BCI Advisor User manual

Advisor® Vital Signs Monitor
Service Manual
-English
Catalog Number 1887R
Version 2, June 2008
©2008 Smiths Medical family of companies. All rights reserved.

Table of Contents
Advisor®Service Manual i
Table of Contents
Revision History....................................................................................................................... v
Warranty and Service Information....................................................................................... vii
Proprietary Notice ..................................................................................................................................................................................vii
Warranty ....................................................................................................................................................................................................vii
Limited Warranty............................................................................................................................................................................vii
Disclaimer of Warranties..............................................................................................................................................................vii
Conditions of Warranty................................................................................................................................................................vii
Limitation of Remedies................................................................................................................................................................vii
Warranty Procedure .................................................................................................................................................................... viii
CE Notice ................................................................................................................................................................................................. viii
Chapter 1: Introduction....................................................................................................... 1-1
About This Manual ...............................................................................................................................................................................1-1
Replacing Components......................................................................................................................................................................1-1
Conventions ...........................................................................................................................................................................................1-1
Denition of Symbols .........................................................................................................................................................................1-2
General Warnings, Cautions, and Notes.......................................................................................................................................1-3
ECG Warnings, Cautions, and Notes...............................................................................................................................................1-7
Impedance Respiration Warnings, Cautions, and Notes ........................................................................................................1-8
Oximetry Warnings, Cautions, and Notes....................................................................................................................................1-8
Non-invasive Blood Pressure Warnings, Cautions, and Notes........................................................................................... 1-10
Invasive Blood Pressure Warnings, Cautions, and Notes..................................................................................................... 1-11
Temperature Warnings, Cautions, and Notes.......................................................................................................................... 1-11
Capnograph Warnings, Cautions, and Notes........................................................................................................................... 1-12
Chapter 2: Routine Maintenance......................................................................................... 2-1
General Cleaning ..................................................................................................................................................................................2-1
Performance and Safety Checks .....................................................................................................................................................2-1
System, Cables, and Cords Inspection ..........................................................................................................................................2-1
Non-invasive Blood Pressure Calibaration Verication...........................................................................................................2-2
ECG Calibration Verication..............................................................................................................................................................2-3
CO2HILO Calibration ...........................................................................................................................................................................2-5
Critical Failure Alarm (CFA) Verication ........................................................................................................................................2-6
Performing Patient Safety Checks..................................................................................................................................................2-7
General Requirements ...............................................................................................................................................................2-7
Ground Resistance Check..................................................................................................................................................................2-7
Enclosure Leakage Current ...............................................................................................................................................................2-8
Patient Leakage Current.....................................................................................................................................................................2-8
Dielectric Withstand - Hi-pot Test...................................................................................................................................................2-9

Table of Contents
ii Advisor®Service Manual
Chapter 3: Block Level Description ..................................................................................... 3-1
Advisor® Vital Signs Monitor Product Description....................................................................................................................3-1
AC Power Entry Board.........................................................................................................................................................................3-1
Universal AC to DC Power Supply Assembly ..............................................................................................................................3-2
DC Power Interconnect Board .........................................................................................................................................................3-2
Battery Charger Board (Rechargeable Battery Option) ..........................................................................................................3-2
SpO2(Pulse Oximetry) Board............................................................................................................................................................3-2
Non-Invasive Blood Pressure (NIBP) Assembly ..........................................................................................................................3-3
LCD Backlight Inverter Board ...........................................................................................................................................................3-3
Printer Adapter Board (Printer Option).........................................................................................................................................3-3
CO2Module (Optional) .......................................................................................................................................................................3-3
Main Board..............................................................................................................................................................................................3-4
Main Board - Microprocessor...................................................................................................................................................3-4
Main Board - Reset System.......................................................................................................................................................3-4
Main Board - Clocks.....................................................................................................................................................................3-4
Main Board - System Programmable Logic Device (PLD)..............................................................................................3-4
Main Board - Memory.................................................................................................................................................................3-5
Main Board - Video Generation...............................................................................................................................................3-5
Main Board - Audio Generation..............................................................................................................................................3-5
Main Board - Logic Power and Patient Isolation Power .................................................................................................3-5
Main Board - Thermal Printer Interface (Optional)...........................................................................................................3-5
Main Board - Communications Port (Optional) and Smart Media Interface..........................................................3-6
Main Board - Front Panel Interface........................................................................................................................................3-6
Main Board - Critical Failure Alarm System.........................................................................................................................3-6
Main Board - Digital Signal Processor (Isolated Side) .....................................................................................................3-7
Main Board - Patient Signal Acquisition (Isolated Side).................................................................................................3-7
Main Board - ECG (Isolated Side)............................................................................................................................................3-7
Main Daughter Board - Impedance Respiration Option (Isolated Side) ..................................................................3-8
Main Daughter Board - IBP & Temperature Option (Isolated Side)............................................................................3-8
Main Board - Isolated Power Supply.....................................................................................................................................3-9
Main Board - Isolated Communications ..............................................................................................................................3-9
Chapter 4: Diagrams............................................................................................................. 4-1
Chapter 5: ECG Technical Reference.................................................................................... 5-1
Respiration Leado Sensing and Active Noise Suppression ................................................................................................5-1
Tall T-Wave Rejection Capability......................................................................................................................................................5-1
Heart Rate Averaging Method and Display Update Rate.......................................................................................................5-1
Heart Rate Meter Accuracy and Response to Irregular Rhythm..........................................................................................5-1
Response Time of Heart Rate Meter to Change in Heart Rate .............................................................................................5-1
Time to Alarm for Tachycardia .........................................................................................................................................................5-1
Display Aspect Ratio............................................................................................................................................................................5-2
Pacemaker Pulse Rejection Capability..........................................................................................................................................5-2
Audible Alarms......................................................................................................................................................................................5-2

Table of Contents
Advisor®Service Manual iii
Visual Alarms..........................................................................................................................................................................................5-2
Line Isolation Transients.....................................................................................................................................................................5-2
Electrode Polarization.........................................................................................................................................................................5-3
Auxiliary Outputs (Optional) ............................................................................................................................................................5-3
Audible Alarm Silencing.....................................................................................................................................................................5-3
Appendix.......................................................................................................................... App-1
Parts Lists, Assembly Drawings, and Schematics................................................................................................................App-1
The serial autocorrelation technology in the monitor is covered by U.S. Patent No. 5,558,096.
BCI, Advisor and the Smiths design mark are trademarks of the Smiths Medical family of companies. The symbol
indicates the trademark is registered in the U.S. Patent and Trademark Oce and certain other countries. All
other names and marks mentioned are the trade names, trademarks or service marks of their respective owners.

Table of Contents
iv Advisor®Service Manual
This page is intentionally left blank.

Revision History
Advisor®Service Manual v
REVISION DATE COMMENT
Rev. 2 June, 2008 Added Design frame, Smiths Medical logo and BCI lozenge to front•
cover.
Added Australian Representative to Warranty section and back•
cover.
Added WEEE Recycling instructions.•
Added warnings about AC Power.•
Added warning about the oximeter displaying dashes under certain•
conditions.
Changed some cautions and notes to warnings.•
Added cautions about certain cleaning agents causing brittleness of•
plastics.
REVISION DATE COMMENT
Rev. 1 October, 2006 Added new Patient Safety checks to Chapter 2: Ground Resistance•
Check, Enclosure Leakage Current, Patient Leakage Current, and
Dielectric Withstand- Hi-pot Test.
Updated HILO Calibration section in chapter 2.•
Updated Line Art.•
Updated patent and trademark statements.•
Moved Warranty and Service Information from Chapter one to new•
section.
Updated Proprietary Notice in Warranty Section.•
Updated Warranty and Service information.•
Added CE Notice to Warranty section and back cover.•
Updated corporate symbols and denitions.•
Updated warnings, cautions, and notes.•
Added Dangerous voltage symbols to applicable warnings in•
Chapter 2.
New page numbering scheme for appendix drawings.•
Revision History

Revision History
vi Advisor®Service Manual
This page is intentionally left blank.

Warranty and Service Information
Advisor®Service Manual vii
Proprietary Notice
Information contained in this document is copyrighted by Smiths Medical PM, Inc. and may not be duplicated in
full or part by any person without prior written approval of Smiths Medical PM, Inc. Its purpose is to provide the
user with adequately detailed documentation to eciently install, operate, maintain, and order spare parts for
the device supplied. All information contained in this document is believed to be current and accurate as of the
date of publication or revision, but does not constitute a warranty.
Warranty
Limited Warranty
Smiths Medical PM, Inc. (“Seller”) warrants to the original purchaser that the Product, not including accessories,
shall be free from defects in material and workmanship under normal use, if used in accordance with its labeling,
for one year from the date of shipment to the original purchaser.
Seller warrants to the original purchaser that the reusable oximeter sensors supplied as accessories, shall be free
from defects in materials and workmanship under normal use, if used in accordance with its labeling, for one
year from the date of shipment to the original purchaser (USA only).
Disclaimer of Warranties
THE FOREGOING EXPRESS WARRANTY, AS CONDITIONED AND LIMITED, IS IN LIEU OF AND EXCLUDES ALL
OTHER WARRANTIES WHETHER EXPRESS OR IMPLIED, BY OPERATION OF LAW OR OTHERWISE, INCLUDING
BUT NOT LIMITED TO, ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR
PURPOSE.
Seller disclaims responsibility of the suitability of the Product for any particular medical treatment or for any
medical complications resulting from the use of the Product. This disclaimer is dictated by the many elements
which are beyond Seller’s control, such as diagnosis of patient, conditions under which the Product may be used,
handling of the Product after it leaves Seller’s possession, execution of recommended instructions for use and
others.
Conditions of Warranty
This warranty is void if the Product has been altered, misused, damaged by neglect or accident, not properly
maintained or recharged, or repaired by persons not authorized by Seller. Misuse includes, but is not limited to,
use not in compliance with the labeling or use with accessories not manufactured by Seller. This warranty does
not cover normal wear and tear and maintenance items.
Limitation of Remedies
The original purchaser’s exclusive remedy shall be, at Seller’s sole option, the repair or replacement of the
Product. THIS IS THE EXCLUSIVE REMEDY. In no event will Seller’s liability arising out of any cause
whatsoever (whether such cause is based on contract, negligence, strict liability, tort or otherwise) exceed
the price of the Product and in no event shall Seller be responsible for consequential, incidental, or
special damages of any kind or nature whatsoever, including but not limited to, lost business, revenues,
and prots.
Warranty and Service Information

Warranty and Service Information
viii Advisor®Service Manual
Warranty Procedure
To obtain warranty service in the USA, you must request a Customer Service Report (CSR) number from Technical
Service. Reference the CSR number when returning your Product, freight and insurance prepaid, to:
Smiths Medical PM, Inc.,
N7 W22025 Johnson Drive,
Waukesha, WI 53186-1856
Phone: [phone]
Fax: [phone]
Toll Free: 1 800 558 2345 (USA only)
Seller will not be responsible for unauthorized returns or for loss or damage to the Product during the return
shipment. The repaired or replaced Product will be shipped, freight prepaid, to Purchaser.
To obtain warranty information outside of the USA, contact your local distributor.
Keep all original packing material, including foam inserts. If you need to ship the device, use only the original
packaging material, including inserts. Box and inserts should be in original condition. If original shipping
material in good condition is not available, it should be purchased from Smiths Medical PM, Inc.
Damages occurred in transit in other than original shipping containers are the responsibility of the shipper. All
costs incurred returning devices for repair are the responsibility of the shipper.
CE Notice
@Marking by the symbol 2indicates compliance of this device to the Medical Device Directive
93/42/EEC.
Authorized Representative (as dened by the Medical Device Directive):
Smiths Medical International Ltd.
Colonial Way, Watford, Herts,
WD24 4LG, UK
Phone: [phone]
Fax: [phone]
Australian Representative:
Smiths Medical Australasia Pty. Ltd.
61 Brandl Street, Eight Mile Plains,
QLD 4113, Australia
Tel: [phone]

Chapter 1: Introduction
Advisor®Service Manual 1-1
About This Manual
This manual is intended for persons trained in service, maintenance, and repair of modern electronic medical
equipment. It provides service maintenance, troubleshooting, and detailed electronic circuit descriptions for the
Advisor®Vital Signs Monitor. Thorough knowledge of this monitor’s operation, as described in the Advisor® Vital
Signs Operation Manual, is required before attempting to repair this equipment.
These instructions contain important information for safe use of the product. Read the entire contents
of these Instructions For Use, including Warnings and Cautions, before using the Advisor®Vital Signs
Monitor. Failure to properly follow warnings, cautions and instructions could result in death or serious
injury to the patient.
Replacing Components
When replacing components, always use parts with the same or better tolerance factors. For example, do not
replace a 1% tolerance resistor with a 5% tolerance resistor, or a 10% tolerance capacitor with a 20% tolerance
capacitor.
Spare components and subassemblies are available from the manufacturer. See Parts Lists, Assembly Drawings,
and Schematics for more information.
Conventions
CONVENTION DESCRIPTION
U14A IC number U14, gate A as shown on the schematic.
U7-7 IC number 7, pin number 7, as shown on the schematic.
Chapter 1: Introduction

Chapter 1: Introduction
1-2 Advisor®Service Manual
Denition of Symbols
SYMBOL DEFINITION
6Caution: Federal (U.S.A.) law restricts this device to sale by or on the order of a physician.
qDebrillator-proof type CF equipment
gAttention, see instructions for use.
1Dangerous voltage.
7Refer servicing to qualied service personnel.
DOutput
0Loudspeaker
wFuse
yDate of Manufacture
<Catalog Number
>Serial Number
IPX1 Drip Proof
1Non AP Device
tGraphical Recorder
8Use by
xOn/O *
→Q←IBP Zero All *
hNIBP Start/Stop *
FPrint Start/Stop *
BAlarm Silence *
XAC Power LED *
MBattery Charge LED *
* International Symbols

Chapter 1: Introduction
Advisor®Service Manual 1-3
Z
Collect
separately
Disposal (EU Countries)
Under the Waste Electrical and Electronic Equipment (WEEE) Directive 2006/96/EC and
implementing regulations, all devices and service items within the scope of the Directive
purchased new after August 13, 2005 must be sent for recycling when ultimately becoming
waste. Devices and items must not be disposed of with general waste.
If purchased before that date, they may also be sent for recycling if being replaced on a
one-for-one, like-for-like basis (this varies depending on the country). Recycling instructions
to customers using Smiths Medical products are published on the internet at:
http://www.smiths-medical.com/recycle
Y
Disposal (other countries)
When disposing of this device, its batteries or any of its accessories, ensure that any
negative impact on the environment is minimized. Contact your local waste disposal service
and use local recycling or disposal schemes. Separate any other parts of the equipment
where arrangements can be made for their recovery; either by recycling or energy recovery.
The main batteries are potentially harmful and will require separate disposal according to
manufacturer’s instructions or local regulations.
Note: If applicable, EU, national or local regulations concerning waste disposal must
take precedence over the above advice.
KEYWORD DEFINITION
WARNING Tells you about something that could hurt the patient or hurt the operator
CAUTION Tells you about something that could damage the monitor
NOTE Tells you other important information
General Warnings, Cautions, and Notes
WARNING! Do not use this device in the presence of ammable anesthetics.
WARNING! ELECTRICAL SHOCK HAZARD when covers are removed. Unit is not user serviceable.
7 Refer servicing to qualied personnel.
WARNING! Do not plug the monitor into an outlet controlled by a wall switch.
WARNING! This device is intended for use by trained healthcare professionals. The operator must be
thoroughly familiar with the information in the operation manual before using the device.
WARNING! This monitor is not for apnea detection. The monitor has not been tested or validated for use
in apnea detection.
WARNING! This monitor is not for home use.
WARNING! Verify proper operating mode before attaching patient. See Select the Patient Type in the
1886R operation manual Chapter 3: Setting Up the Monitor.
WARNING! Do not use this device in the presence of magnetic resonance imaging (MR or MRI)
equipment.
WARNING! Operation of this device may be adversely aected in the presence of computed tomography
(CT) equipment.
WARNING! Operation of this device may be aected in the presence of strong portable and mobile
communications equipment.

Chapter 1: Introduction
1-4 Advisor®Service Manual
WARNING! In the event that earth ground integrity is lost, the performance of this device and/or other
devices nearby may be aected due to excessive RF emissions.
WARNING! The 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
conguration in which it will be used.
WARNING! Equipment is protected against debrillator discharge. Rate meters and displays may be
temporarily aected during debrillation, but will rapidly recover.
WARNING! Where HF (diathermy) is used there is no danger of burning to the patient provided
recommended components are used. Rate meters may be temporarily aected.
WARNING! This device must be used in conjunction with clinical signs and symptoms. This device is only
intended to be an adjunct in patient assessment.
WARNING! If the accuracy of any measurement is in question, check the patient’s vital sign(s) by an
alternative method and then check the monitor for proper functioning.
WARNING! This monitor will not operate eectively on patients who are experiencing convulsions or
tremors.
WARNING! Do not autoclave, ethylene oxide sterilize, or immerse the monitor and other accessories in
liquid. Evidence that liquid has been allowed to enter the monitor voids the warranty.
WARNING! Any monitor that has been dropped or damaged should be checked by qualied service
personnel to ensure proper operation prior to use.
WARNING! Use only original manufacturer or recommended patient cables. Use of accessories other than
those specied may result in increased electro-magnetic (EM) emissions or decreased EM
immunity of the device. To avoid potential electro-static discharge interference, do not use
cables that incorporate metal or metal-coated connectors.
WARNING! There is no debrillator synchronization output on the monitor. Make no connections
between the monitor and a debrillator.
WARNING! Medical electrical equipment, including this device, needs special precautions regarding
electro-magnetic compatibility (EMC) and needs to be installed and put into service
according to the EMC information provided in this manual.

Chapter 1: Introduction
Advisor®Service Manual 1-5
WARNING! The vital signs monitor is suitable for use within the patient environment IEC 60950 approved
equipment must be placed outside of the patient environment. The patient environment is
dened as any volume in which intentional or unintentional contact can occur between the
patient and parts of the system or between the patient and other persons touching parts of
the system.
Figure 1.1: Patient Environment (side)
The dimensions are not prescriptive.
Figure 2.1: Patient Environment (top)
The dimensions are not prescriptive.
WARNING! When connecting this monitor to any instrument, verify proper operation before clinical use.
Use only equipment meeting specications given in this manual. Refer to the instrument’s
user manual for full instructions. Accessory equipment connected to the monitor’s data
interface must be certied according to the respective IEC standards, i.e. IEC 60950 for data
processing equipment or IEC 60601-1 for electro medical equipment. All combinations
of equipment must be in compliance with IEC 60601-1-1 systems requirements. Anyone
connecting additional equipment to the signal input port or signal output port congures a
medical system, and therefore, is responsible that the system complies with the requirements
of the system standard IEC 60601-1-1.
WARNING! Disconnect the AC power supply from the outlet before disconnecting it from the monitor.
Leaving the AC power supply connected to an AC power outlet without being connected to
the monitor may result in a safety hazard.
WARNING! Do not allow any moisture to touch the AC power supply connectors or a safety hazard may
result. Ensure that hands are thoroughly dry before handling the AC power supply.
WARNING! Do not place the monitor in the patient’s bed or crib. Do not place the monitor on the oor.
WARNING! Failure to place the monitor away from the patient may allow the patient to turn o, reset, or
damage the monitor, possibly resulting in the patient not being monitored. Make sure the
patient cannot reach the monitor from their bed or crib.
WARNING! If there is a risk of the AC power supply becoming disconnected from the monitor during use,
secure the cord to the monitor several inches from the connection.

Chapter 1: Introduction
1-6 Advisor®Service Manual
WARNING! Ensure the monitor’s AC rating is correct for the AC voltage at your installation site before
using the monitor. The monitor’s AC rating is shown on the rear panel rating plate. If the
rating is not correct, do not use the monitor.
WARNING! It is the operator’s responsibility to set alarm limits appropriately for each individual patient.
WARNING! Default alarm limits are provided for convenience. Verify that alarm limits are appropriate for
given patient and condition, and adjust according to institutional policy.
CAUTION! Do not allow water or any other liquid to be spilled onto the monitor. Unplug the AC power
cord from the monitor before cleaning or disinfecting the monitor.
CAUTION! This unit contains a lithium ion battery and a rechargeable alkaline battery. These batteries
are not user replaceable. 7 Refer servicing to qualied personnel.
CAUTION! This unit may contain a nickel-metal-hydride battery. Disposal of this battery should be
conducted in accordance with local or federal guidelines. Smiths Medical PM, Inc. cannot
dispose of this battery.
CAUTION! Pressing front panel keys with sharp or pointed instruments may permanently damage the
keypad. Press the front panel keys only with your nger.
CAUTION! Blocking the ventilation holes on the monitor’s rear panel can prevent air circulation inside
the monitor, possibly resulting in damage to the monitor. Leave an air gap behind the monitor
to allow air to circulate through the ventilation holes.
CAUTION! If the device becomes wet, wipe o all moisture and allow sucient time for drying before
operating.
CAUTION! The monitor should be operated from its internal power source (if tted) if the integrity of the
protective earth conductor is in doubt.
CAUTION! Chemicals used in some cleaning agents may cause brittleness of plastic parts. Follow
cleaning instructions in this manual.
CAUTION! Follow local governing ordinances and recycling instructions regarding disposal and recycling
of device components and packaging.
NOTE! All user and patient accessible materials are non-toxic.
NOTE! Each input and output connection of the monitor is electrically isolated. Connection of this
monitor to other equipment will not increase leakage current.

Chapter 1: Introduction
Advisor®Service Manual 1-7
ECG Warnings, Cautions, and Notes
WARNING! PACEMAKER PATIENTS: Rate meters or rate detection software may continue to count the
pacemaker rate during occurrences of cardiac arrest or some arrhythmias. Do not rely entirely
upon rate meter alarms. Keep pacemaker patients under close surveillance. See this manual
for disclosure of the pacemaker pulse rejection capability of this instrument.
WARNING! PACEMAKER PATIENTS: If PACE DETECT is not turned on when monitoring pacemaker
patients, the heart rate readouts derived from the ECG patient connections are likely to
display erroneous high or erratic rates. Keep pacemaker patients under close surveillance. For
pacemaker patients, it may be advisable to select the SpO2 parameter as the primary heart
rate source.
WARNING! Connect only three-lead or ve-lead ECG lead wires from the patient to the ECG patient cable.
Do not connect any other signal source to the ECG patient cable.
WARNING! False low heart rate indicators or false Asystole calls may result with certain pacemakers
because of electrical overshoots.
WARNING! Reliable monitoring of pacemaker patients can only occur with PACE DETECT on.
WARNING! The pacemaker pulse marker shape and size is not to be diagnostically interpreted.
WARNING! Keep pacemaker patients under close observation. Rate detection in the software may
continue to count the pacemaker rate during cardiac arrest and/or arrhythmia conditions.
Therefore, do not rely solely on rate detection alarms.
WARNING! This monitor does not identify or interpret arrhythmia events. The indication of heart rate
may be adversely aected by the presence of cardiac arrhythmias.
CAUTION! A three-lead ECG cable must be used if 3-Lead processing is selected. A ve-lead ECG cable
must be used if 5-Lead processing is selected. Using the incorrect cable for the selected mode
might lead to a oating reference or additional noise on the ECG signal.
NOTE! Follow institutional standards when applying ECG electrodes. Silver/Silver Chloride disposable
electrodes are strongly recommended to avoid polarization eects that result in large input oset
potentials. Use of “squeeze bulb”type electrodes is not recommended.
NOTE! Use only standard AAMI three-lead or ve-lead ECG cables.
NOTE! Line isolation monitor transients may resemble actual cardiac waveforms and thus inhibit heart
rate alarms.

Chapter 1: Introduction
1-8 Advisor®Service Manual
Impedance Respiration Warnings, Cautions, and Notes
WARNING! This monitor is not for apnea detection. The monitor has not been tested or validated for use
in apnea detection.
WARNING! Electrodes of dissimilar metals should not be used.
WARNING! The monitor may not detect all episodes of inadequate breathing.
CAUTION! Ensure conductive parts, including electrodes of the patient cable, do not come into contact
with any conductive surfaces or earth parts.
CAUTION! The respiration parameter is disabled when the monitor is in the neonate operating mode.
NOTE! Follow institutional standards when applying ECG electrodes.
NOTE! The ECG/Respiration cable uses a standard AAMI three-lead or ve-lead ECG/Respiration
connector. Use only standard AAMI three-lead or ve-lead ECG wires.
NOTE! The ECG/Respiration patient circuit is electrically isolated.
NOTE! The monitor is protected against damage from debrillator, diathermy, and electrocautery
discharge.
Oximetry Warnings, Cautions, and Notes
WARNING! Prolonged use or the patient’s condition may require changing the sensor site periodically.
Change the sensor site and check skin integrity, circulatory status, and correct alignment at
least every 4 hours.
WARNING! When attaching sensors with Microfoam®tape, do not stretch the tape or attach the tape too
tightly. Tape applied too tightly may cause inaccurate readings and blisters on the patient’s
skin (lack of skin respiration, not heat, causes the blisters).
WARNING! Using a damaged sensor may cause inaccurate readings, possibly resulting in patient injury
or death. Inspect each sensor. If a sensor appears damaged, do not use it. Use another sensor
or contact your authorized repair center for help.
WARNING! Using a damaged patient cable may cause inaccurate readings, possibly resulting in patient
injury or death. Inspect the patient cable. If the patient cable appears damaged, do not use it.
Contact your authorized repair center for help.
WARNING! If any of the integrity checks fail, do not attempt to monitor the patient. Use another sensor
or patient cable, or contact the equipment dealer for help if necessary.
WARNING! Use only SpO2sensors supplied with, or specically intended for use with, this device.
WARNING! Tissue damage may result from overexposure to sensor light during photodynamic therapy
with agents such as verteporphin, pormer sodium and meta-tetrahydroxyphenylchlorin
(mTHPC). Change the sensor site at least every hour and observe for signs of tissue damage.
More frequent sensor site changes or inspections may be indicated depending upon the
photodynamic agent used, agent dose, skin condition, total exposure time or other factors.
Use multiple sensor sites.

Chapter 1: Introduction
Advisor®Service Manual 1-9
WARNING! Under certain clinical conditions, pulse oximeters may display dashes if unable to display
SpO2and/or pulse rate values. Under these conditions, pulse oximeters may also display
erroneous values. These conditions include, but are not limited to: patient motion, low
perfusion, cardiac arrhythmias, high or low pulse rates or a combination of the above
conditions. Failure of the clinician to recognize the eects of these conditions on pulse
oximeter readings may result in patient injury.
WARNING! Optical cross-talk can occur when two or more sensors are placed in close proximity. It can be
eliminated by covering each site with opaque material.
WARNING! SpO2measurements may be adversely aected in the presence of high ambient light. Shield
the sensor area (with a surgical towel, for example) if necessary.
WARNING! Dyes introduced into the bloodstream, such as methylene blue, indocyanine green, indigo
carmine, patent blue V (PBV), and uorescein may adversely aect the accuracy of the SpO2
reading.
WARNING! Signicant levels of dysfunctional hemoglobins, such as carboxyhemoglobin (as with CO-
poisoning) or methemoglobin (as with sulfonamide therapy), will aect the accuracy of the
SpO2measurement.
WARNING! Any condition that restricts blood ow, such as use of a blood pressure cu or extremes in
systemic vascular resistance, may cause an inability to determine accurate SpO2and pulse
rate readings.
WARNING! Remove ngernail polish or false ngernails before applying SpO2sensors. Fingernail polish
or false ngernails may cause inaccurate SpO2readings.
WARNING! Failure to carefully route the cable from the sensor to the monitor may allow the patient to
become entangled in the cable, possibly resulting in patient strangulation. Route the cable
in a way that will prevent the patient from becoming entangled in the cable. If necessary, use
tape to secure the cable.
CAUTION! Unplug the sensor from the monitor before cleaning or disinfecting.
CAUTION! Do not autoclave, ethylene oxide sterilize, or immerse the monitor and other accessories in
liquid. Evidence that liquid has been allowed to enter the monitor voids the warranty.
NOTE! Obstructions or dirt on the sensor’s red light or detector may cause a sensor failure. Make sure
there are not obstructions and the sensor is clean.
NOTE! If the oximeter parameter is being monitored, the pitch of the pulse beep is determined by the
SpO2value. The higher the SpO2value, the higher the pulse beep pitch; the lower the SpO2value,
the lower the pulse beep pitch.
NOTE! The low SpO2alarm limit minimum test value is 85. If you change the low SpO2alarm limit to a
value less than 85 and then change the patient type, add a new patient, or power down/power up
the monitor, a minimum value of 85 takes the place of the value you entered.

Chapter 1: Introduction
1-10 Advisor®Service Manual
Non-invasive Blood Pressure Warnings, Cautions, and Notes
WARNING! Blood pressure measurements may be inaccurate if cus and/or hoses other than those
specied by Smiths Medical PM, Inc. are used.
WARNING! Repeated use of STAT mode for periods longer than 15 minutes should be avoided to reduce
the patient’s risk for soft tissue or nerve damage. When using the monitor for long periods of
time, select the longest clinically appropriate measurement interval and periodically examine
the patient for signs of injury and ensure proper cu placement.
WARNING! Make sure that hoses are not kinked, compressed, or restricted.
WARNING! Check that operation of the equipment does not impair the circulation of the monitored
patient.
WARNING! Blood pressure measurements may not be accurate for patients experiencing arrhythmias.
WARNING! Do not verify the Non-Invasive Blood Pressure calibration while the cu is attached to a
patient.
WARNING! Verify cu size is correct for the selected patient mode on the monitor.
CAUTION! To ensure that the unit remains in calibration, perform a calibration verication on a yearly
basis.
CAUTION! Extremity and cu motion should be minimized during blood pressure determinations.
CAUTION! Proper blood pressure cu size and placement are essential to the accuracy of the blood
pressure determination.
CAUTION! Any blood pressure recording can be aected by the position of the patient, his or her
physiologic condition, and other factors.
CAUTION! Blood pressure measurements should be interpreted by a clinician.
NOTE! There are no user-serviceable adjustments for the Non-Invasive Blood Pressure calibration
verication. If the monitor appears to be out of calibration, contact your authorized repair center
for help.
NOTE! Systolic and diastolic blood pressure measurements determined with this device are equivalent
to those obtained by the trained observer using the cu/stethoscope auscultation method,
within the limits prescribed by the American National Standard, Electronic or Automated
Sphygmomanometers. AAMI SP10-1992
NOTE! Mean arterial blood pressure measurements determined with this device are equivalent to those
obtained by an intra-arterial blood pressure measurement device as determined by Smiths
Medical PM, Inc.
NOTE! Clinical validation studies are available upon request.