ZOE PPM3 User manual

Nightingale Monitoring System
PPM3 User's Guide

ii Nightingale PPM3 User's Guide April 2019
Zoe Medical, Inc.
460 Boston Street
Topsfield, MA 01983
Nightingale Monitoring System PPM3 User's Guide
Part Number 122-0062, Revision C
©Zoe Medical 2005 - 2019 All rights reserved
Printed in the United States of America
EC Representative:
MedNet GmbH
Borkstrasse 10
48163 Muenster
Germany
Telephone [phone]
Fax [phone]
"Nightingale Monitoring System," "Nightingale MPC," "Nightingale PPM3,"
and "Personal Patient Monitor" are trademarks of Zoe Medical, Inc.
The information in this document is subject to change without notice.
This document contains proprietary information that is protected by
copyright. No part of this document may be reproduced in any manner, in
whole or in part (except for brief excerpts in reviews and scientific papers)
without the prior written consent of Zoe Medical.
Zoe Medical makes no warranty of any kind on this material, including but
not limited to, the implied warranties of merchantability and fitness for a
particular purpose. Zoe Medical shall not be liable for errors contained
herein or for incidental or consequential damages concerning the
furnishing, performance, or use of this material.
All Zoe Medical monitoring devices are intended for use only by qualified
medical personnel.
Before using any Zoe Medical monitoring device, be sure to read carefully
and understand all manuals provided with the device.
Caution: United States Federal law restricts this device to sale by or on
the order of a physician.

April 2019 Nightingale PPM3 User's Guide iii
User Assistance
If you have a question or need help operating the Nightingale PPM3, please
contact Zoe Medical Technical Support:
Email: [email protected]
Phone: [phone]
For the latest information about answers to frequently asked questions, please
consult our web site:
www.zoemedical.com

April 2019 Nightingale PPM3 User's Guide v
Table of Contents
Nightingale Monitoring System....................................................................i
PPM3 User's Guide.....................................................................................i
User Assistance.........................................................................................iii
General Information...................................................................................xi
1. Overview........................................................................................1-1
1.1. System Diagram......................................................................1-1
1.2. Scope of this User's Guide ......................................................1-2
1.3. PPM3 Diagrams ......................................................................1-3
1.4. PPM3 User Interface ...............................................................1-8
1.5. Main Features of the PPM3...................................................1-11
2. Getting Started ..............................................................................2-1
2.1. Parts you should have.............................................................2-1
2.2. Mounting solutions...................................................................2-2
2.3. How to Connect the PPM3 to Power and Communications.....2-3
2.3.1. Checklist before Connecting to Patient............................2-11
2.4. How to Connect the PPM3 to the Patient ..............................2-12
2.5. How to Check the PPM3 Setup............................................. 2-12
3. ECG and Heart Rate Monitoring....................................................3-1
3.1. Overview of ECG and Heart Rate Monitoring..........................3-1
3.2. Getting Started with ECG on the PPM3...................................3-1
3.3. Checking the ECG Signal........................................................3-2
3.4. Standard Electrode Placement (AHA) .....................................3-5
3.5. Standard Electrode Placement (IEC).......................................3-6
3.6. Electrode Placement for Paced Patients (AHA).......................3-7
3.7. Electrode Placement for Paced Patients (IEC)........................3-8
3.8. Verifying Proper Pacemaker Handling.....................................3-9
3.9. ECG and Heart Rate Monitoring Messages........................... 3-10
4. Respiration Monitoring...................................................................4-1
4.1. Overview of Respiration Monitoring.........................................4-1
4.2. Getting Started with Respiration on the PPM3 ........................4-1
4.3. Checking the Respiration Signal..............................................4-1
4.4. Pediatric Considerations..........................................................4-3
4.5. Respiration Monitoring Messages ...........................................4-4
5. Pulse Oximetry Monitoring.............................................................5-1
5.1. Overview of Pulse Oximetry Monitoring...................................5-1
5.2. Getting Started with Pulse Oximetry on the PPM3..................5-1
5.3. Checking the Pulse Oximetry Signal........................................5-2
5.4. Pediatric Considerations..........................................................5-4
5.5. Pulse Oximetry Monitoring Messages .....................................5-5

vi Nightingale PPM3 User's Guide April 2019
6. Non-Invasive Blood Pressure Monitoring.......................................6-1
6.1. Overview of NBP Monitoring....................................................6-1
6.2. Getting Started with NBP on the PPM3...................................6-1
6.3. Checking the NBP Measurement ............................................6-2
6.4. Pediatric Considerations..........................................................6-6
6.5. Hypertensive Considerations................................................... 6-6
6.6. NBP Monitoring Messages......................................................6-7
7. Oridion CO2Monitoring..................................................................7-1
7.1. Overview of CO2Monitoring ....................................................7-1
7.2. Getting Started with Oridion CO2on the PPM3 .......................7-1
7.3. Checking the CO2Signal.........................................................7-2
7.4. Integrated Pulmonary Index.....................................................7-3
7.5. Oridion CO2Monitoring Messages ..........................................7-7
8. Masimo CO2Monitoring................................................................. 8-1
8.1. Overview of CO2Monitoring ....................................................8-1
8.2. Getting Started with Masimo CO2on the PPM3 ......................8-2
8.3. Checking the CO2Signal.........................................................8-4
8.4. Masimo LED Indicator .............................................................8-5
8.5. Zeroing Masimo CO2 Modules.................................................8-5
8.6. Masimo CO2Monitoring Messages .......................................8-11
9. Invasive Blood Pressure Monitoring..............................................9-1
9.1. Overview of IBP Monitoring.....................................................9-1
9.2. Checking the IBP Signal(s)......................................................9-3
9.3. IBP Monitoring Messages........................................................9-5
10. Temperature Monitoring ..............................................................10-1
10.1. Checking the Temperature....................................................10-1
10.2. Temperature Monitoring Messages....................................... 10-3
11. Working With Menus ...................................................................11-1
11.1. Parameter Menus..................................................................11-2
11.1.1. ECG and Heart Rate........................................................11-2
11.1.2. Respiration ...................................................................... 11-4
11.1.3. Pulse Oximetry ................................................................ 11-5
11.1.4. Non-Invasive Blood Pressure ..........................................11-7
11.1.5. Oridion CO2 / Capnography .............................................11-9
11.1.6. Masimo CO2 / Capnography.......................................... 11-10
11.1.7. Invasive Blood Pressure................................................ 11-12
11.1.8. Temperature.................................................................. 11-13
11.2. Front Panel Keypad Menus.................................................11-14
11.2.1. SETUP Key and Submenus .......................................... 11-14
11.2.2. Password Protected Menus...........................................11-29
11.2.3. NBP INTERVAL Key......................................................11-35

April 2019 Nightingale PPM3 User's Guide vii
11.2.4. STANDBY Key...............................................................11-37
11.2.5. TRENDS Key.................................................................11-37
11.2.6. MAIN SCREEN Key....................................................... 11-37
12. Managing Alarms.........................................................................12-1
12.1. Alarm Presentation Basics.....................................................12-2
12.1.1. Audible Alarm Tones ....................................................... 12-2
12.1.2. Visual Alarm Colors......................................................... 12-2
12.1.3. How to Silence Alarms..................................................... 12-3
12.1.4. Alarm Messages..............................................................12-4
12.1.5. How to Enable or Disable Alarms.................................... 12-5
12.1.6. Alarm Validation............................................................... 12-6
12.1.7. Alarm Handling at Start-up ..............................................12-6
12.1.8. Alarm Reports..................................................................12-6
12.1.9. Audible Alarm Tones While Connected to the MPC ........ 12-7
12.1.10. Second Speaker Alarm Tones........................................12-8
12.2. Alarm Conditions ...................................................................12-9
12.3. What To Do When You Hear An Alarm Tone ......................12-15
12.4. Manual Self-test of the Alarm System.................................. 12-16
13. Centralized Monitoring................................................................. 13-1
13.1. Connecting to the MPC..........................................................13-1
13.2. Remote Control Settings........................................................13-2
13.3. Disconnecting from the MPC.................................................13-2
14. Viewing Trends............................................................................14-1
15. Entering Standby Mode...............................................................15-1
16. Battery Operation ........................................................................ 16-1
17. Strip Chart Recorder Option........................................................17-1
17.1. Basic Operation.....................................................................17-1
17.2. Recorder Settings..................................................................17-2
17.3. Strip Chart Recordings ..........................................................17-3
17.4. Trend Recordings..................................................................17-4
17.5. Recorder Messages...............................................................17-4
18. Troubleshooting........................................................................... 18-1
19. PPM3 Monitor Settings................................................................ 19-1
20. Accessories.................................................................................20-1
21. Cleaning ......................................................................................21-1
22. Maintenance and Storage............................................................22-1
22.1. PPM3 Functional Tests.......................................................... 22-1
22.2. PPM3 Calibration Procedures ............................................... 22-5
22.3. Battery Replacement.............................................................22-7
22.4. Storage..................................................................................22-7
22.5. Warranty................................................................................ 22-8

viii Nightingale PPM3 User's Guide April 2019
22.6. Password Control ..................................................................22-1
23. Disposal....................................................................................... 23-1
24. Technical Data............................................................................. 24-1

April 2019 Nightingale PPM3 User's Guide ix
Table of Figures
Figure 1. Nightingale Monitoring System.............................................1-1
Figure 2. PPM3 Front View..................................................................1-3
Figure 3. PPM3 Rear View ..................................................................1-4
Figure 4. PPM3 Left View....................................................................1-5
Figure 5. PPM3 Right View..................................................................1-6
Figure 6. Partially Engaged Power Connector.....................................1-7
Figure 7. Fully Engaged Power Connector..........................................1-7
Figure 8. PPM3 Front Panel ................................................................1-8
Figure 9. Sample of PPM3 Main Screen............................................1-10
Figure 10. PPM3 Startup Screen........................................................2-4
Figure 11. PPM3 Shutdown Screen....................................................2-5
Figure 12. New Patient Screen With Previous Patient........................2-9
Figure 13. Main Screen With No Patient Admitted............................2-10
Figure 14. ECG Waveform and HR Value ..........................................3-2
Figure 15. Standard AHA Electrode Placement..................................3-5
Figure 16. Standard IEC Electrode Placement...................................3-6
Figure 17. Paced AHA Electrode Placement......................................3-7
Figure 18. Paced IEC Electrode Placement........................................3-8
Figure 19. RR Waveform and Value...................................................4-2
Figure 20. SpO2Waveform and Value................................................5-2
Figure 21. NBP Value with Interval.....................................................6-2
Figure 22. Oridion CO2Waveform and Values...................................7-3
Figure 23. Integrated Pulmonary Index...............................................7-4
Figure 24. Masimo ISA Module With Nomoline ...................8-1
Figure 25. Masimo IRMA Module With Airway Adapter......................8-1
Figure 26. Nomoline Adpater ‒ Female Luer Lock .............................8-2
Figure 27. Snapping IRMA Onto Adapter ......................................8-3
Figure 28. Masimo CO2Waveform and Values..................................8-4
Figure 29. IBP Waveforms and Values...............................................9-3
Figure 30. TEMP Value.....................................................................10-1
Figure 31. Setup HR Menu............................................................... 11-2
Figure 32. HR/PR Values Sourced From SpO2 or ART ...................11-3
Figure 33. Setup RR Menu............................................................... 11-4
Figure 34. Setup SpO2Menu............................................................ 11-5
Figure 35. Setup NBP Menu............................................................. 11-7
Figure 36. Setup CO2Menu With Oridion Capnography................... 11-9
Figure 37. Setup CO2Menu With Masimo Capnography................ 11-10
Figure 38. Setup IBP Menu.............................................................11-12
Figure 39. Setup TEMP Menu ........................................................11-13

xNightingale PPM3 User's Guide April 2019
Figure 40. SETUP Key Menu.......................................................... 11-14
Figure 41. Main Screen With Alarms Paused Message & Timer.... 11-15
Figure 42. Setup Parameters Menu................................................ 11-16
Figure 43. Numbers Only Main Screen........................................... 11-17
Figure 44. Setup Waveforms Menu ................................................11-18
Figure 45. Setup Waveform Menu with IBPs..................................11-19
Figure 46. Setup Audio Menu......................................................... 11-20
Figure 47. Setup Alarms Menu –Screen 1.....................................11-21
Figure 48. Setup Alarms Menu –Screen 2.....................................11-23
Figure 49. Setup Alarms Menu –Screen 3.....................................11-24
Figure 50. Patient Information Menu............................................... 11-25
Figure 51. Adult Patient Type .........................................................11-25
Figure 52. Restore Department Defaults Menu ..............................11-26
Figure 53. Setup Administration Menu............................................ 11-27
Figure 54. Setup Configuration Menu............................................. 11-28
Figure 55. Enter Password Menu ................................................... 11-29
Figure 56. Setup Alarms Menu.......................................................11-30
Figure 57. Setup System Menu ......................................................11-32
Figure 58. Set Date and Time Menu............................................... 11-33
Figure 59. Save Department Defaults Menu...................................11-34
Figure 60. Setup NBP Interval Menu ..............................................11-35
Figure 61. Silenced & Active HR Limit Alarm....................................12-3
Figure 62. Trends Menu....................................................................14-2
Figure 63. Clear Trends Menu..........................................................14-3
Figure 64. Standby Menu.................................................................. 15-1
Figure 65. Standby Mode.................................................................. 15-2
Figure 66. Wakeup From Standby Mode.......................................... 15-2
Figure 67. Main Screen With Battery Icon ........................................16-1
Figure 68. PPM3 Recorder Connection............................................17-1
Figure 69. Replacing Recorder Paper ..............................................17-1
Figure 70. Setup Recorder Menu......................................................17-2