ZOLL M Series User manual

Non-Invasive
Blood
Pressure
9650-0214-01 Rev. D

The issue date or revision level for this operation guide is shown on the front cover.
ZOLL and M Series are trademarks of ZOLL Medical Corporation.
2002 by ZOLL Medical Corporation. All rights reserved.

Table of Contents
ZOLL M Series Non-Invasive Blood Pressure iii
PREFACE ........................................................................................................................................................................V
How Do I Use This Manual?..........................................................................................................................v
Safety Summary..............................................................................................................................................v
General NIBP Safety........................................................................................................................v
Cuff and Hose Safety ......................................................................................................................vi
Indications for Use.........................................................................................................................................vi
Contraindications for Use..............................................................................................................................vi
SunTech CE Contact......................................................................................................................................vi
INTRODUCTION ..............................................................................................................................................................1
What Can I Do With the NIBP Option?.........................................................................................................1
How Do I Use the NIBP Option?...................................................................................................................1
How Does the NIBP Option Work? ...............................................................................................................2
How Do I Read the Display?..........................................................................................................................3
PREPARING TO TAKE MEASUREMENTS .........................................................................................................................5
Setting Up the Hose and the Cuff...................................................................................................................5
Selecting the Cuff.............................................................................................................................5
Connecting the Hose ........................................................................................................................5
Applying the Cuff to the Patient ......................................................................................................6
Accessing NIBP Features...............................................................................................................................6
Displaying the NIBP Menu ............................................................................................................................7
Displaying the NIBP menu ..............................................................................................................7
Selecting Cuff Inflation Settings ....................................................................................................................8
Turning Off Auto Adjust..................................................................................................................8
Setting Cuff Inflation Pressure.........................................................................................................9
Setting Alarms................................................................................................................................................9
Setting Alarm Limits......................................................................................................................10
Enabling, Disabling and Suspending Alarms.................................................................................10
Triggering NIBP measurements.....................................................................................................10
TAKING MEASUREMENTS ............................................................................................................................................10
Taking a Single Measurement......................................................................................................................12
Taking STAT Measurements........................................................................................................................12
Starting STAT Measurements........................................................................................................13
Aborting STAT Measurements......................................................................................................13
Taking Automatic Measurements.................................................................................................................13
Setting the Measurement Interval .................................................................................................. 13
Starting Automatic Measurements.................................................................................................14
Taking an Additional Measurement...............................................................................................14
Aborting a Single Measurement.....................................................................................................14
Stopping All Automatic Measurements.........................................................................................15
Aborting Measurements................................................................................................................................15
PRINTING DATA...........................................................................................................................................................16
MAINTAINING THE NIBP OPTION ...............................................................................................................................16
Performing the Daily Checkout Procedure...................................................................................................16
Cleaning the Hose.........................................................................................................................................17
Cleaning Non-Disposable Cuffs...................................................................................................................17
SPECIFICATIONS...........................................................................................................................................................17
SOFTWARE LICENSE ....................................................................................................................................................19
ORDERING ACCESSORIES.............................................................................................................................................19
TROUBLESHOOTING .....................................................................................................................................................21

iv ZOLL M Series Non-Invasive Blood Pressure
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ZOLL M Series Non-Invasive Blood Pressure v
Preface
How Do I Use This Manual?
This manual insert describes the set up and use of the M Series Non-Invasive Blood Pressure option.
If you already know how to use the M Series, start by reading the Safety Summary, Indications for Use
and Introduction sections of this insert. Familiarize yourself with all the procedures in this insert
before you use the NIBP option. Consult the Troubleshooting section if the M Series fails to operate
as expected.
If you do not know how to use the M Series, see the M Series Operator’s Guide and the relevant
inserts. Thoroughly read the safety considerations and warnings sections in both the M Series
Operator’s Guide and the relevant inserts before operating your M Series product.
Place this insert in the three-ring binder along with the M Series Operator’s Guide and all other option
inserts.
Safety Summary
The following is a short summary of warnings, cautions and other safety information related to the
NIBP option. Additional warnings and cautions are in the text of this insert. Read this section
thoroughly before operating the NIBP Option.
General NIBP
Safety • Read the M Series Operator’s Guide and this manual insert before use.
• The M Series NIBP option is to be operated by qualified personnel only.
• Consult a physician for the proper interpretation of pressure measurements.
• Do not use the NIBP option on newborns or infants whose upper arm circumference is less than 13
cm.
• Do not use on patients known to be susceptible to bruising.
• Use caution when using on elderly hypertensive patients, as such patients may be more susceptible
to bruising.
• Do not use in the presence of oxygen-rich atmospheres, flammable anesthetics or other flammable
agents (such as gasoline). Do not use near the site of a gasoline spill. Explosion may result.
• Route patient cabling and hoses carefully to avoid patient entanglement, strangulation or
compression of hose.
• Do not select a cuff inflation pressure that exceeds the patient’s expected systolic pressure by more
than 30-40 mmHg (4.0-5.3 kPa). The factory-installed default cuff inflation pressure is 160 mmHg
(21.3 kPa).
• Do not attach the cuff to a limb being used for IV infusion or SpO2monitoring. Cuff inflation might
block the infusion, causing harm to the patient or inaccurate measurements.
• Keep patients as still as possible during measurement. Patient movement or vibrations from outside
sources, particularly moving vehicles, can degrade the measurement accuracy.
• Do not touch the bed, patient, or any equipment connected to the patient during defibrillation. A
severe shock to the operator can result.
• Do not allow exposed portions of the patient’s body to come in contact with metal objects, such as
a bed frame during defibrillation. Unwanted electrical pathways can result.

vi ZOLL M Series Non-Invasive Blood Pressure
• Check patient regularly for signs of skin irritation or impaired circulation in the monitored limb.
• If an alarm occurs while the alarms are suspended, audio alarms do not sound, only visual alarms
display.
• If the accuracy of measurements is suspect, first check the patient's vital signs by alternate means.
Then check the cuff, hose and M Series NIBP option for proper functioning.
• Do not immerse the M Series device, batteries, patient cables, sensors or airway adapters in water,
solvents, or cleaning solutions.
• Do not sterilize.
• Connect the ECG-out jack and modem (if available) only to other equipment with galvanically
isolated circuits.
• The cuff, hose and fitting are defibrillator proof. Using the NIBP option introduces no risk for shock
due to defibrillation. The cuff and hose are non-conductive. Using the NIBP option introduces no
risk for burns due to electro-surgery.
Cuff and Hose
Safety • Only use cuffs, hoses and connectors supplied or specified by ZOLL.
• Ensure that the hose is not kinked or obstructed before taking measurement.
• Do not use damaged cuffs, hoses or connectors.
• Improper cuff selection or placement can cause inaccurate measurements or patient injury.
• Position the cuff so it is level with the heart during measurement.
• Do not place the cuff on a limb with an SpO2sensor or an infusion line.
• Do not repeat NIBP measurements (particularly STAT measurements) at intervals less than 3-5
minutes over an extended period of time. Rapidly repeating measurement can impair circulation in
the monitored limb.
• Do not sterilize or immerse the cuffs or hoses.
Indications for Use
The ZOLL M Series NIBP option is indicated for the noninvasive measurement of arterial blood
pressure for resting patients in critical care and transport. The M Series NIBP option is designed to
measure blood pressure for adult and pediatric patients only.
Contraindications for Use
Use of the ZOLL M Series NIBP option is not indicated for use on neonatal patients or infants whose
upper arm circumference is less than 13 cm.
SunTech CE Contact
All cuff, hose andNIBP questions with regards to the Declaration of Conformity with European Union
Directives should be directed to the authorized representative for SunTech:
SunTech Medical Instruments Ltd.
Oakfield Industrial Estate
Stantom Harcourt Road
Eynsham, Witney
OX8 ITS
UK

ZOLL M Series Non-Invasive Blood Pressure 1
Introduction
What Can I Do With the NIBP Option?
With the NIBP option you can do the following:
• Take a single blood pressure measurement.
• Take a STAT measurement - as many measurements (up to ten) as possible within five minutes.
• Take repeated measurements at user-programmable intervals.
• Immediately abort any measurement in progress by pressing one button.
• Set the cuff inflation pressure to adjust automatically based on the previously measured systolic
value.
• Display systolic, diastolic and mean blood pressure on the screen.
• Configure alarms to go off when the unit detects blood pressure values above or below user-
programmable limits.
• Perform any of the above operations without leaving Monitor, Pacer or Defib mode.
How Do I Use the NIBP Option?
To take safe and accurate blood pressure measurements using the M Series NIBP option, you must do
all of the following:
1. Select the proper sized cuff.
2. Connect the hose to the M Series and to the cuff.
3. Apply the cuff to the patient.
4. Display the NIBP menu.
5. Set the cuff inflation pressure (if the current setting is not appropriate).
6. Configure alarms (if the current setting is not appropriate).
7. Take blood pressure measurement(s).
8. Read the display.
NOTE To facilitate quick reactions in emergency situations, press the NIBP button instead of completing
steps 4 - 7.
Each step corresponds to a section in this chapter. Read each section carefully before you use the
M Series NIBP option.
WARNING Do not use the NIBP option without proper training. Setting initial inflation pressure too high can
result in serious injury to the patient. Patient movement, very low pulse volume or vibration from
outside sources can influence the accuracy of blood pressure measurements.

2 ZOLL M Series Non-Invasive Blood Pressure
How Does the NIBP Option Work?
The NIBP option uses the oscillometric method to measure arterial blood pressure and consists of the
following parts:
• Blood pressure cuff.
•Hose.
• Pump.
• Pressure sensor and signal processing electronics/software (inside the M Series).
When taking a measurement, the M Series performs the following cycle:
1. Cuff inflates to preset pressure, cutting off the flow of blood through the arteries in the monitored
limb.
2. Cuff deflates incrementally.
3. When the cuff pressure drops far enough, the blood flow in the patient’s arteries resumes.
4. Pressure oscillations caused by the restricted blood flow travel from the cuff, through the hose, and
to the M Series.
5. A sensor inside the M Series measures the pressure oscillations and calculates the corresponding
systolic, diastolic, mean blood pressure and pulse rate values.
6. Blood pressure values display on the screen.
This cycle takes approximately 30 seconds. If set to do so, the M Series repeats the cycle at a user-
selected interval.
If the sensor cannot detect systolic pressure, the M Series immediately increases the cuff inflation
pressure and completes the measurement. If the M Series finds a fault, it displays a corresponding
message on the screen. If after 180 seconds the M Series has not been able to determine systolic,
diastolic or mean pressure, it aborts the measurement and deflates the cuff.
When taking automatic interval measurements, the M Series does not start a new measurement unless
30 seconds have elapsed since the end of the previously completed measurement cycle.

ZOLL M Series Non-Invasive Blood Pressure 3
How Do I Read the Display?
After each measurement, the NIBP display area displays the following blood pressure values:
• Systolic.
• Diastolic.
• Mean.
To access most NIBP features you must press a softkey with the proper softkey label. To facilitate
quick reaction in emergency situations, you can control some NIBP features by pressing the NIBP
button (see the following figure):
Figure 1: M Series Front Panel with NIBP Option
NOTE Depending on the options included in your M Series, your front panel and display may differ slightly
from the illustrations in this insert.
NIBP Display Area
Softkey Labels
Softkeys
NIBP Button NIBP Connector

4 ZOLL M Series Non-Invasive Blood Pressure
The NIBP display area consists of:
• Symbols that represent the status of blood pressure measurements.
• Numbers that represent the measurement values (see Figure 2 and Table 1):
Figure 2: NIBP Display Area
The movement of the Cuff Inflation Status Bar reflects the cuff inflationpressure. As the cuff inflates,
the Cuff Inflation Status Bar lengthens. As the cuff deflates, the Cuff Inflation Status Bar shortens.
When the cuff is fully deflated, the Cuff Inflation Status Bar is not displayed.
The Artifact indicator flashes when the M Series unit detects artifact in the signal. Under such
circumstances, perform additional blood pressure measurements. If you repeatedly obtain artifact, use
alternate techniques to obtain blood pressure prior to taking clinical action.
The M Series default unit of measure is millimeters of mercury (mmHg), but you can configure the M
Series to display kilopascals (kPa). See the M Series Configuration Guide for instructions on how to
configure alternate units of measure.
Table 1: NIBP Display Symbols
Display Symbols: Status:
Not taking any NIBP measurements.
Taking a single measurement
alternating with
Taking STAT measurement.
alternating with
Taking Auto measurement.
alternating with
Between Auto measurements.
Alarms enabled.
Alarms disabled
Cuff Inflation
Status Bar
Alarm Status Diastolic
BP Value
Systolic
BP Value
Mean BP
Value
Artifact
Indicator