GE S5 Owners Manual
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Patient Side Module, E-PSM, E-PSMP (Rev. 01) 5 Document no. M1215098-002 1.2.4 Temperature Measurement range10 to 45 °C (50 to 113 °F) Measurement accuracy ±0.1 °C (25 to 45.0 °C) ±0.2 °C (10 to 24.9 °C) Display resolution 0.1 °C (0.1 °F) Temperature test automatic (every 10 min.) Probe type compatible with YSI 400 series Single use sensors ±0.3 °C (25 to 45.0 °C) ±0.4 °C (10 to 24.9 °C) 1.2.5 Invasive blood pressure Measurement range -40 to 320 mmHg Measurement accuracy ±5% or ±2 mmHg Zero adjustment range ±150 mmHg Calibration range ±25% Scales upper limit is adjustable between 10 and 300 mmHg in steps of 10 mmHg. Lower limit is 10% of selected upper limit below zero. Sweep speed 12.5, 25, 50 mm/s Digital display Range-40 to 320 mmHg Resolution ±1 mmHg Waveform display Range-30 to 300 mmHg Pulse rate from arterial pressure Measurement range 30 to 250 bpm Resolution 1 bpm Accuracy ±5 bpm or ±5% whichever is greater 1.2.6 Respiration The EMC immunity of the respiration measurement has been tested with 1 Vrms and 1 V/m. This level has been used for optimizing the immu nity of the respiration measurement to damp the operating frequency of the electrosurgery equipment. WARNING Impedance respiration me asurement is intended for patients over three years old. Measurement range 4 to 120 breath/min Accuracy ±5 breath/min or ±5% Resolution 1 breath/min Averaging time 30 s Update interval 10 s Respiration waveform Sweep Speeds6.25 mm/s and 0.625 mm/s
E-modules 6 Document no. M1215098-002 1.3 Technical specifications 1.3.1 NIBP Deflation rate, PR dep.3 to 8 mmHg/s Inflation time 20 to 185 mmHg, 1 to 5 s Automatic software control, max. inflation pressure adult 280 ±10 mmHg child 200 ±10 mmHg infant 145 ±5 mmHg Over pressure limit, stops measurement after 2 seconds adult 320 mmHg child 220 mmHg infant 160 mmHg The safety circuit limits the maximum cuff pressure to 320 mmHg in adult/child mode or to 160 mmHg in infant mode. Independent timing circuit limits the pressurizing (>15 mmHg) time to 3 minutes maximum in adult/child mode, and to 90 seconds at (>5mmHg) in infant mode. Zeroing to ambient pressure is done automatically. Inflation pressure is adjusted according to the previous systolic pressure, typically 40 mmHg above. If the systolic pressure is not found, the inflation pressure is increased typically 50 mmHg. Max. measurement time adult 120 s child 120 s infant 75 s Pressure transducer accuracy is better than ±3 mmHg or ±2% whichever is greater. Max. error ±4 mmHg. Protection against electrical shock Type BF defibrillator-proof 1.3.2 ECG Defibrillation protection5000 V, 360 J Recovery time 5 s Input impedance >2.5 MΩ (10 Hz) CMRR >100 dB (ST) System noise
Patient Side Module, E-PSM, E-PSMP (Rev. 01) 7 Document no. M1215098-002 1.3.5 Invasive blood pressure Digital display averaging Digital displays Art and P1 are averaged over 5 seconds and updated at 5 seconds intervals. All other pressures have respiration artifact rejection. Accuracy ±5% or ±2 mmHg, whichever is greater Transducer and input sensitivity 5 µV/V/mmHg Filter 0 to 4 - 22 Hz adjustable Zero set accuracy ±1 mmHg Calibration resolution ±1 mmHg Zero time less than 15 s Protection against electrical shock Type CF defibrillator-proof NOTE: The accuracy of the measurement may be different from the specified, depending on the transducer/probe used. Please refer to the transducer/probe specification. 1.3.6 Respiration Excitation frequency, 12-lead ECG 31.25 kHz Breath detection automatic, manually adjustable minimum detection: 0.2, 0.4, 0.6, 0.8, 1.0 Input dynamic range 0.2 to 20 Ω Input impedance range 100 to 5000 Ω Respiration Rate min. 4 breath/min max. 120 breath/min Lead off detection >3 M Ω
E-modules 8 Document no. M1215098-002 2 Functional description 2.1 Measurement principle 2.1.1 NIBP NIBP (Non-Invasive Blood Pressure) is an indirect method for measuring blood pressure. The NIBP measurement is performed according to the oscillometric measuring principle. The cuff is inflated with a pressure slightly higher than the presumed systolic pressure, and deflated at a speed based on the patient’s pulse, collecting data from the oscillations caused by the pulsating artery. Based on these oscillations, values for systolic, mean, and diastolic pressures are calculated. The following parts are necessary for the NIBP measurement: •E-PSMP/E-PSM module •twin hose (adult or infant model) •blood pressure cuffs (various sizes) 2.1.2 ECG Electrocardiography analyzes the electrical acti vity of the heart by measuring the electrical potential produced with electrodes placed on the surface of the body. ECG reflects: •electrical activity of the heart •normal/abnormal function of the heart •effects of anesthesia on heart function •effects of surgery on heart function See the “Users Guide” or the “User’s Reference Manual” for electrodes’ positions and other information. 2.1.3 Pulse oximetry A pulse oximeter measures the light absorption of blood at two wavelengths, one in the near infrared (about 940 nm) and the other in the red region (about 660 nm) of the light spectrum. These wavelengths are emitted by LEDs in the SpO 2 probe, the light is transmitted through peripheral tissue and is finally detected by a PI N-diode opposite the LEDs in the probe. The pulse oximeter derives the oxygen saturation (SpO 2) using an empirically determined relationship between the relative absorption at the two wavelengths and the arterial oxygen saturation SaO 2. In order to measure the arterial saturation accurately, pulse oximeters use the component of light absorption giving variations synchronous with heart beat as primary information on the arterial saturation. A general limitation of pulse oximet ry is that due to the use of only two wavelengths, only two hemoglobin species can be discriminated by the measurement.
Patient Side Module, E-PSM, E-PSMP (Rev. 01) 9 Document no. M1215098-002 The modern pulse oximeters are empirically calibrated either against fractional saturation SaO 2frac; Formula 1 or against functional saturation SaO 2func; Formula 2 Functional saturation is more insensitive to changes of carboxyhemoglobin and methemoglobin concentrations in blood. The oxygen saturation percentage SpO 2 measured by the module is calibrated against functional saturation SaO 2func. The advantage of this method is that the accuracy of SpO2 measurement relative to SaO 2func can be maintained even at rather high concentrations of carboxyhemoglobin in blood. Independent of th e calibration method, pulse oximeters are not able to correctly measure oxygen content of the arterial blood at elevated carboxyhemoglobin or methemoglobin levels. Plethysmographic pulse wave The plethysmographic waveform is derived from the IR signal and reflects the blood pulsation at the measuring site. Thus the amplitude of the waveform represents the perfusion. Pulse rate The pulse rate calculation is done by peak detection of the plethysmographic pulse wave. The signals are filtered to reduce noise and checked to separate artifacts. Figure 2 Absorption of infrared light in the finger bin Dyshemoglo HbHbO HbO fracSaO2 2 2++ = HbHbO HbO funcSaO2 2 2+ = absorption_of_light.vsdNo pulsation Pulsatile bloodTime Venous blood Tissue Arterial blood Intensity of transmitted light Transmitted light Variable absorption due to pulse added volume of arterial bloodImax (DC-component) Imax Imin Incident light AC-component
E-modules 10 Document no. M1215098-002 Figure 3 Pulse oximetry probe parts layout and schematic diagram The standard probe is a finger clamp probe which contains the light source LEDs in one half and the photodiode detector in the other half. Different kinds of probes are available from GE Healthcare. 2.1.4 Temperature The temperature is measured by a probe whose resistance varies when the temperature changes, called NTC (Negative Temperature Coefficient) resistor. The resistance can be measured by two complementary methods: •Applying a constant voltage across the resistor and measuring the current that flows through it. •Applying a constant current through the resistor and measuring the voltage that is generated across it. The E-PSM(P) module uses the constant current me thod. The NTC-resistor is connected in series with a normal resistor and a constant current is applied through them. The temperature dependent voltage can be detected at the junction of the resistors, thus producing the temperature signal from the patient. The signal is amplified by analog amplifiers and further processed by digital electronics. 2.1.5 Invasive blood pressure To measure invasive blood pressure, a catheter is inserted into an artery or vein. The invasive pressure setup, consisting of a connecting tubing, a pressure transducer, an intravenous bag of normal saline, all connected together by stopcocks, is attached to the catheter. The transducer is placed at the same level with the heart, and is electrically zeroed. The transducer is a piezo-resistive device that converts the pressure signal to a voltage. The monitor interprets the voltage signal so that pressure data and pressure waveforms can be displayed. PSM_absorption_of_infrared.vsd Emitter Detector SpO2 sensor connectorIRED RED
Patient Side Module, E-PSM, E-PSMP (Rev. 01) 11 Document no. M1215098-002 2.1.6 Respiration Impedance respiration is measured across the thorax between ECG electrodes. The respiration signal is made by supplying current between the electrodes and by measuring the differential current from the electrodes. The signal measured is the impedance change caused by breathing. The respiration rate is calculated from these impedance changes, and the respiration waveform is displayed on the screen. 2.2 Main components 2.2.1 E-PSMP/E-PSM Figure 4 Front panel of E-PSMP The E-PSMP and E-PSM modules contain three main PC boards, the STP board, the ECG board, and the NIBP board. Each of these boards contain a processor and software in the processor flash memory. The boards produce their own supply voltages from the Vmod 13.8-16 V line that is available via the module bus connector. In addition to this, the NIBP board provides +5V for the ECG and STP board non-isolated side components. The NIBP board provides also the synchronization signal for the ECG and STP board power supplies. There are two input boards; the STP input board and the ECG input board attached to the front panel of the module. The front panel has five connectors and four keys. There is one connector for two temperature measurements, one for two invasive blood pressure measurements, one for ECG, one for NIBP, and one for SpO 2 measurement. The NIBP connector includes two plungers for NIBP hose identification. The keys are for NIBP Auto On/Off, NIBP Start/Cancel, P1 zero, and P2 zero. NOTE: The connectors and keys depend on the mo dule variant, and some variants may not have all the mentioned connectors and keys. 1. Module keys 2. NIBP connector 3. InvBP connector in E-PSMP only 4. Temperature connector 5. SpO 2 connector 6. ECG and impedance respiration connector 7. Tab for removing the module 7 1 2 4 5 3 6
E-modules 12 Document no. M1215098-002 2.2.2 NIBP board Figure 5 NIBP board functional block diagram Signal processing Two signals from the pressure transducers are amplified and sent to the A/D converter. After the converter, digitized signals are sent to the microprocessor for data processing. The NIBP board is controlled with an H8/3052 microprocessor at 16 MHz oscillator frequency. Memory The NIBP program memory (processor flash me mory) size is 512k x 8. The processor has 4 kBytes RAM and there is also an external RAM memory, the size of which is 128k x 8. Variable values of the NIBP measurement are stored into the external RAM. The EEPROM size is 512 x 8 and it is used to store the calibration values for the pressure transducers, the pulse valve constants gained during measurements, the PC board identification, and the module serial number. P ressure sensors PSM_NIBP_blockdiag.vsd P a tie n t a n d N IB P c u ff NIBP cuff hose NIBP connector with NIBP hose id e n tific a tio n Drivers for pum p & valves Safety CPUMain CPU NIBP control keys RS 485 com m unicationPower supply+5 V and synchronization signal fo r E C G - a n dSTP-boards M odule bus connector N IBP pneum atics (m anifold) NV memoryNV memory for continued p a tie n t d a ta Pum p
Patient Side Module, E-PSM, E-PSMP (Rev. 01) 13 Document no. M1215098-002 Software control The software controls valves and a pump. In addi tion to the individual on/off signals for each component there is a common power switch for the valves and the pump that can be used at pump/valve failures. In addition to external RS485 reset line, the microprocessor system is equipped with its own power-up reset. See the section in the ECG board’s description: “RS485 communication.” Safety circuit The NIBP board is equipped with an independent safety circuit to disconnect supply voltages from the pump and the valves if the cuff has been pressurized longer than the preset maximum measurement time, or if the pressure of the cuff is inflated over the specified pressure limit. The maximum measurement time values and pressure limits for different measurement modes have been specified in the te chnical specification section of this manual. Pneumatics The module has the following pneumatics parts: 1.Intake air filter ; for preventing dust and other parts from entering the air pump and the valves. 2. Air pump ; for pumping the measuring pressure of the cuff. 3. (Pulse) Valve ; for producing a linear pressure fall (bleeding) in order to measure the blood pressure of the patient. Note that in the service menu also names Valve and Set valve have been used for this valve. 4. Safety valve ; The safety valve is intended to be used for deflating the cuff in single fault case, i.e. to prevent too long a measurement ti me or too high an inflation pressure of the cuff. Note that also Exh2 valve has been used to designate the Safety valve in service menu. 5. Main pressure sensor ; for measuring the pressure of the blood pressure cuff and the pressure fluctuations caused by arterial wall movement. 6. Safety pressure sensor; for detecting the cuff loose, cuff occlusion situations, etc. and for recognizing the pressure sensor fault. 7. Cuff connector; for connection and hose identification.
E-modules 14 Document no. M1215098-002 Figure 6 NIBP pneumatics diagram Power supply section of the NIBP board All connections are established via a 5-pin connector (female). The module needs a +15 V (dirty) power supply to operate. The supply voltage Vmod 13.8- 16 V is generated in the power supply section of the monitor. The other voltages nee ded for the operation of the NIBP measurement are made on the NIBP board. The NIBP power supply synchronizes the ECG and STP isolation power and supplies non-isolated 5 V to the ECG and STP board. Safety pressure sensor Main pressure sensor Dump valve Proportional valve Air pump Intake air filterCuff connector PSM_NIBP_pneum_diagr.vsd S1 S2 Plunger Plunger