Corometrics 115 User manual

COROMETR
115 FETAL MO
OPERATOR'S MANUAL
1

CONTENTS
INTRODUCTION ........................................... 1
SAFETY
................................................... 2
CONTROLS
AND INDICATORS ............................. 5
Front Panel Controls
........................................ 5
Front Panel Connectors ...................................... 7
........................................
Front Panel Displays 7
Tie and Date Set Pushbuttons ............................... 8
........................................
Strip Chart Recorder 9
................................................. Rear Panel 10
Rear Panel Connectors ...................................... 10
OPERATION
............................................... 12
Selecting Monitoring Modes
.................................. 12
Fetal
Heart Rate Monitoring ....................... : ......... 12
.............................................
Uterine Activity 12
Preparing Monitor For Use
.................................. 13
Mounting Strain Gauge ...................................... 14
Chart Paper Installation
..................................... 16
Monitor
Self Test Routines ................................... 18
Application of Monitor
to Patient ............................. 19
FHR Recording . Ultrasound ............................... 19
...................................
F,H R Recording . Phono
22
FHR Rmrding . Internal Direct FECG ...................... 25
Uterine Activity Recording . Tocodynamometer ............... 27
Uterine Activity Recording . Catheter and Strain Gauge ........ 29
Flushing and Calibration of the Strain Gauge ................. 31
Dual Heart Rate Monitoring .................................. 35
......................................
Alphanumeric Messages 38
.....................................
SET TIME AND DATE 40
CARE AND CLEANING .................................... 43
......................................
TROUBLESHOOTING 46
SPECIFICATIONS .......................................... 48
.............................................
ACCESSORIES 50

Features
-
* Quiet, easy-to-load recorder with high-resolution dot
matrix printhead.
Prints out continuous trends and
alphanumeric data on one strip chart in single or dual
heart rate modes.
* Automatic mode selection. The desired monitoring
mode is selected simply by inserting the appropriate
transducer plug into the front panel connector.
* Easy-to-use durable transducer connectors.
* All functions controlled by pushbuttons-including
audio volume, UA reference, time/date set, and paper
advance.
* Cleaner more accurate traces with fewer "dropouts"
using ultrasound or phono because of patented autocor-
relation processing.
* U.S. Patent No. 3,982,528

Section 1
INTRODUCTION
The CorometricsB Model 115 Fetal Monitor is capable of
monitoring two heart rates (maternal and
fetal or twins)
and maternal uterine contractions. Simultaneous trends of
' beat-to-beat heart rate and uterine activity (UA) are plotted
continuously on the built-in
dual channel strip chart
recorder. Fetal heart rate
(FHR) and UA are displayed
continuously on the front-panel numeric display. The
Model
115 is capable of monitoring heart rate and uterine
activity using the following external or internal clinical
methods.
External
Monitoring Modes
1) Continuous-Wave Doppler Ultrasound: A transducer
placed on the abdomen is used to direct
an ultrasonic beam
toward the fetal heart and to sense Doppler-shied echoes
created by moving cardiac structures.
A patented
autocorrelationprocess is used to determine the timing of
successive cardiac cycles.
2) Phono: An acoustically sensitive transducer placed on
the maternal abdomen senses fetal heart -sounds which are
used to compute the fetal heart rate. The patented
autocorrelationprocessing is
also used in the Phono Mode
to improve measurement accuracy.
3) Tocodynamometer: Relative Pressure within the uterus
is measured using a tocotransducer strapped to the
abdomen in the area of the uterine fundus. The readings
are recorded on the strip chart paper
in a relative scale
from
0 to 100.
Internal Monitoring Modes
1) Direct Fetal ECG: FECG waveforms are obtained via a
spiral electrode attached to the fetal presenting part. FHR
is computed on a beat-to-beat basis using the time interval
between R-wave peaks. The instantaneous FHR pattern is
printed on the strip chart paper and the FHR appears on
the numeric display.
2) Intrauterine Catheter and Strain Gauge: Amniotic fluid
pressure is measured using
a transcervical intrauterine
catheter and externally mounted strain gauge. Pressure
trends are plotted over the range of
0 to 100 rnrnHg.
Maternal Monitoring Mode
MECG waveforms are obtained via electrodes placed on
the maternal chest and abdomen. MHR is computed on a
beat-to-beat basis using the time interval between R-wave
peaks. The instantaneous MHR pattern is printed on the
strip chart paper and the MHR appears on the numeric
display.

Section 2
SAFETY
GENERAL USE AND POWER PRECAUTIONS
IMPORTANT: Read this manual before operating the
monitor. Keep this
manual available for future reference
and orientation of new personnel.
Refer to supplementary "Guide to Fetal
Heart Rate
Monitoring" for limitations of internal and external
monitoring techniques.
This monitor is ordinarily shipped with provisions to
operate from a hospital grade three-wire 117-volt electrical
outlet. The monitor
can be changed to operate from other
types of outlets and voltages with appropriate modifications
performed by personnel authorized by Corometrics Medical
Systems, Inc.
Do not defeat the three-wire grounding feature in the
power cord by means of adapters, plug modifications or
other methods.
A dangerous shock hazard to both patient
' and operator may result.
Monitors should be plugged into the same circuit
as other
equipment in use on
the same patient. Your hospital
engineering staff should identify outlets that are on the
same circuit in patient
areas.
This equipment is not designed for use in an explosive
atmosphere, in
the presence of flammable anaesthetics, or
inside an oxygen tent. Use under these conditions may
present an explosion hazard.
LEAKAGE CURRENT
Corometrics monitors are equipped with isolated inputs
(ECG) and isolated transducers (Phono
, ultrasound, strain
gauge, and tocodynamometer). Leakcase current is limited
to a few microamperes even if full power-line vcltage is
applied to the patient leads. However, for maximum patient
safety, the following procedures are recommended.
Keep equipment clean and free of transducer gel, electrode
cream, and other substances.
Do not operate if unit is wet because of spills or
condensation. Condensation could occur
if a monitor is
moved from building to building such as from a cold
environment to a warm and humid location.

DIRECT MEASURING PRECAUTIONS
Because the tip of the spiral electrode is designed to
penetrate the fetal epidermis, the possibility of trauma,
hemorrhage and infection exists.
Direct monitoring should be used only under aseptic
conditions.
Membranes must be ruptured prior to the introduction of
either the spiral electrode or the intrauterine catheter.
When inserting
an intrauterine catheter, do not force the
catheter guide or catheter since it is possible to perforate
the uterus.
Contraindications: The electrode should NOT be applied to
the fetal face, fontanels or genitalia or when it is not
possible to identify the portion of
the fetal body where-
application is contemplated. Direct monitoring should NOT
be used when placenta previa or bleeding from the uterine
cavity
is present; when genital infections (e.g., herpes,
Group
B streptococcus, gonorrhea) or other infections
exist.
-
-

Section 3

Section 3
CONTROLS AND INDICATORS
FRONT PANEL CONTROLS
Volume
Two pushbuttons used to change the volume of sound emitted by the rear-panel speaker. Depressing the button
with the arrow pointing up causes the volume to increase. Depressing
the button with the arrow pointing down
causes the volume to decrease. Volume control has no effect on the processing used to compute heart
rate.
UA Reference
Pushbutton which sets the pressure reference level on the UA recorder channel at 0-mmHg for the strain gauge
or at
10 for the tocodynamometer. To activate, depress and hold for 1 second.
Test
Pushbutton used to initiate a monitor self-test routine. To activate, depress and hold for 1 second.
Mark
,Depressingthe Mark button causes an arrow-shaped mark to be printed on heart rate channel of the strip chart
paper-
Record
Depressing pushbutton activates the recorder, provided paper has been installed. Once the recorder is activated,
- --
* s
depressing Record again turns it off.
An amber light next to the Record pushbutton will be on when the recorder is activated and off when the recorder
is deactivated or if paper has run out. It
will flash when the end of the paper is approaching. When the recorder
is out of paper, the recorder
will automatically stop and cannot be restarted until chart paper is inserted.
Paper Advance
Pressure on pushbutton causes the recorder to advance chart paper at the speed of 25 crnlminute for as long as
the pushbutton is depressed. The recorder will print the monitoring modes, time, date and chart speed informa-
tion
20 seconds after the pushbutton is released, if the recorder is activated.
Power
Pushbutton switch that turns the monitor on and off. A green light next to the Power pushbutton is illuminated
when the Power switch is activated.
Automatic ~aseline 'Zeroing" in External UA Monitoring Mode.
If pressure falls below 0, automatic UA reference wiU occur and new baseline reference is set at 0. The center
margin for the strip chart will automatically
be annotated with "UA REF".