Escort Prism SE 20414 User manual

ESCORT Prism™ & Prism SE
Patient Monitor
Reference Manual
Prism SE Model
20411
20412
20413
20414
Prism Model
20401
20403

ESCORT Prism™ & Prism SE
Patient Monitor
Reference Manual
Federal law restricts this device to sale by or on the order of a physician.
E9030-33R Rev F
Medical Data Electronics •12723 Wentworth Street •Arleta, California 91331-4330
[phone] •FAX [phone]
Medical Data Electronics •Rembrandtlaan 1B, 3723 BG •Bilthoven, The Netherlands
Tel: [phone] Fax: [phone]
Prism Model
20401
20403
Prism SE Model
20411
20412
20413
20414

ii
Preface
The ESCORT Prism and Prism SE Series monitors are intended only as an adjunct to patient
assessment. They cannot replace skilled nursing care and proper surveillance. Carefully read this
reference manual, all directions for use of monitor accessories, and all precautionary information
before attempting clinical use of any Prism or Prism SE. Always keep high-risk patients under
close surveillance. This monitor is a portable patient monitor intended for monitoring vital signs
of critically ill adult, pediatric and neonatal patients in the hospital environment.
Carefully read the Defibrillator/Pacer section of this manual, all directions for use of the
defibrillator/pacer, and all precautionary information before attempting clinical use of the
defibrillator/pacer.
The information in this document is subject to change without notice.
Warranty
The Prism, Prism SE and the Defibrillator/Pacer are warranted against defects in materials and
workmanship for a period of twelve (12) months from the date of shipment to the original
purchaser. Batteries, cables, cuffs, and sensors are warranted ninety (90) days from date of
shipment. Warranty is valid only to the original buyer. Defective equipment should be returned
freight prepaid to Medical Data Electronics. Equipment returned with defective parts and
assemblies will be either repaired or replaced. This warranty is not applicable if repair has been
attempted, if the instrument has been damaged due to operation outside the environmental and
power specifications for the product, or due to improper handling or use.
The foregoing warranty is in lieu of all other warranties expressed or implied, including but not
limited to any implied warranty or merchantability, fitness or adequacy for any particular purpose or
use. Medical Data Electronics shall not be liable for any incidental or consequential damages.
Technical Service
If you experience any problems with this product, please call:
Technical Service Tel: [phone]
Technical Service FAX: [phone]
Email [e-mail]
Trademarks and Acknowledgments
ESCORT®and the MDE logo are registered trademarks of MDE.
ESCORT GuardianTM, and ESCORT PrismTM are trademarks of MDE.
MASIMO® is a registered trademark of Masimo Corp.
C-Lock®and NELLCOR® are registered trademarks of Nellcor, Inc.
SureTemp®is a registered trademark of Welch AllynTM Inc.
Medico2 is a trademark of Oridion Systems Ltd.
Mircrostream®and FilterLine®are registered trademarks of Oridion Systems Ltd.

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Safety Considerations (Prism & Prism SE)
Read the following sections before using the Prism or Prism SE monitors. These cautions and
warnings are presented to both increase patient safety and prevent damage to the monitor.
WARNING: Shock hazard. Do not remove cover. There are NO user
serviceable parts. Contact qualified service personnel for all service
and repair.
Do not under any circumstances remove grounding conductor from
power plug. If there is any doubt about the integrity of the protective
earth conductor arrangement, operate monitor on internal battery
power until AC power supply protective conductor is fully functional.
To maintain patient electrical isolation, connect only to other
equipment with electronically isolated circuits.
WARNING: As with all electrical equipment, carefully route patient
cabling to reduce possibility of patient entanglement or strangulation.
WARNING: There is a potential fire hazard when used with oxygen-
emitting equipment, and danger of explosion when used near
flammable anesthetics.
WARNING: Do not use monitor during magnetic resonance imaging
(MRI). Induced current could potentially cause burns. The monitor
may affect MRI image and the MRI unit may affect the accuracy of the
monitor.
WARNING: To avoid shock hazard with RS-232 System
Interconnection, first consult IEC60601-1 for system interconnection
guidance. Specific requirements for system interconnection are
dependent upon device connected to the monitor and relative locations
of each device from patient, and relative location of connected device
to room containing the monitor. In all circumstances, the monitor
must be connected to a grounded AC power supply. The monitor is
referred to as an IEC 601/F device in the Summary of Situations
contained in IEC60601-1.
WARNING: When a remote display monitor is connected to the unit
via the VGA connector on side of unit, it is essential the remote
monitor is powered from a properly rated and approved isolation
transformer. This is required to meet earth leakage limits of 0.5 mA,
as per IEC60601-1, Cl. 19.3 for monitor.
WARNING: When connecting monitor to any other instrument, verify
proper operation before clinical use. Refer to the other instrument’s
operation manual for complete instructions.
WARNING: All input/output interfaces to the patient monitors must
be CSA601.1/UL2601-1, EN 60601-1 approved devices.
WARNING: Do not under any circumstance use replacement parts
and connect devices that are not approved by Medical Data
Electronics.

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CAUTION: Always locate the Prism or Prism SE and its power cord
away from any electrosurgery and diathermy equipment and its power
cord and cables.
CAUTION: When operating either the Prism or Prism SE monitor
from an AC power source, the wall receptacle must be a three-wire,
grounded, hospital grade outlet. Use only the monitor’s original
hospital grade AC power plug and cord, or an equivalent hospital
grade plug and cord. If in doubt about integrity of grounding of the
main supply connection, the unit must be operated by battery power.
CAUTION: DO NOT plug the unit into a multiple outlet power strip
to avoid summation of leakage currents.
CAUTION: Do not use in ambient temperatures above 40° C or below
5° C.
CAUTION: When using an external DC power source, the
equipotential connector must be used as a protective ground terminal.
Symbols (Prism & Prism SE)
The following symbols appear on the Prism and Prism SE monitors, and may appear on accessory
items. Familiarize yourself with these symbols and their meaning before using the monitor.
Type CF Defibrillation Protected Equipment: Isolated patient connections
comply with allowable leakage current limits for direct cardiac application
and are protected against effects of defibrillation.
Type CF Applied Part: Isolated Patient connections comply with the
allowable leakage current limits for direct cardiac application.
Attention: Consult accompanying documents.
Replace Fuses as Marked: For protection against fire, replace only with
fuses of same type and rating.
Caution: Dangerous voltage.
Alternating Current: 100-240V @ 50/60 Hz.
Equipotential Connection: When external DC power is used, the
equipotential connection must be used as a protective ground terminal.
Fuse: Voltage and current ratings appear adjacent to symbol.
The CE symbol indicates device conforms to the Medical Device Directive.
Single patient use only.

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Table of Contents
Chapter 1 – Physical Description........................................................................................................... 1-1
Prism & Prism SE Front Panel..................................................................................................... 1-1
Fixed Function Keys (USA and International)............................................................................. 1-2
ON/STBY .............................................................................................................................. 1-2
ALARM SUSPEND .............................................................................................................. 1-2
ALARM SETUP.................................................................................................................... 1-3
FREEZE................................................................................................................................. 1-3
NIBP START/STOP.............................................................................................................. 1-3
PATIENT TYPE....................................................................................................................1-3
SYSTEM SETUP .................................................................................................................. 1-3
PAGE HOME ........................................................................................................................ 1-3
RECORD ............................................................................................................................... 1-4
Parameter Softkeys....................................................................................................................... 1-4
WAVEFORM SOFTKEYS................................................................................................... 1-4
SYSTEM SOFTKEYS........................................................................................................... 1-4
Indicators...................................................................................................................................... 1-5
AC ON INDICATOR ............................................................................................................ 1-5
BATTERY CHARGING INDICATOR................................................................................ 1-5
ALARM INDICATORS........................................................................................................ 1-5
Prism & Prism SE Display Screen ............................................................................................... 1-6
ECG Lead in Use................................................................................................................... 1-7
Softkey Labels for Parameters Displayed in the Waveform Display Zone (WDZ)............... 1-7
Alarm Status for Parameters in the Waveform Display Zone................................................ 1-7
Alarm Status for Parameters in the NODZ............................................................................ 1-7
Numeric-Only Display Zone (NODZ)................................................................................... 1-7
Message Area for Parameters in the NODZ .......................................................................... 1-7
System Message Area............................................................................................................ 1-8
Message Area for Parameters in the WDZ ............................................................................ 1-8
Waveform Display Zone with Associated Numerics............................................................. 1-8
Current Monitoring Mode (Patient Type selected)................................................................ 1-8
Prism SE Rear Panel..................................................................................................................... 1-9
External DC Input (12 - 28V) Connector ............................................................................ 1-10
Fuse Holder and Fuse Replacement..................................................................................... 1-10
AC Power Cord Input Connector and Optional Power Cord Mounting Bracket................. 1-10
Battery Compartment........................................................................................................... 1-11
Model & Serial Number Label............................................................................................. 1-11
Add-On Module Interface.................................................................................................... 1-11
Auxiliary Output Connector ................................................................................................ 1-11
VGA Output Connector....................................................................................................... 1-11
Serial Interface (ISP Port).................................................................................................... 1-11
Equipotential Connector (Grounding Terminal).................................................................. 1-11
Prism Rear Panel ........................................................................................................................ 1-12
External DC Input (12 - 28V) Connector ............................................................................ 1-13
Equipotential Connector (Grounding Terminal).................................................................. 1-13
Batteries ............................................................................................................................... 1-13
Defibrillator/Pacer Interface ................................................................................................ 1-13
Fuse Holder/Voltage Selector and Fuse Replacement......................................................... 1-13

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AC Power Cord Input Connector and Optional Power Cord Mounting Bracket................. 1-13
Auxiliary Output Connector ................................................................................................ 1-14
Add-On Module Interface.................................................................................................... 1-14
Recorder Release Lever....................................................................................................... 1-14
Model & Serial Number Label............................................................................................. 1-14
Prism SE Side Panel................................................................................................................... 1-15
Connector Panel................................................................................................................... 1-15
Dual Channel Recorder........................................................................................................ 1-15
SureTemp Unit..................................................................................................................... 1-15
Prism Side Panel......................................................................................................................... 1-16
Multiparameter Module ....................................................................................................... 1-16
Dual Channel Recorder Module .......................................................................................... 1-16
Serial Interface (ISP Port).................................................................................................... 1-16
VGA Output Connector....................................................................................................... 1-17
Prism’s Modular Components.................................................................................................... 1-18
Prism SE’s Modular Components.............................................................................................. 1-19
Chapter 2 – General Instructions for Using the Patient Monitor....................................................... 2-1
Determine the Power Source........................................................................................................ 2-1
Prism’s Modular Batteries............................................................................................................ 2-1
Prism SE’s Battery ....................................................................................................................... 2-1
Prism’s Multiparameter Module...................................................................................................2-1
Prism SE’s Connector Panel......................................................................................................... 2-2
Turning Monitor ON and OFF..................................................................................................... 2-2
Vital Sign Setup Menus................................................................................................................ 2-2
Temporary Suspension of Monitoring.......................................................................................... 2-3
Basic Configuration Functions..................................................................................................... 2-3
Monitor Default Settings.............................................................................................................. 2-5
Setting Up Parameter Display Options......................................................................................... 2-5
Parameter Availability and ON/OFF Status........................................................................... 2-5
Parameter ON/OFF................................................................................................................2-5
Parameter Labels ON/BLANK.............................................................................................. 2-5
Parameter Colors and Tones.................................................................................................. 2-5
“MORE PRAMS AVAIL” .................................................................................................... 2-6
Chapter 3 – Vital Sign Parameter Usage............................................................................................... 3-1
ECG.............................................................................................................................................. 3-1
Patient Preparation................................................................................................................. 3-2
Selecting a Telemetry Patient to Monitor.............................................................................. 3-4
Correcting CHK Leads (Check Leads) Errors....................................................................... 3-4
Respiration.................................................................................................................................... 3-5
Cardiovascular Artifact Detection (CVA) ............................................................................. 3-5
Using CO2 as the Resp Source.............................................................................................. 3-5
Pulse Oximetry (SPO2)................................................................................................................ 3-6
SPO2 Sensor Accessories—Nellcor ...................................................................................... 3-8
SPO2 Sensor Accessories—Masimo ..................................................................................... 3-9
SPO2 Alarm Delay ................................................................................................................3-9
SPO2 Averaging Time........................................................................................................... 3-9
Temperature Monitoring ............................................................................................................ 3-10

vii
Measuring a Patient’s Temperature with Continuous Probes.............................................. 3-10
Measuring a Patient’s Temperature with SureTemp®.......................................................... 3-10
Noninvasive Blood Pressure Measurements (NIBP).................................................................. 3-11
Selecting an appropriate NIBP Cuff .................................................................................... 3-13
Displaying the NIBP Table.................................................................................................. 3-13
Invasive Blood Pressure............................................................................................................. 3-14
Pulmonary Artery Monitoring ............................................................................................. 3-15
Storage of Invasive Pressure Values to VSC....................................................................... 3-16
5th Trace Option ...................................................................................................................3-16
Cardiac Output and Hemodynamic Calculations ....................................................................... 3-17
Selecting a Thermodilution Catheter ................................................................................... 3-18
End Tidal Carbon Dioxide (ETCO2) (Prism Only).................................................................... 3-19
ETCO2 (CO2) Sensor and Airway Adapter Maintenance (Prism Only)............................. 3-21
End Tidal Carbon Dioxide (ETCO2) (Prism SE Only).............................................................. 3-22
Graphical Trends........................................................................................................................ 3-24
Vital Sign Chart (VSC) .............................................................................................................. 3-24
Storing VS Charts in Monitor Memory............................................................................... 3-26
“Episodic” VS Entries.......................................................................................................... 3-26
Clearing Patient Data from VSC (Vital Sign Chart)............................................................ 3-26
Oxycardiorespirogram (OxyCRG/CRG).................................................................................... 3-27
Alarms........................................................................................................................................ 3-28
Alarm Bells.......................................................................................................................... 3-30
Alarm Tones......................................................................................................................... 3-30
Latch Alarms........................................................................................................................ 3-31
Recorder ..................................................................................................................................... 3-31
Chapter 4 – Additional User Infromation............................................................................................. 4-1
Wireless Communication to a Central Station ............................................................................. 4-1
Guidelines for Cleaning................................................................................................................ 4-1
Maintenance and Calibration........................................................................................................ 4-2
Telemetry Monitoring .................................................................................................................. 4-2
CIS Functions............................................................................................................................... 4-2
Storage and Transport .................................................................................................................. 4-2
Chapter 5 – Main Setup Menus ............................................................................................................. 5-1
System Setup Menus .................................................................................................................... 5-1
ECG Setup Menus........................................................................................................................ 5-2
Respiration Setup Menus.............................................................................................................. 5-2
Pulse Oximetry (SPO2) Setup Menus.......................................................................................... 5-3
Invasive Blood Pressure (IBP) Setup Menus ............................................................................... 5-3
Noninvasive Blood Pressure (NIBP) Setup Menus...................................................................... 5-4
Continuous Temperature Setup Menus........................................................................................ 5-5
SureTemp Menu........................................................................................................................... 5-5
End Tidal Carbon Dioxide (ETCO2) Setup Menus ..................................................................... 5-6
Cardiac Outpt Setup Menus.......................................................................................................... 5-6
Vital Sign Chart (VSC) Setup Menus .......................................................................................... 5-7
Chapter 6 – Factory Defaults ................................................................................................................. 6-1

viii
System Setup Factory Defaults .................................................................................................... 6-1
Recorder Factory Defaults............................................................................................................ 6-2
Vital Signs Chart Factory Defaults............................................................................................... 6-2
ECG Setup Factory Defaults........................................................................................................ 6-3
Respiration Setup Factory Defaults..............................................................................................6-3
SPO2 Setup Factory Defaults....................................................................................................... 6-4
BP1 Setup Factory Defaults ......................................................................................................... 6-5
BP2 Setup Factory Defaults ......................................................................................................... 6-6
BP3 Setup Factory Defaults ......................................................................................................... 6-7
NIBP Setup Factory Defaults....................................................................................................... 6-8
CO2 Setup Factory Defaults......................................................................................................... 6-9
CO Setup Factory Defaults........................................................................................................... 6-9
Temp1 Setup Factory Defaults................................................................................................... 6-10
Temp2 Setup Factory Defaults................................................................................................... 6-10
Chapter 7 – System & Parameter Messages .........................................................................................7-1
System Messages.......................................................................................................................... 7-1
System Messages ................................................................................................................... 7-1
Battery Messages................................................................................................................... 7-2
Parameter Messages ..................................................................................................................... 7-2
ECG/Respiration Messages ................................................................................................... 7-2
SPO2 Messages...................................................................................................................... 7-3
Invasive Blood Pressure (BP1/BP2/BP3) Messages.............................................................. 7-3
Noninvasive Blood Pressure (NIBP) Messages..................................................................... 7-4
ETCO2 Messages................................................................................................................... 7-4
SureTemp Messages .............................................................................................................. 7-5
Cardiac Output (CO) Messages ............................................................................................. 7-6
Chapter 8 – Defibrillator/Pacer.............................................................................................................. 8-1
Introduction.................................................................................................................................. 8-1
Safety Considerations (Defib/Pacer)............................................................................................ 8-1
Symbols (Defib/Pacer) ................................................................................................................. 8-2
Cleaning, Maintenance, & Calibration......................................................................................... 8-2
Defibrillator/Pacer Front Overview..............................................................................................8-3
Defibrillator/Pacer Rear Overview...............................................................................................8-4
Defibrillator/Pacer Front Panel..................................................................................................... 8-5
Using Defibrillator and Pacer Paddles and Electrodes................................................................. 8-6
External Paddles .................................................................................................................... 8-6
Pediatric Paddles.................................................................................................................... 8-6
Disposable Adhesive Electrodes............................................................................................ 8-6
To Apply Disposable Adhesive Electrodes to the Patient: .................................................... 8-7
Internal Paddles...................................................................................................................... 8-7
Operating the Defibrillator........................................................................................................... 8-8
Disarming the Defibrillator.................................................................................................... 8-9
“Hands-Off” Defibrillation........................................................................................................... 8-9
To Defibrillate Using “Hands-Off” Procedure: ..................................................................... 8-9
Synchronized Cardioversion ......................................................................................................8-11
To Initiate Synchronized Cardioversion Procedure:............................................................ 8-11
Operating the Pacer .................................................................................................................... 8-11
To Pace with Dedicated Electrodes: .................................................................................... 8-12
Pacing and Defibrillating with the Same Electrodes............................................................ 8-14

ix
Chapter 9 – Clinical Information System.............................................................................................. 9-1
Introduction............................................................................................................................ 9-1
Operation ............................................................................................................................... 9-1
Accessing the CIS Menu........................................................................................................ 9-2
Interacting with the CIS Menu............................................................................................... 9-3
CIS Status Message Zone ...................................................................................................... 9-4
Setting up a Patient for Data Collection ................................................................................ 9-4
Initializing a New Patient Record: .................................................................................. 9-5
Initiating a Patient Query: ............................................................................................... 9-5
Confirming the Patient:................................................................................................... 9-7
Filing Vital Signs / Results....................................................................................................9-7
Selecting the Appropriate Filing Mode:.......................................................................... 9-7
Using the VSC Function to Set Up CIS Charting Intervals ............................................ 9-8
Manually Entering Vital Signs Data Using the CIS Menu............................................ 9-13
CIS Module Storage Capacity....................................................................................... 9-14
Deleting Vital Signs Entries................................................................................................. 9-14
Viewing the Current Patient Information............................................................................. 9-15
Special Circumstances ......................................................................................................... 9-15
Sending Patient Data Stored in the CIS Module After the Fact.................................... 9-15
Using the Temporary Name Feature ............................................................................. 9-17
Retrieving Vital Signs from Previous Patients.............................................................. 9-18
RS-232 Communication....................................................................................................... 9-19
Parameter Packet........................................................................................................... 9-19
Waveform Packet .......................................................................................................... 9-20
Additional Waveforms .................................................................................................. 9-23
Wiring Diagrams........................................................................................................... 9-24
Chapter 10 – Troubleshooting.............................................................................................................. 10-1
Chapter 11 – Supplies, Accessories, & Options.................................................................................. 11-1
Chapter 12 – Specifications .................................................................................................................. 12-1