Covidien Nellcor OxiMax N-600x User manual

Operator’s Manual
Nellcor
N-600x Pulse Oximeter
Alarm Management System
Oximax
TM
Technology
TM

COVIDIEN, COVIDIEN with logo, and Covidien logo are U.S. and internationally registered
trademarks of Covidien AG. Other brands are trademarks of a Covidien company.
©2014 Covidien.
U.S. Patents 5,485,847; 5,676,141; 5,743,263; 6,035,223; 6,226,539; 6,411,833;
6,463,310; 6,591,123; 6,708,049; 7,016,715; 7,039,538; 7,120,479; 7,120,480;
7,142,142; 7,162,288; 7,190,985; 7,194,293; 7,209,774; 7,212,847; 7,400,919.
To obtain information about a warranty, if any, contact Covidien Technical Services at
1.800.635.5267 or your local representative.
Purchase of this instrument confers no express or implied license under any Covidien patent
to use the instrument with any pulse oximeter that is not manufactured or licensed by
Covidien.

Operator’s Manual i
Table Of Contents
Chapter 1. Safety Information............................................................... 1
Overview ..............................................................................................................................1
Warnings ..............................................................................................................................1
Cautions ...............................................................................................................................3
Chapter 2. General Introduction ........................................................... 5
Overview ..............................................................................................................................5
Oximeter Description and Intended Use..................................................................5
Description................................................................................................................................5
Intended Use ............................................................................................................................5
List of Components..........................................................................................................6
Front Panel ..........................................................................................................................7
User Interface............................................................................................................................7
Oximeter Visual Indicators...................................................................................................8
Monitoring Values ...............................................................................................................10
Audible Indicators................................................................................................................11
Rear Panel ......................................................................................................................... 12
Rear Panel Symbols and Descriptions ..........................................................................12
Oximeter Features ......................................................................................................... 13
OxiMax SPD™ Alert Feature..............................................................................................13
SatSeconds™ Alarm Management Feature.................................................................13
Pulse Rate Delay Alarm Management Feature..........................................................17
Oximeter Display View Options................................................................................ 17
General Care Format (GCF) Display ...............................................................................17
Plethysmographic (Pleth) Display..................................................................................18
Blip Display ............................................................................................................................18
Real-Time Trend Display....................................................................................................18
Chapter 3. Setting Up the Oximeter.................................................... 21
Safety Reminders ........................................................................................................... 21
Connecting to an AC Power Source........................................................................ 22
Using Battery Power ..................................................................................................... 23
Connecting an OxiMax™ Pulse Oximetry Sensor................................................ 24
Reducing EMI (Electromagnetic Interference) .................................................... 25
Chapter 4. Operating the Oximeter..................................................... 27
Overview ........................................................................................................................... 27
Monitoring Oximeter Power...................................................................................... 27
Battery Fuel Gauge..............................................................................................................27
Low Battery Indicator .........................................................................................................28
Powering the Oximeter ............................................................................................... 29
Power Prerequisites ............................................................................................................29
Power-on Self -Test (POST)...............................................................................................29
Automatic Shutdown and Power Off............................................................................30

ii Operator’s Manual
Using OxiMax™ Pulse Oximetry Sensors................................................................ 31
Sensor Detection..................................................................................................................31
Sensor Detection Failure ...................................................................................................32
Managing the Oximeter Backlight........................................................................... 32
Managing the View Display ....................................................................................... 33
Using the General Care Format (GCF) Display...........................................................33
Using the Pleth Display......................................................................................................34
Using the Blip Display.........................................................................................................35
Using the Real-Time Trend Display ...............................................................................36
Adjusting the Volume of Audible Tones ............................................................... 39
Adjusting the Pulse Beep Volume..................................................................................39
Managing Oximeter Alarms .............................................................................................39
Managing Audible Alarms................................................................................................40
Using Oximeter Softkey Menus ................................................................................ 41
Navigating Menu Options.................................................................................................41
Adjusting the Factory Default Settings........................................................................49
Using the OxiMax SPD™ Alert Feature..........................................................................54
Using the Pulse Rate Delay Alarm Management Feature .....................................57
Using the SatSeconds™ Alarm Management Feature ............................................58
Chapter 5. Managing Oximetry Data .................................................. 61
Managing Oximeter Trend Data............................................................................... 61
Trend Data Basics.................................................................................................................61
Reading the Trend Data Display.....................................................................................62
Storing Trend Data ..............................................................................................................65
Clearing Trend Information..............................................................................................66
Managing OxiMax™ Pulse Oximetry Sensor Data .............................................. 67
Understanding Sensor Messages...................................................................................67
Using Sensor Event Records.............................................................................................70
Data Port Connectivity................................................................................................. 77
Overview .................................................................................................................................77
Data Port Communications..............................................................................................79
Data Output Information ..................................................................................................80
Using the Nurse Call Interface................................................................................... 84
Nurse Call Feature................................................................................................................84
Setting Nurse Call RS-232 Polarity .................................................................................85
Calculating the Analog Voltage Output ................................................................ 86
Chapter 6. Using OxiMax™ Pulse Oximetry Sensors and
Accessories....................................................................... 87
Overview ........................................................................................................................... 87
OxiMax™ Pulse Oximetry Sensors ............................................................................ 87
Selecting an OxiMax™ Pulse Oximetry Sensor...........................................................87
OxiMax™ Pulse Oximetry Sensor Features..................................................................90
Biocompatibility Testing ...................................................................................................90
Optional Accessories .................................................................................................... 90
Overview .................................................................................................................................90
GCX Adapter Plate ...............................................................................................................91

Operator’s Manual iii
GCX Wall Mount Arm and Channel ...............................................................................92
GCX Roll Stand ......................................................................................................................93
Soft-Sided Carrying Case...................................................................................................94
Chapter 7. Performance Considerations ............................................ 95
Overview ........................................................................................................................... 95
Performance Considerations ..................................................................................... 95
Primary Considerations......................................................................................................95
Oximetry Considerations...................................................................................................96
Patient Conditions...............................................................................................................96
OxiMax™ Pulse Oximetry Sensor Performance Considerations.................... 96
Safety Information...............................................................................................................96
Inaccurate Sensor Measurement Conditions.............................................................97
Signal Loss ..............................................................................................................................97
Recommended Usage........................................................................................................97
Chapter 8. Troubleshooting ................................................................ 99
Overview ........................................................................................................................... 99
Help and Support........................................................................................................... 99
Technical Services................................................................................................................99
On-Screen Help.....................................................................................................................99
Error Codes.....................................................................................................................103
Prompts and Error Messages...................................................................................103
Primary Speaker Failure.............................................................................................107
Low and Critical Battery Conditions......................................................................109
Obtaining Technical Assistance..............................................................................112
Returning your Oximeter ..........................................................................................112
Chapter 9. Oximeter Maintenance.................................................... 113
Overview .........................................................................................................................113
Cleaning ..........................................................................................................................113
Periodic Safety Checks ...............................................................................................113
Service..............................................................................................................................114
Chapter 10. Theory of Operations ...................................................... 115
Overview .........................................................................................................................115
Understanding Pulse Oximetry...............................................................................115
Theoretical Principles .......................................................................................................115
Automatic Calibration......................................................................................................116
Functional versus Fractional Saturation ....................................................................116
Measured versus Calculated Saturation ....................................................................116
Oximeter Features .......................................................................................................117
SatSeconds™ Alarm Management Feature...............................................................117
Pulse Rate Delay Alarm Management Feature........................................................117
OxiMax SPD™ Alert Feature............................................................................................118
OxiMax™ Pulse Oximetry Sensor Technology .........................................................118
Functional Testers and Patient Simulators.........................................................119

iv Operator’s Manual
Chapter 11. Product Specifications .................................................... 121
Overview .........................................................................................................................121
Physical Characteristics..............................................................................................121
Electrical Requirements.............................................................................................121
Power......................................................................................................................................121
Battery....................................................................................................................................121
Rating of Nurse Call Relay ...............................................................................................122
Environmental Conditions........................................................................................122
Operating..............................................................................................................................122
Transport and Storage .....................................................................................................122
Performance Specifications......................................................................................122
Measurement Range.........................................................................................................122
Product Compliance ...................................................................................................124
Product Standards for Compliance .............................................................................124
Product Safety Standards................................................................................................124
Electromagnetic Compatibility (EMC) Standards...................................................124
Manufacturer’s Declaration......................................................................................125
Basics ......................................................................................................................................125
Electromagnetic Compatibility (EMC) ........................................................................125
Sensor and Cable Compliance ......................................................................................127
Safety Tests.....................................................................................................................128
Ground Integrity.................................................................................................................128
Leakage Current .................................................................................................................129
Chapter 12. Clinical Study .................................................................. 131
Overview .........................................................................................................................131
Methods ..........................................................................................................................131
Study Population .........................................................................................................132
Study Results .................................................................................................................133
Adverse Events or Deviations..................................................................................134
Conclusion......................................................................................................................134

Operator’s Manual 1
1SafetyInformation
Overview
This section contains safety information requiring users to exercise appropriate
caution while using the OxiMax N-600x™ pulse oximeter.
Warnings are identified by the WARNING symbol shown above.
Warnings alert you to potential serious outcomes (death, injury, or adverse events) to
the patient or user.
Cautions are identified by the CAUTION symbol shown above.
Cautions alert the user to exercise care necessary for the safe and effective use of the
OxiMax N-600x pulse oximeter.
Notes are identified by the NOTE symbol shown above. Notes are listed before or
after procedural steps or information and provide additional guidelines or
information on the subject being described.
Warnings
WARNING
The OxiMax pulse oximetry sensor extrapolates from the date and time provided by
the Nellcor OxiMax N-600x pulse oximeter when recording the sensor event record to
the sensor. The accuracy of the date/time is determined by the date/time setting of the
pulse oximetry monitor. Set the pulse oximeter date and time to the correct value
before connecting a record-enabled sensor to keep the date and time consistent for as
long as the sensor remains connected. Since a sensor with sensor event record data can
be transported from one oximeter to another, having discrepancies in the date/time

Safety Information
2Operator’s Manual
between oximeters and the sensor event record data will affect the order in which the
sensor event record data appear. To eliminate this potential problem, set all oximeters
within an institution to the same time.
WARNING
Explosion hazard—Do not use the OxiMax N-600x pulse oximeter in the presence of
flammable anesthetics.
WARNING
Do not spray, pour, or spill any liquid on the pulse oximeter, its accessories, connectors,
switches, or openings in the chassis, since this may cause damage to the oximeter.
WARNING
Supplemental oxygen will attenuate patterns of desaturation. A patient’s respiratory
compromise can be proportionally more severe before patterns appear in the
saturation trend. Remain vigilant when monitoring a patient on supplemental oxygen.
WARNING
The LCD panel contains toxic chemicals. Do not touch broken LCD panels. Physical
contact with a broken LCD panel can result in transmission or ingestion of toxic
substances.
WARNING
Do not silence or decrease the volume of the OxiMax N-600x pulse oximeter’s audible
alarm if patient safety could be compromised.
WARNING
Failure to cover the OxiMax pulse oximetry sensor site with opaque material in high
ambient light conditions may result in inaccurate measurements. Pulse oximetry
readings and pulse signals can be affected by certain environmental conditions,
OxiMax pulse oximetry sensor application errors, and certain patient conditions. See
the appropriate sections of this manual for specific safety information.
WARNING
The use of accessories, sensors, and cables other than those specified may result in
inaccurate readings of the OxiMax N-600x pulse oximeter and increased emission and/
or decreased electromagnetic immunity of the oximeter .
WARNING
When installing the pulse oximeter’s AC power cord, ensure the cord is carefully
positioned to prevent tripping and entanglement.

Cautions
Operator’s Manual 3
Cautions
Caution
When connecting the OxiMax N-600x pulse oximeter to any instrument, verify proper
operation before clinical use. Both the pulse oximeter and the instrument connected to it
must utilize a grounded outlet. Accessory equipment connected to the pulse oximeter’s data
interface must be certified according to IEC Standard 60950 -1: 2005 for data-processing
equipment or IEC Standard 60601-1:1988 + A1:1991 + A2:1995 for electromedical
equipment. All combinations of equipment must be in compliance with IEC Standard
60601-1-1:2000 Requirements for Medical Electrical Systems. Anyone connecting additional
equipment to the signal input port or signal output port (data port connector) is configuring
a medical system and, therefore, is responsible for ensuring that the system complies with
the Requirements for Medical Electrical Systems IEC Standard 60601-1-1:2000 and the
electromagnetic compatibility IEC Standard 60601-1-2:2001 + A1:2004. Oximeter accuracy
may degrade if it is connected to secondary I/O devices when the equipment is not
connected to earth reference.
Caution
Federal law (U.S.A.) restricts this device to sale by or on the order of a physician.
Caution
Dispose of battery in accordance with local requirements and regulations.

Safety Information
4Operator’s Manual
Page Left Intentionally Blank

Operator’s Manual 5
2 General Introduction
Overview
WARNING
The OxiMax N-600x pulse oximeter is intended only as an adjunct in patient
assessment. It must be used in conjunction with clinical signs and symptoms.
This manual contains information for operating the OxiMax N-600x™ pulse oximeter.
Before operating the oximeter, thoroughly read the N-600x Operator's Manual. The
latest version of this manual is available on the Internet at:
www.covidien.com/rms
Oximeter Description and Intended Use
Description
The OxiMax N-600x pulse oximeter provides continuous noninvasive monitoring of
functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate. With the
proper firmware, activation of the pulse oximeter’s OxiMax SPD™ Alert (SPD) feature
is possible.
Intended Use
The Nellcor N-600x Pulse Oximetry System with N-600x Pulse Oximeter and Nellcor
Sensors and Cables with OxiMAX technology is indicated for prescription use only for
the continuous non-invasive monitoring of functional oxygen saturation of arterial
hemoglobin (SpO2) and pulse rate. The N-600x Pulse Oximeter is intended for use
with neonatal, pediatric, and adult patients during both no motion and motion
conditions and for patients who are either well or poorly perfused, in hospitals,
hospital-type facilities, intra-hospital transport, and home environments.
The N-600x with SPD feature is intended for use on adults to detect patterns of
desaturation that are indicative of repetitive reductions in airflow through the upper
airway and into the lungs.
Intended typical usage may be defined to include the following for the OxiMax N-600x pulse
oximeter:

General Introduction
6Operator’s Manual
•Hospital use typically covers such areas as general care floors (GCFs), operating rooms, special procedure
areas, intensive and critical care areas within the hospital and in hospital-type facilities. Hospital-type facilities
include physician office-based facilities, sleep labs, skilled nursing facilities, surgicenters, and sub-acute
centers.
•Intra-hospital transport includes transport of a patient within the hospital or hospital-type facility.
•Homecare use involves a lay person (parent or other similar non-critical caregiver) in the home environment.
Use with any particular patient requires the selection of an appropriate OxiMax™
pulse oximetry sensor. Refer to Using OxiMax™ Pulse Oximetry Sensors and Accessories,
page 87.
Through the use of the four softkeys, users can access trend information, change
alarm limits, adjust the internal time clock, select the communications protocol, and
choose the interface language native to the language of the facility, caregiver, or
user. See Using Oximeter Softkey Menus, page 41.
Figure 1. Front Panel Menu Softkeys
The oximeter can operate on AC power or on an internal battery. The controls and
indicators for the oximeter are illustrated and identified in OxiMax N-600x Pulse
Oximeter Front Panel, Figure 2 on page7 and OxiMax N-600x Pulse Oximeter Rear
Panel, Figure 3 on page12.
List of Components
The typical OxiMax N-600x pulse oximeter carton ships with the following packing
list of contents.
Table 1. Typical Packing List
Quantity Item
1OxiMax
N-600x pulse oximeter
1 Nellcor OxiMax pulse oximetry sensor or assortment pack
1DOC-10 pulse oximetry cable
1N-600x Operator’s Manual (applicable to country of sale) and/or
compact disc
1 Hospital-grade power cord (applicable to country of sale)
2 Fuses, 0.5 A, 250 volts, slow-blow, IEC
(5 x 20 mm)
1N-600x Quick Guide

Front Panel
Operator’s Manual 7
Front Panel
Figure 2. OxiMax N-600x Pulse Oximeter Front Panel
User Interface
Note:
Pressing a key, except the ON/STANDBY key, should result in either a valid or an invalid tone.
If the key pressed fails to emit a tone, contact a qualified service technician.
ON/STANDBY Key—Use to turn the oximeter on and off.
ALARM SILENCE Key —Use to silence ANY current alarms for the alarm silence
duration period. After silencing an alarm, press the key again to reactivate the alarm.
Additionally, use it to view and adjust alarm silence duration and alarm volume. The
ALARM SILENCE key clears “SENSOR OFF,” “LOW BATTERY,” and “SENSOR DISCONNECT”
Table 2. List of Front Panel Components
1SpO2Sensor Port 14 ADJUST UP & DOWN Keys
2Low Battery Indicator 15 Pulse Rate (BPM) Upper Limit Value
3AC Power Indicator 16 Pulse Rate (BPM) Lower Limit Value
4ON/STANDBY Key 17 Neonate Mode Icon
5Battery Fuel Gauge 18 HELP/CONTRAST Key
6SatSeconds™Icon & Limit Value 19 Fast Response Mode Icon
7SPD Icon & Sensitivity Value 20 Pulse Rate (BPM)
8Blip Bar 21 Menu Selection Softkeys
9%SpO2Real-time Value 22 Menu Bar
10 %SpO2Upper Limit Value 23 Data In-Sensor Indicator
11 %SpO2Lower Limit Value 24 Interference Indicator
12 Alarm Silence Indicator 25 Pulse Search Indicator
13 ALARM SILENCE Key 26 Oximeter Speaker

General Introduction
8Operator’s Manual
messages from the display. It lights continuously when an audible alarm has been
silenced. It flashes when the alarm silence duration has been set to OFF.
WARNING
Pressing ALARM SILENCE will keep ALL alarms from sounding for the alarm silence
duration period.
WARNING
Should the caregiver silence an SPD alarm, this resets the index that tracks repetitive
patterns of desaturation and silences ALL alarms.
Caution
Should the caregiver fail to clear a primary audible alarm within two (2) minutes, a secondary
alarm with a unique pitch sounds.
ADJUST UP Key —Use to increase variable parameters of the oximeter.
ADJUST DOWN Key—Use to decrease variable parameters of the oximeter.
HELP/CONTRAST Key—Use to access the on-screen help or adjust the screen
contrast.
•Press and release the HELP/CONTRAST key to launch on-screen help.
•Press and hold the HELP/CONTRAST key while simultaneously pressing the ADJUST UP and
ADJUST DOWN keys to increase or decrease the contrast of the display screen.
Softkey Menu Bar—Use to display the current softkey menu functions.
Oximeter Visual Indicators
AC Power Indicator—Lights continuously when connected to an AC power source
and also shows when the battery is charging. Does not light when the oximeter is
running on the internal battery.
Low Battery Indicator— Lights continuously when 15 or fewer minutes of battery
capacity remain, then flashes when the battery capacity reaches a critically low
condition.
Pulse Search Indicator—Lights continuously prior to initial acquisition of a pulse
signal and during prolonged, challenging monitoring conditions. The pulse search
indicator flashes during a loss-of-pulse signal.
Interference Indicator—Lights whenever the oximeter algorithm detects the
incoming signal quality is degraded. An intermittently lit Interference Indicator is
common during patient monitoring, and indicates the oximeter algorithm is
dynamically adjusting the amount of data required for measuring SpO2and Pulse
Rate. When lit continuously, the oximeter algorithm has extended the amount of
data required for measuring SpO2and Pulse Rate. In this case, fidelity in tracking
rapid changes in these values may be reduced.
Note:
Degradation can be caused by ambient light, poor sensor placement, electrical noise,
electro-surgical interference, patient movement, or other causes.

Front Panel
Operator’s Manual 9
Data In-Sensor Indicator—Lights to indicate that the attached OxiMax pulse
oximetry sensor contains a patient sensor event record. The sensor event record
information may be viewed or printed.
Battery Fuel Gauge—Displays the battery charge remaining on the oximeter. The
battery fuel gauge consists of four bars, each corresponding to approximately 1.5
hours of operating time. All four bars are lit when the battery is fully charged. No bars
are lit when a low battery condition exists. Visible in all display views. See Battery Fuel
Gauge, page 27.
Plethysmographic (pleth) Waveform—This non-normalized waveform uses real-
time sensor signals, reflecting relative pulsatile strength and quality of incoming
signals. This indicator is only available in the pleth display view.
Pulse Amplitude (blip bar)—Indicates pulse beat and the relative (non-normalized)
pulse amplitude. As the detected pulse becomes stronger, more bars light with each
pulse. This indicator is only available in the blip and general care format (GCF) display
views.
%SpO2 Value—Indicates hemoglobin oxygen saturation levels. The display value
flashes zeros during loss-of-pulse alarms and flashes the %SpO2value when the
SpO2is outside the alarm limits. The oximeter continues to update the display during
Pulse Search. Current upper and lower alarm limit settings appear as smaller values
to the right of the dynamic %SpO2value. Visible in all display views.
Pulse Rate Value—Displays the pulse rate in beats per minute. It flashes during
loss-of-pulse alarms and when the pulse rate is outside of the alarm limits. During
Pulse Search, the oximeter continues to update the display. Pulse rates outside of the
pulse rate range of 20 to 250 bpm are displayed as 0 and 250, respectively. Current
upper and lower alarm limit settings appear as smaller values to the right of the
dynamic pulse rate value. Visible in all display views.
Saturation Pattern Detection (SPD) Icon—The OxiMax SPD™ Alert (SPD) feature
detects patterns of desaturation in the SpO2trend in adults. When the SPD feature is
enabled, the oximeter detects patterns of desaturation indicative of repetitive
reductions in airflow through a patient’s upper airway into the lungs. When the SPD
feature detects patterns of desaturation in the SpO2trend in adults, caregivers are
alerted to these patterns via a visual indicator, and optionally, an audio alarm. The
triangle icon for SPD appears on the monitor display when the feature is enabled.
The triangle fills from the bottom to the top as patterns become more severe. The
triangle empties from top to bottom as the patterns become less severe. If the
triangle fills, an alarm sounds. With SPD enabled, the default setting is On with the
sensitivity set to 1. The feature can be turned off in the LIMITS menu. Caregivers can
select from three alarm sensitivity settings: 1 (most sensitive), 2 (medium sensitivity)
or 3 (least sensitive), with 1 resulting in more alarms and 3 resulting in fewer alarms.
The rate at which the SPD icon fills depends on the SPD sensitivity setting. To explore
activation, contact Nellcor’s Technical Services Department at 1.800.635.5267 or your
local Nellcor representative. To use the feature, reference Using the OxiMax SPD™ Alert
Feature, page 54.

General Introduction
10 Operator’s Manual
SatSeconds Icon—The SatSeconds feature provides alarm management for mild or
brief SpO2limit violations. When the SatSeconds feature is enabled, the SatSeconds
circle icon fills in the clockwise direction as the SatSeconds alarm management
system detects SpO2readings outside of the limit setting. The SatSeconds icon
empties in counterclockwise direction when SpO2readings are within limits. When
the SatSeconds icon reaches full, a medium priority alarm sounds. Visible in all
display views. For more information about using the feature, reference Using the
SatSeconds™ Alarm Management Feature, page 58.
Fast Response Mode Icon—Appears at bottom right of the menu bar when
enabled. The oximeter algorithm responds to changes in the SpO2data at differing
rates: two to four seconds in Fast Mode and five to seven seconds in Normal Mode
when calculating %SpO2. The response mode setting does not affect the algorithm’s
calculation of pulse rate, nor does it influence the recording of trend data, which
occurs at one-second intervals. The response mode, however, may impact the SPD
alarm behavior. Visible in all display views when enabled. For more information
about using the feature, reference To set the response mode, page 48.
Neonate Alarm Limits Icon—Appears at the bottom far right of the menu bar when
enabled. Visible when the alarm limits are set to neonate limit values, but not when
set to adult limit values. For more information about using the feature, reference To
set adult or neonatal modes, page 52.
Monitoring Values
WARNING
Failure to cover the OxiMax pulse oximetry sensor site with opaque material in high
ambient light conditions may result in inaccurate measurements.
The OxiMax N-600x pulse oximeter continuously assesses the quality of the pulse
oximetry signal while monitoring patient SpO2and pulse rate. Oximeter front panel
values reflect the data derived from monitoring.
The N-600x pulse oximeter algorithm automatically extends the amount of data
required for measuring SpO2and pulse rate depending on the measurement
conditions.
•Normal conditions—During normal measurement conditions the averaging time is six
to seven seconds (approximately three seconds in Fast Mode).
•Brief abnormal conditions—During conditions such as those caused by low perfusion,
interference (e.g., external interference such as ambient light or patient movement), or a
combination of these, the oximeter automatically extends the amount of data required
beyond seven seconds. If the resulting dynamic averaging time exceeds 20 seconds, the
pulse search indicator is lit solid and %SpO2and Pulse Rates update every second.
•More severe conditions—As these conditions extend, the required amount of data
continues to increase. If the dynamic averaging time reaches 40 seconds, the pulse search
indicator flashes to denote a loss-of-pulse condition and %SpO2and pulse rate flash
values of zero. This activates the audible alarm state.

Front Panel
Operator’s Manual 11
Audible Indicators
Audible indicators include pitched tones and beeps. Caregivers may choose to
silence alarms by pressing the ALARM SILENCE key.
WARNING
Pressing ALARM SILENCE will keep ALL alarms from sounding for the alarm silence
duration period.
Caution
Should the caregiver fail to clear a primary audible alarm within two (2) minutes, a secondary
alarm with a unique pitch sounds.
Table 3. Audible Indicator Functions
Function Description
Alarm Silence Reminder Three beeps sound approximately every three minutes with the alarm silence duration set
to OFF and the alarm silence reminder function enabled.
Piezo Tone A high-pitched piezo tone sounds if there is no user response to an audible alarm, or if the
oximeter detects a failure of the primary speaker.
Pulse Beep Single beep sounds for each detected pulse. The pitch of the pulse beep signal changes
with a point-by-point rise or fall in the saturation level.
High Priority Alarm High-pitched, fast-pulsing tone indicates loss-of-pulse.
Note: If a High Priority Alarm is not silenced within 30 seconds by pressing the
ALARM SILENCE key, the oximeter increases the urgency level of the audible alarm
signal by alternating a piezo tone with the primary alarm tone.
Medium Priority Alarm Medium-pitched, pulsing tone indicates an SpO2or pulse rate limit violation.
Note: If a Medium Priority Alarm is not silenced within two minutes by pressing the
ALARM SILENCE key, the oximeter increases the urgency level of the audible alarm
signal by alternating a piezo tone with the primary alarm tone.
Low Priority Alarm Low-pitched, slow-pulsing tone at 3.5 second intervals indicates an OxiMax pulse
oximetry sensor disconnect, low battery, or oximeter failure.
Note: If a Low Priority Alarm is not silenced within two minutes by pressing the
ALARM SILENCE key, the oximeter increases the urgency level of the audible alarm
signal by alternating a piezo tone with the primary alarm tone.
SPD Alarm A trio of quick high-, medium-, high-pitched tones at 2.5 second intervals.
High SpO2Alarm A pair of quick medium-pitched tones followed by a high-pitched pulsing tone at 2.5
second intervals.
Power-On Self-Test Pass One-second tone indicates the oximeter has been turned on and has successfully
completed the power-on self-test.
Confirmation Tone Three beeps sound to confirm default settings are either saved or reset to factory defaults,
or the trend data has been deleted.
Invalid Softkey Press Quick, low-pitched tone indicates a softkey has been pressed that is inappropriate for the
current state of the oximeter.
Valid Softkey Press Quick, medium-pitched tone indicates appropriate softkey has been pressed.
Volume Setting Tone Continuous tone indicates alarm volume adjustment.

General Introduction
12 Operator’s Manual
Rear Panel
Figure 3. OxiMax N-600x Pulse Oximeter Rear Panel
Rear Panel Symbols and Descriptions
Warning! See Instructions for Use
Fuse replacement
Equipotential terminal (ground)
Date of manufacture
Data interface
Proper WEEE Waste Disposal
Type BF applied part - Not defibrillator proof
Table 4. Rear Panel Components
1Equipotential Terminal (Ground)
2AC Power Connector
3Data Port Connector
4Fuse Holder
5Supply Voltage Selector Switch

Oximeter Features
Operator’s Manual 13
Oximeter Features
OxiMax SPD™ Alert Feature
The OxiMax SPD™ Alert (SPD) feature detects patterns of desaturation in adults that
are indicative of repetitive reductions in airflow through a patient's upper airway into
the lungs. Relative reductions in a patient's minute ventilation over a period of time
may cause a progressive drop in alveolar partial pressure of oxygen, leading to
arterial desaturation. If these decreases in ventilation are repetitive, they generate
distinct patterns in the saturation trend. Patterns of repetitive desaturation often
develop gradually over time, increasing in severity. Detection of patterns indicates
that a patient might be suffering progressively severe decrements in airflow that
may increase in acuity if left untreated.
Patterns of desaturation are multiple, sequential occurrences of a desaturation
followed by a resaturation. The SPD feature qualifies patterns of desaturation
resulting from such repetitive reductions in airflow based on specific characteristics.
•The severity of the desaturation event (the depth of the desaturation during the event)
and the extent of the following resaturation
•The regularity of the desaturation events (how often the pattern repeats)
•The slope of the desaturation/resaturation trends that form the events
The SPD feature qualifies these patterns of desaturation over a period of six (6)
minutes. Depending on the sensitivity setting for SPD, patterns that persist may
result in an SPD alarm, alerting the caregiver to the condition.
Figure 4. Clinically Significant Desaturation Patterns
Reference Oximeter Display View Options, page 17, Managing the View Display, page
33, Using the OxiMax SPD™ Alert Feature, page 54, and OxiMax SPD™ Alert Feature,
page 118 for details.
SatSeconds™ Alarm Management Feature
The oximeter monitors the percentage of hemoglobin binding sites saturated with
oxygen in the blood. With traditional alarm management, upper and lower alarm

General Introduction
14 Operator’s Manual
limits are set to alarm at specific SpO 2 levels. When the SpO 2 level fluctuates near an
alarm limit, the alarm sounds each time it violates the alarm threshold. SatSeconds
monitors both degree and duration of desaturation as an index of desaturation
severity. Thus, the SatSeconds feature helps distinguish clinically significant events
from minor and brief desaturations that may result in nuisance alarms.
Figure 5. First SpO2Event: No SatSeconds Alarm