Nellcor N-200 User manual

To contact Nellcor’s representative: In the United States, call 1-800-NELLCOR or
510 463-4000; outside of the United States, call Nellcor’s local representative.
Caution: Federal law (U.S.) restricts this device to sale by or on the order of a
physician.
2003Nellcor Incorporated. All rights reserved. 066515-0203
OPERATOR’S MANUAL
NELLCOR N-200
Pulse Oximeter

Tyco Healthcare Group LP
Nellcor Puritan Bennett Division
4280 Hacienda Drive
Pleasanton, CA 94588 USA
Toll Free: 1.800.NELLCOR
Authorized Representative
Tyco Healthcare UK LTD
154 Fareham Road
Gosport, PO13 OAS, U.K.
To obtain information about a warranty, if any, for this product, contact
Nellcor Technical Services or your local Nellcor representative.
NELLCOR, DURASENSOR, DURA-Y, OXIBAND, OXICLIQ, OXISENSOR,
OXISENSOR II, OXINET, C-LOCK, and the Nellcor knob configuration are
trademarks of Nellcor Incorporated.
ThinkJet is a trademark of Hewlett-Packard Company.
Covered by one or more of the following U.S. Patents and foreign equivalents:
4,621,643; 4,653,498; 4,700,708; 4,770,179; 4,869,254; 4,911,167; 4,928,692; 4,934,372;
5,078,136.

iii
CONTENTS
Figures
Tables
Safety Information .................................................................. 1
Warnings............................................................................ 1
General ........................................................................ 2
Alarms.......................................................................... 2
Electrical ...................................................................... 2
Sensors ....................................................................... 2
Measurements ............................................................. 3
Symbols ................................................................................... 5
Quick Guide to Operation ...................................................... 7
Basic Operation ................................................................. 7
Alarm Functions ................................................................. 7
Check Alarm Limits...................................................... 7
Adjust Alarm Limits ...................................................... 7
Adjust Alarm Volume ................................................... 8
Silence Alarm Temporarily........................................... 8
Adjust Alarm Silence Period ........................................ 8
Pulse Tone Volume............................................................ 8
Features ................................................................................... 9
Overview ............................................................................ 9
Automatic Self-Test and Startup .................................. 9
Oximeter Configurable Settings................................... 10
Principles of Operation .......................................................... 11
Operating Principles........................................................... 11
C-LOCK ECG Synchronization.................................... 11
Automatic Calibration................................................... 12
Functional versus Fractional Saturation....................... 12
Measured versus Calculated Saturation...................... 13
Setup ........................................................................................ 15
Unpacking and Inspection.................................................. 15
Testing ............................................................................... 15
Components ...................................................................... 16
Display ......................................................................... 16
Controls ....................................................................... 16
Front Panel .................................................................. 16
Interface/Powerbase Rear Panel ................................. 18

Contents
iv
Rear-Panel Switches ................................................... 20
C-13-200 and C-20-200 Patient Modules .................... 20
C-13-200M Patient Module ......................................... 21
NELLCOR Sensors ................................................................. 23
Selecting a NELLCOR Sensor........................................... 23
Cleaning and Reuse .......................................................... 24
Performance Considerations ............................................. 25
Guide to Operation ................................................................. 27
Basic Operation ................................................................. 27
Pulse Oximetry Subsystem Features................................. 28
Pulse Tone .................................................................. 28
Alarm Functions ........................................................... 29
Oximetry Operating Modes .......................................... 33
C-LOCK ECG Synchronization.................................... 34
Trend and Event Memories ......................................... 38
User-Defined Events.................................................... 43
Limit Events ................................................................. 44
Communications Formats............................................ 49
Interface/Powerbase .................................................... 58
Battery Operation......................................................... 59
Connecting to Other Instruments ......................................... 61
Overview ............................................................................ 61
RS-232 Communication Protocol ...................................... 61
Serial Data Connector Pin Assignments ..................... 61
Communications Formats............................................ 63
Setting Baud Rate........................................................ 65
Connecting the N-7000 Interface ....................................... 65
Connecting to the N-7500 Network.................................... 66
Connecting the N-9000 Recorder/Interface ....................... 66
Connecting Other Strip-Chart Recorders........................... 67
Connecting the Thinkjet Printer.......................................... 68
Connecting the P-200 Printer ............................................ 69
Maintenance ............................................................................ 71
Service ............................................................................... 71
Cleaning ............................................................................. 71
Battery Testing................................................................... 71
Determining Software Version ........................................... 72
Technical Assistance ......................................................... 72
Returning the N-200........................................................... 73

Contents
v
Troubleshooting ..................................................................... 75
Status Messages ............................................................... 75
Troubleshooting Guide....................................................... 77
General System Problems ........................................... 78
General Oximetry Subsystem Problems ..................... 79
Trend Memory Problems ............................................. 84
Specifications ......................................................................... 85
Performance ...................................................................... 85
ECG ................................................................................... 86
Environmental Conditions .................................................. 87
Electrical Characteristics.................................................... 88
Physical Characteristics..................................................... 89
FIGURES
1 Oxyhemoglobin Dissociation Curve ................................... 13
2 N-200 Front Panel ............................................................. 16
3 Interface/Powerbase Rear Panel ....................................... 18
4 C-13-200 and C-20-200 Patient Modules .......................... 20
5 C-13-200M Patient Module ................................................ 21
6 Standard Limb Lead Selection........................................... 36
7 Sample ThinkJet Trend Graph........................................... 41
8 Sample ThinkJet Event Graph ........................................... 46
TABLES
1 Rear-Panel Dip Switch ....................................................... 20
2 Selected NELLCOR Sensors............................................. 24
3 Default Alarm Settings ....................................................... 31
4 SERIAL COMM Connector Pin Assignments .................... 62
5 Output Format Switch Settings .......................................... 63
6 Baud Rate Switch Settings ................................................ 65

1
SAFETY INFORMATION
Warnings
WARNINGS
General
DANGER! Explosion hazard. Do not use in the presence
of flammable anesthetics.
The N-200 is to be operated by qualified personnel only.
Before use, carefully read this manual, accessory
directions for use, all precautionary information, and
specifications. The user must check that the equipment
functions safely and see that it is in proper working
condition before being used.
The N-200 is intended only as an adjunct in patient
assessment. It must be used in conjunction with clinical
signs and symptoms.
Do not use NELLCOR pulse oximeters during magnetic
resonance image (MRI) scanning. Adverse reactions
include: potential burns to patients as a result of contact
with attachments heated by the MRI RF pulse; potential
degradation of the MR image; and, potential reduced
accuracy of oximeter measurements. Always remove
oximetry devices and attachments from the MR imaging
environment before scanning a patient.
For preamplification requirements, only an N-200
patient module should be used with the N-200 pulse
oximeter. Do not use any other patient module (for
example, the N-100 patient module).

Safety Information
2
Alarms
Do not silence the audible alarm or decrease its volume
if patient safety could be compromised.
Check the audible alarm silence duration before
temporarily silencing the audible alarm.
Each time the monitor is used, check alarm limits to
ensure they are appropriate for the patient being
monitored.
Electrical
Electric shock hazard. Cover to be removed only by
qualified service personnel. There are no user-
serviceable parts inside.
Note: Do not connect to an electrical outlet controlled
by a wall switch because power to the monitor
could be inadvertently turned off.
Sensors
Before use, carefully read the sensor Directions for Use.
Use only NELLCORoxygen transducers (sensors). Use of
other oxygen transducers may cause improper oximeter
performance.
Tissue damage can be caused by incorrect application
or use of a sensor (for example, wrapping the sensor too
tightly or applying supplemental tape). Inspect the
sensor site routinely to ensure skin integrity and
correct positioning and adhesion of the sensor. If skin
integrity changes, move the sensor to another site.
Inspect the sensor and cable for fraying, cracking,
breakage, or other damage. If defects are noted, do not
use the sensor. Do not immerse sensor completely in
water, solvents, or cleaning solutions (because the
connector is not waterproof). Do not sterilize by
irradiation, steam, or ethylene oxide.

Safety Information
3
Measurements
Loss of pulse signal can occur for the following reasons:
¥ The sensor is too tight.
¥ There is excessive illumination, such as from
sunlight or a surgical or bilirubin lamp.
¥ The sensor is placed on an extremity with a blood
pressure cuff, arterial catheter, or intravascular line.
¥ The patient is in shock, has hypotension, severe
vasoconstriction or anemia, hypothermia, arterial
occlusion proximal to the sensor, or cardiac arrest.
Inaccurate measurements may be caused by:
¥ Incorrect application or use of a sensor.
¥ Significant levels of dysfunctional hemoglobins, such
as carboxyhemoglobin or methemoglobin.
¥ Significant levels of indocyanine green, methylene
blue, or other intravascular dyes.
¥ Exposure to excessive illumination, such as surgical
lamps (especially ones with a xenon light source),
bilirubin lamps, fluorescent lights, infrared heating
lamps, or direct sunlight. Exposure to excessive
illumination can be corrected by covering the sensor
with a dark or opaque material.
¥ Excessive patient movement.
¥ Venous pulsations.
¥ High-frequency electrosurgical interference and
defibrillators.
¥ Placement of the sensor on an extremity that has a
blood pressure cuff, arterial catheter, or
intravascular line.