether or pure
alcohol because these substances dry the skin and increase resistance.)
 Dry skin thoroughly to increase capillary blood flow in the tissue and remove skin debris and
oil.
4.2 Connecting ECG Cables

Warning To protect the monitor from damage during defibrillation, to obtain accurate ECG
information, and to protect against noise and other interference, use only ECG
electrodes and cables approved by Philips.
Ensure that the ECG connectors or electrodes never come into contact with other
conductive parts, or with ground. In particular, ensure that all of the ECG
electrodes are attached to the patient.
Note — Both poor quality and incorrect attachment of the electrodes will cause signal loss
or noise increasing.
To connect ECG cables:
1. Attach the clips or snaps to the electrodes before placing them. If you are not using pregelled
electrodes, apply electrode gel to the electrodes before placement.
2. Place the electrodes on the patient according to the selected lead placement. Refer to 4.3.3
“Placing ECG Leads”.
3. Plug the patient cable into the ECG connector on the monitor. ECG waveforms and value are
shown on the screen.
4.3 About ECG Leads

A pair of electrodes forms a lead. Each lead presents a profile of the electrical activity of the same
heart. Lead II is the most commonly used one. The monitor can monitor multiple leads and display
multiple ECG waveforms.

Monitoring ECG
4.3.1 Choosing a Lead Mode

To choose the lead mode:
1. Select the ECG waveform to open the ECG Setup menu.
2. Select Lead Mode to open the Lead Mode menu.
3. Choose a lead mode. Options are Three Lead or Five Lead.
Note — The monitor only displays one ECG waveform if the lead mode is set to Three
Lead.
When you replace the electrodes, if the new lead set has more leads than the previous one, the
monitor detects the new lead positions automatically. On the other hand, if the new lead has fewer
leads than the previous one, you must reset the Lead Mode. If you remove the leads but do not set
accordingly, the monitor gives alarm for Leads Off. The alarm stops once you choose the right
Lead Mode.
4.3.2 Choosing a ECG Lead

To choose an ECG Lead:
1. Select the ECG waveform to open the ECG Setup menu.
2. Select ECG Lead to open the ECG Lead menu.
3. Choose the required ECG lead.
– For Three Lead, options are I, II, III.
– For Five Lead, options are I, II, III, V, aVR, aVL, aVF.
4.3.3 Placing ECG Leads

When placing electrodes, choose a flat, non-muscular site where the signal will not be affected by
movement or bones. Correct lead placement is always important for accurate diagnosis, especially
in the precordial leads, which are close to the heart. QRS morphology can be greatly altered if an
electrode is moved away from its correct location.
Note — The lead location depends on the type of surgical operation. For example, for
chest surgery, the electrodes should be attached to the side or the back of the chest.
The labels and colors of the ECG electrodes differ according to the standards. The electrode
placement illustrations in this guide use the AAMI and IEC labels and colors. The following table
describes the AAMI and IEC labels and lead colors.
AAMI IEC
Lead Color Lead Color
RA White R Red
LA Black L Yellow
LL Red F Green
RL Green N Black
V Brown C White

Monitoring ECG
The following figure shows the 3-lead ECG electrode locations:
AAMI IEC
The following figure shows the 5-lead ECG electrode locations:
AAMI IEC
4.4 Monitoring Patients with Pacemakers

You must enable pace pulse detection when monitoring patients with pacemakers. The pace pulse
detection feature detects and filters pacemaker-generated signals, so that they are not counted as
regular QRS complexes.
Once pace pulse detection is enabled, a pace detection icon " " appears in the ECG waveform
channel on the screen. Pacemaker spike signal and pace pulse mark (a short yellow line) are also
shown in the ECG waveform, indicating the position where the pace pulse was detected.
If you disable pace pulse detection, the pace detect icon " " disappears.
Warning When monitoring patients with pacemakers, if pace pulse detection is not
disabled, the pace pulse will be counted as regular QRS complexes.
Some pace pulses are difficult to reject. When this happens, the pace pulse is
counted as a QRS complex, which can result in an incorrect heart rate count and
failure to detect cardiac arrest. Healthcare professionals should closely observe
patients with the pacemaker.

Monitoring ECG
4.5 The ECG Display

In the ECG channel on the screen, a time mark appears every second under the ECG waveform,
forming a dynamic time scale to make it easy for your observation. The following figure shows the
ECG display.
Figure 4-1 ECG Display

Note — When the ECG module is overloaded or any part of the amplifier is saturated, the
monitor displays the top or bottom of the ECG waveform with broken lines or a flat line.
When it returns from abnormal to normal, a trace of the recovery process is shown.
4.6 Configuring ECG Waveform

Use the ECG Setup menu to:
 Change ECG waveform size
 Change ECG waveform baseline
 Change ECG waveform sweeping speed
 Change ECG waveform color
To open ECG Waveform menu:
1. Select the ECG Waveform pane.
2. Open the ECG Setup menu.
4.6.1 Changing ECG Waveform Size

If the displayed ECG waveform is too small or clipped, you can adjust the size of the waveform.
Changing the ECG waveform size does not affect the ECG signal analyzed by the monitor.
A 1mV calibration bar is shown in the ECG channel on the screen. Comparing the waveform with
the calibration bar helps you understand the ECG signal strength.
To change the ECG waveform size:
1. Open the ECG Setup menu for the waveform you want to change.
2. Select ECG Gain to open the ECG Gain menu.
– ×1/4
– ×1/2
– ×1

Monitoring ECG
– ×2
– ×4
– Auto
Once the gain is changed, ECG waveform size changes accordingly.
Note — If you set the gain to X4, the 1mV calibration bar disappears. If you set the gain to
Auto, the monitor chooses the best gain for the current waveform.
4. Close the menu.
4.6.2 Adjusting ECG Waveform Baseline

When there is any excursion with the ECG waveform, you can adjust the ECG waveform baseline.
To adjust the ECG waveform baseline:
1. Open the ECG Setup menu for the waveform you want to change.
2. Select Baseline Setting. Select ECG baseline value: -50 - 50.
3. Close the menu.
4.6.3 Changing ECG Waveform Speed

The waveform speed setting in the ECG menu determines the speed at which the waveform is
drawn across the screen. For more information on changing this setting, see 2.8.2 “Changing the
Waveform Speed”.
The ECG waveform speed options are:
 50.0 mm/s
 25.0 mm/s
 12.5 mm/s
 6.25 mm/s
Note — Changes to the waveform speed of one ECG waveform apply to all of the
displayed ECG waveforms.
4.6.4 Changing ECG Waveform Color

For information on changing ECG waveform color, see 2.8.3 “Changing the Waveform Color”.
4.7 Choosing Heart Rate Source

You can choose one of lead signal in the ECG waveform channels for heart rate detection. The
monitor calculates HR, analyzes and detects arrhythmia on basis of the signals from this channel.
The heart rate source indicator displays on top of the selected channel.
To choose the heart rate source:
2. Select HR Source to open the HR Source menu.
3. Select the desired ECG channel.
4. Close the menu.
If the lead on the selected HR source ECG channel is off, HR source switches to the next available
ECG channel from top down. If an ECG signal on an ECG channel is detected, use the lead on
such ECG channel as the HR source.

Monitoring ECG
4.8 Choosing ECG Mode

The monitor offers three ECG modes for different monitoring environments. You can choose a
mode according to your need. The current ECG mode displays on top of the ECG waveform
channel.
To choose the ECG mode:
2. Select ECG Mode to open the ECG Mode menu.
3. Select the desired ECG mode:
– Monitor
In Monitor mode, the monitor displays ECG waveform with the artifacts caused false alarms
filtered.
– Operation
In Operation mode, the monitor reduces false readings and interference. Use this only in locations
(operating rooms, for example) where there is significant external interference that might cause
ECG waveform distortion. This mode is not affected by calibration.
– Diagnostic
In Diagnostic mode, the original (unfiltered) ECG waveform displays.
4. Close the menu.
4.9 Enabling or Disabling Filter

Filter removes the interference of the power supply whose work frequency is 50Hz or 60Hz on
ECG waveforms. So the monitor only displays the ECG waveforms after the interference is
removed.
To enable or disable Filter:
2. Select the Filter check box to select the desired setting:
– Check Filter, Filter is enabled.
– Uncheck Filter, Filter is disabled.
3. Close the menu.
4.10 Enabling or Disabling ECG Analog Signal Output

The monitor takes HR detected signals as ECG synchronized signals, which will be used by the
defibrillator at cardiac synchronization .You need to connect the ECG analog signal output cable to
the Analog Signal Output port on the back of the monitor for analog signal output.
Warning Make sure both the monitor and the defibrillator are working safely and
effectively before using them for cardiac synchronization.
Note — Your administrator can enable or disable ECG analog signal output
(password-protected). You can enable or disable ECG analog signal output only when your
administrator enables it.
To enable or disable analog signal output:

Monitoring ECG

2. Select the More to open the More menu.
3. Select ECG Analog Signal Output check box to select the desired setting:
– Check ECG Analog Signal Output, analog signal output is enabled.
– Uncheck ECG Analog Signal Output, analog signal output is disabled.
4. Close the menu.
4.11 Configuring ECG Alarms

You can enable or disable ECG alarms, and change the limits. For details please refer to 3.8
“Changing Alarm Limits”.
4.12 ECG Safety Information

Warning For pacemaker patients, the monitor can continue to count pacemaker rate
during cardiac arrest or some arrhythmias. Do not rely entirely upon the
monitor’s alarm. Keep pacemaker patients under close observation.
Use only ECG cables or leads specified by the company. Other ECG cables and
leads can cause improper performance and/or provide inadequate protection
during defibrillation. Simultaneous using electrodes of different metallic
materials may cause hyperpolarization or accelerated polarization of electrode.
Ensure that the ECG connectors or electrodes never come into contact with
other conductive parts, or with ground. In particular, ensure that all of the ECG
electrodes are attached to the patient.
Line isolation monitor transients may resemble actual cardiac waveforms and
thus inhibit heart rate alarms. Such transients may be minimized by proper
electrode and cable placement, as specified in this manual and electrode
directions for use.
When a defibrillator is used, ensure that the electrodes and patient cables are
not in contact with metal or other conductive surface or device grounds. Do not
contact with the patient, the table or the monitor during defibrillation.
Do not use non-defibrillation cables to perform defibrillation on a patient.
During RESP monitoring, do not use cables from an anti-electrosurgical unit.
Properly ground electro-surgical equipment to reduce hazards from current
inflow which might cause interference to the ECG signals. When using ES
equipment, place the patient lead wires and cables far away from the operating
room table and other devices.
Never entangle the electrosurgical (ES) cables with ECG cables. When using
electro-surgical equipment, never place ECG electrodes near the grounding
plate of the ES devices, as this can cause interference on the ECG signal. Place
the ECG electrodes halfway between the ES grounding plate and the ES knife to
avoid burning.
Use an appropriate orange electrode ECG cable or lead cable with an orange
connector when measuring ECG in the operating room. These cables have
additional circuitry to protect the patient from burns during fulguration and to
reduce electrical interference. Do not use these cables for respiration
measurement.
Implanted pacemakers which can adapt to the Minute Volume may occasionally
react on the Impedance measurement used by patient monitors for the

Monitoring ECG
determination of the RESP value and execute pacing with the maximum
programmed rate. Switching off the RESP measurement can prevent this.
During complete heart block or pacemaker failure (to pace or capture), tall
P-waves (greater than 1/5 of the average R-wave height) may be erroneously
counted by the arrhythmia algorithm, resulting in missed detection of cardiac
arrest.
When arrhythmia monitoring paced patients who exhibit only intrinsic rhythm,
the monitor may erroneously count pace pulses as QRS complexes when the
algorithm first encounters them, resulting in missed detection of cardiac arrest.
For patients who exhibit intrinsic rhythm only, the risk of missing cardiac arrest
may be reduced by monitoring these patients with the low heart rate limit at or
slightly above the basic/demand pacemaker rate. A low heart rate alarm alerts
you when the patient begins pacing. Proper detection and classification of the
paced rhythm can then be determined.
Instruments such as defibrillators or telemetry units produce filtered ECG
signals. Such signal will be filtered again if used as the output signal of the
patient monitor. This may result in failure to detect pace pulse, non-capture or
cardiac arrest, causing damage to the monitoring performance on patients with
pacemaker.
Using the monitor in conjunction with a pacemaker or other electric generator
on the same patient or when the patient has arrhythmia may result in
mismeasurement of HR by the monitor. The result is that the monitor may
continue displaying ECG signals even after the patient's death. Healthcare
professionals should observe the patient closely to make correct diagnosis in
time.
When an external pacemaker is being used on a patient, arrhythmia monitoring
is severely compromised due to the high energy level in the pacer pulse. This
may result in the arrhythmia algorithm’s failure to detect pacemaker
non-capture or asystole.
Note — Do not completely immerse the ECG cable in water, solvents or cleaning solutions
as the connectors are not waterproof.
The ECG cable connected to the patient during defibrillation may be damaged. For cables
that have been attached to the patient during defibrillation, carefully check that they are
functioning properly before using them again.
We recommend that you use Ag-Agcl ECG electrodes recommended by the manufacturer
or with quality guarantee, and replace the ECG electrodes at least every 24 hours to
ensure good ECG signal quality during long term monitoring, regardless of the age of
patient monitored. The reason is that, after 24 hours of use, the gel in the electrode starts
to dry, with adhesive strength weakened, besides, after long term monitoring, the patient
will feel uncomfortable with sensitive skin stimulated by the gel. ECG electrodes are for
single use and should be disposed of properly as medical waste.
Enabling pacemaker detection at the same time does not affect the monitoring on patients
with pacemaker. However, it is best to disable this function when the patient does not wear
a pacemaker, to avoid that the monitor counts the artifacts in the waveform as pacemaker
signal.
Thorough skin cleansing is very important role for minimizing static interference. Before
using high-frequency surgical equipment, carefully clean the skin and properly place the
electrodes to reduce the risk of burns when the neutral electrode connection fails.

Monitoring Respiration
Chapter 5 Monitoring Respiration

The monitor measures the thoracic impedance between two ECG electrodes on the patient’s chest.
Changes in the impedance due to thoracic movement produce the respiration (RESP) waveform on
the monitor screen. The monitor counts the waveform cycles to calculate the respiration rate (RR).
Note — When the monitor works in the Operation ECG mode, it stops monitoring RESP.
5.1 Lead Placement for Monitoring Respiration

Correct patient skin preparation techniques for electrode placement are important for RESP
measurements. See 4.1 “Preparing the Skin”.
Connect ECG leads by using the instruction in 4.2 “Connecting ECG Cables”. The monitor
displays RESP waveform and numeric on the screen.
Cardiac Overlay: Cardiac activity that affects the RESP waveform is called cardiac overlay.
Correct electrode placement can help to reduce cardiac overlay: avoid the liver area and the
ventricles of the heart in the line between the respiratory electrodes. This is particularly important
for neonates.
Lateral Chest Expansion: Some patients, especially neonates, expand
their chests laterally. In these cases, it is best to place the two
respiratory electrodes in the right mid-axillary and left lateral chest
areas at the patient’s maximum point of breathing movement to
optimize the respiratory wave.
Abdominal Breathing: Some patients with restricted chest movement breathe mainly abdominally.
In these cases, you may need to place the left leg electrode on the left abdomen at the point of
maximum abdominal expansion to optimize the respiratory wave.
5.2 Enabling or Disabling RESP

To enable or disable RESP:
2. Select the More to open the More menu.
3. Select the RESP check box to select the desired setting:
– Check RESP, RESP is enabled.
– Uncheck RESP, RESP is disabled.
Note — If RESP is disabled, the monitor displays the message RESP OFF in the RESP
waveform channel.
4. Close the menu.
5.3 The Respiration Display

The following figure shows an example of the respiration waveform and numeric pane. On the
monitor, the respiration measurement is displayed as a continuous wave and a numeric respiration
rate. In Manual mode, the detection level (a dotted line) is displayed on the waveform. If the wave
falls below the threshold, the monitor alarms.

Figure 5-1 RESP Display
5.4 Selecting a RESP Detection Mode

You can choose to detect RESP in automatic mode or manual mode.
To select a RESP detection mode:
1. Select the RESP waveform channel to open the RESP Setup menu.
2. Select the Manual check box to select the desired setting:
– Check Manual, manual detection mode is enabled.
– Uncheck Manual, manual detection mode is disabled, the monitor RESP works in auto
detection mode.
3. Close the menu.
5.4.1 Using Manual Detection Mode

Use Manual mode for situations where:
 The respiration rate and the heart rate are close.
 Patients have Intermittent Mandatory Ventilation.
 Respiration is weak. Try repositioning the electrodes to improve the signal.
In Manual mode you must set Respiration detection level.
To set the Respiration detection level:
1. Select the RESP waveform channel to open the RESP Setup menu.
2. Select the RESP Threshold. Select a threshold value: 0% - 100%.
Note — Use the dotted detection level line in the Respiration waveform to determine when
the desired level is reached. Once it is set, the detection level will not automatically adapt
to different breathing depths. Remember, if the breathing depth changes, you may need to
change the detection level.
3. Close the menu.
5.4.2 Using Auto Detection Mode

In Auto mode, the monitor adjusts the detection level automatically, depending on the wave height
and the presence of cardiac artifact.
Note that in Auto mode:
 The detection level (a dotted line) is not displayed on the waveform.

 The algorithm expects a heart rate and therefore needs at least 3 electrodes attached to the
patient. If you are monitoring respiration with only two electrodes, the detection algorithm
becomes less sensitive which may result in reduced breath detection performance.
Use Auto mode for situations where:
 The respiration rate is not close to the heart rate.
 Breathing is spontaneous, with or without continuous positive airway pressure (CPAP).
 Patients are ventilated, except patients with Intermittent Mandatory Ventilation (IMV).
5.4.3 Respiration Detection Mode and Cardiac Overlay

In Auto detection mode, if ECG breaks off when you are monitoring Respiration, the monitor
cannot compare ECG with Respiration rate in order to detect cardiac overlay. The monitor set
Respiration detection level to a high level automatically, to avoid taking cardiac overlay as
Respiration rate.
In Manual detection mode, Cardiac overlay can in certain situations trigger the respiration counter.
This may lead to a false indication of a high respiration rate or an undetected apnea condition. If
you suspect that cardiac overlay is being registered as breathing activity, raise the detection level
above the zone of cardiac overlay. If the Respiration wave is so small that raising the detection
level is not possible, you may need to optimize the electrode placement as described in “Lateral
Chest Expansion”.
5.5 Configuring RESP Waveform

Use the RESP Setup menu to:
 Change RESP waveform size
 Change RESP waveform sweeping speed
 Change RESP waveform fill
 Change RESP waveform color
To open RESP Setup menu:
1. Select the RESP waveform pane.
2. Open the RESP Setup menu.
5.5.1 Changing RESP Waveform Size

You can adjust the size of the displayed Respiration waveform to check more closely.
To change the RESP waveform size:
2. Select RESP Gain to open the RESP Gain menu.
– ×1/2
– ×1
– ×2
Once the gain is changed, RESP waveform size changes accordingly.
4. Close the menu.

5.5.2 Changing RESP Waveform Speed

The waveform speed setting determines the speed at which the waveform is drawn across the
screen. For more information on changing this setting, see 2.8.2 “Changing the Waveform Speed”.
The RESP waveform speed options are:
 50.0 mm/s
 25.0 mm/s
 12.5 mm/s
 6.25 mm/s
5.5.3 Enabling or Disabling Waveform Fill

By default, RESP waveform is in a single line. You can enable waveform fill to display RESP
waveform as a bold line.
To enable or disable waveform fill:
2. Select the Waveform Fill check box to select the desired setting:
– Check Waveform Fill, the RESP waveform is drawn in a bold line.
– Uncheck Waveform Fill, the RESP waveform is drawn in a single line.
3. Close the menu.
5.5.4 Changing RESP Waveform Color

For information on changing RESP waveform color, see 2.8.3 “Changing the Waveform Color”.
5.6 Configuring RESP Alarms

You can enable or disable RESP alarm, and change the limits. For details please refer to 3.8
"Changing Alarm Limits".
5.7 Configuring Apnea Alarm

The apnea alarm is a high priority alarm used to detect apneas. The respiration measurement does
not recognize obstructive and mixed apneas - it only indicates an alarm when a user-defined time
has elapsed since the last detected breath.
To configure apnea alarm:
1. Select the Alarm Setup button in the tool bar, or select the RESP numeric pane to open the
Alarm Setup menu.
2. Select the RR (RESP) tab.
3. Select the Apnea Alarm check box to select the desired setting:
– Check Apnea Alarm, the Apnea alarm is enabled.
– Uncheck Apnea Alarm, the Apnea alarm is disabled.
4. If you need to change Apnea alarm time, select Apnea Alarm Time. Options range from 10
seconds to 60 seconds.
5. Close the menu.

5.8 RESP Safety Information

Warning This monitor is not an apnea monitor. It is just a RR monitor, not intended to
detect apnea.
The monitor cannot detect apnea if you do not set the detection level correctly in
Manual Detection Mode. If the detection level is set too low, the monitor is more
likely to detect cardiac activity and mistakenly explains it as the respiratory
activity in case of an apnea.
The safety and effectiveness of the respiration measurement method in the
detection of apnea, particularly the apnea of prematurity and infant, has not been
established.
If operating under conditions according to EMC Standard EN 60601-1-2 (Radiated
Immunity 3V/m), field strengths above 1V/m might cause erroneous
measurements at various frequencies. Therefore, avoid using electrically
radiating equipment in close proximity to the respiration measurement unit.
The monitor measures respiration by using ECG cables and electrodes. Do not
use an operating room (OR) ECG cable set to monitor respiration. This is
because of the higher internal impedance of the OR cable set. Use only OR ECG
cable set in electro-surgery.
Implanted pacemakers which can adapt to the Minute Volume may occasionally
react on the Impedance measurement used by patient monitors for the
determination of the RESP value and execute pacing with the maximum
programmed rate. Switching off the RESP measurement can prevent this.


Monitoring SpO2
Chapter 6 Monitoring SpO2

Pulse oximetry uses a motion-tolerant signal processing FAST algorithm. It provides these
measurements:
 Oxygen saturation of arterial blood (SpO2)
Computing method: SpO2(%)＝oxygenated hemoglobin/(oxyhemoglobin+ deoxyhemoglobin).
 A SpO2 (pleth) waveform: A visual indication of a patient’s pulse.
 A pulse rate: The value is derived from the pleth wave.
 A perfusion value: Numerical value for the pulsatile portion of the measured signal caused by
arterial pulsation.
Note — SpO2 monitoring is not suitable for neonates.
6.1 Selecting and Applying an SpO2 Sensor

When selecting a sensor, consider the patient’s weight and activity level, adequacy of perfusion,
availability of sensor sites, need for sterility, and anticipated duration of monitoring.
See Chapter 13 "Accessories" for recommended SpO2 sensors.
To correctly apply the sensor:
 Remove colored nail polish from the application site.
 Ensure that the sensor is applied to smooth skin sites with sufficient arterial blood flow, and
that no excessive patient movement and/or vibration occurs.
 Apply the sensor at the same level as the patient’s heart.
 Ensure that the sensor is not on extremities with an arterial catheter or intra vascular venous
infusion line.
 Ensure that the sensor is the appropriate size. The sensor should not be so loose as to fall off,
nor should it be too tight.
 Ensure that the light emitter and the photo-detector are directly opposite each other. All light
from the emitter must pass through the patient’s tissue.
Warning Never apply an SpO2 sensor at ambient temperatures above 41 ˚C (105.8℉)

because this can cause severe burns after prolonged application.
If a sensor is too loose, it might compromise the optical alignment or fall off. If it
is too tight, for example because the application site is too large or becomes too
large due to edema, excessive pressure may be applied. This can result in
venous congestion distal from the application site, leading to interstitial edema,
hypoxemia and tissue malfunction.
Do not apply SpO2 sensor and NBP cuff on the same limb. Inflation of the cuff will
interfere with SpO2 monitor and cause false alarm.
6.2 Connecting SpO2 Cables

Connect one end of the sensor cable to the SpO2 connector of the monitor, attach the other end to
the patient site (or use an extension cable). Once the patient’s SpO2 is detected, the monitor
displays SpO2 waveform and numeric on the screen.

Monitoring SpO2
Warning Position the sensor cable and connector away from power cables to avoid
electrical interference.
For neonatal patients, make sure that all sensor connectors and adapter cable
connectors are outside the incubator. The humid atmosphere inside can cause
inaccurate measurements.
6.3 SpO2 Display

The illustration below shows SpO2 display. The SpO2 waveform standardizes according to the
display area of the screen. The waveform height is irrelevant to the actual light strength.
Figure 6-1 SpO2 Display
6.4 Configuring SpO2 Waveforms

Use the SpO2 Setup menu to:
 Change SpO2 waveform sweeping speed
 Change SpO2 waveform color
To open the SpO2 Setup menu:
1. Select the SpO2 waveform pane.
2. Open the SpO2 Setup menu.
6.4.1 Changing SpO2 Waveform Speed

The waveform speed setting determines the speed at which the waveform is drawn across the
screen. For more information on changing this setting, see 2.8.2 "Changing the Waveform Speed".
The SpO2 waveform speed options are:
 50.0 mm/s
 25.0 mm/s
 12.5 mm/s
 6.25 mm/s
6.4.2 Changing SpO2 Waveform Color

For information on changing SpO2 waveform color, see 2.8.3 "Changing the Waveform Color".

Monitoring SpO2
6.5 Enabling or Disabling SpO2 Pulse Rate

When SpO2 pulse rate is enabled, the monitor displays SpO2 pulse rate in the SpO2 pulse rate
numeric pane. When SpO2 pulse rate is disabled, the monitor stops detecting SpO2 pulse rate.
To enable or disable SpO2 pulse rate,
2. Select the PR On check box to select the desired setting:
– Check PR ON, SpO2 pulse rate is enabled.
– Uncheck PR ON, SpO2 pulse rate is disabled.
3. Close the menu.
6.6 Changing SpO2 Response Mode

The SpO2 Response setting determines how quickly the monitor report changes in SpO2 values.
The longer the average processing time, the longer the SpO2 value reflects a physiological event.
To change the SpO2 response mode:
2. Select SpO2 Response to open the SpO2 Response menu.
– Normal
Use this setting for most monitoring situations.
– Fast
Use this setting for special applications when you need a fast response. Do not use this setting
if motion artifact is an issue.
– Slow
Use this setting when motion artifact is an issue. SpO2 changes are reported more slowly
compared to the other modes.
4. Close the menu.
6.7 Assessing Suspicious SpO2 Readings

When the patient’s pulse rate is very low, or strong arrhythmia is present, the SpO2 pulse rate may
differ from the heart rate calculated from ECG. However, this does not indicate an inaccurate SpO2
value.
If you doubt the measured SpO2 value, use the pleth wave to assess the signal quality.
When using a pulse oximetry monitor, abnormally interrupted readings may display due to failure
of connecting the patient to the connector, movement of sensor, ambient light (especially strobe
and flashing light) or electromagnetic interference. In particular, bundled sensors are very sensitive
to the small movements that can occur when the sensor is swinging.
6.8 Configuring SpO2 Alarms

You can enable or disable SpO2 alarm, and change the limits. For details please refer to 3.8

Monitoring SpO2
6.8.1 Desatuation Alarm (Desat)

The Desaturation alarm is a high-priority alarm that alerts you to a potentially life-threatening drop
in oxygen saturation. The Desat alarm is not configurable; it is based on the current SpO2 low
alarm limit. The Desat alarm limit is fixed at 10 less than the current low limit for adults and
pediatric patients and 5 less for neonates.
6.9 Configuring SpO2 Pulse Rate Alarms

You can enable or disable SpO2 pulse rate alarm, and change the limits. For details please refer to
3.8 "Changing Alarm Limits".
6.10 SpO2 Safety Information

The patient monitor is calibrated to indicate functional oxygen saturation.
Warning Injected dyes, such as methylene blue, or intravascular dyshemoglobins

(methemoglobin and carboxyhemoglobin) can lead to inaccurate measurements.
Interference can be caused by:
 High levels of ambient light. To avoid this problem, cover the application
site with opaque material.
 Electromagnetic interference.
 Excessive patient movement and vibration.
High oxygen levels can predispose a premature infant to retrolental fibroplasia.
If this is a consideration, do not set the high SpO2 alarm limit to 100%. This is
equivalent to switching the alarm off.
Never use disposable sensors on patients who have allergic reactions to the
adhesive.
Do not use the SpO2 sensors during magnetic resonance imaging (MRI)
scanning. Induced current could potentially cause burns. In order to avoid this,
properly arrange the cable to avoid forming an induction coil. Remove the
sensor from the patient immediately if it is not working properly.
Avoid placing the sensor on extremities with an arterial catheter, or
intravascular venous infusion line.
To dispose of pulse oximeter equipment or components, follow local
regulations regarding disposal of hospital waste.
Caution The sensor consists of sensitive electronic components which may be damaged
if misused. Keep sharp-edged objects away from the cable.
Improper cleaning of the sensor could compromise the SpO2 sensor life span.
Note — Use only the specified sensor and cables. Before using the sensor, you need to
verify the compatibility between the monitor and the probe and cables, otherwise, damage
to the patient may be caused.
The sensor may cause skin irritation or rupture after prolonged application. Inspect the
application site for skin behavior and optical alignment every 2-3 hours. If the skin texture
changes, moves the sensor to another site. Change the application site at least every 4
hours.

Monitoring SpO2
Do not apply the sensor too tight, which can cause venous pulse. This could result in
circulation block and inaccurate measurement.
Follow with the Instructions for Use of the sensor and all Warnings and Notes therein.
Ensure that the light emitter and the photo-detector are directly opposite each other. All
light from the emitter must pass through the patient’s tissue.

Monitoring SpO2

Monitoring NBP
Chapter 7 Monitoring NBP

The monitor uses the oscillometric method for measuring NBP. The principle of the Oscillometric
method of measuring blood pressure is stopping the arterial blood stream with the pressure of the
inflation cuff. As the cuff pressure decreases, the air pressure oscillation wave caused by the blood
stream can be measured in the cuff. The Systolic (SYS), Diastolic (DIA) and Mean Arterial
Pressure (MAP) are recognized by amplitude changes of the oscillometric wave under different
cuff pressures.
Note — NBP monitoring is not suitable for neonates.
7.1 Selecting and Applying an NBP Cuff

Select an NBP cuff based on the patient’s arm size, it is marked on the cuff. When applying the
cuff, deflate it completely first. Wrap the cuff 2-5 cm above the patient’s left arm. The index line
should fall between the two range lines and the arterial marking should be over the patient’s
brachial artery with the cuff correctly on the brachial artery. Place the hose along the left or the
right side of the patient’s arm to avoid tangling.
For information on recommended NBP cuffs, see Chapter 13 "Accessories".
7.2 Connecting the NBP Cuff and Hose

Connect the selected cuff to the hose and the hose to the NBP connector on the side panel of the
monitor. The hose clicks into place when seated correctly.
Note — Do not squeeze the hose to avoid blockage between the monitor and the hose.
7.3 Measuring NBP

Note — Select an appropriate cuff and ensure that the correct patient type is selected
before monitoring. Wrong cuff sizes can overload inflation pressure on pediatric or
neonatal patients.
When measuring NBP, keep the patient’s left arm at heart level with the palm upwards.
A cuff that is too loose or too tight can cause inaccurate measurements. Also, if the cuff is
too loose, it may not deflate properly. Select a proper cuff for different patients and
correctly place the cuff to collect reliable results.
7.3.1 Measurement Limitations

NBP measurements are impossible with heart rate extremes of less than 40 bpm or greater than 300
bpm, or if the patient is on a heart-lung machine.
The measurement may be inaccurate:
 If a regular arterial pressure pulse is hard to detect.
 With cardiac arrhythmias, including APB, VPB and AF.
 With excessive and continuous patient movement such as shivering or convulsions.
 With rapid blood pressure changes.
 With severe shock or hypothermia that reduces blood flow to the peripheries.
 With obesity, where a thick layer of fat surrounding a limb dampens the oscillations coming
from the artery.

Monitoring NBP
 On an edematous extremity.
 In the process of CPR (Cardiopulmonary Resuscitation).
7.3.2 Selecting an NBP Measurement Mode

There are three NBP measurement modes:
 Manual — you can manually take NBP measurement as needed.
 Interval — the monitor takes NBP measurements every n minute(s), in which n means the
number of minute between two measurements. You can set the interval in the NBP Setup
menu.
 Stat — the monitor continuously measure patient NBP for 5 minutes. Use Stat for continuous
NBP monitoring of supervised patients in special cases.
Warning Prolonged cycling of an NBP cuff may cause the following: purpura, ischemia, or
neuropathy. Inspect the extremity of the cuffed limb for normal color, warmth and
sensitivity. Move the cuff to another site or stop the blood pressure
measurements if any abnormality is detected.
7.4 NBP Display
Figure 7-1 NBP Display
7.5 Configuring NBP

Use the NBP Setup menu to:
 Change fading time interval
 Select whether the alarm limits appear in the NBP numeric pane
 Select an NBP measurement interval
 Start and stop NBP STAT measurement
To open the NBP Setup menu:
1. Select the NBP numeric pane.
2. Open the NBP Setup menu.

Monitoring NBP
7.5.1 Selecting a Fading Time Interval

After manual measurement or STAT measurement, the NBP results and time marks are displayed
in the NBP numeric pane. After a period of time, these NBP results and time marks fade out.
The monitor only displays NBP results of 24 hours. 24 hours later, the NBP results are cleared and
replaced by “-”.
To select a fading display time:
2. Select Fade Time Interval to open the Fade Time Interval menu.
– 10′00″
– 15′00″
– 30′00″
– 60′00″
4. Close the menu.
7.5.2 Changing Alarm Limits Display

The NBP numeric pane can only display one set of alarm limits at one time.
To choose the alarm limits to display:
2. Select Alarm Limit Select to open the Alarm Limit Select menu.
3. Select one of the following alarm limits to display:
– SYS Limit
– DIA Limit
– MAP Limit
4. Close the menu.
7.5.3 Selecting NBP Measurement Interval

You can choose to measure the patient’s blood pressure at predefined time intervals.
An interval is measured from the end of one NBP measurement (when the pump starts) to the start
of the next measurement.
To select the NBP measurement interval:
2. Select Interval Time to open the Interval Time menu.
3. Select one of the following alarm limits to display:
– Manual
– ¨3′00″, 5′00″, 10′00″, 15′00″, 30′00″, 60′00″, 90′00″, 120′00″, 240′00″ or 480′00″.
4. Close the menu.
If the NBP measurement interval is set to Manual, the monitor starts and stops an NBP
measurement when you press the NBP key on the front panel.

Monitoring NBP
If the NBP measurement interval is set to a value, the NBP measurement icon " " in the NBP
numeric pane flashes to remind you to start NBP measurement. Press the NBP key on the front
panel to begin the first interval measurement. The Interval icon " " and the remaining time
before the next measurement starts appear in the NBP numeric pane. When the remaining time
comes down to 0, the next measurement starts automatically.
7.5.4 Starting NBP Stat Measurements

Warning Continual NBP measurements can cause injury to the patient being monitored.
Weigh the advantages of frequent measurement and/or use of Stat mode against
the risk of injury.
To enable Stat measurement:
2. Select the Stat check box to select the desired setting:
– Check Stat, Stat measurement is enabled.
– Uncheck Stat, Stat measurement is disabled.
3. Close the menu.
After the monitor enters Stat mode, the Stat measurement icon " stat" in the NBP numeric pane
flashes to remind you to start NBP measurement. Press the NBP key on the front panel to start Stat
measurements. The monitor takes as many measurements as possible within a 5-minute period. The
remaining time is shown after the Interval icon " ".
Press the NBP key on the front panel to stop Stat measurements.
7.6 Enabling or Disabling NBP Pulse Rate

When NBP pulse rate is enabled, the monitor displays pulse rate in the NBP numeric pane. If you
disable NBP pulse rate, the monitor stops monitoring NBP pulse rate.
To enable NBP pulse rate:
2. Select the PR check box to select the desired setting:
– Check PR, NBP pulse rate is enabled.
– Uncheck PR, NBP pulse rate is disabled.
3. Close the menu.
7.7 Viewing NBP Measurement Results

When an NBP measurement is complete, the NBP measurement result is added to the numeric list
of the NBP numeric pane. The numeric list only displays several sets of the most recent results.
The number of the result depends on the NBP channel size. If the NBP data displayed is full, the
monitor automatically deletes one set of old data when storing new NBP measurement results.
For details please refer to 9.6.1 "Viewing NBP History Data".

Monitoring NBP
7.8 Configuring NBP Alarms

NBP alarms include SYS alarm, DIA alarm, MAP alarm and SYS-DIA Pressure Difference alarm.
You can enable or disable NBP alarms, and change the limits. For details please refer to 3.8
7.9 Configuring NBP PR Alarms

You can enable or disable NBP PR alarms, and change the limits. For details please refer to 3.8
7.10 Calibrating NBP

NBP cannot be calibrated by the user. The cuff pressure sensor should be inspected and calibrated
at least every two years by qualified service representatives. If you need to calibrate NBP during
use, please contact the service representatives.
7.11 NBP Safety Information

Warning The monitor is a defibrillator-proof device. Usage of the defibrillator does not
interfere with NBP measurement.
Do not reuse disposable NBP cuff.
Only use the specified cuff to avoid the danger caused by over-inflation.
The pressure value measured by the monitor is equivalent to that measured by
auscultation, tolerance from which complies with YY0667-2008.
In some cases, rapid, prolonged cycling of an NBP cuff has been associated
with any or all of the following: ischemia, purpura, or neuropathy. Apply the cuff
according to the directions and check the cuff site and cuffed extremity
regularly when blood pressure is measured at frequent intervals or over
extended periods of time.
Check the patient’s limb to assure that circulation is not constricted, i.e. no
discoloration or ischemia of the extremities. Check the limb at regular intervals
based on the circumstances of the specific situation.
Do not place the cuff on any extremity where circulation is compromised or has
the potential to be compromised. Do not measure NBP on patients with
sickle-cell disease, or any condition where skin damage has occurred or is
expected to occur.
Never use the NBP cuff on a limb with an intravenous infusion or arterial
catheter in place. This could cause tissue damage around the catheter when the
infusion is slowed or blocked during cuff inflation.
Never apply the blood pressure cuff to the same extremity as the one to which
an SpO2 sensor is attached because the cuff inflation disrupts SpO2 monitoring
and leads to nuisance alarms.
Use clinical judgment before using NBP monitoring on patients with serious
blood clot disease due to the risk of hematoma in the limb with the cuff.

Monitoring NBP

Monitoring Temperature
Chapter 8 Monitoring Temperature

The monitor measures temperature through the sensor temperature and electrical impedance. The
monitor can measure two temperatures simultaneously, TEMP1 and TEMP2. The monitor displays
the temperature values and the difference between these two temperatures in the numeric pane.
8.1 Selecting and Connecting Temperature Probes

Warning Before taking temperature measurements, ensure that the temperature probe is
not in contact with a heat source; cool the probe for at least 5 minutes before
starting a temperature measurement.
Note — When using a skin surface probe, ensure good contact between the probe and the
patient skin. It is recommended to place the probe on the artery under the armpit, and ask
the patient to hold the arm tight to the body.
To select and connect the temperature probe:
1. Select a temperature probe with proper type and size for your patient. See Chapter 13
"Accessories" for compatible temperature probes.
2. If you are using a disposable probe, connect the probe to the temperature cable.
3. Plug the probe or the temperature cable into the temperature connector on the monitor.
4. Attach the probe on an appropriate part of the patient (e.g. mouth, rectum), apply a rubber
sheath on the probe.
5. Check if the alarm settings (on/off, alarm limits) are suitable for the patient and temperature
measurement.
6. Start the temperature measurement, see 8.3 “Enabling or Disabling Temperature Monitoring”.
7. Temperature numeric values appear on the monitor screen.
The following factors can affect temperature measurements:
 Improper position of the temperature probe.
 Poor heat balance, heat dissipation.
 Patient temperature fluctuation.

8.2 Temperature Display

The following figure shows an example of a temperature numeric pane.
Figure 8-1 Temperature Display
8.3 Enabling or Disabling Temperature Monitoring

If you enable temperature monitoring, the monitor measures the patient’s temperature continuously.
As long as the probe is attached to the patient, the temperature numeric is displayed on the screen.
To enable or disable temperature monitoring:
1. Select the Layout button to open Layout Menu.
2. Select the Normal tab. The preview of this layout is shown under the tab.
3. Select the Channel Selection menu.
– TEMP. TEMP is enabled and shown in the preview.
– None. TEMP is disabled. The preview is blank.
8.4 Configuring TEMP Alarms

You can enable or disable TEMP alarm, and change the limits. For details please refer to 3.8
8.5 TEMP Safety Information

Warning The disposable probes are sterile and should be handled accordingly. See the
probe package for a Use By date.
Use only the specified probes for your monitor.
Use only the approved consumables to reduce the risk of monitor damage
during defibrillation.
Do not reuse disposable probes.

When the probe is disconnected or loose, the monitor stops measuring the
temperature with no audible alarm. To ensure patient’s safety, check the probe
connection and position periodically.
Use disposable sheath to reduce the risk of cross-infection. Sheaths are
intended for single use and should be disposed of properly as medical waste
after use.
Do not use a probe if you see any signs of damage.


Viewing Trend Data
Chapter 9 Viewing Trend Data

Trend data is useful for assessing a patient’s progress over a period of time. You can view trend
information in graphic or form through the Trend function.
9.1 Trend Data Overview

A trend record is defined as the data that is captured from the time you start a new patient until you
either shut down the monitor or admit a different patient. When you start a new patient, all current
patient data is cleared from the trend database.
Select the Trend button in the tool bar to open the Trend menu.
Use the Trend menu to:
 View ECG waveform
 Analyze heart rate variation
 View graphical trend
 View tabular trend
 View and analyze NBP history data
 View alarm/event history
 View “data management center”
 Export patient data
The trend database can store up to 120 minutes of ECG waveform, 50 days of graphical trend data
and 1600 sets of NBP list, at least 200 alarm/event records (including ARR).When the memory is
full, the oldest data is deleted to make room for newer data.
The time of each ECG waveform that the monitor saves is no longer than 12 seconds.
Continuous measurements (for example, SpO2 and Respiration) are captured and stored in the trend
database every 18 seconds; aperiodic measurements (for example, NBP) are recorded at the time
that the measurement is completed.
If you want to print the trends, refer to Chapter 11 "Using the Recorder".
9.2 Viewing ECG Waveforms

You can view the patient’s most recent 12 minutes of ECG waveforms, and analyze the ECG
waveforms in details. You can also view the patient’s most recent 120 minutes of ECG waveforms,
refer to 9.8.1 "Recalling 120 Minutes of ECG Waveforms".
9.2.1 Viewing ECG Waveforms of a Segment

To view ECG waveforms of a segment:
1. Open the Trend menu.
2. Select ECG Recall to open the ECG Recall window, as shown in Figure 9-1.

Viewing Trend Data
Figure 9-1 ECG Recall Window

The ECG Recall window displays a zoom view of all ECG waveforms that can be recalled. The
time indicators on the left are the starting points of the recalled waveforms displayed in three lines.
Each line includes 24 seconds of ECG waveform.
3. To view ECG waveform segment in other pages, select Page to move between segments.
4. To view the ECG waveforms on different lines, select Up/Down to move between lines.
5. Select L/R to move between ECG waveforms of segments.
The selected ECG waveform segment is shown at the bottom of the window (from HR source)
with the lead mode and the waveform gain on the above part, the starting and ending times of this
segment on the below part.
6. To scan the ECG waveforms of a segment, select Scan. The recalled waveforms are shown in
scanning mode.
9.2.2 Analyzing ECG Waveform of a Segment

To analyze an ECG waveform segment:
1. Select the segment of the ECG waveform that you want analyze, refer to 9.2.1 "Viewing ECG
Waveforms of a Segment".
2. Select Analysis to display the ECG Analysis window of the segment. All ECG waveforms of
this segment are shown on the ECG Analysis window.
3. Select L/R to select the required ECG waveform. The analysis view of this ECG waveform is
shown above the ECG Analysis window.

Viewing Trend Data
4. Select Position to choose the start of this ECG segment for analysis (background of the
Position turns pink).
5. Choose an end position (background of the Position button turns blue). The Time and
Amplitude under the ECG waveform indicate the relative time and relative amplitude
between the start and end of the ECG waveform.
6. Close the menu.
9.3 Analyzing HR Variation

The monitor analyzes cyclical variation of the patient’s sinus heart rate over a period of time, and
provides the statistical result.
Note — The “day time start” and “day time end” settings are password-protected. Your
administrator can define them.
To analyze HR variation:
2. Select HR Variation Analysis to display the HR Variation Analysis window.
The HR Variation Analysis window shows the statistical results of the HR variation analysis
starting from when ECG monitoring is enabled. The analysis results include the data of patient
average HR, average day HR, average night HR, maximum HR, minimum HR, out of range HR by
percentage, higher HR by percentage and lower HR by percentage, as well as HR trend and
distribution graphs.
3. If you want to change the HR variation analysis condition to restart the analysis. Select Reset
Time. The monitor re-analyzes HR variation and shows the new statistical results.
4. If you want to re-analyze HR variation, redefine the HR variation analysis conditions.
5. If you want to print the HR variation analysis results, select Print.
6. Close the menu.
9.4 Viewing Graphical Trends

The Trend Display window displays the patient’s most recent 120 hours data in graphic form. To
review the data older than 120 hours, see 9.8.2 "Recalling 50 days of Graphical Trend Data".
Note — The Trend Display window only displays the trends of parameter selected in the
Channel Setup.
To display the Trend Display window:
2. Select Trend Display to open the Trend Display window, as shown in Figure 9-2.

Viewing Trend Data
Figure 9-2 Trend Display Window

In the window, the parameter value and its corresponding alarm limits are on the left. Use the
vertical scroll bar to scroll through the parameter graphs. Use the horizontal scroll bar to move the
graphical display forward or backward in time. The timestamps on the bottom of the graphical
display indicate the time range of the currently displayed trend data. If you want to change the
displayed time scale, refer to 9.4.1 "Changing Graphical Trend Data Resolution".
In graphic trend of some parameters, two horizontal lines are drawn to indicate the high and low
alarm limits.
The blue vertical line is the moment when the trend data is viewed.
NBP measurement results are shown in vertical line segments. The top of the line segment stands
for SYS, the middle for MAP and the bottom for DIA.
9.4.1 Changing Graphical Trend Data Resolution

Changing the Time Scale setting in the Graphical Trend Menu increases or decreases the resolution
of the data in the graphical display. If you expect rapid change of measurement data, select a
monitoring duration with high resolution.
To change the time scale:
1. Open the Trend Display window.
2. Select Zoom (background of the Zoom button turns yellow). Select one of the options:
– 2 hours
– 4 hours

Viewing Trend Data
– 8 hours
– 24 hours
– 48 hours
– 72 hours
– 96 hours
– 120 hours
Select OK, the time scale is changed.
3. Close the menu.
9.4.2 Checking Graphical Trend by Scrolling

To check the graphical trend by scrolling:
1. Open the Trend Display window.
Note — The graphical trend data in the Trend Display window does not refresh
automatically as the new data is stored. You need to reopen the Trend Display window in
order to view the newly stored data.
2. To view the graphical trend in other pages, select L/R, the display moves display moves
forward or backward by half a page for you to check the trends.
3. If you want to check graphical trend data of different moments on the same page,
– select Cursor once (background of the Cursor button turns yellow), rotate the
navigation wheel to check the graphical trend slowly.
– select Cursor twice (background of the Cursor button turns red), rotate the navigation
wheel to check the graphical trend fast.
4. If you want to view graphical trend data of other parameters, select Up/Down.
5. Close the menu.
9.5 Viewing Tabular Trends

The Trend List window displays patient data in a tabular format of columns and rows. The most
recent measurement is displayed in the top row of the Trend List window. Each row begins with
the date and time at which the measurements were taken followed by the measurement values. A
dash (-) indicates that the parameter was not measured.
Note — When you shut down the monitor, data in the Trend list will not be saved.
To display the Trend List window:
2. Select Trend List to open the Trend List window.
9.5.1 Changing Displayed Parameters

If a parameter is selected that is not currently being measured in the Trend List window, the
column header appears in the Trend List window but the column displays a dash. If a parameter is
not selected, the column for that parameter does not appear in the Trend List window.
Note — You cannot change the order in which the parameters are displayed.
To change the displayed parameters:
1. Open the Trend List window.
2. Select the check boxes next to the parameters on the top of the Trend List window.

Viewing Trend Data
– Check a parameter, increase parameters in the Trend List.

– Uncheck a parameter, clear parameters from the Trend List.
3. Close the menu.
9.5.2 Checking Tabular Trend by Scrolling

To check the tabular trend by scrolling:
2. Select Step and choose a step: 1 - 20.
3. Select Up/Down and check the display of Tabular Trend.
4. Close the menu.
9.6 Viewing and Analyzing NBP History Data

In the NBP History Data window, you can view NBP history data and monitor dynamic blood
pressure.
The NBP History Data window displays all NBP measurement values for the current patient in a
tabular format of columns and rows. The most recent data appears in the top row. Each row
contains the time when the NBP measurement occurred. A dash (-) indicates that the parameter was
not measured.
Note — When you shut down the monitor, data in the NBP History Data window remains.
To open the NBP History Data window:
2. Select NBP History Data to open the NBP History Data window.
9.6.1 Viewing NBP History Data

To view NBP history data:
1. Open the NBP History Data window.
2. To view the NBP history record one by one, select Up/Down.
3. To view the NBP history data on another page, select Page.
9.6.2 Monitoring Dynamic Blood Pressure

The monitor monitors the patient’s NBP data in a period of time dynamically, counts data of NBP
and PR, including the average value, highest value, lowest value, percentage out of normal range.
So you can get more accurate information about the patient’s NBP.
When you open the Dynamic Blood Pressure Analysis window for the first time, the monitor
performs dynamic monitoring to all NBP history data of this patient and provides the result. Start
Time and End Time define the time scale of the dynamic monitoring.
To change the dynamic monitoring time scale:
2. Select Dynamic Blood Pressure Analysis to open the Dynamic Blood Pressure Analysis
window.
3. Select Start Time. Choose a time where you want to start the dynamic monitoring.

Viewing Trend Data
4. Select End Time. Choose a time where you want to stop the dynamic monitoring.
The Dynamic Blood Pressure Analysis window shows the dynamic monitoring result for this time
scale.
9.7 Viewing Alarm/Event History

To view alarm/event history:
2. Select Alarm/Event to open the Alarm/Event window.
3. Perform one of the following:
– To view all physiological alarms, select the Physiological Alarm tab. The Physiological
Alarm tab displays all physiological alarms.
– To view all technical alarms, select the Technical Alarm tab. The Technical Alarm tab
displays all technical alarms.
– To view all manual events, select the Manual Event tab. The Manual Alarm tab
displays all manual alarms.
4. To view more alarms/events, select Page.
To view all currently active alarms, refer to 3.10 "Viewing All Effective Alarm Events".
9.7.1 Viewing Trends Associated with Physiological Alarms

To view the trends associated with the physiological alarms:
2. Select the Physiological Alarm tab.
3. Select the physiological alarm record. The ECG waveform and other associated measurement
results of the moment when this alarm occurred are shown.
9.8 Viewing the Data Manager

The data manager allows you to recall 120 minutes of ECG waveforms or check 50 days of
graphical trend data. In the Data Manager window, the data is stored in segments in the time order.
Storage Time Range indicates the length of each segment.
To open the Data Manager window:
2. Select Data Manager to open the Data Manager window.
9.8.1 Recalling 120 Minutes of ECG Waveforms

Each ECG segment includes 12 minutes of ECG waveform, and the monitor can store up to 10
segments. You can recall the most recent 120 minutes of ECG waveform.
To recall 120 minutes of ECG waveform:
1. Open the Data Manager window.

Viewing Trend Data
2. Select ECG Recall to open the ECG Recall window.

3. Select an ECG waveform segment you want to recall.
4. Use the ECG Recall window to view the ECG waveform of that segment. Please refer to 9.2
“Viewing ECG Waveforms”.
9.8.2 Recalling 50 days of Graphical Trend Data

Each graphical trend segment includes 120 hours of trend data, and the monitor can store up to 10
segments. You can recall up to 50 days of graphical trend data.
To view 50 days of graphical trend data:
1. Open the Data Manager window.
2. Select Trend Display to open the Trend Display window.
3. Select a graphical trend segment you want to recall.
4. Use the Trend Display window to view the graphical trend of that segment. Please refer to
9.4 “Viewing Graphical Trends”.
9.9 Exporting Patient Data

You can export the patient data from the monitor using USB Data Manager.
To export the patient data:
1. Connect a USB flash drive to the monitor via the USB port on the rear panel.
2. Open the Trend window.
3. Select USB Data Manager to open the USB Data Manager window.
4. Select Save Current Data to save the patient data to the USB flash drive.

Calculation
Chapter 10 Calculation
Calculations are patient data that is not directly measured, but calculated by the monitor when
appropriate information is provided.
The monitor can perform the following calculations:
Drug Oxygenation Ventilation Hemodynamic

Drug Body surface area: BSA Partial pressure of Cardiac index: CI
concentration Oxygen consumption: oxygen in the alveoli: Stroke volume: SV
Infusion rate VO2 PAO2 Stroke index: SI
Titration rate Arteriovenous oxygen Alveolar-arterial Systemic vascular
Medication content difference: oxygen difference: resistance: SVR
time C(a-v)O2 AaDO2 Systemic vascular
Oxygen extraction ratio: Fraction of inspired resistance index: SVRI
O2ER oxygen: Pa/FiO2 Pulmonary vascular
Oxygen delivery: DO2 Arterial to alveolar resistance: PVR
Partial pressure of oxygen oxygen ratio: a/AO2 Pulmonary vascular
in the alveoli: PAO2 Minute volume: MV resistance index: PVRI
Alveolar-arterial oxygen Dead space: Vd Left cardiac work:
difference: AaDO2 Physiologic dead LCW
Arterial oxygen content: space in percent of Left cardiac work
CaO2 tidal volume: Vd/Vt index: LCWI
Content of capillary Alveolar volume: VA Left ventricular stroke
oxygen: CcO2 work: LVSW
Shunt fraction: Qs/Qt Left ventricular stroke
Arteriovenous oxygen work index: LVSWI
content difference: CvO2 Right cardiac work:
RCW
Right cardiac work
index: RCWI
Right ventricular stroke
work: RVSW
Right ventricular stroke
work index: RVSWI
Body surface area:
BSA
Select the Calculator button in the tool bar to open the Calculator menu.
10.1 Drug Calculation

The monitor provides a Drug Calculation window to allow you to calculate a drug concentration,
infusion rate, titration rate, and dosage. You can also generate a titration chart for infusion speed
and time.
10.1.1 Calculating Drug Concentration

Drug Concentration = Total Dose/ SOL Volume.
To calculate drug concentration:
1. Open the Calculator menu.
2. Select Drug Concentration to open the Drug Concentration window.

Calculation
3. Enter the following information before calculation:

– Patient Name: Enter a maximum of 8 letters. The Patient Name does not have to be the
same as that in the Patient Information window.
– MRN (Medical Record Number): Enter a maximum of 8 letters. The MRN does not
have to be the same as that in the Patient Information window.
– Patient Type: You can select Adult, Pedi. and Neo. The Patient Type does not have to
be the same as that in the Patient Information window.
– Drug Name: You can select 15 drug names: Dopamine, Dobutamine, Epinephrine,
Nipride, Nitroglycerin, Heparin, Diazepam, Penicillin, Pitocin, Aminophylline,
Drug A, Drug B, Drug C, Drug D and Drug E. Drug A, B, C, D and E are defined by
the doctor as any drugs other than those specified in the menu.
– Weight: Enter a number that is no greater than 200. The unit is kg.
– Total Dose: Select one of these units: g, mg, mcg, mEg, unit, k unit, or m unit.
– SOL Volume (Solution Volume): Volume of the diluted liquid in ml unit.
Note — The fields with an asterisk * are mandatory. If you enter incorrect data, the monitor
displays asterisks *** in the data field and an error message on the bottom of the screen.
4. After you enter the required information, the monitor automatically calculates the drug
concentration.
10.1.2 Calculating Infusion Rate, Titration Rate and Medication

Time
Infusion Rate is the SOL volume injected per unit time. It uses milliliter per hour (ml/h) as the unit.
Infusion Rate = Dosage/ Drug Concentration.
Medication Time is the time to complete the infusion of the total dose. It uses hour (h) as the unit.
Medication Time = Total Dose/ Dosage.
The unit of titration rate is GTT/min. Titration Rate = Infusion Rate x Volume per Drop.
To calculate the infusion rate:
1. Calculate the drug concentration, see 10.1.1 “Calculating Drug Concentration”.
2. Select Dosage. Enter the information using the screen keyboard. The monitor calculates and
displays Infusion Rate, Titra. Rate and Medication Time.
Dosage is the drug volume injected per unit time. The dosage is related to the Dosage Unit
selected. When the Dosage Unit is changed, the Dosage value changes accordingly. You can select
one of the following units: Dose/min, Dose/h, Dose/kg/min or Dose/kg/h.
3. If you change Volume per Drop, the monitor re-calculates titration rate. Volume per Drop
has options of 15 GTT/ml (15 drops per milliliter for glass infusion sets) and 20 GTT/ml (20
drops per milliliter for disposable infusion sets).
Note — When the Patient Type is Neo., the Titration Rate and Volume per Drop are not
valid.
10.1.3 Using the Titration Chart

You can view the injected drug dosage for different infusion rates.
To use the titration chart:
1. Calculate the drug concentration, see 10.1.1 “Calculating Drug Concentration”.

Calculation
2. Calculate the infusion rate, titration rate, and medication time, see 10.1.2 “Calculating
Infusion Rate, Titration Rate and Medication Time”.
3. Select Titration Chart. Titration chart information is shown.
4. If you want to change the displayed step, select Step and choose an option from 1 to 10.
5. If you want to view more titration chart information, select Page to view other pages.
10.2 Calculating Oxygenation

To calculate oxygenation:
2. Select Oxygenation Calculation to open the Oxygenation Calculation window.
3. Use the navigation wheel and on-screen keyboard to enter the following information before
calculation:
– C.O.: Cardiac output, with the unit L/min.
– Height: with the unit cm.
– Weight: with the unit kg.
– HB: Hemoglobin, with the unit g/L.
– FiO2: Fraction of inspiration O2, with the unit %.
– PaO2: Arterial Partial Pressure of Oxygen, with the unit mmHg.
– PaCO2 Arterial Partial Pressure of Carbon Oxygen, with the mmHg.
– SaO2: Arterial Oxygen Saturation, with the unit %.
– PvO2: Vein Partial Pressure of Oxygen, with the unit mmHg.
– RQ: Respiratory Quotient.
– SvO2: Vein Oxygen Saturation, with the unit %.
– ATMP: Atmospheric Pressure, with the unit mmHg.
Note — Input the data in the fields above the Oxygenation Calculation window. If the
input exceeds the allowed range, an error message appears.
4. Select Start Cal. to start calculation.
The results are shown in the Oxygenation Calculation window below.
10.3 Calculating Ventilation

To calculate ventilation:
2. Select Ventilation Calculation to open the Ventilation Calculation window.
3. Use the navigation wheel and on-screen keyboard to enter the required information before
calculation.
Note — Input the data in the fields above the Ventilation Calculation window. If the input
exceeds the allowed range, an error message appears.

Calculation

The results are shown in the Ventilation Calculation window below.
10.4 Calculating Hemodynamics

To calculate hemodynamics:
2. Select Hemodynamics to open the Hemodynamics window.
3. Enter the required information before calculation.
Note — Input the data in the fields above the Hemodynamics window. If the input
exceeds the allowed range, an error message appears.
The results are shown in the Hemodynamics window below.

Using the Recorder
Chapter 11 Using the Recorder

Use the recorder to generate records for patient’s monitoring results. The records include:
 Real-time waveform record
 ECG waveform recall record
 Printed record on physiological alarms
 Tabular trend record
 NBP trend record
 Calculation record
Press the Print key on the front panel to start or stop printing.
The record consists of the heading and the content. Printing time, patient information, printing
speed and the parameter data etc. (depending on what you are printing) make up the record.
11.1 Loading the Recorder Paper

Note — Use only thermal paper supplied by Philips to avoid damaging the recorder.
To load the recorder paper:
1. Insert your finger into the recorder latch (marked OPEN) and lift it to open the recorder door,
as shown in Figure 11-1.
Figure 11-1 Opening the Recorder Door

2. Remove the empty paper core.

Using the Recorder
3. Place a new roll in the holder so that the end comes from under the roll, extending beyond the
recorder door, as shown in Figure 11-2.
Figure 11-2 Loading Paper

4. Pull at least 25 mm of the paper out of the door, close the recorder door.
5. Press the Print key to test the recorder.
Note — When the paper is out, the recorder is malfunctioning or the recorder door is not
closed, the monitor prompts a message, indicating the recorder is not ready.
11.2 Printing Real-Time Waveforms

The monitor prints real-time waveforms, either continuously or at a pre-defined interval.
If Timed Printing is enabled, after you press the Print key on the front panel, the recorder prints
the real-time waveforms at a pre-defined interval. The time length of each printing is configurable
in the Print Setup menu, refer to 11.4 “Changing Print Time”.
If Timed Printing is disabled, after you press the Print key on the front panel, the recorder prints
90 seconds of real-time waveforms continuously.
In Timed Printing, if you want to print an extra section of waveforms, set an Advance Time, refer
to 11.5 “Configuring Advance Time”.
Select the Print Setup button in the tool bar to open the Print Setup menu.
Use the Print Setup menu to:
 Change the timed printing interval.
 Change the print speed.
 Choose the real-time printing waveforms
 Print signal-channel ECG waveform
11.2.1 Changing Timed Printing Interval

To change the timed printing interval:
1. Open the Print Setup menu.
2. Select Timed Printing to open the Timed Printing menu.

Using the Recorder
– OFF
– 15 minutes
– 30 minutes
– 1 hour
– 4 hours
– 8 hours
– 12 hours
Set it to OFF to disable Timed Printing, or choose one interval time for the recorder to print the
real-time waveforms.
4. Close the menu.
11.2.2 Changing Print Speed

To change the print speed:
2. Select Print Speed to open the Print Speed menu.
– Auto
– 12.5mm/s
– 25mm/s
– 50mm/s
Note — When you set the print speed to Auto, the print speed uses ECG waveform
sweeping speed (except 6.25 mm/s).
4. Close the menu.
11.2.3 Choosing Real-Time Printing Waveforms

The recorder can print real-time waveforms of up to three channels at one time, you can choose
which to print.
To choose the real-time printing waveforms:
2. Select Channel 1 Waveform, to open the Channel 1 Waveform menu.
3. Select a waveform for channel 1.
Note — You can only choose an ECG waveform for channel 1.
4. Close the Channel 1 Waveform menu.
5. Repeat step 2 to 4 to set channel 2 and channel 3.
Note — When you set the channel 2 and channel 3 to NONE, the recorder prints signal
channel ECG waveform.
11.3 Enabling Print on Physiological Alarm

You can configure the monitor to automatically print a record when a physiological alarm occurs.
The print out includes the heading and the real-time waveform. The waveform length depends on
the setting in the Print Setup menu. See 11.2.2 “Changing Print Speed”.
If you want to print an extra section of waveforms before the alarm occurs, set an Advance Time,
refer to 11.5 “Configuring Advance Time”.

Using the Recorder
Whether to print the waveform of the parameter that triggers the alarm depends on the Print Mode
setting. See 11.3.1 “Choosing Alarm Print Mode”.
To enable print on physiological alarm:
2. Select the Alarm Trigger check box to select the desired setting:
– Check Alarm Trigger, enable print on physiological alarm.
– Uncheck Alarm Trigger, disable print on alarm.
3. Close the menu.
11.3.1 Choosing Alarm Print Mode

The alarm print modes of the recorder include Auto and Default. In the Auto mode, waveform of
the parameter that triggered the alarm is printed on channel 2, replacing the setting in the Channel
2 Waveform menu. In the Default mode, waveform of the parameter that triggered the alarm is not
printed.
To choose alarm print mode:
2. Select Alarm Print Mode to open the Alarm Print Mode menu.
– Check Auto, waveform of the parameter that triggered the alarm is printed.
– Check Default, waveform of the parameter that triggered the alarm is not printed.
3. Close the menu.
11.4 Changing Print Time

This is to set the time length of a waveform to print.
To change the print time:
2. Select Print Time.
– 10 seconds
– 15 seconds
– 20 seconds
– 30 seconds
4. Close the menu.
11.5 Configuring Advance Time

If you want to record the waveform before printing starts, set an Advance Time.
To set an advance time:
2. Select Advance Time Setup to open the Advance Time Setup menu.
– NONE
– 1 second

Using the Recorder
– 2 seconds
– 3 seconds
4. Close the menu.
11.6 Printing ECG Recall Waveforms

To print ECG recall waveforms:
1. Open the Print ECG Recall window, refer to 9.2 “Viewing ECG Waveforms”.
2. Press the Print key on the front panel. The recorder prints the ECG recall waveform (time
length is 90 seconds).
11.7 Printing Tabular Trends

You can print the tabular trends that are shown on the screen. On the print out, the newest tabular
trend is printed last.
To print the tabular trends:
2. Press the Print key on the front panel to print the tabular trends that are shown on the screen.
3. If the required tabular is not on the current screen, use the Up/Down button to turn the page.
11.8 Printing NBP History Data

To print the NBP history data:
2. Press the Print key on the front panel to print the NBP history data that are shown on the
screen.
3. If the required data is not on the current screen, use the Up/Down button to turn the page.
11.9 Printing Calculation Results

You can print the titration of the drug calculation, oxygenation, ventilation, and hemodynamic
calculations. The print out includes heading and calculation result.
To print the calculation:
1. Perform the calculation, refer to Chapter 10 “Calculation”.
2. When the calculation result window is open, press the Print key on the front panel.
11.10 Removing the Recorder

To remove the recorder:
1. Shut down the monitor, unplug the AC power cable.
2. Open the recorder door, as shown in Figure 11-3.
3. Use a cross screwdriver to remove the two screws securing the recorder, pull out the recorder.

Using the Recorder
Figure 11-3 Removing the Recorder
11.11 Storing the Recorder Papers

Store the printouts properly for future check. For long term storage, make copies of the printouts.
When storing the recorder papers,
 Keep the recording strips in a dry, dark and cool place. Avoid exposure to high temperature,
humidity, direct sunshine, and fluorescent lighting to avoid surface discoloration. Avoid
exposure to ambient temperatures over 50˚C and liquids.
 Avoid exposure to starch, adhesive agent, oily water or carbon paper to avoid surface
discoloration.
 Avoid exposure to ethane, oxide, plastic rubber, adhesive tape, fluorescent ink or red inks to
avoid surface discoloration.
 Never squeeze, apply friction or scratch the paper.
 Never place two printing surfaces together to avoid ambiguous recording.

Cleaning and Care
Chapter 12 Cleaning and Care

This chapter gives general guidelines on the cleaning and care of your monitor and accessories.
Use only the Philips approved cleaning methods and agents listed in this chapter. Unapproved
cleaning methods and agents may cause contamination or damage to the product, shorten the
service life or result in hidden danger.
For cleaning, disinfection and sterilization of reusable cables and sensors, please refer to the
attached instructions. If there are no such instructions attached, please refer to the instructions on
cleaning, disinfection and sterilization in this chapter.
12.1 General Guidelines

Keep the monitor, cables and accessories free of dust and dirt. After cleaning and disinfecting,
check the equipment carefully. Do not use if you see signs of deterioration or damage.
Follow these general precautions:
 Always dilute cleaning agents and sterilized solution according to the instructions in this
chapter or use lowest possible concentration.
 Never allow liquid to enter the case.
 Never immerse any part of the equipment in liquid or allow any liquid to enter electrical
contacts.
 Never pour liquids on the monitor.
 Never use abrasive material (such as steel wool or silver polish).
 Never use bleach, abrasive cleaning agents or strong solvents such as acetone or
acetone-based compounds.
 Never autoclave, steam sterilize, or ultrasonically clean the monitor or cables.
 Never use alcohol on the patient cables. Alcohol can cause the plastic to become brittle and
fail prematurely.
Warning If you spill liquid on the exterior of the monitor or accessories, use a clean cloth
to dry the monitor. If you believe the liquid may have gotten inside the monitor,
power off the monitor and contact your service representative.
12.2 Cleaning
It is critical to periodically clean the monitor and accessories according to the regulation of your
facility.
12.2.1 Cleaning the Monitor

Note — Do not permit any liquid to enter the monitor and avoid pouring liquids on the
monitor while cleaning.
To clean the monitor:
1. Turn off the patient monitor and unplug the AC power cord.
2. Clean the monitor at room temperature. Use a soft cloth and any of the following cleaning
agents:
– Isopropyl alcohol (70% solution in water)

Cleaning and Care
– Mild soap and water

– Sodium hypochlorite (chlorine bleach), 3% solution in water
3. Dry the cleaned parts with a clean, dry cloth.
12.2.2 Cleaning the Cables

To clean the cables:
1. Dampen a soft cloth with one of the following cleaning agents:
– Alcohol-free hand soap
– Sodium hypochlorite (chlorine bleach), 3% solution in water
Note — This solution might discolor the cable.
2. Dry the cables with a clean, dry cloth.
12.2.3 Cleaning the SpO2 Sensor

To clean the SpO2 sensor:
1. Wipe all sensor surfaces with a clean cloth dampened with one of the following cleaning
agents:
– mild detergent
– salt solution (1%)
2. Wipe the sensor with a water-dampened cloth to remove all cleaner residues.
3. Dry all sensor surfaces with a clean, dry cloth. Set the sensor aside allowing it to dry
completely.
12.2.4 Cleaning the NBP Cuff

Note — Never dry-clean the cuff.
To clean the NBP cuff:
1. Remove the rubber bladder from the cuff (if applicable).
2. Clean the cuff in detergent (mild soap washing).
3. Clean the cuff in water to remove all soap residues.
4. Air-dry the cuff.
5. Check the cuff and tube. If you see any signs of deterioration or damage, do not use it.
6. Put the rubber bladder back into the cuff.
12.2.5 Cleaning the Temperature Probe
Caution Never heat the probe over 100˚C (212℉). Only heat to 80˚C (176℉) - 100˚C (212℉)
for a short time.
To clean the temperature probe:
1. Wipe the probe with a clean cloth dampened with one of the following cleaning agents:
– mild detergent
2. Wipe the probe with a water-dampened cloth to remove all cleaner residues.

Cleaning and Care
3. Dry the cleaned probe with a clean, dry cloth.
12.2.6 Cleaning the Recorder

After long term use, deposits of paper debris may collect on the print head making recordings
unevenly fainter in horizontal stripes on the printouts, and shortening the life of the print head and
roller.
Note — Do not use any hard metal or sharp tool (for example, a screwdriver) to remove
debris on the print head.
To clean the print head:
1. Use electrostatic discharge (ESD) precautionary measures.
2. Power off the monitor and open the recorder door to remove the paper roll from the recorder.
3. Soak a cotton swab in alcohol (70%) and gently wipe the surface of the thermal print head.
4. Clean the roller using the same method in Step 3.
5. Reload the paper roller after the alcohol is dried and close the recorder door.
12.3 Disinfection
Disinfect the monitor and accessories periodically as determined by hospital’s policy. Clean the
monitor and accessories before disinfection.
Note — Never mix disinfecting solutions (such as bleach and ammonia) as hazardous
gases may result.
12.3.1 Disinfecting the Monitor

To disinfect the monitor:
1. Soak a lint-free swab in one of the following disinfectants and gently wipe the surface of the
monitor:
– Ethanol (up to 70%), 1- and 2- Propanol (up to 70%)
– Glutaraldehyde (up to 3.6%)
2. Clean the surface of the monitor with a wet lint-free cloth to remove remaining disinfectant.
3. Use a dry cloth to clean the monitor.
12.4 Sterilizing the Monitor

Sterilization is not recommended for this monitor, accessories or supplies unless otherwise
indicated in the Instructions for Use that accompany the accessories and supplies.
12.5 Routine Inspection

Warning Only authorized professionals can open the monitor case.
To perform routine inspection for the monitor and accessories:
1. Shut down the monitor and unplug the AC power cable.
2. Examine the unit exterior for general physical condition. Make sure that the monitor is clean
and the housings and connectors are not cracked or broken.

Cleaning and Care
3. Examine all cables, the power plug and cord for damage. Make sure that the prongs of the
plug do not move in the casing. If damaged, replace it with an appropriate one.
4. Inspect all accessories (cables, transducers, sensors and so on). If any show signs of damage,
do not use.
5. Inspect the patient cables, leads and their strain reliefs for general condition. Make sure there
are no breaks in the insulation. Make sure that the connectors are properly engaged at each
end to prevent rotation or other strain.
12.6 Maintenance
Under the conditions that meet the intended use of this product and an average daily use of 6 hours,
the life expectancy is 10 years. Internal parts may need to be repaired and replaced.
The following tasks are for qualified service professionals only.
Ensure that these tasks are carried out as indicated by the monitor’s maintenance schedule, or as
specified by local laws. Clean and disinfect equipment to decontaminate it before testing or
maintaining it.
Table 12-1 Maintenance
Maintenance Task Maintenance Schedule

At least once every two years, or:
 as needed
 after any repairs where the power supply is removed or
Safety checks
replaced
 after repair resulting from falling
 after the monitor case has been opened
Performance assurance for
At least once every two years or if you suspect that the
all measurements not listed
measurement values are incorrect.
below
NBP calibration At least once every two years, or as specified by local laws.
Battery See 2.4.3 “Conditioning the Battery”.
12.7 Troubleshooting
If you suspect a problem with an individual measurement, read the related section in this guide and
double check the measurement settings. If the problem remains, call your service personnel. If you
suspect an intermittent, system-wide problem, call your service personnel.
Use the following table to troubleshoot problems with the monitor and accessories. For more
information on troubleshooting the monitor, see GS20 Patient Monitor Service Guide. If needed,
the company also provides circuit diagram and part list.
Table 12-2 Troubleshooting
Problem Solution
Inaccurate HR  Check/adjust the lead position.
measurements  Check/re-clean the skin.
 Check/replace ECG electrode

Cleaning and Care
Problem Solution
The monitor does not show  Ensure that the environment is dry and that the monitor is
the ECG baseline waveform not wet. If there is dampness in the environment or monitor,
consistently on the screen run the monitor continuously for 24 hours to dry it out.
and the waveform moves  Check the quality of the electrode and whether the patient
out of the display area at site where the electrode is attached is clean. Replace the
times. electrode or clean the contact site, if necessary.
The lead wires are  Ensure that the electrode is in good contact with the patient.
connected but there is no  Check all the extension parts of the ECG lead wires. The
ECG waveform and the circuit between the plugs and pins of the 5 ECG extension
screen displays Leads Off. cables are open. Replace the lead wire if the circuit is open.
 Check the ECG electrode and replace the electrode after
long-term use.
The SpO2 values turn on and In long term monitoring or operation, patient movement may
off during SpO2 monitoring. result in SpO2 interruptions. Keep the patient stabilized.
There is no SpO2 waveform  Check whether the red light of the finger probe is flashing.
or values. If there is no red light flashing, there might be poor contact.
 Check whether the environmental temperature is too low.
Do not expose the patient’s arm to cold air since this can
affect readings.
There is no temperature The TEMP sensor might be off the patient or the monitor. If the
displayed. problem continues, consult your service representative.
 Ensure that the cuff is correctly applied, refer to 7.1
Cuff Loose displays in the “Selecting and Applying an NBP Cuff”.
NBP numeric pane.  Check the cuff for damage. If any sign of damage shows,
replace it.
Overpressure displays in There is a problem with the inflation circuit inside the monitor,
the NBP numeric pane. consult your service representative.
Make sure the recorder has paper. If the problem continues,

The recorder does not work.
please consult your service representative.

Cleaning and Care

Accessories
Chapter 13 Accessories
Note — Refer to the packaging for the accessories’ manufacture dates.
Accompanying registered accessories are for one year use.
Do not reuse disposable accessories.
13.1 ECG Cables

Table 13-1 ECG Cables
Philips Part
Item Description
Number
989803177341 3-Lead ECG Cable+Lead AAMI Snap style
989803177331 5-Lead ECG Cable+Lead AAMI Snap style
989803160641 3/5-Lead ECG Trunk Cable, AAMI/IEC
989803160651 3-Lead Grabber, AAMI
989803160661 3-Lead Grabber, IEC
ECG Cables 989803160691 5-Lead Grabber, AAMI
989803160701 5-Lead Grabber, IEC
989803143171 3-Leadset Grabber, General Use/ICU, IEC
989803143181 3-Leadset Grabber, General Use/ICU, AAMI
989803143191 5-Leadset Grabber, General Use/ICU, IEC
989803143201 5-Leadset Grabber, General Use/ICU, AAMI
ECG Electrode 40493D Adult Foam ECG Electrode
13.2 SpO2 Sensors

Table 13-2 SpO2 Sensors
Item Philips Part Description

Number
M1191B Adult finger SpO2 Sensor, for patient size＞50kg, 2m
M1191BL Adult finger SpO2 Sensor, for patient size＞50kg, 3m
Pedi/Small adult finger SpO2 sensor , for patient size
SpO2 Sensor M1192A
(15-50 kg), 1.5m
M1196A Adult/Pedi Clip SpO2 Sensor, for patient size＞40kg, 3m
989803204041 8-pin Adult SpO2 Sensor

Accessories
13.3 NBP Cuffs and Interconnect Tubes

Table 13-3 NBP Cuffs and Interconnect Tubes
Philips Part
Item Description
Number
989803177501 NBP Cuff -Adult Thigh GCF1205
989803177531 Reusable NBP Cuff -Adult Large GCF1204
NBP Cuff 989803177521 NBP Cuff - Adult GCF1203
989803177511 NBP Cuff - Pediatric GCF1202
989803177481 NBP Cuff - Infant GCF1200
Blood Pressure
989803177471 Blood Pressure Interconnect Tube - Adult/Infant, 3m
Interconnect Tube
13.4 Temperature Probes

Table 13-4 Temperature Probes
Philips Part
Item Description
Number
Esophageal/Rectal Temperature Probe (autoclave
21075A
Temperature sterilization), 12FR, reusable, continuous measuring, 3m
Probe Skin Surface Temperature Probe (autoclave sterilization),
21078A
9.5mm diameter, reusable, continuous measuring, 3m
13.5 Accessories
Table 13-5 Accessories
Philips Part
Item Description
Number
Li-Ion Battery 989803195041 Li-Ion Battery
989803172771 Roll stand
Roll stand
989803172761 Wall mount

Specifications
Chapter 14 Specifications
14.1 ECG Specifications
Table 14-1 ECG Specifications
Type CF
Auxiliary current (Leads Off Active electrode: < 100nA
detection) Reference electrode: < 900nA
Excitation current parameter Current: < 250 µA
for RESP measurement Frequency: 37 kHz
The relative change in the amplitude of the displayed signal
Measured voltage deviation
caused by the application of ± 300 mV DC voltage does not
caused by polarization voltage
exceed ±5%.
Tall T-wave rejection ≥ 1.2 mV (Adult/Pediatric)
capability ≥ 0.6 mV (Neonate)
Aspect ratio 0.24 s/mV – 0.6 s/mV
Type of averaging:
In normal circumstance, the heart rate is higher than 50
bpm, the heart rate is acquired by averaging the 12 most
Type of averaging to compute
recent RR intervals.
the minute heart rate
If each of 3 consecutive RR intervals is larger than 1200
ms (means heart rate is lower than 50 bpm), the heart rate
is acquired by averaging the 4 most recent RR intervals.
Response time of heart rate HR change from 80/min to 120/min: ≤ 10s.
meter to change in heart rate HR change from 80/min to 40/min: ≤ 10s.
Heart rate updating rate of the
1s
display
Bandwidth: 1–100 Hz
Sensitivity: 0.5V/mV
Auxiliary Output
Propagation Delay Time: ≤ 35ms
No internal pacemaker pulse represented
The monitor does not reject the pacemaker pulses with
Pacemaker pulse rejection overshoot.
performance Amplitude: (aP) from ±2mV to ±700mV
Bandwidth: (dP) from 0.1ms to 2ms
Suppression of pacemaker
pulse detector to fast ECG Minimum input slew rate: 0.9V/s
signals
In the Monitoring, Operation, or Extended mode, the operator
Pacemaker pulse detector
can disable the pacemaker pulse detection (or cause it to be
failure
ignored).
The monitor shall comply with YY1079-2008, 10s after the
Overload protection application of differential mode voltage 1V (p-v) of mains
power supply frequency.
QRS amplitude (p-v RTI) 0.5mV - 5mV
QRS width (monitor-adult) 70ms - 120ms
QRS width
40ms - 120ms
(monitor-neonate/pediatric)

Specifications
QRS no response amplitude
(except for neonate mode) ≤ 0.15 mV
(p-v RTI)
1mV QRS no response width
≤ 10ms
(except for neonate mode)
Power frequency voltage The maximum power frequency sine wave-to-valley
tolerance amplitude is not less than 100 μV (p-v).
Drift tolerance Compliant with 4.2.5.3 in YY1079-2008.
Adult/Pediatric: 15bpm - 300bpm
HR measurement range
Neonate: 15bpm - 350bpm Step:1bpm
HR measurement accuracy ±1 % or ±5 bpm, whichever is greater
Adult/Pediatric: 15bpm - 300bpm
HR alarm limit range
Neonate: 15bpm - 350bpm
HR alarm resolution 1bpm
No more than nominal value ±10% or ±5bpm, whichever is
HR alarm limit accuracy
greater.
Time to alarm for cardiac
≤10s
arrest
Time to alarm for low heart
≤10s
rate
Time to alarm for high heart
≤10s
rate
Time to suspend audible
1 minute, non-adjustable
alarms
Input Dynamic Range Compliant with 4.2.8.1 in YY1079-2008.
Input impedance ≥2.5MΩ
System noise ≤30µV(p-vRTI)
Multi-channel interference Compliant with 4.2.8.4 in YY1079-2008.
Gain control and stability Compliant with 4.2.8.5 a), c) and d) in YY1079-2008.
Time base selection and
Compliant with 4.2.8.6 a) in YY1079-2008.
accuracy
Output display Compliant with 4.2.8.7 a) in YY1079-2008.
Accuracy of rebuilt input
Compliant with 4.2.8.8 in YY1079-2008.
signal
Calibration voltage < ±10%.
CMRR (common mode The output signal amplitude should not exceed V (p-v) RTI
rejection ratio) within 60s, with CMRR≥89dB.
Baseline control and stability Compliant with 4.2.8.11 in YY1079-2008.
Pacemaker pulse display
Compliant with 4.2.8.12 in YY1079-2008.
capability
Interval: ≤ 35ms
Synchronous pulse of Amplitude: 500 times the input signal amplitude
cardioversion Width: No signal processing
Output impedance: ≥1.5MΩ
Electrosurgical interference
Comply with 4.2.8.14 in YY1079-2008.
suppression
ECG cables 3/5-lead
Leads off alarm Audible and visual indicators

Specifications
6.25 mm/s,12.5 mm/s, 25 mm/s, 50 mm/s
Display sweep speeds
Error less than ±10%.
×1/4, ×1/2, ×1, ×2, ×4, Auto
ECG gain
Error less than ±10%, 1/4 grade error undefined.
Defibrillator protected Tested with 5 kV, recovery time< 5s
Monitoring Mode: 0.67Hz - 40Hz (Adult), 0.67Hz - 55Hz
(Pediatric)
Bandwidth
Operation Mode: 0.67Hz - 20Hz
Extended Mode: 0.05Hz - 100Hz
14.2 SpO2 Specifications

Averaging the transmitted and displayed SpO2 and pulse rate, or other processing, can be
controlled by the user-selectable SpO2 response mode: Slow (20 seconds), normal (10 seconds) and
fast (5 seconds). Depending on the alarm limits and the difference between the displayed alarm
limit values, the delay time to generate alarm signals ranges from 1 second to 20 seconds.
Pulse oximeter equipment measurements are statistically distributed, only about two-thirds of pulse
oximeter equipment measurements can be expected to fall within ±Arms of the value measured by
a CO-oximeter.
Note — SpO2 calibration is not needed.
Table 14-2 SpO2 Specifications
Type CF
SpO2 measurement and alarm
0% - 100%
limit range
Depends on the accessories.
70 % ～ 100 %:
1 M1192A: ±4%
SpO2 measurement accuracy
M1196A, M1191B, M1191BL: ±3%
989803204041: ±3%
Undefined for other scope
SpO2 pulse rate measurement and
30 bpm - 300bpm
alarm limit range
SpO2 PR accuracy ±2 bpm or ±2%, whichever is greater
2
Wavelength range 500nm - 1000nm for all specified sensors
Maximum optical output power 15 15mW for all specified sensors
Data update period Typically 2 seconds, maximum 30 seconds
PR sound PR tone
PR display Numeric
SpO2 waveform sweeping speed 6.25 mm/s, 12.5 mm/s, 25mm/s, 50 mm/s, error undefined
1. Sensor accuracy was obtained by performing controlled hypoxia studies on healthy,

non-smoking adult volunteers (according to EN ISO9919). The SpO2 readings have been
compared to CO-oximeter measurements on arterial blood samples. To represent the general
population, data from at least 10 subjects (male and female) with a wide range of skin color
was taken to validate SpO2 accuracy. A functional tester cannot be used to assess the accuracy
of a pulse oximeter monitor and blood oxygen sensor.

Specifications
2. Information about wavelength ranges can be useful for clinicians performing photo dynamic
therapy.
14.3 RESP Specifications

Table 14-3 RESP Specifications
Type CF
Work mode Thoracic impedance
Respiration rate measurement
0 rpm - 150 rpm, resolution: 1rpm
and alarm limit range
0rpm -120rpm: ±1 rpm
RESP accuracy
121rpm - 150rpm: ±2 rpm
Apnea alarm duration 10s - 60s
6.25 mm/s, 12.5 mm/s, 25mm/s, 50mm/s
Display sweep speeds
Error undefined.
Alarm delay <10s
Waveform gain ×1/2, ×1, ×2, error undefined.
14.4 TEMP Specifications

Table 14-4 TEMP Specifications
Type CF
TEMP measurement and
0˚C- 50˚C (32˚F - 122˚F)
alarm limit range
RESP accuracy ±0.1 ˚C
Unit ˚C or ˚F
Resolution 0.1˚C
Skin surface probe: <10 min
Minimum measuring time
Esophageal/rectal probe: < 2 min
Updating time Approximately 1 second
14.5 NBP Specifications

Table 14-5 NBP Specifications
Type CF
Measuring method Oscillometric method
Measuring parameter SYS, DIA, MAP, PR
Unit mmHg or kPa
Manual
Work mode Auto (3, 5, 10, 15, 30, 60, 90, 120, 240, 480 minutes)
STAT (5 minutes)
For a blood pressure monitor, the differences between
repeated measurements at each point within the scale,
Repeatability
measured at static continuous low pressure, should be no more
than 0.533 kPa (4 mmHg).

Specifications
Regardless of rise or drop in blood pressure, the maximum
NBP sensor accuracy error in measurements within the cuff should be ±0.4 kPa (±3
mmHg) at any measurement point in the range.
Adult/Pediatric:
SYS: 30 mmHg- 254 mmHg (4.0 kPa – 33.9 kPa)
DIA: 10 mmHg- 220 mmHg (1.3 kPa – 29.3 kPa)
NBP measurement and alarm MAP: 20 mmHg - 235 mmHg (2.7 kPa – 31.3 kPa)
limit range Neonate:
SYS: 30 mmHg - 135 mmHg (4.0 kPa – 18.0 kPa)
DIA: 10 mmHg - 110mmHg (1.3 kPa – 14.7 kPa)
MAP: 20 mmHg - 125mmHg (2.7 kPa – 16.7kPa)
Max. Std. Deviation:8 mmHg(1.1 kPa)
NBP accuracy
Max. Mean Error:±5 mmHg (±0.7 kPa)
Adult/pediatric: 0mmHg- 300mmHg (0 kPa- 40.0kPa)
Cuff pressure range
Neonate: 0 mmHg- 150 mmHg (0 kPa- 20.0kPa)
Adult: 160 mmHg (22.7 kPa)
Initial inflation pressure range Pediatric: 120 mmHg (21.3 kPa)
Neonate:90 mmHg (13.3 kPa)
+30 mmHg above the last measured Systolic value (only for
Subsequent cuff inflation
Auto and STAT)
NBP PR measuring range and
40bpm -240bpm
alarm limit range
PR measuring accuracy ±5bpm or ±5%, whichever is greater.
Display resolution 0.133 kPa (1 mmHg)
Static pressure measurement
0.0 kPa -34.7 kPa (0 mmHg -260 mmHg)
range
14.6 Display Specifications

Table 14-6 Display Specifications
Display type Color TFT LCD
Size 26cm (10.4")
Resolution 800x600
14.7 Interface Specifications

Table 14-7 Interface Specifications
Interface Specification
Nurse Call Alarm Output Connector: 3.5 mm phone jack, N.O and N.C contacts
Contact rating:
≤ 1A @ < 25Vac
≤ 1A @ < 60Vdc
Isolation: 1.5 kV
ECG analog output port 5 mm phone jack
USB ports Software upgrade or data export

Specifications
14.8 Power Specifications

Table 14-8 Power Specifications
Mains power input: 100V-240V～, 50 Hz/60 Hz
AC Power
Power input: 115VA
Capacity: 4800mAh
Dimensions: 148mm×60mm×23mm
Weight: 340g
Typical operating time (new, fully charged battery): 2.5 hours
Battery Charging time (energy from 0 to 90%): < 8 hours
Charge mode: Automatic (with charge protection feature) when the
monitor is powered by AC power source.
Discharge protection: When powered by battery, the monitor
powers off when battery power is very low.
Cycle life≥ 300 charges
14.9 Recorder Specifications

Table 14-9 Recorder Specifications
Type Thermal array recorder
Printing mode Real-time, timed and alarm-triggered
Paper width 50mm
Print speed 12.5 mm/s , 25.0mm/s, 50.0mm/s, accuracy ±5%.
14.10 Physical Specifications

Table14-10 Physical Specifications
Net weight (without battery,
3.6kg
recorder)
Gross weight 7.3kg
Dimensions 316mm×265 mm×131mm
Packing Dimensions 351mm×370 mm×329mm
14.11 Environmental Specifications

Table 14-11 Environmental Specifications
Temperature - working 5˚C - 40˚C (41°F – 104°F)
Temperature - storage and for the device-20°C – 55°C (-4°F – 131°F)
transportation for the device plus accessories-20°C – 40°C (-4°F – 104°F)
Relative humidity -
15% – 80%, condensation free
operating

Specifications
Relative humidity - storage 15% – 95%, condensation free
and transportation (15% – 80% with recorder)
Barometric pressure -
70.0 kPa - 106.0 kPa
working
Barometric pressure -
50.0 kPa - 106.0 kPa
storage and transportation

Specifications

Alarm Specifications
Appendix A Alarm Specifications

This appendix describes this information:
 Physiological alarm messages
 Technical alarm messages
 Default alarm limits
 Auto alarm limit formula
A.1 Physiological Alarms

Table A-1 Physiological Alarms
Alarm Message Priority Cause
Asystole No QRS is detected for 4 consecutive minutes (no
High
VF or chaos signal)
The heart rate value has exceeded the high alarm
HR: high Medium
limit.
The heart rate value has dropped below the low
HR: Low Medium
alarm limit.
RESP: Apnea High No RESP signal is detected.
The respiration value has exceeded the high alarm
RESP: RR High Medium
limit
The respiration value has dropped below the low
RESP: RR Low Medium
alarm limit
SpO2: High Medium The SpO2 value has exceeded the high alarm limit.
The SpO2 value has dropped below the low alarm
SpO2: Low Medium
limit.
Adult/Pediatric: The SpO2 value has dropped below
the low alarm limit by 10%.
SpO2: Ultra-low High
Neonate: The SpO2 value has dropped below the
low alarm limit by 5%.
The SpO2 pulse rate has exceeded the high alarm
SpO2: PR High Medium
limit.
The SpO2 pulse rate has dropped below the low
SpO2: PR Low Medium
alarm limit.
The Systolic blood pressure value has exceeded the
NBP: SYS High Medium
high alarm limit.
The Systolic blood pressure value has dropped
NBP: SYS Low Medium
below the low alarm limit.
The Diastolic blood pressure value has exceeded the
NBP: DIA High Medium
high alarm limit.
The Diastolic blood pressure value has dropped
NBP: DIA Low Medium
NBP: MAP High Medium The MAP value has exceeded the high alarm limit.
The MAP value has dropped below the low alarm
NBP: MAP Low Medium
limit.
The NBP pulse rate value has exceeded the high
NBP: PR High Medium
alarm limit.
GS20 Patient Monitor Instructions for Use A-1


The NBP pulse rate value has dropped below the
NBP: PR Low Medium
low alarm limit.
NBP: SYS-DIA The blood pressure difference value has exceeded
High
High the high alarm limit.
The blood pressure difference value has dropped
NBP: SYS-DIA Low High
The temperature 1 value has exceeded the high
TEMP: T1 High Medium
alarm limit.
The temperature 1 value has dropped below the low
TEMP: T1 Low Medium
alarm limit.
The temperature 2 value has exceeded the high
TEMP: T2 High Medium
alarm limit.
The temperature 2 value has dropped below the low
TEMP: T2 Low Medium
alarm limit.
A.2 Technical Alarms

TableA-2 Technical Alarms
There is a monitor failure or communication
ECG: No Signal Medium
between the monitor and alarm function has failed.
The monitor algorithm cannot analyze ECG data
ECG cannot analyze Medium
reliably.
ECG I: Leads Off
ECG II: Leads Off
ECG III: Leads Off
ECG V: Leads Off Medium Not all of the ECG electrodes are connected.
ECG aVR: Leads Off
ECG aVL: Leads Off
ECG aVF: Leads Off
RESP: Leads Off Medium Not all of the ECG electrodes are connected.
RESP: No Signal Medium
RESP: Cardiac Overlay Medium Respiration rate value and HR value are close.
SpO2: No Signal Medium
SpO2: No Sensor Medium The SpO2 sensor is disconnected from the monitor.
SpO2: Interference Medium There is SpO2 interference.
SpO2: Equip Malfunction Medium There has been a SpO2 equipment failure.
SpO2: Sensor Malfunction Medium There has been a SpO2 sensor failure.
There is an irregular SpO2 pulse pattern caused by
SpO2: Noisy Signal Medium excessive patient movement or electrical
interference.
Erratic SpO2 measurement. Often due to a faulty
SpO2: Erratic Medium
sensor, or incorrect positioning of the sensor.
SpO2: Low Perf. Medium The perfusion value is lower than 0.1.
SpO2: Probe Off Medium The SpO2 sensor is off.
NBP: Overpressure Medium The NBP tube may be blocked.
A-2 GS20 Patient Monitor Instructions for Use


NBP: Cuff Position Error Medium The blood pressure cuff is in the wrong position.
NBP: Air Leak Medium There is air leakage.
The blood pressure value has exceeded the pressure
NBP: Out of Range Medium
range limits.
NBP: Measurement Error Medium There is an error in the NBP measurement.
The blood pressure cuff is not connected or placed
NBP: Cuff Loose Medium
correctly.
TEMP: No Signal Medium
TEMP1: Sensor The T1 temperature probe has become
Medium
Disconnected disconnected.
TEMP2: Sensor The T2 temperature probe has become
Medium
Disconnected disconnected.
TEMP1: Self-Test Failed Medium There is an error in T1 self-testing.
TEMP2: Self-Test Failed Medium There is an error in T2 self-testing.
Battery: Low Low Battery power is low.
Battery: Ultra Low High Battery power is extremely low.
CMS: Network The monitor is disconnected from the Central
Low
Disconnected Monitoring System.
EMR: Communication There is a communication error when connecting
Low
Error EMR.
Monitoring Resumed Low The monitoring is interrupted.
A.3 Default Alarm Limits

The following tables show the default alarm limits for all physiological alarms.
Table A-3 Default Alarm Limits
Measurement/Limits Adult Pediatric Neonate
High 120 160 200
HR/PR (bpm)
Low 40 70 90
High 100 100 100
SpO2 (%)
Low 90 90 88
High 40 40 40
RESP (rpm)
Low 6 6 6
High 42.0 42.0 42.0
TEMP (˚C)
Low 30.0 30.0 30.0
Table A-4 Default Alarm Limits
High 160/21.3 120/16.0 100/13.3
NBP sys (mmHg/kPa)
Low 100/13.3 70/9.3 40/5.3
High 100/13.3 70/9.3 60/8.0
NBP DIA (mmHg/kPa)
Low 60/8.0 40/5.3 20/2.7
High 110/14.7 90 /12.0 70 /9.3
NBP MAP (mmHg/kPa)
Low 70 /9.3 50 /6.7 24 /3.2
NBP SYS-DIA High 60/ 8.0 60 /8.0 60/ 8.0
GS20 Patient Monitor Instructions for Use A-3


(mmHg/kPa) Low 20 / 2.7 20 /2.7 20 / 2.7
High 120 160 200
NBP PR (bpm)
Low 40 70 90
A.4 Auto Set Alarms

The following tables list the formulas used for calculating the Auto Set Alarm Limits.
Table A-5 Auto Set Alarm Calculations
Parameter Higher Limit Lower Limit
Adult/Pediatric Neonate Adult/Pediatric Neonate
Heart Rate HR × 1.25 or 299 HR+40 HR × 0.8 or 16 bpm HR-30
bpm (whichever is (180-210 bpm) (whichever is greater) (80 -100 bpm)
smaller)
Respiration RR×1.5 or 30rpm RR+25 RR×0.5 or 4rpm RR-50
(whichever is (75 - 95 rpm) (whichever is greater) (25 - 40 rpm)
smaller)
Pulse Rate Pulse×1.25 or Pulse+40 Pulse×0.8 or 31bpm Pulse-30
(SpO2) 299bpm (whichever (180 -210 bpm) (whichever is greater) (80 -100 bpm)
is smaller)
Pulse Rate Pulse×1.25 or Pulse+40 Pulse×0.8 or 41bpm Pulse-30
(NBP) 239bpm (whichever (180-210 bpm) (whichever is greater) (80 -100 bpm)
is smaller)
Temperature Temp+0.5°C/Temp+ 0.9°F Temp-0.5°C/Temp-0.9°F
SpO2 Same as default alarm limit Same as default alarm limit
Table A-6 Auto Set Alarm Calculations
Higher Limit Lower Limit
Parameter Pediatric Pediatric
Adult/Pediatric Adult/Pediatric
(< age 5) (< age 5)
SYS +15 SYS -15
SYS
(90 -115 mmHg) SYS×0.68+10mmHg (45 - 60 mmHg)
NBP SYS ×0.86+38mmHg
SYS +2 SYS ×0.68+1.3kPa SYS -2
SYS ×0.86+5.1kPa
(12.0 -15.3 kPa) (6.0 -8.0 kPa)
DIA +15 DIA -15
DIA ×0.86+32mmHg (55-75 mmHg) DIA ×0.68+6mmHg (20-40 mmHg)
NBP DIA
DIA ×0.86+4.3kPa DIA +2 DIA ×0.68+0.8kPa DIA -2
(7.3 - 10.0 kPa) (2.7 -5.3 kPa)
MAP +15 MAP -15
MAP
(65-75 mmHg) MAP×0.68+8mmHg (35 -45 mmHg)
NBP MAP ×0.86+35mmHg
MAP +2 MAP ×0.68+1.1kPa MAP -2
MAP ×0.86+4.7kPa
(8.7 -10.0 kPa) (4.7 - 6.0 kPa)
A-4 GS20 Patient Monitor Instructions for Use

Electromagnetic Compatibility (EMC)
Appendix B Electromagnetic Compatibility

(EMC)
This appendix lists the tests and compliance levels that make the GS20 Patient Monitor suitable for
use in the specified electromagnetic environment according to YY0505-2012.
B.1 Instructions for Use

Medical electrical equipment can either generate or receive electromagnetic interference. This
product has been evaluated for electromagnetic compatibility (EMC) with the appropriate
accessories according to YY0505-2012. Radio frequency (RF) interference from nearby
transmitting devices can degrade performance of the product. Electromagnetic compatibility with
surrounding devices should be assessed prior to using the product.
Fixed, portable, and mobile radio frequency communications equipment can also affect the
performance of medical equipment. See your service provider for assistance with the minimum
recommended separation distance between RF communications equipment and the product.
The cables, sensors/transducers, and other accessories for which compliance is claimed are listed in
this manual.
Warning Use of accessories, transducers, and cables other than those specified may
result in increased emissions and/ or decreased immunity of the GS20 Patient
Monitor.
The GS20 Patient Monitor should not be used adjacent to or stacked with other
equipment. If adjacent or stacked use is necessary, the monitor should be
observed to verify normal operation in the configuration in which it is used.
Caution The following ports of the GS20 Patient Monitor are sensitive to ESD during
monitoring:
SpO2
ECG
To reduce ESD, please follow these instructions:
Do not contact the connector pins.
Ensure that the following ESD precautions are applied when connecting and
disconnecting the port cables:
— Make sure the operator is grounded before connecting the cable or
touching the grounded metal.
— Wear ESD grounded ribbon and ESD protective cloths.
— Provide ESD training for all users. Users should understand what is ESD,
how does it cause damage and how to prevent it.
GS20 Patient Monitor Instructions for Use B-1

B.2 Guidance and Manufacturer's EMC Declaration

The GS20 Patient Monitor is intended for use in the electromagnetic environment specified in the
following tables. The customer or the user of the GS20 Patient Monitor should assure that they are
used in such an environment.
B.2.1 Electromagnetic Emissions for All Equipment and Systems

The following table shows electromagnetic emissions to all equipment and system.
Table B-1 Electromagnetic Emissions for All Equipment and Systems
Emission test Compliance Electromagnetic Environment Guidance

The GS20 Patient Monitor uses RF energy only for
RF emissions its internal function. Therefore, its RF emissions are
Group 1
GB4824 very low and are not likely to cause any interference
in nearby electronic equipment.
RF emissions
Class A
GB4824
Harmonic emissions
Class A
GB17625.1 The GS20 Patient Monitor is suitable for use in all
establishments, other than domestic establishments.
Voltage
fluctuations/flicker
Complies
emissions
GB17625.2
B-2 GS20 Patient Monitor Instructions for Use

B.2.2 Electromagnetic Immunity for All Equipment and Systems

The following table shows electromagnetic immunity for all equipment and system.
Table B-2 Electromagnetic Immunity for All Equipment and Systems
YY0505 Testing Compliance Electromagnetic Environment

Immunity Test
Level Level — Guidance
Floors should be wood, concrete
Electrostatic or ceramic tile. If floor are
±6kV contact ±6kV contact
discharge (ESD) covered with synthetic material,
±8kV air ±8kV air
GB/T17626.2 the relative humidity should be
at least 30%.
Electrical fast Mains power quality should be
±2kV for power ±2kV for power
transient/burst that of a typical commercial or
supply lines supply lines
GB/T17626.4 hospital environment.
±1kV differential ±1kV differential
Mains power quality should be
Surge mode mode
that of a typical commercial or
GB/T17626.5 ±2kV common ±2kV common
hospital environment.
mode mode
＜5% UT for 0.5 ＜5% UT for 0.5
cycle cycle
(＞95% dip in (＞95% dip in
Mains power quality should be
UT) UT)
that of a typical commercial or
Voltage dips,
hospital environment. If the user
short interruptions 40% UT for 5 40% UT for 5
of the GS20 patient monitor
and voltage cycle cycle
requires continued operation
variations on (60% dip in UT) (60% dip in UT)
during power mains
power supply
interruptions. It is recommended
input lines 70% UT for 25 70% UT for 25
that the GS20 be powered from
GB/T 17626.11 cycle cycle
an uninterruptible power supply
(30% dip in UT) (30% dip in UT)
or a battery.
＜5% UT for 5s ＜5% UT for 5s
(＞95% dip in (＞95% dip in
UT) UT)
Power frequency magnetic fields
Power frequency
should be at levels characteristic
magnetic field
3A/m 3A/m of a typical location in a typical
(50Hz /60Hz)
commercial or hospital
GB/T 17626.8
environment.
Remark: UT is the AC mains voltage prior to application of the test level.

B.2.3 Electromagnetic Immunity for Equipment and Systems not

Life-Supporting
The following table shows electromagnetic immunity for equipment and systems not
life-supporting.
Table B-3 Electromagnetic Immunity for Equipment and Systems not Life-Supporting
YY0505 Testing Electromagnetic Environment
Immunity Test Compliance
Level — Guidance
Portable and mobile RF
communications equipment should
be used no closer to any part of the
GS20 patient monitor, including
cables, than the recommended
separation distance calculated from
the equation applicable to the
frequency of the transmitter.
Recommended separation distance
d =[3.5/ V1] p
d =[3.5/ E1] p
3V (effective 80MHz -800MHz
Conducted RF
value) [V1] V (effective
GB/T 17626.6 d =[7/ E1] p
150kHz-80MHz value)
800MHz - 2.5GHz
Radiated RF P — the maximum output power
3V/m [E1] V/m
GB/T 17626.3 rating of the transmitter in watts
80MHz-2.5GHz
(W) according to the transmitter
manufacturer;
d — the recommended separation
distance in meters (m).
Field strengths from fixed RF
transmitters, as determined by an
electromagnetic site survey should
be less than the compliance level in
each frequency range.
Interference may occur in the
vicinity of equipment marked with
the following symbol:

Remarks: At 80MHz and 80MHz, the field strength for the higher frequency range applies.
1. Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV
broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic
environment due to fixed RF transmitters, an electromagnetic site survey should be
considered. If the measured field strength in the location in which the GS20 patient monitor is
used exceeds the applicable RF compliance level above, the GS20 patient monitor should be
observed to verify normal operation. If abnormal performance is observed, additional
measures may be necessary, such as reorienting or relocating the GS20 patient monitor.
2. Over the frequency range 150 kHz to 80 MHz, field strengths should be less than [V1] V/m.

B.2.4 Recommended Separation Distances

The GS20 patient monitor is intended for use in an electromagnetic environment in which radiated
RF disturbances are controlled. The customer or the user of the GS20 patient monitor can help
prevent electromagnetic interference by maintaining a minimum distance between portable and
mobile RF communications equipment (transmitters) and the GS20 patient monitor as
recommended below, according to the maximum output power of the communications equipment.
The following table shows the recommended separation distances between portable and mobile RF
communications equipment and GS20 patient monitor.
Table B-4 Recommended Separation Distances
Separation Distance According to Frequency of

Transmitter /m
Rated Maximum Output 150 kHz - 80 80MHz
Power of Transmitter (W) MHz 800 MHz-2.5GHz
-800MHz
d =[3.5/ V1] p d =[3.5/ E1] p
d =[7/ E1] p
0.01 0.12 0.12 0.23

0.1 0.38 0.38 0.73
1 1.2 1.2 2.3
10 3.8 3.8 7.3
100 12 12 23
1. For transmitters rated at a maximum output power not listed above, the recommended
separation distance (d) in meters (m) can be estimated using the equation applicable to the
frequency of the transmitter, where P is the maximum output power rating of the transmitter
in watts (W) according to the transmitter manufacturer.
Note — At 80 MHz and 800 MHz, the separation distance for the higher frequency range
applies.
These guidelines may not apply in all situations. Electromagnetic propagation is affected
by absorption and reflection from structures, objects and people.


Manufacturer’s address
No. 2 Keji North 3rd Road, Nanshan District,
Shenzhen P.R.China 518057
© 2019 Philips Goldway (Shenzhen) Industrial Inc.

All rights are reserved. Reproduction or transmission in whole or in part, in any form or by any means, electronic, mechanical or otherwise, is prohibited
without the prior written consent of the copyright owner.
Printed in China
P/N: 453564883131 Revision A
*453564883131*
*A*

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Instructions for Use

Instructions for Use

Symbol Description Symbol Description

On/Standby key Audio Pause key

Alarm Pause key Waveform Freeze key

NBP key Print key

Fragile, handle with

Recovery Keep upright

Humidity limitation Maximum stacking

Date of manufacture Power LED

Equipotential grounding Charging LED

Non-ionizing radiation On/Off LED

Nurse call connector Manufacturer address

Compliance to WEEE Compliance to WEEE

USB port Serial number

Catalogue number Configuration number

Lot number Key code

GS20 Patient Monitor Instructions for Use iii

Typeface Usage Example

iv GS20 Patient Monitor Instructions for Use

vi GS20 Patient Monitor Instructions for Use

Chapter 2 Basic Operation ................................................................................................... 2-1

Chapter 3 Alarms .................................................................................................................. 3-1

Chapter 4 Monitoring ECG ................................................................................................. 4-1

Contents - 2 GS20 Patient Monitor Instructions for Use

Chapter 5 Monitoring Respiration ...................................................................................... 5-1

Chapter 6 Monitoring SpO2 ................................................................................................. 6-1

GS20 Patient Monitor Instructions for Use Contents - 3

Chapter 7 Monitoring NBP .................................................................................................. 7-1

Chapter 8 Monitoring Temperature .................................................................................... 8-1

Chapter 9 Viewing Trend Data ............................................................................................ 9-1

Contents - 4 GS20 Patient Monitor Instructions for Use

Chapter 10 Calculation ....................................................................................................... 10-1

Chapter 11 Using the Recorder .......................................................................................... 11-1

GS20 Patient Monitor Instructions for Use Contents - 5

Chapter 13 Accessories ....................................................................................................... 13-1

Chapter 14 Specifications ................................................................................................... 14-1

Appendix A Alarm Specifications ....................................................................................... A-1

Appendix B Electromagnetic Compatibility (EMC) ......................................................... B-1

GS20 Patient Monitor Instructions for Use Contents - 7

Figure 1-1 GS20 Patient Monitor

1.1 Indications for Use

1.2 Intended Use

GS20 Patient Monitor Instructions for Use 1-1

1.4 Major Parts

1.4.1 The Front Panel

Figure 1-2 GS20 Front Panel

1-2 GS20 Patient Monitor Instructions for Use

8 NBP key Press to start or stop an NBP measurement.

9 Print key Press to start or stop printing.

12 None Alarm LED Please refer to 3.4.1 “Alarm LEDs”.

13 None Handle Used for lifting up the monitor.

1.4.2 The Rear Panel

Figure 1-3 GS20 Rear Panel

3 Ethernet port Standard network connector.

GS20 Patient Monitor Instructions for Use 1-3

4 ECG analog output port Connects to ECG analog output cable

5 None AC power socket Used for connecting to AC power cord.

7 Equipotential grounding Connects to the grounding system

8 None Heat outlet Heat outlet of the monitor.

Warning — Never block the monitor’s heat outtake during operation.