Welch Allyn Acuity Manual

Acuity
®
and
Mobile Acuity LT
Central Monitoring Systems
Directions for use
Software version 8.2x

ii Welch Allyn Acuity Central Monitoring System
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iii
Contents
1 - General information ......................................1
Indications for use ................................................1
General description................................................1
Conventions .....................................................2
General warnings and cautions.......................................3
Acuity System compliance with safety standards ........................7
Related documents................................................8
2 - Acuity System overview ...................................9
System configurations .............................................9
Central station screen.............................................16
3 - Admit and begin monitoring ..............................25
Preadmit a patient to Acuity System monitoring ........................25
Readmit a discharged patient .......................................27
Begin patient monitor communication with the system...................28
Enter and confirm a patient’s ID or room at the central station .............40
4 - Adjust monitoring settings and patient information ...........43
Set up typical monitoring at the Virtual Monitor .........................43
Adjust a patient’s alarm limits.......................................46
Adjust general printing settings .....................................48
Adjust a patient’s waveform displays .................................51
Arrhythmia Analysis option .........................................52
ST Analysis option ...............................................69
Edit patient information ...........................................79
5 - Respond to alarms and alerts .............................83
Overview of central station alarm and alert indications ...................83
Suspend an audible alarm or alert tone for 90 seconds ...................84
Remove a latched arrhythmia alarm ..................................87
Respond to specific alarms and alerts ................................88
Summary of Acuity System alarm and alert levels .......................95
6 - Review or print patient data ...............................97
Review patient data ..............................................97
Print and review printouts.........................................115

iv Contents Welch Allyn Acuity Central Monitoring System
7 - Move a monitored patient ...............................125
Move the patient and monitor to a new location .......................125
Move the patient to a different monitor ..............................131
8 - Discontinue Acuity System monitoring ....................133
Stop monitoring a patient .........................................133
Discharge a patient from Acuity System monitoring ....................136
9 - Status icons ...........................................137
Status icon colors ...............................................137
Patient/monitor status icons .......................................138
System component status icons ...................................145
10 - Troubleshooting and maintenance .......................149
Contact information .............................................149
Contents ......................................................150
Troubleshooting ................................................151
Maintenance ...................................................164
11 - Specifications ........................................175
Monitor/Acuity System compatibility ................................175
General system monitoring capabilities ..............................175
Acuity System heart rate .........................................177
Acuity System pacemaker detection ................................178
Acuity System alarm and alert indications ............................179
Electromagnetic standards compliance ..............................184
Acuity System customizable defaults and factory defaults ...............188
Warranty................................................201
Index ...................................................203

1
1
General information
Indications for use
The Acuity®Central Monitoring Station is intended to be used by clinicians for the central
monitoring of neonatal, pediatric, and adult patients in health care facilities.
In addition to the central monitoring of patient data, waveforms, alarms and alerts, the
Acuity software can include operational modules to provide extended recording of patient
data (Full Disclosure), arrhythmia monitoring and ST analysis.
• Full disclosure stores patient data for up to 96 hours
• Arrhythmia monitoring module provides real-time monitoring and alarms for specific
changes in cardiac rhythms. The clinician is responsible for determining the clinical
significance of each detected arrhythmia event or alarm. The arrhythmia module is not
intended for use with neonatal patients.
• ST analysis module provides real-time monitoring and alarms for ST segment
deviations, from a reference beat, for patients with suspected heart disease and
anomalies. The clinician is responsible for determining the clinical significance of each
selected ST segment deviation or alarm. The ST analysis module is not intended for
use with neonatal patients.
General description
The Acuity Central Monitoring System (Acuity System) is Welch Allyn’s central monitoring
solution. It consists of a central monitoring station, Acuity System software and a
collection of other commercially available networking products.
The Acuity System is available in multiple product configurations. Acuity Systems can be
customized to meet a customer’s unique needs based on hospital policy, health care
facility size and patient census and floor layout. In all cases, the user must carefully review
the features and functionality of the Acuity System to ensure that selected configurations
meet specific clinical needs.
The Acuity System supports patient information management, patient vital-sign alarm and
equipment alert management, patient data and waveform monitoring and review, system
administration and ongoing service.
The Welch Allyn Connectivity Server (WACS) module consists of a server platform on
which one or more of the following software options are installed: Web Server (Acuity
System patient printout files available on Web browsers), AcuityLink®(Acuity System
patient information delivered to mobile devices), HL7 Interface options, Third Party Data
Stream Interface and Clinician Notifier Barcode Interface.

2Chapter 1 General information Welch Allyn Acuity Central Monitoring System
Acuity System software further processes data acquired from patient monitors. Acuity
Systems with the Arrhythmia Analysis module calculate heart rate using multiple ECG
leads and arrhythmia analysis algorithms.
The Acuity System is not directly connected to patients. It is designed to be used as a
central monitoring system for a set of patient monitors that support both continuously and
intermittently acquired data. Supported monitors include, but are not limited to, the
following Welch Allyn devices: Propaq®Encore, Propaq CS, Propaq LT , Micropaq®, and
Welch Allyn 1500 Patient Monitor®, as configured to interface with the Acuity System.
The Acuity System and distributed monitoring devices are prescription devices to be used
by authorized health care professionals using standard institutional procedures and
standards of care for patient monitoring. Staff training in the operation of the Acuity
System and the patient monitoring devices connected to it is essential for optimal use.
Users should be skilled at the level of a technician, nurse, physician, health care provider
or medical specialist, with the knowledge and experience to acquire and interpret
patients’ vital-signs data.
Individuals using the Acuity System should be familiar with its operation as described in
this manual, and they should understand all warnings and cautions in the manual.
Conventions
WARNING Indicates conditions or practices that could lead to illness, injury, or
death.
Caution Indicates conditions or practices that could damage the equipment or
other property.
On the product, means “Consult the accompanying documentation.”

Directions for use Chapter 1 General information 3
General warnings and cautions
Warnings
Related to system components and configuration
WARNING Use only accessories approved by Welch Allyn. The use of any
other accessories can result in inaccurate patient data, can damage the
equipment, and can void your product warranty. See the accessory list or visit
www.welchallyn.com.
WARNING Always use accessories according to the standards of your facility
and according to the manufacturer's directions.
WARNING Welch Allyn has verified that Welch Allyn-specified network
requirements for this Acuity System have been met. Altering the cabling or
connecting the Acuity System to another type of power source could damage
the equipment, cause system restarts or hazardous conditions on the network,
or result in inaccurate patient information at the Acuity Central Station.
WARNING Do not change Acuity System components or configuration, such as
removing or adding a printer or substituting hardware, without approval by Welch
Allyn. Such changes could degrade system performance and affect patient
monitoring.
WARNING Devices connected to the Acuity System must be certified for
overall system compliance according to the European Norm 60601-1 and 60950
safety standards. The interconnection of any device with an Acuity System must
comply with IEC 60601-1-1. Devices listed in the Acuity System installation
planning guide comply with these standards. If in doubt about network
connectors or devices, please consult your facility’s Biomedical Engineering
department or Welch Allyn Technical Support.
WARNING It is strongly recommended that Acuity Systems be installed with
continuous power sources and redundant means of operator surveillance, such
as secondary central stations and hallway message panels. Acuity System
alarms, alerts or other events can go unnoticed if clinical personnel are not
present at the Acuity Central Station or if interruptions occur in power or system
operations. You are responsible to provide percent reliable power to the central
station. The central station will only work with reliable AC power.
WARNING Ensure that no headphones or headphone adapters are connected to
the headphone input of your computer. A connection in the headphone jack of a
computer will cancel speaker output for any audible alarms associated with the
Acuity System.

4Chapter 1 General information Welch Allyn Acuity Central Monitoring System
Related to close physical surveillance and specific patient populations
WARNING Ensure that the volume level on your computer is not set too low or
is not set to mute as this may cause you to miss audible alarms generated from
the Acuity System.
WARNING Replace central station hardware within the the lesser of 3 years or
the original equipment manufacturer’s specification. Failure to perform
preventative maintenance can impact system performance and availability.
WARNING The bedside patient monitor is the primary alarming source for the
patient, and the central station is a backup alarm source. The central station is
only as reliable as its network and should be relied on only as a backup alarming
device.
WARNING Lethal arrhythmia (LTA) analysis by the central station is only as
reliable as the connection to the bedside monitor. With the exception of the
Welch Allyn 1500 monitor in a disconnected state, which provides its own LTA
analysis and alarm, the central station is the primary source for LTA analysis. LTA
alarms will occur at the central station and will also be communicated to the
bedside monitor for annunciation. Thus, in a central station workflow, LTA
analysis and alarming will only be as reliable as the network.
WARNING A paired system CPU (high-availability pair) is strongly recommended
to provide system redundancy.
WARNING The electronic medical record system (EMR) is not intended to serve
as a primary monitoring system for alarms or as an exclusive source for patient
data in determining patient care. The Acuity System is capable of transferring
historical patient data to most customer-specified EMR systems through the
Welch Allyn Connectivity Server (WACS). However, the transferred patient data is
not a substitute for the patient data collected by the primary monitoring system.
WARNING It is important that clinicians understand and communicate to all
staff using the Acuity Central Station that any arrhythmia analysis software
program is an effective tool to assist in patient care, but arrhythmia analysis
packages are unable to achieve 100 percent accuracy for all morphologies and
occurrences of QRS and PVC detection. Thus, close physical surveillance and
clinical interpretation of cardiac data must still be an integral part of every
patient’s care. Clinicians must review all data obtained from the Acuity System
before implementing therapy based on the data.
WARNING Ensure that Acuity System patients are kept under close
surveillance, especially patients prone to arrhythmia events. Use the Acuity
System only in conjunction with close surveillance by trained clinicians.

Directions for use Chapter 1 General information 5
Related to monitoring interruption
WARNING Do not use the Arrhythmia Analysis or ST Analysis feature on
neonates. The Arrhythmia Analysis and ST Analysis options are not intended for
use with neonatal patients.
WARNING Keep all pacemaker patients under close observation. Rate meters
might continue to count the pacemaker rate during occurrences of cardiac arrest
or some arrhythmias. Do not rely solely upon rate meter alarms.
WARNING Central station alarms and other events can go unnoticed if clinical
personnel are not present at the central station or if interruptions occur in power
or system operations.
WARNING The leading cause of patient death or serious injury reported with the
use of patient monitoring equipment is failure to respond to alarms notifying the
user of an adverse change in patient condition. If you are relying on visual alarm
notifications, maintain a clear line of sight and remain within 4 meters of the
central station. If you are relying on audio alarm notifications, make sure that you
can hear audio alarms from where you are. Set the volume as needed considering
the environment and ambient noise levels. Verify that the alarm is audible to a
clinician working at the maximum distance from the central station.
WARNING If you view an Acuity System display remotely and its primary Acuity
System fails, you lose all access to the remote display. Monitoring a patient at an
Auto-Open Secondary (AOS) or Patient List Review (PLR) remote station is not a
substitute for monitoring a patient at the primary Acuity Central Station.
WARNING Use wireless monitors only on patients who can tolerate
intermittent monitoring interruptions. All wireless systems are prone to
intermittent signal dropout. During signal dropout periods, arrhythmia and ST-
segment analyses cannot be performed, and the Acuity System does not show
alarms or alerts.
WARNING If an Acuity Central Station display is intentionally or inadvertently
muted, alarm and alert tones do not occur at the display. If your central station
display includes audible tones, remain aware of whether they are occurring. If
they appear to have stopped, ensure that tones are restored.
WARNING If normal central processing unit (CPU) operation is interrupted, for
example, during CPU maintenance, scheduled and unscheduled reboots, power
loss or a high-availability (HA) CPU switchover period, central station monitoring
and analysis temporarily stop.
The Acuity System cannot collect patient review data during the interruption
period. That data becomes permanently unavailable.
Auto-reboots and HA CPU switchovers occur infrequently, but poor
environmental conditions and failure to perform preventative maintenance can
increase frequency of occurrence.

6Chapter 1 General information Welch Allyn Acuity Central Monitoring System
Cautions
WARNING Whenever an interruption in Acuity System CPU operation occurs,
please contact Welch Allyn Technical Service soon to ensure that your entire
system has returned to normal operating condition and that it does not require
further service.
WARNING Auto-reboots can occur during internal software checks, and wireless
connection can be occasionally disrupted. During this period, the bedside
monitors continue to provide their primary alarming functions.
Caution U. S. Federal law restricts this device to sale by or on the order of a
physician.
Caution Make sure that your barcode scanner is properly configured by Welch
Allyn before use.

Directions for use Chapter 1 General information 7
Acuity System compliance with safety standards
The CE Mark and Notified Body Registration Number signify that the product meets all essential
requirements of European Medical Device Directive 93/42/EEC.
Table 1. Acuity System compliance with safety standards
Acuity System component(s) Product category Organization and
standard
Propaq Encore, Propaq CS, Propaq LT, Welch Allyn
1500 Patient Monitor and Micropaq monitors
Wireless Micropaq, Propaq LT and Propaq CS
monitors
Medical Equipment EN 60601-1:1990
A1:1992, A2:1995
IEEE 802.11, Wireless
LAN Medium Access
Control (MAC) and
Physical Layer (PHY)
Specifications
IEEE 802.11a, 802.11e,
802.11h, 802.1X, 5 GHz
All components operating together as a system Electromagnetic compatibility for
Medical Equipment
IEC 60601-1-2:2007
All components operating together as a system Medical Systems IEC 60601-1-1:2000
All information systems components Information Technology Equipment EN 60950:1994
Acuity System cordless receiver cabinet Electromagnetic compatibility FCC Class Aa
a. When the equipment is operated in a commercial environment, Class A limits provide reasonable protection against
harmful interference. The equipment generates, uses and can radiate radio frequency energy; if it is not used in
accordance with this reference guide, or if it is modified from original installation, it might cause harmful interference
to radio communications. Operation of this equipment in a residential area is likely to cause harmful interference, in
which case the user is required to correct the interference at his own expense.

8Chapter 1 General information Welch Allyn Acuity Central Monitoring System
Related documents
Acuity and Mobile Acuity LT Central Monitoring Systems
Directions for use
Acuity and Mobile Acuity LT Central Monitoring Systems directions for use and
in-service guide CD-ROM (multilanguage)
Acuity and Mobile Acuity LT Central Monitoring Systems directions for use
Acuity Central Monitoring System in-service guide (English)
Mobile Acuity LT installation guide (printed)
Mobile Acuity LT System installation guide (En, Fr, Ger, Sp, It, Pol)
Quick card
Acuity System Icons (English, printed)
Welch Allyn Connectivity Server (WACS)
Welch Allyn Connectivity Server (WACS) CD-ROM (English):
Welch Allyn Connectivity Server directions for use
Welch Allyn Connectivity Server programmer’s guide
AcuityLink-Clinician Notifier directions for use
AcuityLink-Clinician Notifier Software
AcuityLink-Clinician Notifier software installation instructions (English)
Welch Allyn patient monitors
Micropaq Monitor directions for use CD-ROM (multilanguage)
Propaq LT Monitor directions for use CD-ROM (multilanguage)
Propaq CS Monitor directions for use CD-ROM (multilanguage)
Propaq Encore Monitor directions for use CD-ROM (multilanguage)
Welch Allyn 1500 Patient Monitor directions for use CD-ROM (multilanguage)

2
9
Acuity System overview
System configurations
The Acuity System consists of an Acuity Central Station that receives, displays and
analyzes information from various wireless and hardwired monitoring devices. Mobile
Acuity LT Central Stations are laptop computers.
Some Acuity Systems can send patient data to Internet browsers and hospital information
systems (HISs) via the optional Welch Allyn Connectivity Server (WACS). The systems can
receive patient information also from HISs.
The FlexNet®concept allows several Acuity Systems to centrally monitor groups of
patients resident on local Acuity Systems within a hospital and on networked Acuity
Systems in smaller clinics or hospitals. Transfers can occur from system to system and
remote viewing of real-time and historical Full Disclosure data is available for consultation
from any of the Acuity Systems.
Acuity Central Monitoring System Mobile Acuity LT System

10 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System
Diagram of the System
A. Hallway message panel Optional panels, located throughout a unit, visually indicate alarms and some alerts.
B. Welch Allyn 1500 Patient
Monitor
Hardwired, full-featured monitors with 12-lead ECG analysis and large displays
C. Propaq Encore monitor Hardwired, portable, full-featured vital-sign monitors
D. Propaq CS monitor Wireless or hardwired full-featured vital-sign monitors with large displays
E. Micropaq monitor Small, wireless monitors that measure ECG and SpO2. These monitors are useful for
ambulatory patients
F. Propaq LT monitor Small, wireless monitors that measure ECG/Resp, SpO2and NIBP. These monitors are
capable of displaying large numerics.
G. Wireless access point Connects wireless monitors and the Acuity Central Station.
H. Acuity Central Station Monitors all connected patients, stores patient information, and displays alarms and
alerts.
I. Laser printer Optional laser printers give you printouts of various types of patient information.
J. Welch Allyn Connectivity
Server (WACS)
An option to the Acuity System. WACS is a server platform on which software options
are installed.
K. Hospital network Carries information to the Acuity System and carries patient data to the hospital
information system (HIS/CIS).
L. Mobile device running
Clinician Notifier software
AcuityLink is a WACS option that delivers Acuity System patient information to mobile
devices running Clinician Notifier software.
Note Some patient monitors that can communicate within the Acuity System might not
be represented in this diagram.
F
E
A
C
D
I
J
L
H
K
B
G

Directions for use Chapter 2 Acuity System overview 11
Networked Acuity System features
Networked Acuity Systems include various features. This section presents these network
features:
• Remote Patient List Review (PLR) station
• Paired system CPUs (high-availability pairs)
Remote Patient List Review (PLR) station
Some networked Acuity Systems include one or more remote Patient List Review
stations. Clinicians can do these things at a PLR station:
• Open Waveform Windows.
• Open a Virtual Monitor.
• View realtime vital signs in all relevant windows.
• Open review windows.
• Print records and specify auto-printing for a patient.
WARNING If you view an Acuity System display remotely and its primary Acuity
System fails, you lose all access to the remote display. Monitoring a patient at an
Auto-Open Secondary (AOS) or Patient List Review (PLR) remote station is not a
substitute for monitoring a patient at the primary Acuity Central Station.
Networked Acuity System with a remote Patient List Review (PLR) station

12 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System
To open a Waveform Window on a PLR station screen
PLR stations are typically part of an extended Acuity System network.
To open a patient’s Waveform Window from a PLR station, first locate the patient via the
Patient List, and then open the patient’s Waveform Window.
1. In the lower left corner of the Acuity Central Station screen, click .
The Patient List window appears.
2. Scroll the patient list.
• If the patient is listed, proceed to Step 4.
• If the patient is not listed, click Other Patients to view networked Acuity System
units.
The Other Patients Lists window appears.
3. List patients by one of these criteria:
• Click Unit, and then select the unit name from the list in the box on the right.
• Click Last Name or First Name, and then click the first letter of the name.
4. Click a column heading to sort the list by name, location or ID.
Actively monitored patients are listed at the top.
5. Locate the patient name in the list, and then click the name.
6. Click .
The patient’s Waveform Window appears on the PLR station screen.
To close a Waveform Window on a PLR station screen
1. Drag the corresponding map icon to .
The Waveform Window and map icon close.

Directions for use Chapter 2 Acuity System overview 13
Flexible patient access (FPA) using virtual network computing (VNC)
The flexible patient access option allows you to connect to a Patient List Remote using a
VNC connection. Each purchased VNC license allows one VNC client to view real-time and
full-disclosure data on monitored patients.
The Acuity Central Station supports two editions of the VNC server, however these two
editions cannot be mixed on a single Patient List Remote. The VNC Free Edition Server is
pre-installed as a part of the Acuity System, however a license must be purchased in order
to use FPA. The VNC Enterprise Edition Server offers features not included in the free
edition, and can be purchased for an additional fee.
There are three screen resolutions available for the VNC connection.
To log on to flexible patient access using VNC
1. Ensure that you have installed a version of the VNC client application.
2. Launch your VNC client application.
The VNC connection screen appears.
3. Enter the IP address or host name, a colon, and the port number of the VNC server
and press OK. Do not add spaces between your entries.
Note The FPA using VNC configuration is a licensable feature. To order this feature,
contact your Welch Allyn sales representative (see page ii).
Resolution View type Standard port number
1280 x 1024 Standard resolution 5
1680 x 1050 Widescreen resolution 6
1024 x 704 Single patient view 7
Note It is recommended that your biomedical engineer work with your facility’s IT
department and add the host name of your VNC port forwarder to the domain
name server (DNS), so that changes to the port forwarder IP address do not affect
VNC users. It is also recommended that you use “acuity” as the host name of the
port forwarder.

14 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System
4. Enter your VNC client password.
If you are using the VNC Enterprise Edition Server, enter your user name and
password.
5. Press OK.
The Remote Patient List Review window appears. For more information see “Remote
Patient List Review (PLR) station” on page 11.
Note FPA connections are not shared between individual client connections. The Acuity
Central Station allows only one client to connect to each display session. When
you disconnect from a remote viewing session, the windows and views are not
reset. It is recommended that you close all patient windows on the viewing client
before disconnecting.

Directions for use Chapter 2 Acuity System overview 15
Paired system CPUs (High-availability pairs) and switchovers
Acuity Systems that typically support at least 29 patients include a high availability (HA)
central processing unit (CPU). The HA CPU is a redundant Acuity System CPU.
An HA CPU assumes control if the Acuity System CPU’s operation is interrupted. An HA
CPU “switchover” occurs to ensure minimal loss of Acuity Central Station monitoring
capability. Historical data that had been gathered by the non-operational CPU before the
switchover might not be available for some patients until that CPU becomes operational.
At any one time, displays in a paired CPU system should all receive input from either the
Acuity System CPU or the HA CPU.
To ensure that all displays in a paired CPU system receive input from the same CPU
During normal operating conditions
1. Ensure that none of the displays shows a yellow indicator in the top right corner.
If none shows a yellow indicator, the system is receiving input properly. If any display
shows a yellow indicator, proceed to the next step.
2. On any display with a yellow indicator, press the video input button, generally located
on the front of the display.
All displays now receive input from the Acuity System CPU, and alarms and alerts
appear on all of them. No displays show a yellow indicator.
During interruption of Acuity System CPU operation
1. Ensure that all displays show a yellow indicator in their top right corners.
If any display does not show a yellow indicator, proceed to the next step.
2. On any display without a yellow indicator, press the video input button, generally
located on the front of the display.
All displays now receive input from the Acuity System HA CPU, and they all show a
yellow indicator. If one or more of the displays is blank, or if all Virtual Monitors do not
reappear with their original border colors in approximately five minutes, see Table 10
on page 151.
WARNING Whenever an interruption in Acuity System CPU operation occurs,
please contact Welch Allyn Technical Service soon to ensure that your entire
system has returned to normal operating condition and that it does not require
further service.
Yellow indicator: input received from the Acuity System HA CPU.
Acuity System CPU
Acuity System HA CPU
No yellow indicator: input received from the Acuity System CPU.

16 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System
Central station screen
Depending upon the selected screen view, the Acuity Central Station screen can include
these areas:
• Map area
• Virtual Monitor
• Utility space
• Waveform Windows area
Note Depending upon the default screen color scheme of your Acuity Central Station
(black-on-white or color-on-black), your screen colors may not match those shown
in this manual.
A. Utility space Displays a patient’s Setup windows, Review windows, Patient List
window, and Central Station Printer windows.
B. Waveform Windows Abbreviated Virtual Monitors.
C. Acuity System map Shows the location and status of patients, and it displays status icons for
system equipment.
You open a patient’s Waveform Window or Virtual Monitor by clicking the
patient’s map icon once or twice.
D. System buttons Open the patient list, show patients who are connected to wireless
monitors, open system administration windows, and sort the order of
Waveform Windows.
E. Virtual Monitor Displays the patient’s vital-signs information and status.
G. Message window
A. Utility space
B. Waveform Windows
D. System buttons C. Acuity System map
E. Virtual Monitor F. Screen view buttons