Dräger Infinity Acute Care System M540 User manual

Infinity Acute Care System
This Infinity Quick Reference
Guide is not a replacement or
substitute for the Instructions
for Use (IFU). It is for informa-
tional purposes only.
Software Level:
VG4
Quick Reference Guide
M540

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Content
Electrode & Lead Placement
3-6
Terminology
7
Docking, Transport, Power, and Keys
8-10
Function Keys, Tabs, & Dialog Boxes
10-11
Patient Category, Admit and Discharge
12
Audio and Visual Alarms and Silencing
13
Alarm Priorities
14
Views, Waveforms and Parameters
15
Setting Parameter Alarm Limits
16
Parameter Specific Settings
ECG
17-18
NIBP
18
SpO2
19
RRi
20-21
etCO2
18-19
12-Lead ECG
21
Invasive Pressures
22
Warning! This “Quick Reference Guide” is not intended to replace the Instructions for Use manual.
For full information concerning the performance characteristics of the Dräger devices described in
this Quick Reference Guide, each user must carefully read and fully comprehend the Instructions for
Use before operating the respective device.

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Electrode & Lead Placement
DO’S & DO NOT’S
99
Do place the electrode on a clean and dry
area of skin.
99
Do utilize soap, water, and dry skin thor-
oughly.
99
Do remove hair if necessary for proper elec-
trode placement.
99
Do change electrodes Q 24-
48 hours, or per
hospital policy.
U
Do Not utilize alcohol to dry and clean area
of skin for electrode placement.
U
Do Not place electrodes over bony promi-
nences or area of increased muscle move-
ment/activity.
U
Do Not assume electrodes are “g
ood” if the
tape portion is attached to the patient’s skin.
U
Do Not braid, tie or knot leads.
Note:
Always follow hospital-approved practices or the recom-
mendations of the electrode manufacturer.

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Electrode Colors*
IEC
AHA/US
Electrode Location
L
Yellow
LA
Black
Left arm
F
Green
LL
Red
Left leg
R
Red
RA
White
Right arm
N
Black
RL
Green
Right leg (neutral)
C
White
V
Brown
Moveable chest
C+
Gray & White
V+
Gray & Brown
2nd M oveable chest
Standard 6 Lead Configuration
IEC AH A
Standard 5 Lead Configuration
IEC AH A

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Standard 3 Lead Configuration
IEC AH A
Pacemaker Configuration 5 electrodes
IEC AH A
Warning: Make sure the pacemaker detection is turned OFF for patients
without pacemakers and that it is ON for patients with pacemakers. Al-
ways keep pacemaker patients under close surveillance.

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12-Lead Configuration (ten electrodes)
IEC
AH A
Respiratory lead placement for infants
IEC
AH A

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Terminology
INFINITY ACUTE CARE SYSTEM (IACS)
- Monitors located at the bedside of the patient or accompany-
ing the patient on transport. They provide continuous moni-
toring and data collection of multiple parameters.
- Includes M540, Cockpit (C700/500), and M500.
M540
- Transport component and patient connection point of the
IACS.
M500
- Docking Station that secures the M540 and charges the inter-
nal battery.
- Provides communication between the M540 and the
C700/500.
- If the M540 is part of an IACS configuration, the M500 controls
the communication between the M540, the Cockpit, and the
Infinity Central Station.
INFINITY CENTRAL STATION (ICS)
- Provides simultaneous central monitoring and critical care
management of up to 32 patients per ICS. It is the secondary
patient monitoring display and alarm source for Infinity patient
monitors displayed on the main screen.
- Provides a bed view port for each M540 device, a waveform
area, a parameter box and a header bar.

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Docking and Transport, Power & Fre-
quently Used Keys
M500 DOCKING STATION WITH M540
- M500 secures and powers the M540 monitor.
- M500 stores default profile settings that can be adopted
upon docking.
- M500 connects M540 to Infinity network that may include an
Infinity Central Station (centralized alarm management and
data retrieval station for up to 32 patients), a network record-
er, and a network printer.
- M540 facilitates transport of patient when undocked, by main-
taining all patient connections and alarm settings.
TO UNDOCK M540 (release for transport)
1. Push locking tab toward the back of M500
2. While holding the M540 firmly with one hand press one of the
release buttons on M500 and remove from M500
TO DOCK M540
1. Align curved portion of M540 with curved portion of M500
2. Press M540 into M500 until it clicks in place.
3. Push the locking tab toward the front of M500.

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ON/OFF FIXED KEY
- Turns the M540 on or off. The button LED flashes when the
M540 is undocked; is solid when the M540 is docked.
BATTERY LED SYMBOL
- This symbol lights up when the M540 is docked to indicate the
battery is being charged; it does not light up when the M540 is
undocked.
AUDIO PAUSE FIXED KEY
- Pauses acoustic alarm signals for two minutes
Note: Quiet Mode is Activated – If a new alarm condition with a priority
higher than the currently paused alarm occurs, a truncated alarm tone
sounds. In addition, the alarm is represented by visual alarm signals corre-
sponding to the alarm priority. If the new alarm is of lower priority than the
paused alarm, the new alarm condition is only represented by a visual alarm
signal. No acoustic alarm tones sound.
If Quiet Mode is Deactivated - Any new alarm condition breaks through the
Audio Pause period with full acoustic and visual alarm annunciation.
NIBP START/STOP FIXED KEY
- Starts/stops non-invasive blood pressure measurements
TO CALIBRATE THE M540 TOUCH SCREEN
If the Touch screen is out of alignment, calibration should be per-
formed.
1. Push and hold the following two keys simultaneously.
2. Touch each cross appearing successively on screen with finger-
tip.
BLUE HEADER BAR

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The blue header bar appears along the top of the screen. It is al-
ways visible and displays the following:
- Remaining battery charge symbol when fully charged all
segments are filled in. Segments appear empty as battery de-
pletes. With fully charged battery, undocked M540 life is ap-
proximately 3 hours. Low Battery message appears and low
priority alarm sounds when 10 minutes of battery run time
remains before M540 shuts down automatically.
- Network connection symbol when connected to the network
- Patient category (adult pediatric, & neonate)
- Bed label
- Patient name and alarm message field
- Current time
- Wireless symbol when M540 on wireless transport
- Alarm banner field indicating if and how an alarm is silenced
Function Keys, Tabs, & Dialog Boxes
TABS
Tabs along the top and sides of dialog boxes open more setup op-
tions
DIALOG BOXES
Windows within screens that offer setup or review functions

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Function Keys
8 Configurable keys that offer access to patient and monitor setup
and review screens
Key
Function
ALARMS (fixed)
Opens Alarm settings dialog window.
Activate All Alarms Pause or adjust
Alarm volume.
REVIEW (fixed)
Opens the Event recall dialog window.
MENU (fixed)
Opens the Main menu dialog window.
It also closes any open
dialog and re-
turns to the monitoring view.
VIEW (fixed)
Scrolls through (up to) five preconfig-
ured screen layouts.
STANDBY (option)
Places the M540 into the Standby
mode.
CODE (option)
Starts the Code functions within the
Cockpit when the M540 is docked in an
IACS configuration.
DISCHARGE (option)
Discharges patient.
RECORD (option)
When on a network and connected to
strip recorder will prompt a recording
PRIVACY (option)
When connected to a Central if activat-
ed displays blank screen at M540 and
all monitoring is done at Central.
MARK (option)
Stores an event in the Event recall dia-
log window or at Central.
PATIENT (option)
Opens the Demographics dialog win-
dow.
Rest ECG report (op-
tion)
Generates a diagnostic quality 12 lead
ECG report.

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Patient Category, Admit and Discharge
Confirm Patient Category for Adult, Pediatric, or Neonatal Mode.
If Category incorrect:
1. Press the Menu function key.
2. Touch the Patient setup tab.
3. Touch Patient category and Select the appropriate category
(Adult, Pediatric, & Neonate). Each patient category has spe-
cific alarm defaults associated with it.
4. The message “Changing category will change alarm set- tings
and algorithmic processing” appears.
5. Press OK. The Patient setup dialog window closes and label
changes to indicate new patient category.
Enter Patient’s Demographic Information for Admission
1. Press the Menu function key
2. Touch the Patient setup tab.
3. Select Name, ID, and Admit date and use onscreen keyboard
to enter data.
4. Press Confirm.
Note: When connected to a Central Station data entry is easily achieved
with keyboard and mouse. Height and weight may be entered at the Infinity
Central Station.
TO DISCHARGE A PATIENT
1. Press Discharge function key.
2. Press Discharge to confirm or Cancel to resume monitoring of
patient.
3. Main Screen will show “Discharged, Touch screen to resume
monitoring”.
Note: All patient data is deleted upon discharge and default limit settings
are restored.

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Audio & Visual Alarms and Silencing
TO PAUSE AUDIO ALARMS FOR 2 MINUTES
1. Press Audio Pause key.
Note: Quiet Mode is Activated – If a new alarm condition with a priority
higher than the currently paused alarm occurs, a truncated alarm tone
sounds. In addition, the alarm is represented by visual alarm signals corre-
sponding to the alarm priority. If the new alarm is of lower priority than the
paused alarm, the new alarm condition is only represented by a visual alarm
signal. No acoustic alarm tones sound.
If Quiet Mode is Deactivated - Any new alarm condition breaks through the
Audio Pause period with full acoustic and visual alarm annunciation.
TO PRE-SILENCE ALARMS FOR 2 MINUTES
Allows one to audio pause in advance any potential alarm condi-
tions before they occur. If multiple alarm conditions arise during an
active pre-silence period, the M540 triggers a single alarm tone
sequence for the highest-grade alarm event.
1. Press the yellow key on the M540
oAny alarm conditions are reported visually by a
corresponding alarm message and a blinking
parameter box.
oA single alarm tone sequence is generated for the first
occurrence of an alarm condition of low, medium or high
priority.
oThe alarm message Audio paused appears in the far right
field of the header bar along with a countdown timer and
the following symbol:
Note: Pre-Silence functions only if Quiet Mode is activated.
TO ADJUST ALARM VOLUME
1. Press Alarms function key.
2. Touch Alarm Volume and change to desired %.

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Alarm Priorities
HIGH-PRIORITY ALARMS
- Report conditions that require immediate intervention; for ex-
ample, asystole.
- The alarming parameter’s box and alarm message field have red
background, and audible alarms*sound when active.
- Are latched, (audio / visual alarms continue until the alarm is
acknowledged, even if the alarm condition has ceased to ex-
ist). To acknowledge press .
MEDIUM-PRIORITY ALARMS
- Report conditions that require prompt attention but may not be
life-threatening; for example, low SpO2.
- The alarming parameter’s box and alarm message field have a
yellow background, and audible alarms* sound when alarms are
active.
- Are non-latched (audio / visual flashing alarms stop when situa-
tion corrects self), but alarm status message will remain in the
header bar. To remove message press .
LOW -PRIORITY ALARMS
- Alerts to technical issues that may compromise the ability of the
system to monitor the patient; for example, SpO2 probe off. Also
may be set to alert to lower risk arrhythmias, such as couplets.
- The alarming parameter’s box and alarm message field have cyan
background, and audible alarms* sound when active.
- Are also non-latched alarms, except status bar does not remain
active when situation resolved.
Note: Audible alarm signals are distinct for each alarm priority. Specific
characteristics including break through alarms will vary depending on the
default alarm pattern (Infinity, IEC fast or IEC slow) & software level.

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Views, Waveforms and Parameters
ECG, NIBP, SpO2, RRi, Temp, CO2, Invasive lines
Views
Each M540 supports five pre-configured views, which control the
content and the appearance of the main screen. You can switch to
a different view by touching the View key. Touching the View key
brings up the next screen to view. Choose the view that allows you
to view and interact with the waveforms and parameters that are
connected and being monitored.
Parameter Waveforms
TO CONFIGURE THE WAVEFORMS
1. Touch desired waveform area to open the waveform chan-
nel dialog window.
2. Touch Waveform and select the desired label for the wave-
form you want to view in the waveform dialog window.
3. To adjust the size for each waveform, touch Size, or Scale
and select the appropriate size.
Parameter Boxes
All setting changes are made by pressing the desired parameter
box and using the Alarm limits or Settings tab.

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Setting Parameter Alarm Limits
TO CONFIGURE ALARM LIMITS FOR EACH PARAMETER
1. Touch a parameter box to access the parameter’s dialog win-
dow (i.e., HR, NIBP).
2. The parameter’s limits tab is viewable
3. Touch the Upper or Lower alarm limit value.
4. Touch the Up or Down arrow to change the alarm setting.
5. Touch OK.
Note: For each parameter there may be more tabs along right side of dialog
window for setting more limits (i.e. PVC’s, Systolic, Diastolic, etc.).
TO TURN A PARAMETER ALARM OFF
1. Touch the parameter box desired.
2. Press the Alarm On box and it turns Off
ALARM ARCHIVE
Determines what happens in response to an Alarm.
1. Off – no event is stored and no recording is generated.
2. Record – Stores the event for later review
3. Store – stores the event for later review in Event recall.
4. Str/Rec – generates a timed recording and stores the event for
later review.

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Parameter Specific Settings
ECG
ARR (ARRYTHMIA) LIMITS
1. Touch HR parameter box > touch ARR Limits tab
2. Touch bottom most tab along right side of dialog box to scroll
to the Arrhythmia limit you want to adjust (i.e. VF, Vtach,
Brady, etc.)
3. Touch Alarm to choose setting: High, Medium, Low, or Off
4. Touch Archive setting for the alarm; Str/Rec, Store, Record, or
Off.
5. Touch and adjust Rate and/or Count if ARR has adjustable
settings.
TO SHOW ALL LEADS
1. Touch Heart rate parameter box> touch Settings tab.
2. Touch Show all leads.
3. Touch center of All Leads screen to view additional leads.
TO SELECT LEADS FOR PROCESSING
1. Touch Heart rate parameter box> touch Settings tab.
2. Touch ECG 2 tab
3. Touch ARR lead 1 to change lead assignment for channel 1,
Touch ARR lead 2 to change the assignment for channel 2
4. Select desired lead for processing of ECG Alarms

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TO SELECT PACER DETECTION
1. Touch Heart rate parameter box > touch Settings tab
2. Touch > ECG 2 tab
3. Touch Pacer detection – On / or Off.
TO ADJUST QRS DETECTION THRESHOLD
1. Touch Heart rate parameter box > touch Settings tab.
2. Touch > ECG 2 tab
3. Select Normal or Low QRS Threshold
*Note – Low detects QRS complexes of low amplitude.
TO RELEARN ECG
Not available in Neonatal mode
1. Touch Heart rate parameter box.
2. Touch Settings tab > ARR tab > Relearn.
NIBP - Non-Invasive Blood Pressure
TO START A NIBP SINGLE MEASUREMENT
1. Press the NIBP Start / Stop fixed key .
oPressing the key again stops the measurement.
oNIBP inflation limit settings - Adult, pediatric, and neonatal
-can be selected in NIBP parameter box > Settings tab
TO SET INTERVAL TIME
1. Touch NIBP parameter box.
2. On Settings tab, Touch the Interval time button and select
desired time interval.
3. Press NIBP key to initiate cycling.
oAn interval timer bar appears in the parameter box between
interval measurements and indicates interval timed BP’s are
in use.

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TO SUSSPEND INTERVAL MODE
1. Press the NIBP key longer than two seconds, to set the
interval to Off.
2. To resume interval times > reset desired interval frequency in
the Settings tab and initiate by pressing NIBP key .
SpO2 Monitoring
The accuracy of SpO2 monitoring depends largely on the strength
and quality of the SpO2 signal.
TO CHANGE PULSE TONE VOLUME
1. Touch SpO2 parameter box > touch Settings.
2. Touch Tone Volume and select desired % volume.
TO CHANGE PULSE TONE SOURCE
1. Touch SpO2 parameter box > touch Settings.
2. Touch Tone Source and select ECG or SpO2.
Note: Refer to M540 Instructions for Use manual for further device specific
information for Masimo or Nellcor.
RRi - Impedance Respiration
TO RELEARN RESP PROCESSING
1. Touch RRi parameter box > touch Settings.
2. Touch Relearn.
3. RRi waveform is re-analyzed and saved as a reference for
counting the Resp waveform.
TO CHANGE RESP PROCESSING MODE
1. Touch RRi parameter box > touch Settings.
2. Touch Mode and change to Auto or Manual.
oAuto – Optimal breath-detection threshold calculated at the
beginning of RESP monitoring, or with RESP Relearn. In-
tended for patients with regular breathing patterns. Re-

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learn the RRi waveform regularly to reduce artifact and op-
timize breath count.
oManual –The monitor detects breath based on the size of
the waveform. After turning on Manual mode adjust wave-
form size by touching the Resp waveform dialog box and ad-
just up or down to optimize the breath count. Intended for
adult or pediatric patients whose breathing patterns show
excessive variation; or for neonates whose breathing
rhythms tend to be irregular, and whose signals may not be
reliably detected in Auto mode.
TO ADJUST RRi WAVEFORM SIZE
1. Touch RRi waveform.
2. Touch Size and select desired amplitude.
TO DISPLAY RESPIRATORY MARKERS
1. Touch RRi parameter box >touch Settings tab,
2. Touch Marker and touch to turn On.
Note: Respiration markers indicate the time of breath detection. A white
vertical line displays on the Resp waveform where each breath is detected.
TO CHANGE RRc APNEA TIME
1. Touch etCO2 parameter box > touch Settings tab
2. Touch RRc Apnea Archive.
3. Select time duration of apnea event for an alarm to occur.
Mainstream etCO2 Monitoring
CONNECTING THE CO2 SENSOR
1. Connect yellow end of CO2 sensor cable to yellow CO2 con-
nector on M540.
2. Insert correct airway adapter for patient between endotrache-
al tube adapter and the ventilator Y-piece.