GE B20 User manual

B40/B20 Patient Monitor
User's Guide
English
2081499-002 E (Paper)
21 November 2014
© 2014 General Electric Company.
All rights reserved.

B40/B20 Patient Monitor
User's Guide
Related to software VSP-C
0459
All specifications are subject to change without notice.
Document no. 2081499-002 E
21 November 2014
Copyright © 2014 General Electric Company. All rights reserved.
GE Medical Systems Information Technologies, Inc.
8200 West Tower Avenue
Milwaukee, WI USA
Zip: 53223
Tel: [phone] (outside US)
800 558 5102 (US only)
Fax: [phone]
www.gehealthcare.com
GE Healthcare
3F Building 1, GE Technology Park
1 Huatuo Road
Shanghai PRC 201203
Tel: [phone]
Fax: [phone]

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Contents
About this manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
About this device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Safety precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
System introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Monitoring basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Setting up the monitor before use . . . . . . . . . . . . . .29
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
Starting and ending . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Trends and Snapshot . . . . . . . . . . . . . . . . . . . . . . . . . .51
Printing and recording . . . . . . . . . . . . . . . . . . . . . . . . .55
Cleaning and care . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67
Pacemaker detection . . . . . . . . . . . . . . . . . . . . . . . . . .73
Arrhythmia detection . . . . . . . . . . . . . . . . . . . . . . . . . .75
ST Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
Impedance respiration . . . . . . . . . . . . . . . . . . . . . . . .79
Pulse oximetry (SpO2) . . . . . . . . . . . . . . . . . . . . . . . . . .83
Non-invasive blood pressure (NIBP) . . . . . . . . . . . .89
Invasive blood pressure . . . . . . . . . . . . . . . . . . . . . . .95
Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Airway gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Entropy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Technical specifications . . . . . . . . . . . . . . . . . . . . . 135
Electromagnetic Compatibility . . . . . . . . . . . . . . . 149

1
About this manual
This manual contains instructions necessary to operate this device
in accordance with its functions and intended use. Descriptions refer
to the software VSP-C
Information which refers only to certain versions of the product is
accompanied by the model number(s) of the product(s) concerned.
The model number is given on the nameplate of the product.
All illustrations in this manual are provided as examples only. They
may not necessarily reflect your monitoring setup or data displayed
on your monitor.
Manual conventions
Within this manual, special styles and formats are used to
distinguish between terms viewed on screen, a button you must
press, or a list of menu commands you must select:
−Names of hardware keys on the keypad are written in bold
typeface: NIBP Start/Cancel.
−Menu items are written in bold italic typeface: Monitor Setup.
−Emphasized text is in italic typeface.
−When referring to different sections in this manual, section
names are enclosed in double quotes: “Cleaning and care”.
−The word “select” means choosing and confirming.
−Messages (alarm messages, informative messages) displayed on
the screen are written inside single quotes: 'Learning.'
−Note statements provide application tips or other useful
information.
Monitor naming conventions
In this manual, the B40 Patient Monitor and B20 Patient Monitor are
referred to as “the monitor” when a function or a feature applies to
both. For describing monitor-specific issues, the monitors are
referred to as B40 and B20 respectively.
Acquistion module naming conventions
In this manual, the following naming conventions are used to refer
to different modules and module categories:
• Single-width airway module: E-miniC
• CARESCAPE respiratory modules: E-sCO, E-sCAiO
• Airway Gas Option: N-CAiO
• E-modules: All modules with the prefix E-, In parameter chapters,
E-modules refers to those modules that measure the
parameter(s) in question.
• Hemo: Hemodynamic
Illustrations and names
This manual uses illustrations as examples only. Illustrations in this
manual may not necessarily reflect all system settings, features,
configurations, or displayed data.
Names of persons, institutions, and places and related information
are fictitious; any similarity to actual persons, entities, or places is
purely coincidental.

2
Related documents
All publications conform with the product specifications and
applicable IEC publications on safety and essential performance of
electromedical equipment as well as with applicable UL and CSA
requirements valid at the time of printing.
−Clinical aspects, basic methods of measurement and technical
background: B40/B20 Patient Monitor User Reference Manual
−Installation, technical solutions and servicing: B40/B20 Patient
Monitor Technical Reference Manual
−Options and selections of the software: B40/B20 Patient Monitor
Default Configuration Worksheet
−Compatible supplies and accessories: B40/B20 Patient Monitor
Supplies and Accessories
−Other devices closely related to the monitor:
• iCentral and iCentral Client User's Reference Manual
• CIC Pro Clinical Information Center Operator's Manual
• CARESCAPE Central Station User’s Manual
Ordering manuals
A paper copy of this manual will be provided upon request. Contact
your local GE representative and request the part number on the
first page of the manual.

3
About this device
Indications for use: B40
This device is a portable multi-parameter unit to be used for
monitoring and recording of, and to generate alarms for, multiple
physiological parameters of adult, pediatric, and neonatal patients
in a hospital environment and during intra-hospital transport.
The device is intended for use under the direct supervision of a
licensed health care practitioner.
The device is not intended for use during MRI.
The device can be a stand-alone monitor or interfaced to other
devices via a network.
The device monitors and displays : ECG (including ST segment,
arrhythmia detection), invasive blood pressure, heart/pulse rate,
oscillometric non-invasive blood pressure (systolic, diastolic and
mean arterial pressure), functional oxygen saturation (SpO2) and
pulse rate via continuous monitoring( including monitoring during
conditions of clinical patient motion or low perfusion), temperature
with a reusable or disposable electronic thermometer for continual
monitoring Esophageal/Nasopharyngeal/Tympanic/Rectal/Bladder/
Axillary/Skin/Airway/Room/Myocardial/Core/Surface temperature,
impedance respiration, respiration rate, airway gases (CO2, O2, N2O,
anesthetic agents, anesthetic agent identification and respiratory
rate), and Entropy.
Indications for use: B20
This device is a portable multi-parameter unit to be used for
monitoring and recording of, and to generate alarms for, multiple
physiological parameters of adult, pediatric, and neonatal patients
in a hospital environment and during intra-hospital transport.
The device is intended for use under the direct supervision of a
licensed health care practitioner.
The device is not intended for use during MRI.
The device can be a stand-alone monitor or interfaced to other
devices via a network.
The device monitors and displays oscillometric non-invasive blood
pressure (systolic, diastolic and mean arterial pressure), invasive
blood pressure, end-tidal carbon dioxide, heart/pulse rate,
respiration rate, ECG (including arrhythmia and ST segment
analysis), temperature with a reusable or disposable electronic
thermometer for continual monitoring Esophageal/
Nasopharyngeal/Tympanic/Rectal/Bladder/Axillary/Skin/Airway/
Room/Myocardial/Core/Surface temperature, and functional oxygen
saturation (SpO2) and pulse rate via continuous monitoring,
including monitoring during conditions of clinical patient motion or
low perfusion, and Entropy.

4
Service
If the product malfunctions or if assistance, service, or spare parts
are required, contact GE service for technical support or contact
your local representative. It is helpful for you to duplicate the
problem, check and confirm the operation of all accessories to
ensure that they are not the cause of the problem.
Training requirements
No product-specific training is required for the use of this monitor.
Trademarks
Listed below are GE Medical Systems Information Technologies and
GE Healthcare Finland Oy trademarks used in this document. All
other product and company names contained herein are the
property of their respective owners.
Datex, Ohmeda, DINAMAP, Trim Knob, Unity Network, CARESCAPE,
EK-Pro, TruSignal, Entropy, GE Healthcare, GE Medical system,
General Electric Company.
Responsibility of the manufacturer
GE Medical Systems Information Technologies, Inc. is responsible for
the safety, reliability and performance of the equipment only if:
−Assembly operations, extensions, readjustments, modifications,
or repairs are carried out by persons authorized by GE.
−The electrical installation of the relevant room complies with the
requirements of the appropriate regulations.
−The equipment is used in accordance with the instructions for
use.
−The equipment is installed, maintained and serviced in
accordance with the instructions provided in the related
technical manuals.
Product availability
Some of the products mentioned in this manual may not be
available in all countries. Please consult your local representative for
the availability.

5
Classifications
In accordance with IEC 60601-1:
−Class I and internally powered equipment - the type of protection
against electric shock.
−Type BF or CF equipment. The degree of protection against
electric shock is indicated by a symbol on each parameter
module.
−Equipment is not suitable for use in the presence of a flammable
anesthetic mixture with air or with oxygen or nitrous oxide.
−Continuous operation according to the mode of operation.
−Portable Monitor
In accordance with IEC 60529:
−IP21 - degree of protection against harmful ingress of water.
In accordance with EU Medical Device Directive:
−IIb
In accordance with CISPR 11:
−Group 1 Class A;
• Group 1 contains all ISM (Industrial, scientific and medical)
equipment in which there is intentionally generated and/or
used conductively coupled radio-frequency energy which is
necessary for the internal functioning of the equipment itself.
• Class A equipment is equipment suitable for use in all
establishments other than domestic and those directly
connected to a low-voltage power supply network which
supplies buildings used for domestic purposes.
CE marking information
CE compliance
The monitor bears CE Mark CE-0459 indicating its conformity with
the provisions of the Council Directive 93/42/EEC concerning
medical devices amended by 2007/47/EC and fulfills the essential
requirements of Annex I of this directive. The country of manufacture
can be found on the equipment labeling.

6
Product Compliance
• This equipment is suitable for connection to public mains as
defined in CISPR 11.
• This Monitor conforms to general safety standard for medical
devices to IEC 60601-1.
• This Monitor conforms to EMC safety standard to IEC 60601-1-2.
• This Monitor conforms to usability safety standard for medical
devices to IEC 60601-1-6.
• The application of usability engineering to medical device
conforms to IEC 62366.
• The software life cycle processes conforms to IEC 62304.
• The application of risk management analysis to medical device
conforms to ISO 14971.
• The SpO2 Parameter conforms to ISO 80601-2-61.
• The SpO2 Parameter controlled desaturation study conforms to
ISO 14155: 2011.
• The TEMP parameter conforms to ISO 80601-2-56.
• The gas parameter conforms to ISO 80601-2-55.
• This Monitor conforms to particular safety standard for
multifunction patient monitoring equipment to IEC 60601-2-49.
• The invasive blood pressure parameter conforms to the IEC
60601-2-34.
• The ECG parameter conforms to IEC 60601-2-27, with exception
of Sub-clause 201.12.1.101.15.
• The NIBP parameter conforms to IEC 80601-2-30, EN 1060-3,
ANSI/AAMI/ISO 81060-2.
• The Entropy parameter conforms to IEC 60601-2-26.
• The alarm systems of the Monitor conform to IEC 60601-1-8.
Exception
The ECG parameter conforms to IEC 60601-2-27, with exception of
Sub-clause 201.12.1.101.15 QRS detection.
WARNING: In clinical conditions, it is reasonable to
assume that spurious signals of this type are either
random in occurrence, or related to pacemaker
activity. The arrhythmia analysis algorithm is
designed to factor the randomness of spikes into its
rejection logic, and this randomness is not exercised
in the above referenced testing. The algorithm does
correctly reject pace signals as prescribed by IEC
60601-2-27.

7
Safety precautions
These safety messages refer to the entire system. The message specific to parts of the system can be found in the relevant section.
Safety message signal words
Safety message signal words designate the severity of a potential
hazard.
Danger Indicates a hazardous situation that, if not avoided, will
result in death or serious injury.
Warning Indicates a hazardous situation that, if not avoided, could
result in death or serious injury.
Caution Indicates a hazardous situation that, if not avoided, could
result in minor or moderate injury.
Notice Indicates a hazardous situation not related to personal
injury that, if not avoided, could result in property
damage.
Danger safety messages
No danger safety messages apply to this monitoring system.
Warning safety messages
The following warning safety messages apply to this monitoring
system.
• Read all the safety information before using the monitor for the
first time.
• Equipment is intended for clinical professionals.
• For continued safe use of this equipment, it is necessary that the
listed instructions are followed. However, instructions listed in
this manual in no way supersede established medical practices
concerning patient care.
• Single-use devices and accessories are not designed to be
reused. Reuse may cause a risk of contamination, affect the
measurement accuracy and/or system performance, and cause
a malfunction as a result of the product being physically
damaged due to cleaning, disinfection, re-sterilization and/or
reuse.
• There are hazards associated with the reuse of single-use
sample tubing and adapters
• Inspect the sensor for signs of physical damage. Discard a
damaged sensor immediately. Never repair a damaged sensor;
never use a sensor repaired by others.
• Do not sterilize or immerse the sensor or cable in liquid. Do not
spray or soak the connectors.
• Do not route cables in a way that presents a tripping hazard.
• Route all cables away from patient’s throat to avoid possible
strangulation.
• Do not touch the patient, table, instruments, modules or the
monitor during defibrillation.
• To avoid the risk of electric shock, this equipment must only be
connected to a supply mains with protective earth.
• Always check that power cord and plug are intact and
undamaged.
• Use only approved accessories, including mounts, and
defibrillator-proof cables and invasive pressure transducers. For
a list of approved accessories, see the supplies and accessories
list delivered with the monitor. Other cables, transducers and
accessories may cause a safety hazard, damage the equipment
or system, result in increased emissions or decreased immunity
of the equipment or system or interfere with the measurement.
• DISCONNECTION FROM MAINS - When disconnecting the system
from the power line, remove the plug from the wall outlet first.
Then you may disconnect the power cord from the device. If you
do not observe this sequence, there is a risk of coming into

8
contact with line voltage by inserting metal objects, such as the
pins of leadwires, into the sockets of the power cord by mistake.
• If liquid has accidentally entered the system or its parts,
disconnect the power cord from the power supply and have the
equipment serviced by authorized service personnel.
• If a service message appears, discontinue use as soon as
possible and have the device repaired.
• PROTECTED LEADWIRES - Only use protected leadwires and
patient cables with this monitor
• When applying devices intracardially, never contact electrically
conductive parts connected to the heart (pressure transducers,
metal tube connections and stopcocks, guide wires, etc.).
• Do not use the monitor in high electromagnetic fields (e.g., MRI).
• Do not tilt the monitor to avoid liquid entering.
• Do not touch the electrical connector located within the
extension rack housing.
• Never store the monitor with the batteries inside. Storing the
monitor with the batteries inside may result in damage to the
monitor.
• NETWORK INTEGRITY — The monitor resides on the CARESCAPE,
S/5 and/or HL7 network. It is possible that inadvertent or
malicious network activity could adversely affect patient
monitoring. The integrity of the network is the responsibility of
the hospital.
• Don't modify this device without authorization of manufacturer.
If this device is modified, appropriate inspection and testing
must be conducted to ensure continued safe use of equipment.
Caution safety messages
The following caution safety messages apply to this monitoring
system.
• U.S. Federal law restricts this device to sale by or on the order of
a physician.
• SUPERVISED USE - This equipment is intended for use under the
direct supervision of a licensed health care practitioner.
• Dispose of equipment in compliance with instructions and
regulations.
• Reset the monitor if loss of monitoring data occurs.
• Leave space for circulation of air to prevent the monitor from
overheating.
• Before connecting power, check voltage and frequency ratings
of equipment.
• System time changes will result in time differences between
stored and realtime data.
Notice safety message
The following notice safety messages apply to this monitoring
system.
• NOTICE - The warranty does not cover damages resulting from
the use of accessories and consumables from other
manufacturers.
• If the device has been transported or stored outside operating
temperature allow the device stabilize back to operating
temperature range before applying power.
• The equipment is suitable for use in the presence of
electrosurgery. Please notice the possible limitations in the
parameter sections and in the “Techncial specification“ section.

9
System introduction
Safety precautions
Warnings
• All system devices must be connected to the same power supply
circuit
• EXCESSIVE LEAKAGE CURRENT - Do not use a multiple socket
outlet or extension cord.
• INTERFACING OTHER EQUIPMENT - Devices may only be
interconnected with each other or to parts of the system when it
has been determined by qualified biomedical personnel that
there is no danger to the patient, the operator, or the
environment as a result. In those instances where there is any
element of doubt concerning the safety of the connected
devices, the user must contact the manufacturers concerned (or
other informed experts) for proper use. In all cases, safe and
proper operation should be verified with the applicable
manufacturer’s instructions for use, and system standards IEC
60601-1 must be complied with.
• The medical electrical equipment or medical electrical system
may be interfered with by other equipment, even if that other
equipment complies with CISPR EMISSION requirements.
• BEFORE INSTALLATION — Compatibility is critical to safe and
effective use of this device. Please contact your local sales or
service representative prior to installation to verify equipment
compatibility.
System components
NOTE: Your system may not include all these components. Consult
your local representative for the available components.
1. Monitor frame with Software: VSP-C
2. E-modules: Parameter acquisition modules
3. Extension rack
12
3

10
Frame front view
B40 Front view B20 Front view
1. Transportation handle
2. Alarm light
3. Trim knob
4. Command board keys
5. Battery compartment
6. Guide rail for GCX mounting
7. Mains power and battery LEDs
8. On/Off key
9. Hemo connectors
10. E-module
11. Recorder module
10
1
2
3
4
5
6
8
7
9
11

11
Frame back view
Input/Output adapter and connectors B40 back view B20 back view
1. Receptacle for power cord
2. Serial port
3. Defibrillator connector
4. Nurse call connector
5. Network connector
6. Equipotential connector
7. Multi I/O connector
NOTE: 2,3,4 is on the multiple Input/Output adapter.
4
7
1
6
5
32

12
Acquisition modules
B40 acquisition modules:
•E-miniC
•E-sCO,E-sCAiO
•N-CAiO
•E-Entropy
B20 acquisition modules:
•E-miniC
•E-Entropy
E-miniC module
1. Water trap
2. Sample gas inlet
3. Gas outlet
1
2
3

13
E-sCO, E-sCAiO module
E-sCAiO E-sCO
1. D-fend Pro water trap
2. Gas sampling line connector (sampling gas in)
3. Water trap container
4. Gas exhaust line connector (sampling gas out)
N-CAiO module
1. D-fend Pro water trap
2. Gas sampling line connector (sampling gas in)
3. Water trap container
4. Gas exhaust line connector (sampling gas out)
1
2
3
4
1
2
3
4

14
E-Entropy module
1. Module keys
2. Entropy connector
1
2

15
How to identify the Hemo connectors’ configuration
The monitor provides different configurations for Hemo measurement.
The user can identify Hemo connectors’ configuration from connectors and label.
Hemo connectors’ type
Basic feature Optional feature
Identifier
ECG NIBP SpO2IBP Temperature
Hemo with GE SpO2XXGESpO
2X X SpO2_IBP_T
Hemo with Masimo SpO2XXMasimoSpO
2X X MasimoSpO2_IBP_T
Hemo with Nellcor SpO2XXNellcorSpO
2X X NellcorSpO2_IBP_T
Hemo with GE SpO2, without IBP X X GE SpO2XSpO2_T
Hemo with Masimo SpO2,
without IBP
XXMasimoSpO
2XMasimoSpO2_T
Hemo with Nellcor SpO2,
without IBP
XXNellcorSpO
2X NellcorSpO2_T
Hemo with GE SpO2, without IBP
and Temp
XXGESpO
2SpO2

16
Command board keys
(1) ON/OFF key
(2a) Battery status LED (light-emitting diode), see "Battery indicators"
on page 26 for details
(2b) AC power status LED
(3) Admit or discharge a patient; select user modes, see "Using
modes" on page 32
(4) Monitor settings
(5) Print and record different trends and waveforms
(6) Activate parameter specific menus
(7) Zeros invasive pressure channels
NOTE: Functional only when IBP option is available
(8) Start or stop NIBP auto cycling
(9) Reset active alarms
(10) Audio pause active alarms
(11) Return to normal screen view
(12) Start or stop local recording
NOTE: Functional only when recorder option is available
(13) Start or stop the NIBP manual measurement
(14) Take up to 10 snapshots, see "Take snapshots" on page 53
(15) Activate the Alarms Setup menu
(16) View historical trends and alarm events
16
34 9
87
5
1 62a
15 13 12 11
Admit/
Discharge
Monitor
Setup
Print/
Record ECG NIBP Airway
Gas
NIBP Auto
On/Off
Recorder
Start/Stop
Pt.Data &
Trends
Alarms
Setup SpO2 IBP Others NIBP Start/
Cancel
IBP
Zero All
Take
Snapshot
14
2b
10
Alarm
Reset