Dräger Infinity Series User manual

D
Infinity Configured Monitoring Series
Infinity Gamma Series
User’s Guide

Draeger Medical Systems, Inc.
16 Electronics Avenue
Danvers, MA 01923
USA
Authorized EC representative:
Dräger Medical AG & Co. KGaA
Moislinger Allee 53-55
23558 Lübeck
Germany
Infinity Gamma Series User’s Guide
Software Version VF4
This product is covered by one or more of the following patents: 5,224,484;
5,224,740; 5,240,008; 5,285,791; 5,355,890; 5,337,751; 5,375,604.
This device bears the !label in accordance with the provisions of the Direc-
tive 93/42/EEC of June 14, 1993 concerning medical devices.
!"0123
Dräger Medical AG & Co. KGaA, 2003. All rights reserved.
Printed in the United States of America.
Dräger reserves the right to modify the design and specifications contained
herein without prior notice. Please contact your local Dräger Sales Represen-
tative for the most current information.
Reproduction in any manner, in whole or in part, in English or in any other
languages, except for brief excerpts in reviews and scientific papers, is pro-
hibited without prior written permission of Dräger Medical AG & Co. KGaA.
All Dräger devices are intended for use by qualified medical personnel only.
CAUTION: Federal Law in the United States restricts these devices to
sale by, or on order of a physician.
Before using all Dräger devices, read all the manuals that are provided with
your device carefully. Patient monitoring equipment, however sophisticated,
should never be used as a substitute for the human care, attention, and critical
judgment that only trained health care professionals can provide.

VF4 Infinity Gamma Series Page iii
What’s New
The functionality of the Infinity Gamma Series patient monitor
has been improved and expanded to include the following new
features in software version VF4:
!Support of gas monitoring functions in anesthesia and operat-
ing room environments. The Gamma XL can now display
concentrations of CO2, N2O, O2and of the anesthetic agents
halothane, isoflurane, enflurane, sevoflurane, and desflurane.
The Gamma XL receives these gas values from a Dräger Scio
multigas module. Note: This functionality is only available
for the Gamma XL (and not the Gamma). For information
about multigas monitoring, see Chapter 14, Multigas.
!Support of network laser printers. Recording requests can be
sent from the Infinity Gamma Series monitor via the Infinity
network to a network laser printer. For information about
recording functions, see Chapter 7, Recordings.
!Improved SpO2performance during motion artifact. For
information about pulse oximetry, see Chapter 12, Pulse
Oximetry.
NOTES:
!The Gamma XL monitor with Anesthetic Gas Monitoring
requires FDA 510(k) review.
!The Gamma XL monitor with Anesthetic Gas Monitoring is not
yet licensed in accordance with the Canadian Medical Devices
Regulations.

Page iv Infinity Gamma Series VF4
Infinity Gamma Series Software Release Notes
Software Version VF4
!Wireless network operation requires special configurations of the monitor-
ing network and the MULTIVIEW WORKSTATION (a service function). If
you experience problems with wireless network operations, contact your
Service personnel.
!When moving and assigning a wireless monitor to a different central sta-
tion, the original central station may emit a brief network error tone and
display an Offline message instead of the message Bed Disconnected.
However, there is no disruption of network monitoring and the Offline
message clears as soon as you assign a new bed to the central viewport.
!When you change the units of measure at the bedside and the central sta-
tion is showing the monitor’s bed view, you must first exit the central bed
view, before the change of units appears at the central station.
!For network and card data transfer:
— Occasionally, after a data transfer from an Infinity Delta Series monitor,
you may see three or four ST trends instead of the two ST leads monitored
by the Infinity Gamma Series monitor.
!For network data transfer only:
— If ST is enabled, the ST data transferred from an Infinity Delta Series
monitor (VE0) or from a MULTIVIEW Telemetry System (VE0) is ST lead
I and II, regardless of the ST leads selected on the Infinity Gamma Series
monitor. Note: Other ST data will be permanently lost.
— After a network transfer of telemetry data to an Infinity Gamma Series
monitor, ST trend points may appear two minutes apart.
— The IBP data transferred from an Infinity Delta Series monitor (VE0) to
an Infinity Gamma Series monitor is labelled GP1 and GP2.
!NBP parameter values transferred from an Infinity Gamma Series monitor
to an Infinity Delta Series monitor will be displayed in the trend graphs
rather than in the trend tables of the destination monitor.
!On rare occasions, a docked monitor may reset when entering the
Transfer Menu under certain network conditions. The monitor returns
to the state prior to the reset within 30 seconds.
!When power-cycling the monitor or admitting a new patient, saved moni-
toring settings may occasionally return to default settings. Check monitor-
ing settings after these events.
!If the Scio module is unable to measure the concentration of N2O, the mon-
itor may enter the error code *A* (artifact) instead of *F* (failure) into the
trend storage.

VF4 Infinity Gamma Series Page v
!Occasionally, the ECG waveform is not displayed in the second waveform
channel, when you assign SpO2to the first waveform channel. In this case,
click on the second waveform channel and select the desired ECG lead
again.
!When admitting a patient at the MULTIVIEW WORKSTATION, the monitor
does not store the admit date, if it is the current date. In this case, you must
enter the admit date via the monitor’s Patient Admit menu.
!When the values of an anesthetic agent exceed the measuring range, the
monitor displays +++ in the agent parameter box and cycles two out-of-
range error messages, one correctly identifying the agent with out-of-
range values, the other showing a previously monitored agent.

Page vi Infinity Gamma Series VF4
Documentation Features
Notes, Cautions, Warnings
NOTE: A note presents information that helps you operate the
equipment or connected devices.
CAUTION: A caution provides information or instructions that
must be followed to ensure proper operation and performance of
the equipment.
WARNING: A warning contains important information
regarding possible danger to you or the patient that is
present during normal operation of the equipment.

VF4 Infinity Gamma Series Page vii
Chapter Overview
Chapters
Overview.................................................................................... 1
Monitor Setup ........................................................................... 2
Network Applications............................................................... 3
Admission, Discharge, Transfer.............................................. 4
Alarms and Messages.............................................................. 5
Trends........................................................................................ 6
Recordings................................................................................ 7
ECG and Heart Rate ................................................................. 8
Arrhythmia ................................................................................ 9
ST-Segment Analysis ............................................................. 10
Respiration.............................................................................. 11
Pulse Oximetry ....................................................................... 12
End-Tidal CO2......................................................................... 13
Multigas ................................................................................... 14
Non-Invasive Blood Pressure................................................ 15
Invasive Blood Pressure........................................................ 16
Temperature ............................................................................ 17
Appendices
Options and Accessories ....................................................... A
Cleaning, Disinfecting, Sterilizing.......................................... B
Default Settings and Biomedical Support............................. C
Technical Data ......................................................................... D
Glossary
Index

Page viii Infinity Gamma Series VF4
Table of Contents
Overview
Important General Safety Considerations ....................................1-2
Electromagnetic Compatibility ................................................1-2
Reducing EMI ............................................................................1-3
Site of Operation .......................................................................1-3
Electrical Safety ........................................................................1-4
Connections to Peripheral Devices.........................................1-4
Safety, Inspection, and Maintenance ...................................... 1-5
Electrosurgery and Defibrillation Safety ................................1-6
Pacemaker Safety .....................................................................1-6
Device Markings........................................................................1-7
General Description........................................................................1-8
Front Panel ....................................................................................1-10
Back Panel.....................................................................................1-11
Left Side Panel ..............................................................................1-12
Right Side Panel............................................................................1-13
Interface Plate (optional) .............................................................. 1-14
Infinity Gamma Display ................................................................1-15
Alarm Colors ...........................................................................1-15
Display Colors.........................................................................1-16
Rotary Knob ..................................................................................1-17
Fixed Keys ..................................................................................... 1-18
Menus.............................................................................................1-19
Power Sources ..............................................................................1-20
MultiMed/NeoMed Pod.................................................................. 1-21
etCO2 Pod and Multigas Module.................................................1-22
Recorder ........................................................................................1-22
Remote Displays ...........................................................................1-23
Monitor Setup
Getting Started ................................................................................2-2
Using the AC Adapter...............................................................2-2
Using the Battery ...................................................................... 2-4
Assembling MultiMed and NeoMed Pods...............................2-9

VF4 Infinity Gamma Series Page ix
Starting the Monitor......................................................................2-10
Main Screen Configuration ..........................................................2-11
Waveform Selection................................................................2-11
Bottom Channel Display.........................................................2-12
OR Mode ..................................................................................2-15
Show Respiration or etCO2 Parameters...............................2-16
Setting Date and Time ..................................................................2-17
Setting the Master Speaker Volume............................................2-18
Turning External Alarm Lights ON/OFF......................................2-19
Standby..........................................................................................2-20
Saving Setups ...............................................................................2-21
Network Applications
Overview ..........................................................................................3-2
Network Configurations .................................................................3-3
Basic Network Components ....................................................3-4
Basic Bedside Setups...............................................................3-5
Network Operation..........................................................................3-6
Docking Station.........................................................................3-7
Docking and Undocking ...........................................................3-9
Wireless Network Configuration............................................3-11
Wireless Network Operation ..................................................3-13
Network Safety Considerations...................................................3-16
Alarm and Status Messages ........................................................3-17
Admission/Discharge/Transfer
Overview ..........................................................................................4-2
Patient Admission...........................................................................4-3
Admit Menu................................................................................4-4
Patient Category........................................................................4-5
Name and ID ..............................................................................4-6
Admit Date .................................................................................4-8
Patient Discharge............................................................................4-9
Data Transfer.................................................................................4-10
Transfer Across the Network.................................................4-11
Transfer with a Data Memory PC Card..................................4-13

Page x Infinity Gamma Series VF4
Alarms and Messages
Alarm Grades ..................................................................................5-2
Life-Threatening Alarms...........................................................5-2
Serious Alarms..........................................................................5-3
Advisory Alarms ....................................................................... 5-4
Alarm Settings.................................................................................5-5
Setting Alarm Limits ................................................................. 5-6
Turning Parameter Alarms On/Off...........................................5-8
Turning Alarm Recordings On/Off ..........................................5-9
External Alarm Lights...............................................................5-9
Alarm Validation............................................................................5-10
Silencing Alarms...........................................................................5-11
Alarm Silence Key...................................................................5-11
All Alarms OFF Key ................................................................5-12
Assigning Alarm Groups..............................................................5-13
Central Alarms ..............................................................................5-14
Alarms in OR Mode.......................................................................5-15
Messages.......................................................................................5-16
Trends
Overview .......................................................................................... 6-2
Trend Setup .....................................................................................6-3
Trend Graphs ..................................................................................6-4
Trend Table......................................................................................6-6
Special Conditions and Codes ......................................................6-8
Recordings
Overview .......................................................................................... 7-2
Recorder Preparation .....................................................................7-3
Assigning Network Recorders.......................................................7-6
Recording Waveforms....................................................................7-7
Timed Recordings.....................................................................7-7
Continuous Recordings ...........................................................7-8
Recording Formats ...................................................................7-9
Recording Trends .........................................................................7-11

VF4 Infinity Gamma Series Page xi
Recording Alarms .........................................................................7-13
Stored Recordings........................................................................7-14
Event Recall.............................................................................7-14
Saving, Printing, Deleting Stored Recordings .....................7-16
Recording Status Messages ........................................................7-17
ECG and Heart Rate
Overview ..........................................................................................8-2
Patient Preparation .........................................................................8-3
Selecting and Preparing the Electrodes .................................8-3
Preparing the Patient’s Skin ....................................................8-3
Positioning the Electrodes.......................................................8-5
ECG Monitoring Settings ...............................................................8-8
Cable Type .................................................................................8-8
Lead Selection and Display Amplitude...................................8-9
Cascade Display......................................................................8-10
One- or Two-Channel Signal Processing..............................8-11
Pulse Tone Source..................................................................8-12
Pulse Tone Volume .................................................................8-13
Pacer Detection .......................................................................8-14
Displaying Sync Marks ...........................................................8-15
ECG and HR Safety Considerations............................................8-16
HR Alarm Settings...................................................................8-16
Neonatal ECG Monitoring.......................................................8-16
ECG 50/60 Hz Notch Filter Setting.........................................8-16
Muscle Stimulators .................................................................8-16
Electrosurgery (ESU) ..............................................................8-17
Infusion pumps .......................................................................8-19
Defibrillators and Cardioversion ...........................................8-19
High P-Waves and T-Waves...................................................8-19
Pacemakers .............................................................................8-20
AV Sequential or DDD Pacemakers.......................................8-21
Pacemakers with Impedance-Derived Rate Response........8-21
Large Amplitude Pacer Pulses ..............................................8-22
Transcutaneous Electrical Nerve Stimulators (TENS).........8-22

Page xii Infinity Gamma Series VF4
Arrhythmia
Overview .......................................................................................... 9-2
Turning Arrhythmia Monitoring ON ..............................................9-4
Arrhythmia Setup............................................................................9-5
Rate and Count .........................................................................9-6
Arrhythmia Alarms....................................................................9-6
Arrhythmia Alarm Recordings.................................................9-7
Relearning a Patient’s ECG............................................................9-7
ST Segment Analysis
Overview ........................................................................................ 10-2
ST Monitoring Display ..................................................................10-3
ST Setup ........................................................................................10-4
Isoelectric and ST Measuring Points ....................................10-5
ST Reference Complex...........................................................10-7
ST Alarms ......................................................................................10-8
Respiration
Overview ........................................................................................ 11-2
Patient Preparation .......................................................................11-3
Selecting and Preparing the Electrodes ...............................11-3
Preparing the Patient’s Skin ..................................................11-3
Electrode Placement for Respiration Monitoring ................11-3
Respiration Monitoring Display...................................................11-5
Displaying Respiration Data ..................................................11-6
Rsp Display Channel ..............................................................11-7
Resp Display Amplitude......................................................... 11-8
Respiration Monitoring Settings .................................................11-9
Rsp Mode.................................................................................11-9
Resp Markers ........................................................................ 11-10
Apnea Time............................................................................11-11
Coincidence Alarm ...............................................................11-12
Relearning a Patient’s Respiration Pattern ........................11-13
Rsp Safety Considerations ........................................................ 11-14
OxyCRG Monitoring (Neonatal Option) ....................................11-15
Displaying OCRG Waveforms.............................................. 11-15
OCRG Recordings ................................................................11-17

VF4 Infinity Gamma Series Page xiii
Pulse Oximetry
Overview ........................................................................................12-2
Sensor Application .......................................................................12-2
SpO2 Safety Considerations........................................................12-4
SpO2 Monitoring Display .............................................................12-5
SpO2 Display Channel............................................................12-5
SpO2 Display Amplitude ........................................................12-6
Cascade Display......................................................................12-7
SpO2 Monitoring Settings............................................................12-8
Pulse Tone Source..................................................................12-8
Pulse Tone Volume .................................................................12-9
Signal Strength Bar Graph...................................................12-10
Averaging Mode ....................................................................12-11
End-Tidal CO2
Overview ........................................................................................13-2
etCO2 Source ................................................................................13-3
etCO2 Display................................................................................13-4
Monitoring Preparations ..............................................................13-6
Connecting Sensor and etCO2 Pod ......................................13-6
Attaching the Capnostat and Airway Adapter......................13-6
Calibrating the Sensor and Adapter....................................13-10
etCO2 Monitoring Settings.........................................................13-12
Averaging Mode ....................................................................13-12
RRc Apnea Time....................................................................13-13
Balance ..................................................................................13-14
Measuring Mode....................................................................13-15
Anesthetic Agent Compensation.........................................13-15
Atmospheric Pressure Compensation................................13-17
etCO2 Alarms ..............................................................................13-19
Multigas
Overview ........................................................................................14-2
Connections ..................................................................................14-3
Gamma XL with Scio...............................................................14-3
The Scio Module ...........................................................................14-4
Warm-Up ..................................................................................14-6

Page xiv Infinity Gamma Series VF4
Site of Operation .....................................................................14-6
Installing/Removing the Water Trap......................................14-7
Connecting Sampling Lines and Power Cord ......................14-7
OR Mode ........................................................................................14-9
CO2 Display and Setup ........................................................14-11
Multigas Display and Setup .................................................14-12
Non-Invasive Blood Pressure
Overview ........................................................................................ 15-2
Cuff Selection and Placement .....................................................15-4
NBP Safety Considerations ...................................................15-5
NBP Measurements ......................................................................15-6
Single Measurements .............................................................15-6
Interval Mode...........................................................................15-6
Inflation Mode..........................................................................15-8
Measurement Tone ...............................................................15-10
NBP Measurements in OR Mode ...............................................15-11
NPB Alarms .................................................................................15-12
Invasive Blood Pressure
Overview ........................................................................................ 16-2
Invasive Pressure Labels ............................................................. 16-3
IBP Display ....................................................................................16-4
Display Channel and Waveform Amplitude..........................16-4
Selecting and Preparing the Transducer....................................16-6
Zeroing and Calibration Check..............................................16-7
Zero and Calibration Check Troubleshooting ......................16-9
Calibrating Reusable Transducers......................................16-10
Temperature
Overview ........................................................................................ 17-2
Temperature Probes .....................................................................17-3
Placing the Probe....................................................................17-3

VF4 Infinity Gamma Series Page xv
Options and Accessories
Options ........................................................................................... A-2
MultiMed/NeoMed Pods................................................................. A-2
ECG ................................................................................................. A-3
Pulse Oximetry (SpO2) .................................................................. A-4
End Tidal CO2 (etCO2) .................................................................. A-6
Multigas .......................................................................................... A-7
Temperature ................................................................................... A-8
Invasive Blood Pressure (IBP)...................................................... A-8
Non-invasive Blood Pressure (NBP) .......................................... A-10
Power Sources ............................................................................. A-10
Displays and Display Components ............................................ A-12
Recorder ....................................................................................... A-13
Mounting Devices ........................................................................ A-13
Miscellaneous .............................................................................. A-14
Cleaning, Disinfecting, Sterilizing
Cleaning, Disinfecting and Sterilizing.......................................... B-2
Monitor ...................................................................................... B-2
Patient Cables .......................................................................... B-3
Reusable ECG Electrodes....................................................... B-3
Reusable SpO2 Sensor............................................................ B-4
NBP Cuff ................................................................................... B-4
Temperature probes and cables............................................. B-4
Reusable Pressure Transducers and Cables ........................ B-5
Cleaning etCO2 Pod and Accessories......................................... B-7
Capnostat Sensor .................................................................... B-7
Reusable Airway Adapters...................................................... B-7
Nasal Sampling Cannulas and Tubing................................... B-7
Sidestream Sampling Pump.................................................... B-7
Scio Module and Accessories .................................................... B-11
Emptying the Water Trap....................................................... B-11
Cleaning/Replacing the Fan Filter ........................................ B-12

Page xvi Infinity Gamma Series VF4
Default Settings and Biomedical Support
Default Settings.............................................................................. C-2
Biomedical Support ..................................................................... C-12
Startup Tests .......................................................................... C-13
Checking the NBP Calibration .............................................. C-14
Biomed Menu ......................................................................... C-15
Saving a Patient Setup .......................................................... C-16
Locked Options and Demo Mode ......................................... C-17
Diagnostic Logs ..................................................................... C-18
Changing Units of Measure .................................................. C-19
Technical Data
Overview ......................................................................................... D-2
Regulatory Compliance........................................................... D-2
Basic System Components..................................................... D-3
Monitoring Accessories .......................................................... D-9
Monitoring Specifications ..................................................... D-12
Glossary
Index

1 Overview
Important General Safety Considerations...........................1-2
Electromagnetic Compatibility .......................................1-2
Reducing EMI ...................................................................1-3
Site of Operation ..............................................................1-3
Electrical Safety ...............................................................1-4
Connections to Peripheral Devices................................1-4
Safety, Inspection, and Maintenance .............................1-5
Electrosurgery and Defibrillation Safety........................1-6
Pacemaker Safety ............................................................1-6
Device Markings............................................................... 1-7
General Description ..............................................................1-8
Front Panel...........................................................................1-10
Back Panel ...........................................................................1-11
Left Side Panel.....................................................................1-12
Right Side Panel ..................................................................1-13
Interface Plate (optional).....................................................1-14
Gamma Display....................................................................1-15
Alarm Colors...................................................................1-15
Display Colors ................................................................ 1-16
Rotary Knob ......................................................................... 1-17
Fixed Keys............................................................................1-18
Menus ...................................................................................1-19
Power Sources.....................................................................1-20
MultiMed/NeoMed Pod ........................................................1-21
etCO2 Pod and Multigas Module........................................1-22
Recorder...............................................................................1-22
Remote Displays..................................................................1-23

Page 1-2 Infinity Gamma Series VF4
Important General Safety Considerations
CAUTION: Read all operating instructions carefully before using
the monitor. Specific warnings and cautions are found throughout
the User’s Manual where they apply.
CAUTION: These devices are not intended for use in the same
room as magnetic resonance equipment.
WARN I N G : Monitor operation is currently not sup-
ported in the following environments: magnetic reso-
nance imaging (MRI), aircraft, ambulance, home or
hyperbaric chamber environments.
CAUTION: Use only batteries that are approved by Dräger (con-
tact your local representative). The use of non-approved batteries
may damage the device.
NOTE: Dräger recommends replacing any lead-acid battery after
12 months of continued use. For safe disposal of lead-acid and lith-
ium ion batteries, follow your local regulations. To prevent risk of
fire or explosion, never dispose of the battery in fire.
Dräger is liable for the safety, reliability and performance of its
equipment only if (a) maintenance, repairs, and modifications are
carried out by authorized personnel, (b) if components are
replaced with Dräger approved spare parts and (c) if the devices
are used in accordance with Dräger Operating Instructions.
A full technical description is available upon request from your
local Dräger representative.
Electromagnetic Compatibility
The monitor has been designed and tested for compliance with
current regulatory standards as to its capacity to limit electro-
magnetic emissions (EMI), and also as to its ability to block the
effects of EMI from external sources.
The monitor complies with the following standards pertaining to
EMI emissions and susceptibility: EN55011 and EN60601-1-2.

Overview
VF4 Infinity Gamma Series Page 1-3
Reducing EMI
To reduce possible problems caused by electromagnetic interfer-
ence, we recommend the following:
!Use only Dräger-approved accessories.
!Ensure that other products used in areas where patient moni-
toring and/or life-support is used comply to accepted emis-
sions standards (EN55011).
!Try to maximize the distance between electromedical
devices.
!Strictly limit exposure and access to portable radio-frequency
sources (e.g., cellular phones and radio transmitters). Be
aware that portable phones may periodically transmit even
when in standby mode.
!Maintain good cable management. Do not route cables over
electrical equipment. Do not intertwine cables.
!Ensure all electrical maintenance is performed by qualified
personnel.
Site of Operation
CAUTION: The site of operation for the monitor must meet tem-
perature, humidity, and air pressure requirements. For details, see
the product description in Appendix A.
WARN ING: Do not operate the monitor in presence of
flammable anesthetic mixtures with air, oxygen, or
nitrous oxide. Do not use the monitor near devices with
microwave or other high frequency emissions that may
interfere with the monitor’s operation.
WARN I NG: If fluids are accidentally spilled on the mon-
itor, it should be removed from service immediately and
thoroughly inspected by your Biomed to ensure that
there is no compromise in electrical safety.
CAUTION: Place the monitor on a flat and stable surface to pre-
vent it from falling. Do not place the monitor into a cabinet, wall
recess or similar enclosure during operation. These units are con-
vection cooled (no fan) and need adequate airflow to dissipate heat.

Page 1-4 Infinity Gamma Series VF4
Electrical Safety
CAUTION: Operate the monitor and any connected devices only
in a clinical environment where the electrical installation is in
accordance with local electric codes. The universal AC adapter,
CPS, or IDS should be connected to a fully tested, hospital-grade
outlet with proper grounding.
WARN ING: Dräger devices are not intended for use in
areas where there is a danger of explosion. If the devices
are used where flammable anesthetic substances are
used, the possibility of an explosion cannot be excluded.
If the AC adapter, CPS, or IDS is disconnected, the monitor “Bat-
tery charger” light turns off and the unit switches immediately to
battery power.
Connections to Peripheral Devices
All peripheral devices and connections to the monitor (except the
Infinity network) must comply with IEC 60601-1 requirements.
CAUTION: In the interest of patient safety and equipment perfor-
mance, Dräger does not authorize the connection of other manufac-
turers’ equipment not approved by Dräger. It is the user's
responsibility to contact Dräger to determine compatibility and
warranty status if connections to other manufacturers' equipment
are desired.
CAUTION: When connecting peripheral devices to the monitor,
make sure that the entire system complies with the following
requirement: IEC 60601-1-1: Safety requirements for medical elec-
trical systems.