Page 4 GE Medical Systems Information Technologies as repairable. Refer to the 250/250cx Series Service Manual for further information.
Page 5 CE Marking Information 0086 Compliance A GE brand Corometrics 250cx Series Monitor bears CE mark CE-0086 indicating its conformity with the provisions of the Council Directive 93/ 42/EEC concerning medical devices and fulfills the essential requirements of Annex I of this directive.
Page 6 CE Marking Information Exceptions The Monitor System EMC: Immunity Performance None Be aware that adding accessories or components, or modifying the medical device or system may degrade the EMI performance. Consult with qualified personnel regarding changes to the system configuration. CE-2 250cx Series Maternal/Fetal Monitor Revision C...
Page 7: Table Of Contents
Contents Safety ......... 1-1 General Information .
Page 8 Controls, Indicators, and Connectors ....3-1 Front Panel Description ..........3-3 Front Panel Displays .
Page 9 Preparing the Monitor for Patient Use ........4-11 Fetal Heart Rate Monitoring .
Page 10 Automatic Baseline “Zeroing” ........6-4 Internal Method - Intrauterine Pressure (IUP) .
Page 11 Venous Return in Auto Mode ........8-11 Adjusting the Interval Time Between Automatic Determinations .
Page 12 Alarms ........... . . 10-3 Alarm Volume .
Page 13 Annotations from a Central Information System ......11-9 Multiple Annotations ..........11-9 Summary of Annotations .
Page 14 Printing a Waveform Snapshot ........14-5 Recorder On .
Page 15 Strip Chart Recorder ..........17-11 Supplies &...
Page 16 Using the Spectra Alert Option ........C-4 Enabling/Disabling Spectra Alerts .
Page 17: Safety
Safety Revision C 250cx Series Maternal/Fetal Monitor 2036946-001...
Page 18 Safety: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 19: General Information
Responsibility of the Manufacturer GE Medical Systems Information Technologies is responsible for the effects on safety, reliability, and performance if: assembly operations, extensions, readjustments, modifications, or repairs are carried out by persons authorized by GE Medical Systems Information Technologies;...
Page 20: Definitions Of Terminology
Safety: Definitions of Terminology Definitions of Terminology Six types of special notices are used throughout this manual. They are: Danger, Warning, Caution, Contraindication, Important, and Note. The warnings and cautions in this Safety section relate to the equipment in general and apply to all aspects of the monitor.
Page 21: Monitor Contraindications, Warnings, And Precautions
In addition, proper placement of the paddles in relation to the electrodes is required to minimize harm to the patient. DEFIBRILLATION PROTECTION—When used with the GE Medical Systems Information Technologies-recommended accessories, the monitor is protected against the effects of defibrillator discharge.
Page 22 Safety: Monitor Contraindications, Warnings, and Precautions WARNINGS ELECTROSURGERY—The monitor is not designed for use with high-frequency surgical devices. In addition, measurements may be affected in the presence of strong electromagnetic sources such as electrosurgery equipment. EQUIPMENT USE—The use of this equipment is restricted to one patient at a time.
Page 23 EXTERNAL VGA CONNECTIONS—Connect only to GE recommended display. ONLY remove cover plate if external display is used. TELEMETRY CONNECTIONS—Connect only to GE recommended telemetry systems. Contact your GE service representative for more information. Revision C 250cx Series Maternal/Fetal Monitor 2036946-001...
Page 24: Cautions
GE Medical Systems Information Technologies Service Representative. DAILY TESTING—It is essential that the monitor and accessories be inspected every day.
Page 25: Electromagnetic Interference
Turn equipment in the vicinity off and on to isolate the offending equipment. Reorient or relocate the other receiving device. Increase the separation between the interfering equipment and this equipment. If assistance is required, contact your GE Medical Systems Service Representative. Revision C 250cx Series Maternal/Fetal Monitor 2036946-001...
Page 26: Equipment Symbols
Safety: Equipment Symbols Equipment Symbols The following is a list of symbols used on products manufactured by GE Medical Systems Information Technologies. Some symbols may not appear on your unit. Equipment Symbols ATTENTION: Consult accompanying documents. WASTE OF ELECTRICAL AND ELECTRONIC...
Page 27 Safety: Equipment Symbols Equipment Symbols POWER OFF: disconnection from the mains. POWER ON: connection to the mains. VGA connection. Revision C 250cx Series Maternal/Fetal Monitor 1-11 2036946-001...
Page 28 Safety: Equipment Symbols 1-12 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 29: Introduction
Introduction Revision C 250cx Series Maternal/Fetal Monitor 2036946-001...
Page 30 Introduction: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 31: Illustrations
Fetal Monitoring Indications for Use A Corometrics 250cx Series Fetal Monitor is used for fetal surveillance. Surveillance A Corometrics 250cx Series monitor can be used for routine non-invasive and invasive fetal monitoring throughout labor and delivery. Maternal Monitoring Indications for Use A Corometrics 250cx Series Maternal/Fetal Monitor is intended for monitoring maternal vital signs to help assess maternal well-being.
Page 32: Pulse Oximetry
Series Overview The Corometrics 250cx Series monitor provides one solution for high-risk and low- risk labors and deliveries. The monitor lets you start with a fetal or maternal/fetal monitor and add the extended features later, as your clinical needs increase and your budget allows.
Page 33: Fetal Parameters
Introduction: Series Overview Annotations from an optional Model 2116B Keyboard are printed on the strip chart recorder paper. The strip chart recorder is a quiet, easy-to-load, high-resolution thermal array printer. The recorder prints continuous trends and alphanumeric data on one strip chart.
Page 34: Maternal Parameters (259Cx Only)
Introduction: Series Overview Alarm conditions have both audible and visual indications. Only fetal audible alarms can be disabled. Fetal heart rate threshold and signal quality alarms can be cancelled. Optional Spectra Alerts™ simultaneously analyzes FHR and UA information and notifies clinicians of deviations from the norm. Maternal Parameters (259cx only) Built-in maternal vital signs monitoring eliminates the need for separate blood pressure and maternal pulse oximetry monitors.
Page 35: Controls, Indicators, And Connectors
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Page 36 Controls, Indicators, and Connectors: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 37: Front Panel Description
Controls, Indicators, and Connectors: Front Panel Description Front Panel Description FECG TOCO 165 172 NIBP MECG MSpO2 15:00 130/ 85 MAP (107) 03:15 25 mm/s II 2x FECG 03:22:45 Print Freeze Alarms Setup VSHX Monitor Front Panel Front Panel Name Description Display The monitor’s display is divided into several sections.
Page 38 Controls, Indicators, and Connectors: Front Panel Description Front Panel Name Description Mark [Offset] Button The Mark [Offset] button is a multi-function button. Mark: Pressing this button prints an event mark on strip chart paper (on the bottom two lines of the top grid). Offset: When the Heart Rate Offset mode is enabled, pressing and holding this button shifts the secondary FHR trend +20 bpm for visibility purposes.
Page 39 Controls, Indicators, and Connectors: Front Panel Description Front Panel Name Description UA Connector Connect a tocotransducer, IUPC, or strain gauge transducer plug to this white receptacle. Contact your Sales Representative for information about compatibility. US2 Connector Connect the secondary ultrasound transducer plug to this light gray receptacle. US Connector Connect the primary ultrasound transducer plug to this light gray receptacle.
Page 40: Front Panel Displays
Controls, Indicators, and Connectors: Front Panel Displays Front Panel Displays The monitor is divided into two main sections: patient information (the left-side of the monitor) and monitor functionality (the right-side of the monitor). Refer to “Monitor Front Panel” on page 3-3. The keys are ordered for user efficiency.The content and layout of the display can change, depending on which functions are installed in the monitor and the modes of operation in use.
Page 41: Display Example
Controls, Indicators, and Connectors: Front Panel Displays Display Example From the graphic below, you can determine the following: Blood pressure is not active as indicated by the absence of numerics. Maternal pulse oximetry is active by presence of pulse amplitude indicator. MECG is selected as the heart rates source as indicated by the MECG mode title softkey—rather than Pulse.
Page 42: Primary Labor Parameters
Controls, Indicators, and Connectors: Primary Labor Parameters Primary Labor Parameters The primary labor parameters section displays FHR1, FHR2, and UA data. FHR Display The FHR1 and FHR 2 areas are summarized in the following figure and table. FHR Display FHR Display Name Description FHR Value...
Page 43: Ua Display
Controls, Indicators, and Connectors: UA Display Connectors vs. Display Modes Active Connectors FHR1 Area FHR2 Area FECG FECG INOP FECG/US FECG FECG/US2 FECG INOP US/US2 INOP — INOP INOP FECG FECG/US/US2 If three FHR transducers are plugged in, the FECG signal overrides the US signal. UA Display The UA area is summarized by the following figure and table.
Page 44: Additional Parameters
Controls, Indicators, and Connectors: Additional Parameters Additional Parameters The additional parameters area displays NIBP, MHR/P, and MSpO data. Maternal NIBP The maternal NIBP section is summarized in the following figure and table. NIBP 11:41 130/ 85 MAP (107) 03:15 NIBP Display NIBP Display Name Description...
Page 45: Mhr/P Area
Controls, Indicators, and Connectors: MHR/P Area MHR/P Area The MHR/P area is summarized by the following figure and table. MHR/P Display MHR/P Display Name Description MHR/P Value Up to three-digits indicate the MHR/P in beats per minute. MHR/P Alarm Setting This symbol provides information about the MHR/P Indicator audio alarm and the MHR/P high/low alarm limit...
Page 46: Mspo 2 Area
Controls, Indicators, and Connectors: MSpO Area MSpO Area The MSpO area is summarized in the following figure and table. MSpO2 MSpO Display MSpO Display Name Description MSpO Value Up to three digits indicate the percentage of oxygen in the mother’s blood. MSpO Alarm Setting This symbol provides information about the MSpO...
Page 47: Battery-Backed Ram Status
Reset the time and date then power cycle strip chart paper. time and date. the monitor. If message still prints, call GE Service to report. Softkeys A softkey is an area on the screen that can be selected with the Trim Knob control.
Page 48: Dedicated Softkey Area
Controls, Indicators, and Connectors: Softkeys Dedicated Softkey Area Softkeys are located at the bottom of each screen, as shown in “Maternal/Fetal Monitor Display Summary” on page 3-14. Although there are many possible softkeys which may appear in this area, a maximum of five are shown at a time. TOCO 165 172 NIBP...
Page 49 Controls, Indicators, and Connectors: Softkeys Display Summary Name Description Freeze Softkey Freezes waveform for analysis; unfreezes waveform to return to real-time display. Print Softkey Prints 6-second snapshot of frozen waveform, real- time waveform, or maternal vital signs history. Waveform Softkey Selects FECG, MECG, MSpO , or Off.
Page 50: Rear Panel Description
J103 J102 DEVICE TO SALE BY OR ON THE ORDER OF 0086 A PHYSICIAN. J101 J104 GE Medical Systems European Representative Munzinger Straße 3-5; D-79111 Freiburg Germany 100 -120V ~ 50-60HZ 100W J110 U.S. PATS. 3,982,528 4,533,926 4,573,479 J109 J111 CANADIAN PATS.
Page 51 Connector interface. J112 External VGA Connector for external VGA display. Use of Connector recommended GE external display will allow monitor front panel display video to be replicated remotely. Speaker The rear panel speaker emits an audible tone for heart rates, MSpO...
Page 52 0 volts. Do not attempt to connect cables to these connectors without contacting your Biomedical Engineering Department or GE Medical Systems Information Technologies Service Representative. This is to ensure the connectors comply with leakage-current requirements of one of the following applicable standards: Underwriters Laboratories UL-2601-1, Canadian Standards Associations CSA 22.2 No.
Page 53: Setup Procedures
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Page 54 Setup Procedures: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 55: Loading Strip Chart Recorder Paper
Setup Procedures: Loading Strip Chart Recorder Paper Loading Strip Chart Recorder Paper Refer to “Paper Supplies Ordering Information” on page 18-3 to order paper required for use with the 250cx Series Monitor. (HR scale of 30–240 bpm); or (HR scale of 50–210 bpm). Refer to Chapter 11, “Recorder Modes”...
Page 56 Setup Procedures: Loading Strip Chart Recorder Paper Fan the pack of Z-fold paper on all sides to loosen any folds and to ensure proper feed of the paper through the recorder. Fanning the Paper NOTE: The black squares indicate the end of the recorder paper. When the black squares appear, the strip chart recorder has approximately 20 minutes of paper remaining, when running at a speed of 3 cm/min.
Page 57 Setup Procedures: Loading Strip Chart Recorder Paper Unfold two sheets from the top of the package so that they extend toward you. Creating Paper Leader Place the pack in the drawer so that the pack is laying flat in the recorder. Inserting the Paper Close the strip chart recorder door.
Page 58: Power
(If you are unsure about the voltage, contact your hospital Biomedical Engineering Department or GE Service Representative.) Attaching the Power Cord Turn the monitor’s power on. The green indicator light, located near the upper left-hand corner of the Light button, illuminates and a series of tones are heard, indicating that the monitor has been turned on.
Page 59: Self-Test Routine
Setup Procedures: Self-Test Routine Self-Test Routine The 250cx Series Monitor contains a self-test routine which checks the calibration and internal circuitry of the monitor. Initiate the self-test routine at the beginning of each monitoring session to print the results on the patient’s strip chart. NOTE: To stop a self-test routine that Ensure that strip chart is loaded.
Page 60: Using The Trim Knob Control
Setup Procedures: Setup Screens Using the Trim Knob Control General instructions for using the Trim Knob control follow: NOTE: When any setup screen (except To display a parameter setup screen, rotate the Trim Knob control until the bar the General Setup screen) is displayed, cursor highlights the title of the parameter (FECG, US, US2, NIBP, MECG, Pulse, or MSpO ).
Page 61: General Setup Screen
Setup Procedures: General Setup Screen General Setup Screen Following is a sample General Setup screen.You can access this screen from the main screen by selecting Setup. Using the Trim Knob to go to the field you wish to change. and select it by pressing the knob. Choose the desired setting. General Setup Happy Birthday Play Song: Off...
Page 62: Paper Speed
Setup Procedures: General Setup Screen Paper Speed The monitor offers a choice of paper speeds of the strip chart recorder. 1 cm/min: paper saving. 2 cm/min: a compromise between the 1 cm/min and 3 cm/min. 3 cm/min: recommended for greater diagnostic capability. Date It is very important to set the date on your monitor prior to initial use.
Page 63: Preparing The Monitor For Patient Use
Setup Procedures: Preparing the Monitor for Patient Use Preparing the Monitor for Patient Use The following procedures should be performed before use on each patient: Ensure an adequate supply of paper is in the recorder. The recorder will automatically stop when paper runs out. If the recorder requires paper, refer to “Loading Strip Chart Recorder Paper”...
Page 64 Setup Procedures: Preparing the Monitor for Patient Use 4-12 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 65: Fetal Heart Rate Monitoring
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Page 66 Fetal Heart Rate Monitoring: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 67: Ultrasound (External Method)
Fetal Heart Rate Monitoring: Ultrasound (External Method) Ultrasound (External Method) NOTE: Refer to the “Maternal/Fetal Monitoring, Clinical Applications Manual” for patient application information. Methodology An ultrasound (US/US2) transducer placed on the maternal abdomen is used to direct an ultrasonic beam toward the fetal heart; the transducer detects Doppler shifted frequency changes in echoes created by moving cardiac structures.
Page 68: Alert
Fetal Heart Rate Monitoring: FECG (Internal Method) Alert This field controls and shows Spectra Alerts. Refer to Appendix C for more information. Alarm Volume This field controls the alarm volume for all fetal alarms. FECG (Internal Method) Methodology This method uses an electrode attached directly to the fetal presenting part. The electrode is connected to the cable/legplate secured to the mother.
Page 69: Fecg Setup Screen
Fetal Heart Rate Monitoring: FECG Setup Screen FECG Setup Screen Select the FECG softkey to access the FECG Setup screen. FECG TOCO 165 172 FECG Setup High 140-200, Off Off, 60-140 Volume: 5 Alarms High FHR: Audio Alarms: Volume: Exit FECG Setup Screen With Fetal Alarms Enabled Volume This field controls the volume for the FHR beeps derived from FECG.
Page 70: Fetal Heart Rate Alarms
Fetal Heart Rate Monitoring: Fetal Heart Rate Alarms Fetal Heart Rate Alarms FHR Threshold Alarms A fetal heart rate threshold alarm occurs when any fetal heart rate falls outside of the pre-defined alarm limits—greater than the high limit setting or less than the low limit setting.
Page 71: Fhr High Alarm
Fetal Heart Rate Monitoring: Fetal Heart Rate Alarms FHR High Alarm The simplest example of a high FHR alarm occurs when the FHR value is continuously greater than the threshold (high limit) for 5 minutes. When data consistently violates the limit, the time-to-alarm is 5 minutes. FHR (bpm) alarm activates high alarm limit...
Page 72: Sample Clinical Exceptions
Fetal Heart Rate Monitoring: Fetal Heart Rate Alarms Sample Clinical Exceptions The figure below provides an example of FHR fluctuations above and below the high alarm limit setting. FHR (bpm) high alarm limit (threshold) Time (minutes) Fluctuations Near High Alarm Limit Example Whether the pattern shown in the above figure generates an alarm depends on what percentage of the data violates the limit.
Page 73: 100% Signal Loss
Fetal Heart Rate Monitoring: Fetal Heart Rate Alarms 100% Signal Loss In cases where there is a complete absence of signal, the signal quality time-to-alarm is 1.25 minutes. FHR (bpm) 100% signal loss 1.25 min alarm activated Time (minutes) 100% Signal Loss Example Intermittent Signal Loss In the clinical environment, a partial loss of signal is seen more frequently than a complete loss of signal.
Page 74: Summary
Single Fetal Heart Rate Monitoring The Corometrics 250cx Series monitor offers three options to monitor a single fetal heart rate (FHR): US (external) US2 (external) FECG (internal) Please refer to the “FHR Display and Trend Summary”...
Page 75: Heartbeat Coincidence
Fetal Heart Rate Monitoring: Dual Fetal Heart Rate Monitoring FHR Display and Trend Summary DISPLAY MODE TREND ANNOTATION ACTIVE CONNECTORS FHR1 FHR2 FHR1 FHR2 FECG FECG FECG US, US2 FECG, US FECG FECG FECG, US2 FECG FECG FECG, US, US2 FECG FECG NOTE: In the event that three transducers are plugged into the monitor, FECG...
Page 76: De-Activating The Fetal Heart Rate Offset Feature
Fetal Heart Rate Monitoring: Dual Fetal Heart Rate Monitoring A right arrow (→) and a vertical dashed line print to draw attention to the start of the shifted trend. Refer to “Fetal Heart Rate Offset Example,” on page 5-12 for an example of a shifted trend.
Page 77: Uterine Activity Monitoring
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Page 79: Tocotransducer (External Method)
Uterine Activity Monitoring: Tocotransducer (External Method) Tocotransducer (External Method) NOTE: Refer to the “Maternal/Fetal Monitoring, Clinical Applications Manual” for patient application information. Methodology A tocotransducer applied to the maternal abdomen records relative changes in abdominal tension caused by uterine contractions. The mode (TOCO) and value are shown in the UA area of the display.
Page 80: Accounting For Belt Tension
25 mmHg (3.3 kPa) above the baseline; then re-reference one more time. If you still receive the CHECK TOCO message, try a different tocotransducer or contact your GE Service Representative. Manually Setting the Baseline at the Default Value...
Page 81: Internal Method - Intrauterine Pressure (Iup)
Uterine Activity Monitoring: Internal Method - Intrauterine Pressure (IUP) Internal Method - Intrauterine Pressure (IUP) NOTE: To secure a strain gauge post for IUP monitoring, refer to the strain gauge manufacturer’s instructions. Methodology An intrauterine pressure catheter (IUPC) inserted transcervically into the uterine cavity measures intrauterine pressure.
Page 82 Uterine Activity Monitoring: Internal Method - Intrauterine Pressure (IUP) 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 83: Maternal Heart/Pulse Rate Monitoring
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Page 84 Maternal Heart/Pulse Rate Monitoring: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 85: Mhr/P Source
Maternal Heart/Pulse Rate Monitoring: MHR/P Source MHR/P Source The MHR/P can be determined by the MECG, MSpO , and NIBP sections of the monitor. However, the data from only one parameter is: referred to as the MHR/P source displayed in the MHR/P area; used to evaluate an MHR/P alarm condition;...
Page 86: Mhr/P Setup Screen
Maternal Heart/Pulse Rate Monitoring: MHR/P Setup Screen MHR/P Setup Screen Select the mode title softkey—MECG or Pulse—to access the MHR/P Setup screen. (Refer to the following figure.) NOTES The figure below provides an example of MECG selected as the MHR/P source, as indicated by the MECG mode title.
Page 87: Hr/Pr Trace
Maternal Heart/Pulse Rate Monitoring: MHR/P Setup Screen HR/PR Trace This field enables or disables the printing of the MHR/P trace on the strip chart paper. On: The MHR/P trend is printed in grey annotated with MECG MSpO —whichever parameter is selected in the MHR/P Source field. MHR/P data from NIBP is not trended since blood pressure determinations are static measurements.
Page 88: Mecg Pacer
Maternal Heart/Pulse Rate Monitoring: MHR/P Setup Screen The following figure illustrates which electrodes reference the ECG lead obtained. BLACK (LA) BLACK (LA) WHITE (RA) YELLOW (L) YELLOW (L) RED (R) WHITE (RA) RED (R) RED (LL) RED (LL) GREEN (F) GREEN (F) NOTE: AHA label is bolded;...
Page 89: Maternal Ecg Monitoring
The following safety information applies to patients with pacemakers. WARNINGS ACCESSORIES—Use only electrodes, lead wires, and cables recommended by GE Medical Systems Information Technologies. Failure to use recommended accessories may result in inaccurate readings, damage to equipment, or loss of defibrillator protection.
Page 90: Mecg Waveform
Maternal Heart/Pulse Rate Monitoring: Maternal ECG Monitoring CAUTION• FDA POSTMARKET SAFETY ALERT—the United States FDA Center for Devices and Radiological Health issued a safety bulletin October 14, 1998. This bulletin states “that minute ventilation rate-adaptive implantable pacemakers can occasionally interact with certain cardiac monitoring and diagnostic equipment, causing the pacemakers to pace at their maximum programmed rate.”...
Page 91: Maternal Non-Invasive Blood Pressure Monitoring
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Page 93: Blood Pressure Safety Precautions
Maternal Non-Invasive Blood Pressure Monitoring: Blood Pressure Safety Precautions Blood Pressure Safety Precautions NOTES This safety information applies to the non-invasive blood pressure (NIBP) of the monitor. A patient’s vital signs may vary dramatically during the use of cardiovascular agents such as those that raise or lower blood pressure or those that increase or decrease heart rate.
Page 94: Warnings
Maternal Non-Invasive Blood Pressure Monitoring: Warnings CAUTIONS PULSE RATE COMPARISONS—The pulse rate measured by the monitor’s NIBP circuitry may differ from the heart rate measured by the monitor’s MECG circuitry or another maternal ECG monitor because the monitor’s blood pressure module measures peripheral pulses, not electrical signals or contractions of the heart.
Page 95: Nibp Determination
The GE monitor values are based on the oscillometric method of noninvasive blood pressure measurement and correspond to comparisons with intra- aortic values within ANSI/ AAMI Standards for accuracy.
Page 96: Accelerated Determination
Maternal Non-Invasive Blood Pressure Monitoring: SuperSTAT NIBP Determination Accelerated Determination The monitor will try to make an accelerated determination of blood pressure if it has been 16 minutes or less since the last determination and the current blood pressure is similar to the previous reading.
Page 97: Nibp Setup Screen
Maternal Non-Invasive Blood Pressure Monitoring: NIBP Setup Screen NIBP Setup Screen Select the NIBP softkey to access the NIBP Setup screen. Manual FECG TOCO Auto 1 min 165 172 Auto 2 min kPa mode Auto 3 min High 100-250, Auto 4 min NIBP Setup 6.7-20.0 5 mmHg...
Page 98: Nibp Done Volume
Maternal Non-Invasive Blood Pressure Monitoring: NIBP Monitoring NIBP Done Volume This field sets the volume of the sound emitted at the completion of each blood pressure determination. As you adjust the volume, a sample tone sounds. Alarms These fields adjust the high and low alarm limits for maternal systolic, diastolic, and mean arterial pressures, as well as for MHR/P—in increments of 5 mmHg (0.7 kPa) or 5 bpm.
Page 99: Blood Pressure Methodology
Maternal Non-Invasive Blood Pressure Monitoring: NIBP Monitoring and the effect of an alternative site on blood pressure values, proper cuff size and comfort. Warning: Do not place the cuff on a limb being used for intravenous infusion or any area where circulation is compromised or has the potential to be compromised.
Page 100: Hydrostatic Effect
Maternal Non-Invasive Blood Pressure Monitoring: NIBP Monitoring The systolic and diastolic pressures are each indicated with two or three digits and separated by a slash (/). The mean arterial pressure is indicated with two or three digits and enclosed in parentheses. All pressure values are displayed in mmHg or kPa. Systolic, diastolic, MAP, and pulse rate values are printed on the strip chart paper annotated by an outlined diamond ( )which marks the time of the reading.
Page 101: Taking A Manual Reading Between Auto Determinations
Maternal Non-Invasive Blood Pressure Monitoring: NIBP Monitoring Taking a Manual Reading Between Auto Determinations NIBP Start/Stop If the button is pressed during the interval time between automatic readings, a new determination is initiated. IMPORTANT: The countdown timer is not reset whenever a manual blood pressure reading is initiated;...
Page 102: Nibp Interval Button Shortcut
Maternal Non-Invasive Blood Pressure Monitoring: NIBP Monitoring Example 2. The interval time is set at 15 minutes and the countdown timer shows 2 minutes until the next reading — in other words 13 minutes have elapsed. If you change the interval time to 10 minutes, the countdown timer will wait another 10 minutes until the next reading.
Page 103: Terminating A Determination In Progress
Maternal Non-Invasive Blood Pressure Monitoring: Smart BP Feature Terminating a Determination in Progress NIBP Start/ A determination—manual or automatic—can be cancelled by pressing the Stop button. The selected mode (Manual or Auto) remains in effect. The next scheduled automatic determination takes place as planned. Smart BP Feature The 250cx Series monitor has the patented Smart BP feature that prevents an automatic blood pressure determination from occurring during a uterine contraction.
Page 104 Maternal Non-Invasive Blood Pressure Monitoring: Smart BP Feature 8-14 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 105: Maternal Pulse Oximetry Monitoring
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Page 107: Mspo2 Technology
The 250cx Series Monitor measures the maternal oxygen saturation (MSpO ) and pulse rate using the principles of spectrophotometry and plethysmography. Which Module is Installed? GE Medical Systems Information Technologies offers you the choice of one of the following MSpO options: ® Ohmeda Oximetry Technology ®...
Page 108: Theory Of Operation
Maternal Pulse Oximetry Monitoring: MSpO2 Technology Theory of Operation ™ Ohmeda TruSignal Oximetry TruSignal™ Enhanced SpO Ohmeda’s TruSignal Enhanced SpO offers fine performance, especially during challenging conditions of clinical patient motion and low perfusion. With ultra-low- noise technology, TruSignal selects the appropriate clinically-developed algorithm to correct weak signals and generate reliable saturation readings.
Page 109: Nellcor Oximax
Maternal Pulse Oximetry Monitoring: MSpO2 Technology Traditional pulse oximetry assumes that all pulsations in the light absorbance signal are caused by oscillations in the arterial blood volume. This assumes that the blood flow in the region of the sensor passes entirely through the capillary bed rather than through any arterio-venous shunts.
Page 110: Automatic Calibration
Maternal Pulse Oximetry Monitoring: MSpO2 Technology Because a measurement of SpO is dependent upon light from the OxiMax sensor, excessive ambient light can interfere with this measurement. Select an appropriate OxiMax sensor, apply it as directed, and observe all warnings and cautions presented in the directions for use accompanying the OxiMax sensor.
Page 111 Maternal Pulse Oximetry Monitoring: MSpO2 Technology With traditional alarm management, upper and lower alarm limits are set for monitoring oxygen saturation. During monitoring, as soon as an alarm limit is violated by as little as one percentage point, an audible alarm immediately sounds. When the SpO level fluctuates near an alarm limit, the alarm sounds each time the limit is violated.
Page 112: Satseconds "Safety Net
Maternal Pulse Oximetry Monitoring: MSpO2 Technology After approximately 10.9 seconds the SatSeconds alarm would sound, because 50 SatSeconds (the assumed SatSeconds limit in this example) had been exceeded. SECONDS Alarm Response with SatSeconds Saturation levels may fluctuate rather than remain steady for a period of several seconds.
Page 113: Mspo 2 Setup Screen
Maternal Pulse Oximetry Monitoring: MSpO Setup Screen MSpO Setup Screen Select the MSpO softkey to access the MSpO Setup screen. (See figure below.) FECG TOCO 165 172 MSpO Setup MSpO Response Time: Fast Print Interval: 5 min % O2 Trace: Alarms High MSpO2:...
Page 114: Averaging Time (Masimo Technology Only)
Maternal Pulse Oximetry Monitoring: MSpO Methodology Averaging Time (Masimo Technology Only) This menu option only appears when using Masimo Technology and sensor. Choose a response time in order to compensate for different levels of patient activity: 2, 4, 8, 10, 12, 14, or 16 seconds. For the 2 and 4 second averaging settings: The actual averaging times may range from 2 to 4 and 4 to 6 seconds, respectively.
Page 115: Mspo Pulse Beat Audio
Maternal Pulse Oximetry Monitoring: Module and Probe Compatibility MSpO Pulse Beat Audio If MSpO is selected as the MHR/P source, each pulse beat is indicated with a “beep”: the pitch of the beep will vary according to the saturation value; the pitch rises as the saturation value increases;...
Page 116: Modules And Sensors
Maternal Pulse Oximetry Monitoring: Module and Probe Compatibility Modules and Sensors The Masimo, Ohmeda, and Nellcor parameters are used to measure the amount of oxygenated hemoglobin and pulse rate non-invasively. The absorption of selected wavelengths of light is measured with sensors. Although these parameters process the MSpO measurements differently, the function and appearance of MSpO your monitor is the same.
Page 117: Alarms
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Page 119: Introduction
Alarms: Introduction Introduction This chapter provides a summary of alarms for all modalities in the 250cx Series monitor. The monitor provides patient alarms (alarm limit threshold violations) for: FHR1 FHR2 NIBP (systolic, diastolic, and mean arterial pressures) MHR/P (for the selected source) MSpO In addition, the monitor provides signal quality alarms.
Page 120: Alarm Volume
Alarms: Alarm Setup The alarm limits for each modality are configured by a respective setup screen. Refer to Chapter 4, “Setup Procedures”. A Master Alarm Setup screen provides a summary of most alarm limit settings with the exception of the FHR1 and FHR2 limit settings which are set independently.
Page 121: Alarm Setting Indicators
Alarms: Alarm Setup Alarm Setting Indicators An alarm setting indicator displays for FHR1, FHR2, NIBP, MHR/P, and MSpO The following table provides a summary of the two possible states for this indicator NOTE: The FHR alarms may be completely disabled from the password-protected Install Options service screen.
Page 122: Fetal Heart Rate Alarms
Alarms: Fetal Heart Rate Alarms Fetal Heart Rate Alarms FHR Patient Alarms A fetal heart rate patient alarm occurs when any fetal heart rate falls outside of the pre-defined alarm limits—greater than the high limit setting or less than the low limit setting.
Page 123: Resolved Signal Quality Alarm
Alarms: Maternal Alarms Resolved Signal Quality Alarm Resolved signal quality alarms function like most other 250cx Series alarms. As soon as an alarm condition is resolved, both the visual and audible indications automatically disappear. Silencing an FHR Audio Alarm Press the button to cancel the audio;...
Page 124: Active Signal Quality Alarm
Alarms: Maternal Alarms Active Signal Quality Alarm The following signal quality alarms are indicated both visually and audibly. The audio alarm consists of alternating high/low tones. The visual indication varies according to the alarm: Asystole: Dashes “– – –” display in place of the MHR/P numeric. MECG Leads Off: Dashes “–...
Page 125: Alarms Summary
Alarms: Alarms Summary Alarms Summary Summary of 250cx Series Alarms Type Condition Display Message Audible Notification An alarm setting (audio or high/low — displays to the left of the limit) is turned off. FHR mode title. Alarm Defaults Audio: on Volume: 5 Limits: High = 160 bpm, Low = 120 FHR limit (high or low) actively being...
Page 126 Alarms: Alarms Summary Summary of 250cx Series Alarms Type Condition Display Message Audible Notification MHR/P limit (high or low) actively MHR/P numeric flashes. Alternating high/low tones (if MHR/Pa being violated. audio enabled). The tachycardia response time is < 8 seconds. Asystole.
Page 127: Recorder Modes
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Page 129: Modes
Recorder Modes: Modes Modes The 250cx Series Monitor has three recorder modes: off, on, and maternal-only. Factory default is ON. Off Mode When the recorder is off, the yellow Record indicator is off and nothing is automatically printed on the strip chart paper. Even with the recorder turned off, it is possible to manually print the displayed waveform or the maternal vital signs history.
Page 130: Changing Recorder Modes
Recorder Modes: Changing Recorder Modes 1 2 : 4 6 9 7 % P 7 2 1 2 : 4 5 N I B P 1 1 3 / 6 4 M 8 8 P 7 1 1 2 : 4 1 9 8 % P 7 4 1 2 : 3 6...
Page 131: Functionality With A Qs System
Recorder Modes: Functionality with a QS System CAUTION DATA STORAGE—Stored maternal vital signs history data is erased when you turn the monitor off. Therefore, for intermittent monitoring, it is recommended that you leave the monitor on, but turn the recorder off. Refer to Chapter 12, “Maternal Vital Signs History”...
Page 132: Fetal Heart Rate Alarms
Recorder Modes: Trends continuously with all data lines printing in the annotation area; this may result in many blank pages in-between maternal vital signs data. In addition, the FHR mode will list INOP. Contact your Service Representative for clarification on your QS System’s wiring.
Page 133: Spo Scale
Recorder Modes: Annotations Five Trends Printing Simultaneously Scale Two scale options are available for printing the MSpO trends. The scale is printed on the paper along with the trend. This option is located in the password-protected Install Options screen. Auto: The trend plots on an expanded scale of 60–100% or 50–100%, depending on the paper.
Page 134: Standard Annotations
Recorder Modes: Annotations Standard Annotations The most common of the annotations which print on the bottom line are: date time active modes heart rate coincidence enable status fetal heart rate alarm enable status recorder speed telemetry status Blood Pressure Annotations A blood pressure reading can print on any of the first three annotation lines—...
Page 135: Maternal Pulse Oximetry Annotations
Recorder Modes: Annotations Maternal Pulse Oximetry Annotations A maternal pulse oximetry reading prints according to the interval time set on the MSpO Setup screen (for built-in parameter) or the General Setup screen (for external device). For the built-in parameter, a reading also prints for each alarm generated. The reading can print on any of the first three annotation lines—depending on which printing line is available.
Page 136: Summary Of Annotations
Recorder Modes: Summary of Annotations Multiple Annotations Example Summary of Annotations Summary of Annotations Annotation Explanation Time and Date Time and date are both printed on the bottom annotation line 20 seconds after (Example: 10:40 12 AUG 97) the recorder is turned on and when the date changes after midnight. A time stamp automatically prints approximately every 10 minutes—at the 10- minute mark.
Page 137 Recorder Modes: Summary of Annotations Summary of Annotations (Continued) Annotation Explanation CARDIO INOP This annotation prints in place of any trend source if the respective connector (FECG/MECG, US, or US2) is unused. UA INOP This annotation prints in place of the trend source if the UA receptacle is unused. MSpO INOP This annotation prints if the trend is enabled and the Maternal SpO...
Page 138 Recorder Modes: Summary of Annotations Summary of Annotations (Continued) Annotation Explanation Remote annotation from a central information This annotation represents notes received from a remote central information system. For example: system. The computer icon prints in the bottom two lines of the top grid. The icon marks the time of the annotation and also indicates that the information comes from a remote computer such as a QS/Perinatal System.
Page 139: Adjustable Recorder Font Size
Recorder Modes: Adjustable Recorder Font Size Summary of Annotations (Continued) Annotation Explanation This annotation prints on the bottom two lines of the upper grid indicating that the mother perceives fetal movement. The arrow prints each time the mother presses the FM Remote Marker button. Note: A horizontal bar prints as a tail on the arrow for as long as the button is held down.
Page 140: Chart Style Vital Signs Printing
Recorder Modes: Chart Style Vital Signs Printing Summary of Font Settings Printing Description Font Setting 30–240 bpm Scale Paper 50–210 bpm Scale Paper Small Eight annotation lines are available. Four annotation lines are available. Time/date, modes, and annotations all print using Time/date, modes, and annotations all print using the small font size.
Page 141: Examples Of Printing Styles
Recorder Modes: Chart Style Vital Signs Printing Examples of Printing Styles Chart-Style Printing Examples When chart-style printing is enabled: The 15-minute interval prints on the quarter hour (e.g., 9:00, 9:15, 9:30, 9:45, etc.). The 30-minute interval prints on the half hour (e.g., 9:00, 9:30, 10:00, 10:30, etc.). The 60-minute interval prints on the hour (e.g., 9:00, 10:00, 11:00, 12:00, etc.).
Page 142: Strip Chart Paper
Strip Chart Paper Instructions for loading the strip chart paper are provided in Chapter 4, “Setup Procedures”. Two kinds of strip chart paper are available from GE. Z-Fold Chart Paper with Pre-Printed 30–240 bpm Heart Rate Scale (Refer to Figure on Page 11-17.) Z-Fold Chart Paper with Pre-Printed 50–210 bpm Heart Rate Scale (Refer to...
Page 143 Recorder Modes: Strip Chart Paper Top Grid Pre-printed HR Scale Primary Annotation Area Pre-printed UA Scale Bottom Grid Strip Chart Paper with 30–240 bpm Heart Rate Scale Revision C 250cx Series Maternal/Fetal Monitor 11-17 2036946-001...
Page 144: Paper-Low, Paper-Out, And Paper-Loading Error Conditions
Recorder Modes: Paper-Low, Paper-Out, and Paper-LoadING Error Conditions Top Grid Pre-printed HR Scale Primary Annotation Area Pre-printed UA Scale Bottom Grid Strip Chart Paper with a 50–210 bpm Heart Rate Scale PAPER-LOW, PAPER-OUT, and PAPER-LOADING Error Conditions The 250cx Series Monitor alerts you when paper is running low or when the recorder is completely out of paper.
Page 145 Recorder Modes: Paper-Low, Paper-Out, and Paper-LoadING Error Conditions The alarms are summarized by the following Table . The volume of the alarm tone for all three conditions is configured on the password-protected Install Options Screen 1 screen. Recorder Error Conditions Paper Error Recorder Alarm Silence...
Page 146 Recorder Modes: Paper-Low, Paper-Out, and Paper-LoadING Error Conditions 11-20 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 147: Maternal Vital Signs History
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Page 148 Maternal Vital Signs History: For your notes 12-2 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 149: What Is The Maternal Vital Signs History Screen
Maternal Vital Signs History: What is the Maternal Vital Signs History Screen? What is the Maternal Vital Signs History Screen? This feature displays/prints maternal vital signs data in a spreadsheet format—called Vital Signs History. An example of the maternal Vital Signs Screen is shown on page 12-4.
Page 150: Using The Maternal Vital Signs History Screen
Maternal Vital Signs History: Using the Maternal Vital Signs History Screen TOCO 154 135 Vital Signs History Date: 24-Mar 24-Mar 24-Mar 24-Mar 24-Mar Time: 12:00 12:10 12:20 12:30 12:40 NIBP MSpO2 MECG HX Interval: 10 min Print PrintAll View Exit NOTE: NIBP values appear in kPa when in kPa mode.
Page 151: Printing The Maternal Vital Signs History Screen
Maternal Vital Signs History: Using the Maternal Vital Signs History Screen When the screen is called up for display, the previous minute in time is listed at the far right of the screen; the preceding values to be displayed are counted backwards from the previous minute in time, based on the intervals you have selected.
Page 152 Maternal Vital Signs History: Using the Maternal Vital Signs History Screen Vital Signs History Print Example 12-6 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 153: Heartbeat Coincidence
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Page 155: Heartbeat Coincidence Theory
Heartbeat Coincidence: Heartbeat Coincidence Theory Heartbeat Coincidence Theory The heartbeat coincidence feature alerts you when there is the possibility that you may be monitoring a duplicate signal. Heartbeat coincidence is indicated when any two heartbeats have a consistent phase relationship for equal to or greater than 60% of the detected beats for about 60 seconds;...
Page 156 Heartbeat Coincidence: Using the Heartbeat Coincidence Feature NOTE: Although an unlikely scenario, if three channels are picking up the same signal, the heart rate numerics for all three heart rates display in inverse video. If you disconnect a transducer while coincidence is detected, any value displayed in inverse video returns to standard video.
Page 157: Strip Chart Annotation
Heartbeat Coincidence: Using the Heartbeat Coincidence Feature Strip Chart Annotation When heartbeat coincidence detection is enabled, the annotation prints in the center margin of the strip chart paper following the active FHR modes. (Refer to “Simulated Heartbeat Coincidence Detection Trace,” on page 13-5.) As soon as heartbeat coincidence is detected, two overlaid hearts print in the upper portion of the top grid of the strip chart paper;...
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Page 159: Waveforms
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Page 161: Waveform Area
Waveforms: Waveform Area Waveform Area The waveform area displays approximately 4 seconds of waveform data from one of the following: FECG, MECG, or MSpO . The waveform chosen for display is independent of any of the numerics shown on the display. For example: MSpO can be chosen as the maternal pulse rate source (numerics) while the MECG waveform is selected for display in the waveform area.
Page 162: Moving Gap
Waveforms: Waveform Area Moving Gap For all waveforms, a moving gap (a blank gap separating the line in a waveform) scrolls along the screen. The gap can be thought of as a pen drawing the waveform on the screen and erasing old data along the way. The most recent data is displayed to the left of the bar;...
Page 163: Printing A Waveform Snapshot
Waveforms: Printing a Waveform Snapshot Printing a Waveform Snapshot Select the Print softkey to print a 6-second snapshot of the displayed waveform— regardless of whether the waveform real-time or frozen. The following figure provides a sample MECG waveform snapshot on strip chart paper. The waveform is printed on the lower portion of the top (or left) grid.
Page 164: Recorder In Maternal-Only Mode
Waveforms: Printing a Waveform Snapshot Recorder in Maternal-Only Mode If the recorder is running in maternal-only mode, the waveform does not interrupt the printing of data and prints at a high-speed mode of 12 cm/min. When finished, the recorder returns to the maternal-only mode. Recorder Off If the recorder is off, the waveform print using a high-speed mode of 12 cm/min after which the recorder turns off again.
Page 165: Maintenance
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Page 167: Cleaning
Maintenance: Cleaning Cleaning General care and cleaning are required for the 250cx Series Monitor and its accessories. If an accessory is not listed, consult the manufacturer’s instructions. CAUTION Unplug the monitor from the AC power source and detach all accessories from the monitor. Do not immerse accessories in any liquid.
Page 168: Display
Maintenance: Cleaning Display To clean the display screen, use a soft, clean cloth dampened with a glass cleaner. Do not spray the glass cleaner directly onto the display. Do not use alcohol or hospital disinfectants like Cidex* or Betadine. Tocotransducer and Ultrasound Transducer CAUTIONS ABRASION—Do not use abrasive cloth, sharp objects, or abrasive cleaners.
Page 169: Maternal Nibp Cuffs And Hoses
Maintenance: Cleaning Sporicidin* Soap and water Rub soiled area until clean. Dry with a soft, dry cloth. Maternal NIBP Cuffs and Hoses General The cuff must be thoroughly cleaned with the specified detergent before reuse. The additional use of household bleach as described below provides at least intermediate-level disinfection.
Page 170: Maternal Spo 2 Calibration
Calibration The user has the responsibility to validate any deviations from the recommended method of cleaning and disinfection. For additional information on infection control procedures, contact GE Medical Systems Information Technologies Technical Support. Sensors Adhesive sensors are sterile and for single use only. Reusable sensors should be cleaned before reuse with a 70% alcohol solution.
Page 171: Disposal Of Product Waste
If you have questions concerning disposal of the product, please contact GE Medical Systems Information Technologies or its representatives. Revision C 250cx Series Maternal/Fetal Monitor...
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Page 173: Troubleshooting
Troubleshooting This section of the manual provides a troubleshooting guide for the most basic 250cx Series Monitor operational problems. If the response to a specific question is not found, contact Technical Support. Inside the United States: 1-800-558-7044 Outside the United States: Contact your local representative Revision C 250cx Series Maternal/Fetal Monitor 16-1...
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Page 175: General Troubleshooting
Battery Low Icon appears Data Corruption Cycle power. Access setup screens and reset last-used settings Battery needs service. Call GE Service to report No heartbeat or pulse sounds. Volume set too low. Press the Volume buttons or access the respective setup screen(s) (FECG, US, or US2) to increase the volume.
Page 176: Ultrasound Troubleshooting
Troubleshooting: Ultrasound Troubleshooting Ultrasound Troubleshooting Ultrasound Troubleshooting Problem Probable Cause Possible Solution Ultrasound not functioning properly. Transducer not properly connected to Ensure that transducer is securely monitor. attached to monitor. Transducer placement. Wait before moving transducer; FHR often returns. Reposition transducer. Too little gel applied to transducer.
Page 177: Fecg Troubleshooting
Troubleshooting: FECG Troubleshooting FECG Troubleshooting FECG Troubleshooting Problem Probable Cause Possible Solution Internal FECG erratic or not recording Cable not properly connected to monitor. Ensure cable is securely attached to the properly. monitor. Attachment pad or legplate not securely Secure attachment pad or legplate to attached to patient.
Page 178: Internal Ua Troubleshooting
Troubleshooting: Internal UA Troubleshooting External UA Troubleshooting Problem Probable Cause Possible Solution Flashing “+” sign. mmHg > 100 (13.3 kPa) Press the button between UA Reference contractions. CHECK TOCO message is shown in UA UA Reference button pressed before You must wait 10 seconds following area of the display area when the UA circuits stabilized.
Page 179: Mecg Troubleshooting
Troubleshooting: MECG Troubleshooting MECG Troubleshooting MECG Troubleshooting Problem Probable Cause Possible Solution MECG erratic or not functioning properly. Cable not properly connected to monitor. Ensure cable is securely attached to monitor. Electrodes not properly placed. Re-apply electrodes. Clips not attached to electrodes properly. Check clip attachments.
Page 180: Maternal Pulse Oximetry Troubleshooting
Troubleshooting: Maternal Pulse Oximetry Troubleshooting Blood Pressure Troubleshooting Problem Probable Cause Possible Solution COMM ERROR message displayed in Communication error between the built-in Call Biomedical Engineering Department. NIBP area of display. NIBP parameter and the remainder of the monitor circuitry. MOTION message displayed in NIBP area Excessive maternal movement.
Page 181: Technical Specifications
Technical Specifications This section contains a detailed list of the technical specifications for the 250cx Series Monitor. Revision C 250cx Series Maternal/Fetal Monitor 17-1 2036946-001...
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Page 183: General Monitor
Technical Specifications: General Monitor General Monitor General Monitor Technical Specifications Category Technical Specifications Power Requirements Nominal Line Voltage: 100VAC 120 VAC 220 VAC 230 VAC 240 VAC Line Frequency: 50/60 Hz 50/60 Hz 50/60 Hz 50/60 Hz 50/60 Hz Power Consumption (maximum): 100 W 100 W 0.4 A...
Page 184: Operating Modes
Technical Specifications: Operating Modes Operating Modes Operating Mode Specifications CAUTION The monitor may produce incorrect results if operated outside the minimum specified parameter specifications in this table. FECG Mode Technique: Peak detecting, beat-to-beat cardiotachometer Heart Rate Counting Range: 30–240 bpm Heart Rate Resolution: ±...
Page 185 Technical Specifications: Operating Modes Operating Mode Specifications (Continued) MECG Mode Technique: Peak detecting, beat-to-beat cardiotachometer Maternal ECG Electrode Type: Medtronic 1700-003 or equivalent Leads Available: I, II, and III Heart Rate Counting Range: 30–240 bpm Heart Rate Resolution: ± 1 bpm Heart Rate Update Rate: >...
Page 186 The 250cx Series blood pressure parameter complies with the Compliance: American National Standard for Electronic or Automated Sphygmomanometers [AAMI/ANSI SP10-1992]. The GE monitor values are based on the oscillometric method of noninvasive blood pressure measurement and correspond to comparisons with intra-aortic values within ANSI/AAMI Standards for accuracy.
Page 187 Technical Specifications: Operating Modes Operating Mode Specifications (Continued) Maternal Pulse Oximetry Mode (Masimo) Technique: Spectrophotometry and plethysmography. Sensor Accuracy Sensor Model LNOP DC-I, LNOP-Adt, LNCS PC-I, and LNCS-Adt ® Weight Range > 30 kg Saturation No Motion ± 2% Accuracy Motion ±...
Page 188 Technical Specifications: Operating Modes Operating Mode Specifications (Continued) Maternal Pulse Oximetry Mode (Masimo continued) Accuracy specified when used with Masimo SET pulse oximetry modules using PC or LNC series patient cables. Numbers represent ± 1 standard deviation.Plus or minus one standard deviation represents 68% of the population.SpO accuracy from 70% to 100%.Pulse Rate accuracy from 25 to 240 bpm.
Page 189 Technical Specifications: Operating Modes Operating Mode Specifications (Continued) Maternal Pulse Oximetry Mode (Ohmeda) Technique: Spectrophotometry and plethysmography Sensor Type OxiTip+ OXY-AP and OxiTip+ OXY-F Pulse Rate Accuracy: 30-250 bpm; ± 2 digits or ± 2%, whichever is greater (no motion) 30-250 bpm;...
Page 190 Technical Specifications: Operating Modes Operating Mode Specifications (Continued) Maternal Pulse Oximetry Mode (Nellcor) Technique: Spectrophotometry and plethysmography. Sensor Type and Accuracy Range: 70%–100%: OxiMax ® Sensor Models ± 2 digits MAX-A DS-100A ± 3 digits 1–100% Saturation Range: Pulse Rate Range: 30–250 bpm Accuracy: Saturation (SpO...
Page 191: Strip Chart Recorder
Technical Specifications: Strip Chart Recorder Strip Chart Recorder Strip Chart Recorder Technical Specifications Heart Rate Scale Domestic International Chart Width: 7 cm 8 cm Scaling: 30 bpm/cm 20 bpm/cm Range: 30–240 bpm 50–210 bpm Resolution: 1 bpm 1 bpm Uterine Activity Scale Strain Gauge Tocotransducer Chart Width:...
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Page 193: Supplies & Accessories
Supplies & Accessories This section provides an overall listing of supplies and accessories for use with 250cx Series Monitors. To order any of the supplies and accessories listed in this manual: Call 1-800-558-7044 Inside the United States: Outside the United States: Contact your local representative Revision C 250cx Series Maternal/Fetal Monitor...
Page 194 Supplies & Accessories: For your notes 18-2 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 195: General Add-Ons Ordering Information
Supplies & Accessories: General Add-Ons Ordering Information General Add-Ons Ordering Information General Supplies Item Catalog Number (REF) Remote Event Marker 3919BAO Model 2116B Clinical-Notes/Data-Entry System 2116BAX Model 146 Fetal Acoustic Stimulator 0146AAY Exergen TemporalScanner TAT-5000 Assembly 2036641-001 Paper Supplies Ordering Information Paper Supplies Item Catalog Number (REF)
Page 196: Fecg Ordering Information
Supplies & Accessories: FECG Ordering Information FECG Ordering Information FECG Supplies Item Catalog Number (REF) Qwik Connect Plus Spiral Electrode (50/carton) 7000AAO Leg Plate for Qwik Connect Plus Spiral Electrode, 8-foot Cord (round connector) 1590AAO Leg Plate for Qwik Connect Plus Spiral Electrode, 8-foot Cord (rectangular connector) 1591AAO Attachment Pads for Qwik Connect Plus Spiral Electrode Legplate (50/carton) 2464AAO...
Page 197: Mecg Ordering Information
Supplies & Accessories: MECG Ordering Information MECG Ordering Information Defibrillator protection requires the use of GE Medical Systems Information Technologies recommended cables. MECG Supplies and Accessories Item Catalog Number (REF) FECG/MECG Y Adapter Cable 1442AAO FECG Socket Adapter, accepts 1590AAO QuikConnect ® Plus Leg Plates...
Page 198: Mspo 2 Ordering Information
Supplies & Accessories: MSpO Ordering Information NIBP Supplies and Accessories Item Catalog Number (REF) Single-Patient Use, Dual-Tube, Locking-Luer Cuff, Large Adult, 33-47 cm Range (10/carton) 900373-001 NIBP Cuff Hose Adapter 414876-001 MSpO Ordering Information MSpO Supplies and Accessories Item Catalog Number (REF) Ohmeda OxyTip+ Adult Adhesive Sensor (10/box) OXY-AP-10 Ohmeda OxyTip+ Adult Adhesive Sensor (25/box)
Page 199: Factory Defaults
Factory Defaults Factory Defaults are found in the table that follows. Factory defaults settings are dependent upon the model purchased. Revision C 250cx Series Maternal/Fetal Monitor 2036946-001...
Page 200 Factory Defaults: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 201: Table Of Defaults
Factory Defaults: Table of Defaults Table of Defaults Summary of Factory Defaults Setup Field Description Factory Default Default Options Hospital Preference Screen FECG or FHR Volume US/US2 FHR Alarm Limits High Low 200-140, Off 160 120 bpm 60-140, Off Audio Alarms On, Off Volume NIBP...
Page 202 Factory Defaults: Table of Defaults Summary of Factory Defaults Setup Field Description Factory Default Default Options Hospital Preference Screen MSpO Response Time Fast Normal, Fast (Nellcor 506) Response Time Fast Fast (Nellcor NELL-3) Averaging Time (Masimo) 8 seconds 2, 4, 8, 10, 12, 14, 16 seconds Sensitivity (Masimo) Normal...
Page 203 Factory Defaults: Table of Defaults Summary of Factory Defaults Setup Field Description Factory Default Default Options Hospital Preference Screen Master Alarm Limits (mmHg) High High Alarm Systolic 90mmHg 70-240 50-150 Setup Diastolic 50 mmHg 70-130 30-120 50 mmHg 70-150 30-120 MHR/P 50 bpm 100-25...
Page 204 Summary of Factory Defaults Setup Field Description Factory Default Default Options Hospital Preference Screen Install Language Set according to shipping Set according to shipping Options destination destination Screen 1 Line Frequency United States: 60 Hz 50 Hz, 60 Hz (Service) International: 50 Hz Scaling United States: 30–240 bpm...
Page 205 Factory Defaults: Table of Defaults Summary of Factory Defaults Setup Field Description Factory Default Default Options Hospital Preference Screen Install Fetal Alert/Alarm Off, Alarms, Alerts Options Alert Suspend Off, On Screen 2 (Service) Re-Alarm 120 sec 120 - 300 seconds in (MECG and SpO only) 5-second intervals...
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Page 207: Fetal Movement Detection
Fetal Movement Detection Each monitor in the 250cx Series can be upgraded to include fetal movement detection. This feature is designed to detect gross fetal body movements and body movements with associated limb movement. Revision C 250cx Series Maternal/Fetal Monitor 2036946-001...
Page 208 Fetal Movement Detection: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 209: Introduction
Fetal Movement Detection: Introduction Introduction Availability Fetal movement detection is an option which can be installed in your 250cx Series Monitor to function with the US channel. Contact your Sales Representative for information. Methodology Fetal movement detection (FMD) is designed to detect gross fetal body movements and body movements with associated limb movement.
Page 210: Display Indicator
Fetal Movement Detection: Using Fetal Movement Detection While Monitoring Display Indicator When fetal movement detection is enabled, and a transducer is plugged in, the annotation FMD appears in-between the FHR1 and FHR2 mode titles. (Refer to Figure below.) TOCO US Setup FM Detect: Volume: Volume:...
Page 211 Fetal Movement Detection: Using Fetal Movement Detection While Monitoring The annotation resulting from the FM Remote Marker can be configured as one of the following: : commonly used to record a general event; or : commonly used as an indication that the mother has perceived fetal movement.
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Page 213: Spectra Alerts
Spectra Alerts Each monitor in the 250cx Series can be upgraded to include Spectra Alerts. Contact your Sales Representative for more information. This feature analyzes heart rate and uterine activity data to detect certain abnormal trends and alert the clinician. A Nurse Call Light Interface is also provided as part of the Spectra Alerts upgrade.
Page 214 Spectra Alerts: For your notes 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 215: Important Safety Information
Spectra Alerts: Important Safety Information Important Safety Information IMPORTANT INSTRUCTIONS FOR USE—It is mandatory that you read this chapter prior to operating a 250cx Series Monitor with the Spectra Alerts feature enabled. Keep this manual available for future reference and for the orientation of new personnel. The Spectra Alerts option is designed to assist the perinatal staff in assessing the status of a patient at the bedside by recognizing normal and abnormal FHR and UA pattern features.
Page 216: Using The Spectra Alert Option
Spectra Alerts: Using the Spectra Alert Option Using the Spectra Alert Option Enabling/Disabling Spectra Alerts CAUTION CIS—The Spectra Alerts option provides bedside alerts only. If you connect the 250cx Series Monitor to a Quantitative Sentinel or Spectra 400 Alert and Surveillance Central System you must disable the Spectra Alerts feature in the monitor.
Page 217 Spectra Alerts: Using the Spectra Alert Option Spectra Alert Enabled Annotation Possible Alert Conditions Level One Alert Level Two Alert Level Three Alert decreased variability tachycardia (>180 bpm) bradycardia (<90 bpm) flat variability bradycardia (90–99 bpm) prolonged deceleration (<80 bpm) bradycardia (100–119 bpm) late decelerations late, variable, or mixed decelerations...
Page 218: Alert Indications
Spectra Alerts: Alert Indications Alert Indications Active Alerts When the system detects an alert condition, visual and audible indications are provided. (There is no printed indication of the alert.) The alert level, indicated by asterisks, flashes and displays in inverse video between the FHR1 and FHR2 areas; in addition, the associated FHR numerics flash.
Page 219: Resolved Alerts
Spectra Alerts: Alert Indications Resolved Alerts Resolved alerts function similar to the FHR alarms, yet differently from the maternal alarms. Resolved, Unsilenced Alert: You must acknowledge an alert—even if the condition has already been resolved. The visual and audible indication remain Alarm Silence present until you press the button.
Page 220 Spectra Alerts: Alert Indications FECG TOCO 3 UC/10 Alert suspended icon. NIBP MECG MSpO2 25 mm/s II 2x MECG 15:52:58 Print Freeze Alarms Setup VSHX Spectra Alert Suspended Icon Alert restored. Alert suspended. Spectra Alert Suspend/Restore Annotations 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 221: Alert Parameters Summary
Spectra Alerts: Alert Parameters Summary Alert Parameters Summary The FHR setup screens (FECG or US/US2) include an Alert Parameters summary presenting an overview of the alert analysis results for FHR and UA. Fields shown in inverse video are contributing factors to an alert. Some fields contain a second column to provide qualifying information.
Page 222 Spectra Alerts: Alert Parameters Summary Summary of Alert Parameters Alert Analysis Result Possibilities Parameter Label Column 1 Column 2 Duration of Last UC Tetanic # of seconds Tetanic Signal Quality Good Moderate Poor Unknown The next Figure provides an example of an alert with two columns of information. Inverse video indicates the feature is contributing to an alert.
Page 223 Spectra Alerts: Alert Parameters Summary Items listed in inverse video are contributing factors to the alert. Other items may indicate an alert is pending. Alert Parameters Example—FECG is the FHR associated with the alert The next Figure shows an example of alert parameters for the US Setup screen when the FHR is not associated with any alert.
Page 224: Resetting Alerts
Spectra Alerts: Resetting Alerts Resetting Alerts If you do not agree with an alert (see “False Pattern Recognition” and “Mode Switching”), you can clear the data being used via the Alert field on the associated setup screen (FECG or US/US2). NOTEFHR data is collected over time for analysis.
Page 225: Trend Screen
Spectra Alerts: Trend Screen Trend Screen Select the Trend softkey from the FHR Setup screen to display the FHR/UA trend screen. (For dual fetal heart rate monitoring, you can access it from either mode’s setup screen.) The Trend screen displays: the alert level and message, if present;...
Page 226: Enabling/Disabling Uc Frequency Display
Spectra Alerts: Uterine Contraction Frequency Enabling/Disabling UC Frequency Display A UA Setup screen is automatically activated when the Spectra Alerts option is installed and enabled. To enable/disable the UC Display option: Access the UA setup screen by selecting the UA mode title (TOCO or IUP). Set the UA Display field to the desired setting: UA or UA/UCF.
Page 227: Uc Frequency Histogram
Spectra Alerts: Uterine Contraction Frequency UC Frequency Histogram If the Spectra Alerts option is enabled, the UA Setup screen displays a UC Frequency Histogram as shown in the next Figure. Each bar in the graph represents the number of contractions in a 10-minute segment. The graph displays up to 10 bars (or 100 minutes).
Page 228: Nurse Call Interface
Spectra Alerts: Nurse Call Interface Nurse Call Interface The Spectra Alerts option includes a Nurse Call Interface rear panel connector, as shown in the Figure below. This connector attaches to a standard Nurse Call System. The connector’s maximum output is 50 Vdc at 100 mA; the maximum on resistance is 0.5 Ω.
Page 229: Alert Parameters
Spectra Alerts: Alert Parameters Alert Parameters Summary of Alert Parameters ALERT PARAMETERS SUMMARY ON FHR SETUP SCREEN TREND SCREEN Parameter Column 1 Column 2 Message Criteria + message? Alert has not been silenced. Alert Level message Alert has been silenced. High Alert pending: FHR >...
Page 230 Spectra Alerts: Alert Parameters Summary of Alert Parameters ALERT PARAMETERS SUMMARY ON FHR SETUP SCREEN TREND SCREEN Parameter Column 1 Column 2 Message Criteria Unknown (external) Baseline variability is determined to be 5–15 Average (internal) beats peak-to-peak. Increased Alert pending. Approximately 5 minutes of baseline variability which is >...
Page 231 Spectra Alerts: Alert Parameters Summary of Alert Parameters ALERT PARAMETERS SUMMARY ON FHR SETUP SCREEN TREND SCREEN Parameter Column 1 Column 2 Message Criteria Decelerations The analysis of deceleration characteristics Present? DECELERATIONS? has recognized features of either variable, late, mixed, or prolonged decelerations; or decelerations without uterine activity recorded.
Page 232 Spectra Alerts: Alert Parameters Summary of Alert Parameters ALERT PARAMETERS SUMMARY ON FHR SETUP SCREEN TREND SCREEN Parameter Column 1 Column 2 Message Criteria Uterine activity >40 mmHg (5.3 kPa) for 5 minutes. # mmHg (kPa) No alert. (TOCO) UA BASELINE SET? appears in Uterine Activity Display.
Page 233 Spectra Alerts: Alert Parameters Summary of Alert Parameters ALERT PARAMETERS SUMMARY ON FHR SETUP SCREEN TREND SCREEN Parameter Column 1 Column 2 Message Criteria Good Alert pending. Moderate Alert has not been silenced. Poor Unknown (appears when UC is the only SIGNAL QUALITY? active parameter) Three minutes of unsatisfactory data...
Page 234 Spectra Alerts: Alert Parameters C-22 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 235: Frequently Asked
Frequently Asked Questions: Frequently Asked Questions Revision C 250cx Series Maternal/Fetal Monitor 2036946-001...
Page 236 Frequently Asked Questions: 250cx Series Maternal/Fetal Monitor Revision C 2036946-001...
Page 237: Faqs
Frequently Asked Questions: FAQs Question Answer NOTE: When the monitor is powered off, then on again, the settings revert back to the factory default settings or can be saved if you choose Store Current to Hospital in the password-protected Install Options screen. How do I change the alarm limits for Fetal 1.
Page 238 Frequently Asked Questions: Question Answer How do I change the alarm limits for Non- 1. Rotate the Trim Knob to highlight the legend for NIBP. (This legend is slightly above Invasive Blood Pressure? center, on the left side of the display. 2.
Page 239 Frequently Asked Questions: Question Answer How do I enable the MHR/P, Maternal 1. Rotate the Trim Knob to highlight the legend for MHR/P. (This legend is located Heart Rate Pulse, trend recorder tracing? approximately in the center of the display, and may indicate MECG, Pulse or INOP, according on the settings that are currently enabled.
Page 240 Frequently Asked Questions: Question Answer How do I change the alarm limits for 1. Rotate the Trim Knob to highlight the legend for MSpO . (This legend is slightly MSpO , Maternal Blood Oxygen above center, on the right side of the display.) Saturation? 2.
Page 241 Frequently Asked Questions: Question Answer How do I change the Maternal ECG lead Option 1 waveform being displayed? 1. Rotate the Trim Knob to highlight the legend for MHR/P. (This legend is in the approximate center of the display and reads MECG, Pulse or INOP, according to the settings that are currently enabled.) 2.
Page 242 Frequently Asked Questions: Question Answer How do I disable/enable Fetal Movement 1. Rotate the Trim Knob to highlight the legend for US. (This legend is top left on the Detection? (FMD is an optional feature that display.) is purchased separately.) Note: This feature applies only if ultrasound is the source.
Page 243 Frequently Asked Questions: Question Answer How do I enable or change alarm volume 1. Rotate the Trim Knob to highlight the legend for FHR2. (This legend is top left on the settings for Fetal Heart Rate 2? display, and may display as INOP or US2. 2.
Page 244 Frequently Asked Questions: Question Answer How do I enable or change alarm volume 1. Rotate the Trim Knob to highlight the legend for MHR/P. (This legend is located settings for MHR/P (Maternal Pulse)? approximately in the center of the display, and may indicate MECG, Pulse or INOP, depending on the settings that are currently enabled.
Page 245 Frequently Asked Questions: Question Answer How do I change the volume for FHR1 Option 1 audio or heart beat tones? 1. Use the front panel Volume Up or Volume Down buttons (left) to control volume for FHR Channel 1. Option 2 1.
Page 246 Frequently Asked Questions: Question Answer How do I change the volume for MHR 1. Rotate the Trim Knob to highlight the legend for MHR/P. (This legend is located near Pulse tones? the center of the display, and may indicate MECG, Pulse or INOP, depending on the settings that are currently enabled.
Page 247 Frequently Asked Questions: Question Answer How do I change the interval time for taking 1. Rotate the Trim Knob to highlight the legend for NIBP. (This legend is slightly above Non-Invasive Blood Pressures? center, on the left side of the display.) 2.
Page 248 Frequently Asked Questions: Question Answer How do I change the time? 1. Rotate the Trim Knob to highlight the Setup legend at the bottom of the display, below the menu bar. 2. Once the Setup legend is highlighted, press the Trim Knob. 3.
Page 250 Tel: + 86 21 5257 4650 Fax:+ 1 414 355 3790 Fax: + 49 761 45 43 - 233 Fax: + 86 21 5208 2008 GE Medical Systems Information Technologies, a General Electric Company, going to market as GE Healthcare www.gehealthcare.com 0086...

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