BeneView T5
V 1.00
Contents
Appearance
Basic Parameters
----ECG RESP SpO2 NIBP TEMP
Optional Parameters
IBP CO CO2 AG
Advance Parameters
ICG BIS RM
Hardware Principle
Software upgrade
Contents
Appearance
Basic Parameters
----ECG RESP SpO2 NIBP TEMP
Optional Parameters
IBP CO CO2 AG
Advance Parameters
ICG BIS RM
Hardware Principle
Software upgrade
Appearance
T5 Appearance
Front View
1.Physiological alarm lamp
2.Technical alarm lamp
3. Display screen
4. Power On/Off Switch
5. AC power LED
6. Battery LED
7. Press to silence all
system sound
8. Press to pause,
restore or clear alarms
9. Press to freeze or
unfreeze waveforms
10. Press to start or stop
recordings
11. Press to start or stop
NIBP measurements
12. Main menu
13. Knob
T5 Appearance
Side View
T5 Appearance
Rear View
1. AC Power Input
2. USB Connectors
5. Network Connector
6. CIS connector
8. SMR connector
Optional Parameters
IBP CO CO2 AG
Advance Parameters
ICG BIS RM
Hardware Principle
Software upgrade
Basic Parameters
ECG
--Electrocardiogram
--Electrocardiogram
Basic Parameters-ECG
What is ECG?
Bioelectricity
A kind of electricity that produced by the electric excitation of
the heart, which can be detected through electrodes.
A kind of continuous diagram recording Bioelectricity to
reflect all electric activities of the heart.
ECG Demo
RA
LA
RV
LV
Basic Parameters-ECG
Typical ECG waveform
P wave:
It records the electrical
activity of the heart's two
upper chambers (atria).
QRS complex:
It records the electrical
activity of the heart's two
lower chambers (ventricles).
T wave:
It records the heart's return
to the resting state.
Basic Parameters-ECG
Lewis L
Yellow
- Lead aVR: RA (+) to [LA & LF] (-) (Rightward) R
Red
N F
Black Green
Basic Parameters-ECG
RA White R Red
LA Black L Yellow
LL Red F Green
RL Green N Black
V Brown C White
Basic Parameters-ECG
ECG Module
Basic Parameters-ECG
ECG Accessories
- Integrated / Separated
- Clip / Snap
- Defibrillation or not (w or w/o 1kohm)
- 3 leads / 5 leads / 12 leads
Basic Parameters-ECG
ECG Setup
CASCADE:
waveform of each channel is displayed in
two lines
HR FROM:
Heart rate source
Options: ECG, SPO2, IBP, AUTO and ALL
Gain:
Adjust the amplitude of the waveform
Basic Parameters-ECG
ECG Parameter Setup
SMART LEAD OFF: If there is a LEAD OFF in the HR-derived channel, the system will automatically
switch to another lead to restore the display of the ECG waveform in the HR-derived channel.
PACE: Switch "ON" for pace making patient or “OFF" for non-pace making patient
Display modes:
NORMAL DISPLAY: To display 2 ECG waveforms for 5-lead (for 3-lead, only 1 ECG
waveform is displayed.)
MULTI-LEADS DISPLAY: The waveform area on the screen displays 6 ECG waveforms
HALF-SCAN MULTI-LEADS: 6 ECG waveforms are displayed on half of the screen.
Basic Parameters-ECG
ST segment analysis
- ISO: It is the base point, used to indicate the baseline point of the ST analysis.
Default value is 78ms.
Normal range:
-0.05mV ~ +0.1mV
Basic Parameters-ECG
ST segment analysis
Arrhythmia analysis
2.HR doubled
6.COMM error
Basic Parameters-RESP
The RESP display
1 3 2 4
1. Waveform name 5
2. RESP lead: I or II
3. Waveform gain
4. RESP label
5. RR: Respiration rate number
Basic parameters - RESP
Operation Notes:
Keep RA and LA
electrodes horizontally
Keep RA and LL
electrodes diagonally
Typical failures
– SpO2
Basic parameters – SpO2
What is SpO2?
• Hb+O2=HbO2
• SpO2=HbO2/(HbO2+Hb) X 100%
Operations Notes
Sensitivity
- Available options:
High, Med, Low
PLETH waveform
Perfusion
Pulse rate
Normal SpO2 numeric range indicator
Adult ≥ 95%
Neonate 91%~94%
Basic parameters – SpO2
Operations notes:
Select proper sensor for the patient and place the sensor correctly.
Note:
To ensure the light from the sensor is facing right to the finger nail, the
extension cable should be on the back of your hand.
Spo2-Notes for operation
• Make sure the nail covers the light window. (The wire should be on the
upside of the hand.)
• Check per 2-3 hours the sensor placement and move it when the skin
deteriorates.
• Pulse oximeter can overestimate the SPO2 value in the presence of Hb-CO,
Met-Hb or dye dilution chemicals.
3. Venous pulsations
7. Low perfusion
– NIBP
Basic Parameters-NIBP
Theory
The blood pressure is the vertical strength of blood applied
against the wall of the blood vessel as the heart pumps the blood
through the body.
DP=f2 (MP)
SP MP DP t
Basic Parameters-NIBP
Apply the appropriate size of cuff to the patient, and make sure that the
symbol "Φ" is over the humerus artery. Ensure that the cuff is not
wrapped too tightly around the limb. Excessive tightness may cause
discoloration.
Make sure that the cuff edge falls within the range of mark <->.
If it does not, use a larger or smaller one which is suitable.
Basic Parameters-NIBP
NIBP Module
Operations Notes
Display NIBP
1 Group Groups
Interval
MANUAL or 1~480MIN
NIBP STAT
Initiate 5 minutes of continuous,
sequential, automatic NIBP
measurement
VeniPuncture
Use the NIBP cuff to cause sub-
diastolic pressure to block the venous
blood vessel and therefore help
venous punture
Basic Parameters-NIBP
Patient Monitor
Basic Parameters-NIBP
NIBP Accuracy Test
Basic Parameters-NIBP
How to confirm when you think NIBP data are incorrect?
Resetting continuously?
COMM Error
– Temp
TEMP Principle
Principle
Sensor type:
- YSI
Optional Parameters
IBP CO CO2 AG
Advance Parameters
ICG BIS RM
Hardware Principle
Software upgrade
Optional Parameters
– IBP
Basic Parameters-IBP
Piercing skin&vas Intubate catheters into certain
blood vessel
Connecting
Transducers
Calculation
Cable
Transducers
Basic Parameters-IBP
Normal Pressure
saline Transducer
with
heparin
3-way
stopcock
Pressure line
Monitor
IBP Monitoring Procedure
1. Plug the pressure cable into the IBP connector on the monitor and
power on the monitor.
3. Prepare the pressure line and transducer by flushing the system with
normal saline solution. Make sure the tubing and transducer system is
free of air bubbles.
4. Connect the catheter to the pressure line, make sure there is no air
present in the catheter or pressure line.
5. Position the transducer so it is at the same level with the patient’s heart,
approximately mid-axillary line.
Steps:
Turn off patient stopcock before you start the zero procedure.
The transducer must be vented to atmospheric pressure before the zero
procedure.
The transducer should be placed at the same height level with the heart,
approximately mid-axially line.
★ Zero procedure should be performed before starting IBP monitoring or at least once
a day (or each time after connecting/disconnecting the cable)
IBP Calibration
IBP Calibration
1. Turn off the atmosphere stopcock before you start the calibration
procedure.
2. Attach the tubing to the manometer.
3. Make sure that patient is not on connection.
4. Connect the 3-way connector to the 3-way stopcock.
5. Open the port of the 3-way stopcock to the manometer.
6. Select the channel to be calibrated in the menu.
7. Inflate to make the mercury bar rise to the setup pressure value.
8. Adjust until the value in the menu is equal to the pressure value
shown by the mercury calibration.
9. Press Start button, the device will begin calibrating.
10.Wait for the calibrated result. You should take corresponding
measures based on the prompt information.
Optional Parameters
– C.O.
Basic parameters - C.O.
Measurement principle:
Thermodilution Technique
Inflator
CO2
Modules
Principle
Operation
Calibrate & test
CO2 Modules
Sensor
Adapter
CO2 Modules
CO2 Accessory
Comparison
Side-stream
Main stream
Mindray Oridion
Side-stream Microstream®
Patient Adult,Pediatric,Neonate Adult,Pediatric, Adult,Pediatric,Ne
Intubated Intubated or Non- onate;
intubated Intubated or Non-
intubated
Response time < 60 ms < 240 ms 2.9 S
Measure Delay No delay <2S 2.7 S
Sample air Never A few A few
leakage
Sensor price Expensive (reusable) Cheap( Cheap(
disposable) disposable)
Sensor break Some time never Never
Vapor block Nearly never A few Some times
CO2 - Principle
• Lambert
Lambert--Beer Law
Law::
Breath Rate
Vol %
− aLC
I = I0 ⋅ e
6 ETCO2
4
2
0 InspCO
Inhalation Exhalation Inhalation Exhalation
2
3. ATPD or BTPS
leakage.
Aging of device.
3. COMM Error
,or whether the
- Check whether the hardware is connected,
software
supports the module
Measured Gas
CO2
O2
N2O
Anesthesia Agents (AA):
– Enflurane
– Isoflurane
– Sevoflurane
– Desflurane
– Halothane
AG - Principle
Patient Type (Select the right water trap). This will determine the flow rate.
After 30 seconds since setting ‘MEASURE’ status, will show the value of ISO
accuracy,and after 10 minutes , will show the value of full accuracy
Change the water trap every month ; change the water trap when there is a
prompt of block or pump noise becomes loud.
Please take the water trap off when it is not used or set the work mode in
‘STANDBY’
Leakage Test
• Power up the system and allow the multi-gas module to enter full accuracy mode.
Set sample flow to 200 ml/min
• Block the sampling tubing connected to the water trap with the multi-gas analyzer
operating.
• Wait 30s for stabilization.
• Check that there is no air coming out of the Evac outlet by submerging the end of
the evacuation tub into water. There must not be more than 2 bubbles/15 seconds.
AG - Maintenance
Gas Measurement Check
specifications.
perform calibration.
AG - Maintenance
– Replace the water trap every month or more often if the monitor
indicates this.
Optional Parameters
IBP CO CO2 AG
Advance Parameters
ICG BIS RM
Hardware Principle
Software upgrade
ICG Introduction
ICG introduction
• Technology
- What is ICG?
- Principle
- Advantage and disadvantage
- Validity
• Operation
- Module and accessories
- Operation procedure
- The ICG display
- Notes
Q = Ventricular
ECG depolarization
B = Opening aortic
& pulmonic valves
∆Z
C = Maximal slope ∆Z
Y = Closure of pulmonic
valve
O = Opening mitral
∆Z / ∆t valve / rapid filling
of ventricles
Time
Correlation 4
3
Precision ICG CI
2.5
0.40 l/min/m2
2
Bias
1.5
0.07 l/min/m2
1
1 1.5 2 2.5 3 3.5 4 4.5
TD CI
• Sensor placement
Physical
– Height: 122 ~ 229cm
– Weight: 30 ~ 160kg
Precautions
– HR > 250 bpm
– Disease or Open-chest surgeries
– Severe Aortic Valve Regurgitation
– Septic Shock (End stage sepsis)
– Extremely High Blood Pressure (MAP > 130)
– Intra-Aortic Balloon Pump
Warning
– Minute Ventilation Pacemakers(MV Pacemakers)
Summary
Bis method
• Alpha (8-13Hz)
Alert, relaxed. Light anesthesia
• Theta (4-8Hz)
General anesthesia
• Delta (<4Hz)
Deep anesthesia. Ischaemia Overdose
Very ‘deep’ EEG Patterns
• Near-Suppression
• Burst-Suppression
• Isoelectric EEG
What is BIS?
Quatro
Pediatric
Semi-reusable
Sensor Application
Apply sensor on forehead
at angle
2 Inches
Circle #1: Centered, 2 inches (5cm)
above nose
Circle #4: Above/Adjacent to
eyebrow
Circle #3: Either temple between
corner of eye and hairline
Press edges of sensor
Circle all 4 elements
Smoothing Rate
• Options: 10s,15s, 30s
• Each BIS value is based on EEG data from the previous 10 or
30 seconds, depending on smoothing rate
(The same with SPO2 averaging time)
• The smaller rate you choose,the more susceptible it could be.
Response time
• 7.5 to 30 seconds, depending on smoothing rate
How to maintain Bis?
• Technology
- What is RM?
- Principle
- What can we get?
• Operation
- Module and accessories
- Operation procedure
- Operation Notes
• Calibration
What is RM?
RM = respiratory mechanics
Bernoulli principle
The air velocity can determine its
pressure.
Video
V1<V2
P1>P2
Principle
:
Monitor:
3 waveforms:
1. Flow waveform
2. PAW waveform
3. Vol waveform
2 loops:
1. FV (flow-volume) loop
2. PV (paw-volume) loop
What can we get?
18 parameters:
1. Pressure parameters
PIP: peak inspiratory pressure (unit: cmH2O)
Pplat: plateau pressure (unit:cmH2O)
PEEP: positive end expiratory pressure (unit: cmH2O)
Pmean: mean pressure (unit: cmH2O)
What can we get?
2. Flow parameters
PIF: peak inspiratory flow (unit: L/min)
PEF: peak expiratory flow (unit: L/min)
3. Vol parameters
TVi: inspiratory tidal volume (unit: ml)
TVe: expiratory tidal volume (unit: ml)
MVi: inspirator minute volume (L)
MVe: expiratory minute volume (L)
What can we get?
4. Other parameters
RR:
RR respiratory rate (unit: rpm)
I: E
E: ratio of the inspiratory and expiratory time
Compl:
Compl compliance (unit: ml/cmH2O)
Raw:
Raw airway resistance (unit: cmH2O/L/s)
FEV1.0: first second forced expiratory volume (unit: %)
RSBI: rapid shallow breathing index (unit: rpm/L)
NIP: negative inspiratory pressure (cmH2O)
WOB: work of breathing (J/L)
Module and accessory
Accessories
Flow Sensors
To patient
• Check for leaks in the breathing circuit system, as they may significantly affect
respiratory mechanics readings.
• Verify the Ventilation Mode. Improper settings of this function will cause
incorrect calculations of some parameters.
• Match the airway adapter you select to the appropriate patient category. Or
else may produce excessive ventilation resistance ,introduce excessive
airway dead-space, as well as inaccurate scales and alarm limits.
• Periodically check the flow sensor and tubing for excessive moisture or do
some clean work if necessary.
Calibration
• RM Module Zero Calibration
- A zero calibration is carried out automatically whenever the module is switched on
or connected. The 2nd zero calibration will be carried out 10 minutes later. And
after that, zero calibration will be triggered every 30 minutes.
- You can also start a manual zero calibration when there is a drift in the zero:
In the [RM Setup] menu, select [Zero RM].
Optional Parameters
IBP CO CO2 AG
Advance Parameters
ICG BIS RM
Hardware Principle
Software upgrade
Patient Monitor Diagram
and
Hardware Structure
Patient Monitor Structure
• Power Supply
• Main Control Part
• Parameter Measurement
• Man-machine Interface
• Other Auxiliary Functions
Block Diagram – T5
• Hardware Introduction
Parameters Module
EtCO2
2- IBP C.O. BIS RM ICG MPM - 3/5/12 ECG, NIBP, Resp, SpO2, 2-
Temp, 2-IBP
Main Board
Power Board
Front Panel Assembly
Button Board
DVI Interface board
USB Interface Board
3-slot Module Rack Communication Board
MPM Module Rack Communication Board
CF Card Communication Board
Contents
Appearance
Basic Parameters
----ECG RESP SpO2 NIBP TEMP
Optional Parameters
IBP CO CO2 AG
Advance Parameters
ICG BIS RM
Hardware Principle
Software upgrade
Why upgrade?
Solve bugs
OEM solution
Solution 1:
1. PC with Net port
2. Crossover cable
3. Upgrade file and upgrade software
Solution 2:
1. PC with Net port
2. Standard patch cable
3. Hub or switch
4. Upgrade file and upgrade software
What do we need?
Step1: Prepare network cable
Net Port
How to Upgrade?– For Beneview series
CMS+ protocol:
IP address: 196.76.0.1
Sub mask: 255.255.0.0
Gateway: 196.76.0.2
How to upgrade?
Step 6:
Config monitor IP address
How to upgrade
Step 7:
Confirm connection with DOS command ‘ping ***.***.***.***’
Good connection √
(‘Lost =0’)
X Bad connection
(‘Request timed out’)
How to Upgrade