Masimo SET Rainbow SET Rad-57 User manual

OPERATOR’S
MANUAL
Signal Extraction
Pulse CO-Oximeter™
Masimo Rainbow® SET®

The Rad-57 Signal Extraction Pulse CO-Oximeter Operating Instructions intend to provide the necessary infor-
mation for proper operation of all Rad-57 Pulse CO-Oximeter models.
General knowledge of Pulse CO-Oximetry and an understanding of the features and functions of the Rad-57
Signal Extraction Pulse CO-Oximeter models are prerequisites for proper use.
Do not operate any of the Rad-57 Signal Extraction Pulse CO-Oximeter models without completely reading and
understanding these instructions.
NOTICE
Purchase or possession of this device does not carry any express or implied license to use with replacement
parts which would, alone or in combination with this device, fall within the scope of one of the relating patents.
CAUTION:
FEDERAL LAW (U.S.) RESTRICTS THIS DEVICE TO SALE BY OR ON THE ORDER OF A
PHYSICIAN.
For further information contact:
Masimo Corporation
40 Parker
Irvine, CA 92618
USA
Tel.: [phone]
Fax.: [phone]
www.masimo.com
EU Authorized Representative for Masimo Corporation:
MDSS GmbH
Schiffgraben 41
D-30175 Hannover, Germany
Covered by one or more of the following U.S patents: 5482036, 5490505, 5632272, 5685299, 5758644,
5769785, 5919134, 6002952, 6011986, 6067462, 6157850, 6229856, 6236872, 6263222, 6360114, 6388240,
6430525, 6463311, 6501975, 6515273, 6606511, 6643530, 6650917, 6654624, 6684090, 6699194, 6745060,
6816741, 6826419, 6850787, 6861639, 6979812, 7186966, 7215984, 7215986, 7221971, 7254433, 7295866,
7328053, 7373194, 7376453, 7377899, 7467002, 7469157, 7471969, 7489958, 7496393, 7499741, 7509154,
7530955, RE38476, RE38492, international equivalents, or one or more of the patents referenced at www.
masimo.com/patents.htm. Other patents pending.
© 2016 Masimo Corporation. Masimo, , SET, Rad, LNCS, LNOP, Signal IQ, Discrete Saturation Transform,
DST, Rainbow, SpCO,SpMet, and FastSat are registered trademarks of Masimo Corporation.
Rad-57, SIQ, LNOPv, Pulse CO-Oximeter and APOD are trademarks of Masimo Corporation.
EC REP

Rad-57 Signal Extraction Pulse CO-Oximeter Operator’s Manual i
CONTRAINDICATIONS: The Rad-57 is contraindicated for use as an apnea monitor.
Safety Information, Warnings and Cautions
The Rad-57™ is designed to minimize the possibility of hazards from errors in the software program
by following Sound Engineering Design Processes, Risk Analysis and Software Validation.
■The Rad-57 is to be operated by qualified personnel only. This manual, accessories, Directions
for Use, all precautionary information, and specifications should be read before use.
■Explosion hazard. Do not use the Rad-57 in the presence of flammable anesthetics or other
flammable substance in combination with air, oxygen-enriched environments, or nitrous oxide.
■Electric shock hazard. Do not open the Rad-57 cover except to replace the batteries. Only a
qualified operator may perform maintenance procedures specifically described in this manual.
Refer servicing to Masimo for repair of this equipment.
■High intensity extreme lights (such as pulsating strobe lights and direct sunlight) directed on the
sensor, may not allow the Rad-57 to obtain readings.
■ EMI radiation interference such as computer displays and/or LCD/plasma TVs can cause
errors or incorrect measurements on the Rad-57.
■If patient hypoxemia is indicated, blood samples should be analyzed by laboratory devices to
completely understand the patient's condition.
■Pulse rate measurement is based on the optical detection of a peripheral flow pulse and
therefore may not detect certain arrhythmias. The Rad-57 should not be used as a replacement
or substitute for ECG based arrhythmia analysis.
■As with all medical equipment, carefully route patient cabling to reduce the possibility of patient
entanglement or strangulation.
■Do not place the Rad-57 or accessories in any position that might cause it to fall on the patient.
■Do not lift the Rad-57 by the patient cable or sensor.
■Patient Safety - If a sensor is damaged in any way, discontinue use immediately.
■Rad-57 should not be used as the sole basis for diagnosis or therapy decisions. It must be used
in conjunction with clinical signs and symptoms.
■Always remove the sensor from the patient and completely disconnect the patient from the Rad-
57 before bathing the patient.
■Interfering Substances: Dyes, or any substance containing dyes, that change usual blood
pigmentation may cause erroneous readings.
■Do not use the Rad-57 or sensors during magnetic resonance imaging (MRI) scanning. Induced
current could potentially cause burns. The Rad-57 may affect the MRI image, and the MRI device
may affect the accuracy of the Pulse CO-Oximetry parameters and measurements.
■ Do not use the Rad-57 during electrocautery.
■ Do not use the Rad-57 or sensor during defibrillation.
■If using the Rad-57 during full body irradiation, keep the sensor out of the radiation field. If the
sensor is exposed to the radiation, the reading might be inaccurate or the instrument might read
zero for the duration of the active irradiation period.

Rad-57 Signal Extraction Pulse CO-Oximeter Operator’s Manual
ii
Safety Information, Warnings and Cautions, continued
■Do not place the Rad-57 where the controls can be changed by the patient.
■Do not place the Rad-57 on electrical equipment that may affect the instrument, preventing it from
working properly.
■Do not expose the Rad-57 to excessive moisture such as direct exposure to rain. Excessive moisture
can cause the instrument to perform inaccurately or fail.
■Do not place containers containing liquids on or near the Rad-57. Liquids spilled on the instrument
may cause it to perform inaccurately or fail.
■Changes or modifications not expressly approved by the party responsible for compliance could
void the user's authority to operate the equipment
■SpO2is empirically calibrated to functional arterial oxygen saturation in healthy adult
volunteers with normal levels of carboxyhemoglobin (COHb) and methemoglobin (MetHb).
The Rad-57 cannot measure elevated levels of COHb or MetHb. Increases in either COHb or
MetHb will affect the accuracy of the SpO2measurement.
■ Inaccurate SpO2readings can be caused by:
zImproper sensor placement
zElevated levels of COHb and MetHb
zFor increased COHb: COHb levels above normal tend to increase the level of SpO2. The
level of increase is approximately equal to the amount of COHb that is present.
zNOTE: High levels of COHb may occur with a seemingly normal SpO2. When elevated
levels of COHb are suspected, laboratory analysis (CO-Oximetry) of a blood sample
should be performed.
■For increased MetHb: the SpO2may be decreased by levels of MetHb of up to approximately
10% to 15%. At higher levels of MetHb, the SpO2may tend to read in the low to mid 80s.
When elevated levels of MetHb are suspected, laboratory analysis (CO-Oximetry) of a
blood sample should be performed.
■Inaccurate SpCO and SpMet readings can be caused by:
z Improper sensor application
z Intravascular dyes such as indocyanine green or methylene blue
z Abnormal hemoglobin levels
z Low arterial perfusion
z Low arterial oxygen saturation levels including altitude induced hypoxemia
z Elevated total bilirubin levels
z Motion artifact
z SpCO readings may not be provided if SpO2 readings are less than 90%
z SpCO readings may not be provided if SpMet readings are greater than 2%
z Intravascular dyes such as indocyanine green or methylene blue

Rad-57 Signal Extraction Pulse CO-Oximeter Operator’s Manual iii
Safety Information, Warnings and Cautions, continued
z Externally applied coloring (such as nail polish)
z Elevated levels of bilirubin
z Severe anemia
z Low arterial perfusion
z Motion artifact
■Do not place the Rad-57 against a surface or cover the speaker. This can cause the system or
battery (non clinical) alarm to be muffled.
■If the Rad-57 fails any part of the setup procedures remove the instrument from operation
until qualified service personnel have corrected the situation.
■ Use the Rad-57 in accordance with Section 7, Environmental Specications in of this
manual.
■Do not incinerate batteries.
■To protect against injury from electric shock, follow the directions below:
■ Avoid placing the device on surfaces with visible liquid spills.
■ Do not soak or immerse the device in liquids.
■ Use cleanings solutions sparingly.
■ This device complies with part 15 of the FCC Rules. Operation is subject to the following two
conditions: (1) This device may not cause harmful interference, and (2) this device must
accept any interference received, including interference that may cause undesired operation.
■ This equipment has been tested and found to comply with the limits for a Class B digital device,
pursuant to part 15 of the FCC Rules. These limits are designed to provide reasonable
protection against harmful interference in a residential installation. This equipment generates,
uses and can radiate radio frequency energy and, if not installed and used in accordance with
the instructions, may cause harmful interference to radio communications. However, there is
no guarantee that interference will not occur in a particular installation. If this equipment does
cause harmful interference to radio or television reception, which can be determined by turning
the equipment off and on, the user is encouraged to try to correct the interference by one or
more of the following measures:
Reorient or relocate the receiving antenna.
Increase the separation between the equipment and receiver.
Connect the equipment into an outlet on a circuit different from that to which the receiver is
connected.
Consult the dealer or an experienced radio/TV technician for help.
■ In accordance with international telecommunication requirements, the frequency band of 5,150
MHz to 5,250 MHz is only for indoor usage to reduce potential for harmful interference to
co-channel mobile satellite systems.

Rad-57 Signal Extraction Pulse CO-Oximeter Operator’s Manual
iv
Safety Information, Warnings and Cautions, continued
■ This equipment has been tested and found to comply with the limits for medical devices to the EN
60601-1-2: 2002, Medical Device Directive 93/42/EEC and Class B.
■ A functional tester cannot be utilized to assess the accuracy of the Rad-57 or any sensors.
■Cleared Use Only: The device and related accessories are cleared by the Food and Drug
Administration (FDA) for noninvasive patient monitoring and may not be used for any processes,
procedures, experiments or any other use for which the device is not intended or cleared by the
FDA, or in any manner inconsistent with the instructions for use or labeling. The device and
related accessories are not intended for use in combination with other medical devices or in high-
risk applications.
■Disposal of product - Comply with local laws in the disposal of the instrument and/or its
accessories.
■This Class B digital apparatus complies with Canadian ICES-003.

Rad-57 Signal Extraction Pulse CO-Oximeter Operator’s Manual v
Table of Contents
Safety Information, Warnings and Cautions ....................................................................................i
SECTION 1 - OVERVIEW
About this Manual....................................................................................................................... 1-1
Warnings, Cautions and Notes ................................................................................................... 1-2
Product Description .................................................................................................................... 1-3
Features and Benefits...........................................................................................................1-3
Indications for Use ................................................................................................................1-4
Pulse CO-Oximetry..................................................................................................................... 1-5
SpO2General Description ....................................................................................................1-5
SpCO General Description....................................................................................................1-6
SpMet General Description...................................................................................................1-6
Pleth Variability Index - (PVI) General Description ...............................................................1-6
Low Perfusion........................................................................................................................1-6
FastSat..................................................................................................................................1-7
SmartTone ............................................................................................................................1-7
Principlesof Operation..........................................................................................................1-8
Functional vs. Fractional Saturation......................................................................................1-9
Rad-57 vs. Drawn Whole Blood Measurements...................................................................1-9
Masimo SET Signal Extraction Technology For SpO2Measurements.................................1-9
SpMet, and SpCO Measurements During Patient Motion ....................................................1-9
Masimo Rainbow SET Parallel Engines..............................................................................1-10
Masimo SET DST®.............................................................................................................1-10
SECTION 2 - SYSTEM DESCRIPTION
Introduction ................................................................................................................................. 2-1
Rad-57 Front Panel Controls...................................................................................................... 2-2
Rad-57 Rear Panel .................................................................................................................... 2-4
Battery Installation.................................................................................................................2-4
Symbols.................................................................................................................................2-5
SECTION 3 - SETUP
Introduction ................................................................................................................................. 3-1
Unpacking and Inspection .......................................................................................................... 3-1
Preparation for Monitoring .......................................................................................................... 3-1
Monitor Setup ............................................................................................................................. 3-2
Initial Setup............................................................................................................................3-2
SECTION 4 - OPERATION
Introduction ................................................................................................................................. 4-1
Basic Operation .......................................................................................................................... 4-1
General Setup and Use.........................................................................................................4-1
Default Settings.....................................................................................................................4-3
Successful SpO2Monitoring....................................................................................................... 4-5
Masimo Sensors....................................................................................................................4-5
Numeric Display - SpO2........................................................................................................4-5
Numeric Display - Pulse Rate ..............................................................................................4-6
Numeric Display - SpCO (upgraded Instrument) ..................................................................4-7
Numeric Display - SpMet (upgraded Instrument)..................................................................4-7
Numeric Display - PI ...........................................................................................................4-8

Rad-57 Signal Extraction Pulse CO-Oximeter Operator’s Manual
vi
Table of Contents
Pleth Variability Index - PVI (upgraded Instrument)..............................................................4-8
Low Signal IQ (Low SIQ) ......................................................................................................4-8
Low Perfusion........................................................................................................................4-8
Actions to be Taken..............................................................................................................4-9
Sensitivity ..............................................................................................................................4-9
Battery Level Indicator ........................................................................................................4-10
Low Battery Audible Alarm ..................................................................................................4-10
Normal Patient Monitoring .........................................................................................................4-11
Rad-57 Front Panel Control Operation ............................................................................... 4-11
Setup Menu ...............................................................................................................................4-11
Menu Navigation ................................................................................................................. 4-11
Setup Menu Level 1 – Alarm Volume and Alarm Silence ...................................................4-12
Setup Menu Level 2 – Alarm Limits ....................................................................................4-12
Setup Menu Level 3 – Sensitivity, Averaging, FastSat, SmartTone....................................4-13
Setup Menu Level 4 - Trend Settings .................................................................................4-14
Setup Menu Level 5 - LED Brightness and Factory Defaults .............................................4-15
Menu Selection....................................................................................................................4-15
Power Off ............................................................................................................................4-15
Special Menu ............................................................................................................................ 4-16
Special Menu – Line Frequency Configuration...................................................................4-16
Trend Setup and Use................................................................................................................ 4-17
Introduction..........................................................................................................................4-17
TrendCom Utility Installation ...............................................................................................4-17
Erasing Trend Memory........................................................................................................4-17
Trend Data Format..............................................................................................................4-17
SECTION 5 - ALARMS AND MESSAGES
Alarm Indication .......................................................................................................................... 5-1
Alarm Limits ................................................................................................................................ 5-1
Alarm Silence ........................................................................................................................5-3
Alarm Silenced Indicator .......................................................................................................5-3
Messages..............................................................................................................................5-4
SECTION 6 - TROUBLESHOOTING
Troubleshooting .......................................................................................................................... 6-1
SECTION 7 - SPECIFICATIONS
Rad-57 Specifications................................................................................................................. 7-1
Performance..........................................................................................................................7-1
Electrical................................................................................................................................7-2
Environmental .......................................................................................................................7-2
Physical Characteristics ........................................................................................................7-2
SECTION 8 - SENSOR AND PATIENT CABLES
Introduction ................................................................................................................................. 8-1
Selecting a Sensor................................................................................................................8-1
Sensor Application Instructions .............................................................................................8-1
Masimo Rainbow®Sensors..................................................................................................8-2
Rainbow R Series Adhesive Sensors ...................................................................................8-2

Rad-57 Signal Extraction Pulse CO-Oximeter Operator’s Manual vii
Rainbow Adhesive Sensors ..................................................................................................8-2
Rainbow Direct Connect Sensors .........................................................................................8-3
Rainbow Reusable Sensors..................................................................................................8-3
Rainbow Resposable™ Pulse CO-Oximeter Sensor System...............................................8-3
Masimo SpO2Sensors..........................................................................................................8-4
Red Reusable Sensors ........................................................................................................8-4
LNOP®Reusable Sensors ..........................................................................................................................8-4
LNOP®Adhesive Sensors ....................................................................................................8-4
LNOP®Specialty Sensors ....................................................................................................8-5
M-LNCS™/LNCS®Reusable Sensors ................................................................................8-5
M-LNCS™/LNCS®Adhesive Sensors .................................................................................8-5
M-LNCS™/LNCS®Specialty Sensors.................................................................................8-6
LNOPvTM Adhesive Sensors .......................................................................................................... 8-6
Sensor Accuracy ...................................................................................................................8-6
Cleaning And Reuse Of Masimo Reusable Sensors and Cables.........................................8-6
Reattachment of Single Use Adhesive Sensors ...................................................................8-6
SECTION 9- SERVICE AND MAINTENANCE
Introduction ................................................................................................................................. 9-1
Cleaning...................................................................................................................................... 9-1
Battery Replacement.............................................................................................................9-2
Performance Verification............................................................................................................. 9-2
Power-On Self-Test ...............................................................................................................9-2
Key Press Button Test...........................................................................................................9-2
Alarm Limit Test.....................................................................................................................9-3
LED Brightness .....................................................................................................................9-3
Service and Repair ..................................................................................................................... 9-3
Repair Policy .........................................................................................................................9-3
Return Procedure..................................................................................................................9-3
Sales & End-user
License Agreement........................................................................................ 9-5
Warranty...................................................................................................................................... 9-5
Exclusions................................................................................................................................... 9-5
End-User
License ...................................................................................................................... 9-6
Restrictions ................................................................................................................................. 9-6
SECTION 10- ACCESSORIES
Accessories............................................................................................................................... 10-1
Table of Contents