飛利浦監(jiān)護(hù)儀簡(jiǎn)易使用手冊(cè)

1、Guan WeiPCCI2012-12-13飛利浦監(jiān)護(hù)儀簡(jiǎn)易使用手冊(cè)飛利浦監(jiān)護(hù)儀簡(jiǎn)易使用手冊(cè)ConfidentialPCCI, Guan Wei, 2012-12-1327/26/2021ConfidentialPCCI, Guan Wei, 2012-12-133IntelliVue Patient Monitor Family MP20/30 MP40/50 MP60/70 X2 X2 X2 MP80/90FMSConfidentialPCCI, Guan Wei, 2012-12-13更多內(nèi)容請(qǐng)?jiān)斪x隨機(jī)配發(fā)的使用手冊(cè)4ConfidentialPCCI, Guan Wei, 2012-12

2、-13一般介紹一般介紹5ConfidentialPCCI, Guan Wei, 2012-12-13主屏幕信息聯(lián)網(wǎng)狀態(tài)床位號(hào)病人姓名 病人種類是否起搏日期時(shí)間監(jiān)護(hù)設(shè)置改變屏幕報(bào)警/信息波形顯示數(shù)字顯示數(shù)字顯示靈巧鍵自由填空6ConfidentialPCCI, Guan Wei, 2012-12-13狀態(tài)條測(cè)量選擇狀態(tài)信息有未工作的參數(shù)標(biāo)名沖突狀態(tài)正常7ConfidentialPCCI, Guan Wei, 2012-12-13報(bào)警狀態(tài)區(qū)域三星紅色重度報(bào)警一星藍(lán)色輕度報(bào)警二星黃色中度報(bào)警8ConfidentialPCCI, Guan Wei, 2012-12-13屏幕上的按鍵永久鍵靜音報(bào)警暫停主

3、設(shè)定主屏幕9ConfidentialPCCI, Guan Wei, 2012-12-13屏幕上的按鍵靈巧鍵10ConfidentialPCCI, Guan Wei, 2012-12-13屏幕上的按鍵跳出鍵11ConfidentialPCCI, Guan Wei, 2012-12-13操作方式旋鈕主屏幕靜音總報(bào)警開關(guān)菜單逐級(jí)返回操縱桿/旋鈕觸屏12ConfidentialPCCI, Guan Wei, 2012-12-13填滿空白處13ConfidentialPCCI, Guan Wei, 2012-12-13快捷鍵-測(cè)量選擇14ConfidentialPCCI, Guan Wei, 2012-

4、12-13病人類別選擇15ConfidentialPCCI, Guan Wei, 2012-12-13病人是否佩戴起搏器選擇16ConfidentialPCCI, Guan Wei, 2012-12-13監(jiān)護(hù)儀主設(shè)定菜單17ConfidentialPCCI, Guan Wei, 2012-12-1318ConfidentialPCCI, Guan Wei, 2012-12-13待機(jī)19ConfidentialPCCI, Guan Wei, 2012-12-13ECG(心電)20ConfidentialPCCI, Guan Wei, 2012-12-13ECG菜單21ConfidentialPC

5、CI, Guan Wei, 2012-12-13導(dǎo)聯(lián)放置1234S SA AI IE E22ConfidentialPCCI, Guan Wei, 2012-12-13調(diào)整報(bào)警上下限23ConfidentialPCCI, Guan Wei, 2012-12-13關(guān)閉ECG報(bào)警24ConfidentialPCCI, Guan Wei, 2012-12-13心律失常報(bào)警鏈25ConfidentialPCCI, Guan Wei, 2012-12-13心律失常分析內(nèi)容Asystole 停搏Ventricular Fibrillation/Tachycardia室顫/室速Extreme Bradyca

6、rdia極端心動(dòng)過(guò)緩Extreme Tachycardia極端心動(dòng)過(guò)速High heart rate心率快Low heart rate心率慢Ventricular Tachycardia室性心動(dòng)過(guò)速Pacer Not Capture起搏器未捕獲Pacer Not Pacing起搏器未起搏PVCs/min HIGH(PVClimit/min頻發(fā)室早Afib房顫Supraventricular Tach室上性心動(dòng)過(guò)速M(fèi)issed Beat漏搏Pause暫停Irregular HR心律不齊VENRICULAR RHYTHM室性節(jié)律RUN PVCs High多個(gè)連發(fā)室早Pair PVCs成對(duì)室早R-o

7、n-T PVCsR-on-TVentricular bigeminy室性二聯(lián)律Ventricular trigeminy室性三聯(lián)律Non-sustain VT陣發(fā)室速M(fèi)ultiform PVCs多源室早26ConfidentialPCCI, Guan Wei, 2012-12-13心律失常心搏標(biāo)名27ConfidentialPCCI, Guan Wei, 2012-12-13ECG菜單ST分析窗口28ConfidentialPCCI, Guan Wei, 2012-12-13ECG菜單ST報(bào)警范圍調(diào)整29ConfidentialPCCI, Guan Wei, 2012-12-13ST測(cè)量點(diǎn)的確

8、定30ConfidentialPCCI, Guan Wei, 2012-12-13ECG菜單ST環(huán)31ConfidentialPCCI, Guan Wei, 2012-12-13調(diào)整觀察ST環(huán)的間隔時(shí)間32ConfidentialPCCI, Guan Wei, 2012-12-13如何選擇優(yōu)質(zhì)信號(hào)導(dǎo)聯(lián)33ConfidentialPCCI, Guan Wei, 2012-12-13可以監(jiān)測(cè)的導(dǎo)聯(lián)34ConfidentialPCCI, Guan Wei, 2012-12-13RESP(呼吸)35ConfidentialPCCI, Guan Wei, 2012-12-13呼吸菜單36Confiden

9、tialPCCI, Guan Wei, 2012-12-13調(diào)整報(bào)警上下限37ConfidentialPCCI, Guan Wei, 2012-12-13呼吸檢測(cè)模式38ConfidentialPCCI, Guan Wei, 2012-12-13NIBP(無(wú)創(chuàng)血壓)39ConfidentialPCCI, Guan Wei, 2012-12-13測(cè)量原理40ConfidentialPCCI, Guan Wei, 2012-12-13注意事項(xiàng)41ConfidentialPCCI, Guan Wei, 2012-12-13測(cè)量限制42ConfidentialPCCI, Guan Wei, 2012-

10、12-13測(cè)量模式43ConfidentialPCCI, Guan Wei, 2012-12-13測(cè)量的修正44ConfidentialPCCI, Guan Wei, 2012-12-13NBP菜單45ConfidentialPCCI, Guan Wei, 2012-12-13NBP報(bào)警源調(diào)整46ConfidentialPCCI, Guan Wei, 2012-12-13調(diào)整報(bào)警上下限47ConfidentialPCCI, Guan Wei, 2012-12-13NBP測(cè)壓模式48ConfidentialPCCI, Guan Wei, 2012-12-13自動(dòng)測(cè)壓重復(fù)時(shí)間49Confident

11、ialPCCI, Guan Wei, 2012-12-13SpO2(血氧飽和度)50ConfidentialPCCI, Guan Wei, 2012-12-13SpO2菜單51ConfidentialPCCI, Guan Wei, 2012-12-13SpO2報(bào)警調(diào)整52ConfidentialPCCI, Guan Wei, 2012-12-13TEMP(體溫)53ConfidentialPCCI, Guan Wei, 2012-12-13TEMP菜單54ConfidentialPCCI, Guan Wei, 2012-12-13更改標(biāo)名55ConfidentialPCCI, Guan Wei

12、, 2012-12-13調(diào)整報(bào)警56ConfidentialPCCI, Guan Wei, 2012-12-13IBP(有創(chuàng)血壓)57ConfidentialPCCI, Guan Wei, 2012-12-13IBP菜單數(shù)字窗口58ConfidentialPCCI, Guan Wei, 2012-12-13IBP菜單脈搏設(shè)定59ConfidentialPCCI, Guan Wei, 2012-12-13IBP菜單波形窗口60ConfidentialPCCI, Guan Wei, 2012-12-13凍結(jié)波形61ConfidentialPCCI, Guan Wei, 2012-12-13IBP菜

13、單按凍結(jié)波形調(diào)整光標(biāo)觀察壓力62ConfidentialPCCI, Guan Wei, 2012-12-13 ABParterial blood pressure動(dòng)脈血壓 ARTarterial blood pressure (alternative)動(dòng)脈血壓（另一種表示方法） AOaortic pressure主動(dòng)脈壓 CVPcentral venous pressure中心靜脈壓 ICPintracranial pressure顱內(nèi)壓 LAPleft atrial pressure左房壓 RAPright atrial pressure右房壓 Pnon-specific pressure

14、label非特異的壓力標(biāo)名 PAPpulmonary artery pressure肺動(dòng)脈 UAPumbilical arterial pressure臍動(dòng)脈壓 UVPumbilical venous pressure臍靜脈壓有創(chuàng)血壓標(biāo)名63ConfidentialPCCI, Guan Wei, 2012-12-13歸零64ConfidentialPCCI, Guan Wei, 2012-12-13IBP常見(jiàn)故障與排除65ConfidentialPCCI, Guan Wei, 2012-12-13二氧化碳監(jiān)護(hù)主路Mainstream插管病人，傳感器的重量，不適合新生兒和嬰幼兒旁路sidestr

15、eam非插管病人，最小取樣容積100-150CC，不適合新生兒微流Microstream TM非插管病人，取樣容積50CC，適合新生兒ConfidentialPCCI, Guan Wei, 2012-12-13主路CO2 監(jiān)測(cè) 優(yōu)勢(shì) 傳感器在氣道上，滯后時(shí)間短 對(duì)潮氣量沒(méi)有嚴(yán)格要求ConfidentialPCCI, Guan Wei, 2012-12-13主路CO2 M3014A A01 Extension A02 Extension with Mainstream SensorA02 Extension with Mainstream SensorConfidentialPCCI, Guan

16、 Wei, 2012-12-13旁路CO2A03 Extension with Sidestream SensorA03 Extension with Sidestream SensorSupplies !Supplies !M2741A Sidestream CO2 Sensor and AccessoriesConfidentialPCCI, Guan Wei, 2012-12-13旁路CO2 監(jiān)測(cè) 優(yōu)勢(shì) 沒(méi)有傳感器干擾患者氣道 一次性采樣管 可用于插管、非插管患者 缺點(diǎn) 需要經(jīng)常校準(zhǔn) 需要150-250 ml/min氣體用于精確采樣，影響潮氣量 延遲的反應(yīng)時(shí)間：沒(méi)有實(shí)時(shí)圖形 分泌物阻塞采

17、樣管ConfidentialPCCI, Guan Wei, 2012-12-13Microstream CO2 靈活多樣 - 插管和非插管患者 口和鼻呼吸 輸送氧氣（低流量O2解決方案；解決高流量O2傳輸） 成人、兒童和嬰幼兒ConfidentialPCCI, Guan Wei, 2012-12-13測(cè)量原理72ConfidentialPCCI, Guan Wei, 2012-12-13管路連接方法-主路73ConfidentialPCCI, Guan Wei, 2012-12-13管路連接方法-主路74ConfidentialPCCI, Guan Wei, 2012-12-13主路管路連接的

18、注意事項(xiàng)75ConfidentialPCCI, Guan Wei, 2012-12-13管路連接方法-旁路76ConfidentialPCCI, Guan Wei, 2012-12-13管路連接方法-旁路-插管病人77ConfidentialPCCI, Guan Wei, 2012-12-13管路連接方法-旁路-非插管病人78ConfidentialPCCI, Guan Wei, 2012-12-13旁路管路連接的注意事項(xiàng)79ConfidentialPCCI, Guan Wei, 2012-12-13CO2菜單80ConfidentialPCCI, Guan Wei, 2012-12-13報(bào)警

19、調(diào)整81ConfidentialPCCI, Guan Wei, 2012-12-13刻度調(diào)整82ConfidentialPCCI, Guan Wei, 2012-12-13笑氣開關(guān)83ConfidentialPCCI, Guan Wei, 2012-12-13氧氣校正84ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體校正85ConfidentialPCCI, Guan Wei, 2012-12-13注意事項(xiàng)86ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊麻醉氣體模塊開關(guān)M1658AGas Sample Tubin

20、g氣體采樣管M1657B Watertrap 集水器 13902AElbow Airway Adapter氣道彎接頭M1612AStraight Airway Adapter氣道平接頭麻醉氣體模塊待機(jī)按鍵進(jìn)入麻醉氣體模塊菜單87ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體附件的連接88ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊應(yīng)用的注意事項(xiàng)89ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-麻醉氣體監(jiān)測(cè)在主屏幕的顯示90ConfidentialPCCI, Guan W

21、ei, 2012-12-13麻醉氣體模塊-打開麻醉氣體窗口91ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-麻醉氣體窗口顯示92ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-設(shè)定呼吸報(bào)警范圍93ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-CO2設(shè)定窗口94ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-設(shè)定CO2報(bào)警范圍95ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-CO2波

22、形刻度設(shè)定96ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-設(shè)定吸入麻醉氣體報(bào)警97ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-設(shè)定O298ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-設(shè)定某種麻醉氣體的波形刻度99ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-歸零校準(zhǔn)100ConfidentialPCCI, Guan Wei, 2012-12-13麻醉氣體模塊-麻醉氣體報(bào)警范圍調(diào)整101ConfidentialPCC

23、I, Guan Wei, 2012-12-13是來(lái)自自然腦電圖的衍生值是來(lái)自自然腦電圖的衍生值利用能量和雙頻譜的特性集成的數(shù)據(jù)為單一數(shù)利用能量和雙頻譜的特性集成的數(shù)據(jù)為單一數(shù)僅僅需要僅僅需要5 5個(gè)電極個(gè)電極刻度范圍從刻度范圍從0 0到到100100ConfidentialPCCI, Guan Wei, 2012-12-13103BIS監(jiān)測(cè)原理監(jiān)測(cè)原理麻醉（Anesthesia）：麻醉是指借助于藥物等方法而產(chǎn)生的全身或局部感覺(jué)(特別是痛覺(jué))的消失及記憶遺忘狀態(tài)全麻：通過(guò)引起可逆的中樞神經(jīng)系統(tǒng)的抑制和興奮,從而達(dá)到意識(shí)消失和止痛的目的麻醉深度：全身麻醉的深度鎮(zhèn)靜（睡眠，無(wú)意識(shí)）鎮(zhèn)靜（睡眠，無(wú)意識(shí)

24、）肌松肌松鎮(zhèn)痛鎮(zhèn)痛ConfidentialPCCI, Guan Wei, 2012-12-13BIS監(jiān)測(cè)原理監(jiān)測(cè)原理BIS（The Bispectral Index ）： 是來(lái)自自然腦電圖的衍生值 利用能量和雙頻譜集成的單一數(shù)據(jù)，刻度范圍從0到100 BIS的特征：加入相位變化的信息，產(chǎn)生一個(gè)比功率譜更全面的來(lái)自Fourier變換的數(shù)字化腦電信息，能更好地表現(xiàn)各種臨床情況發(fā)生的EEG變化全貌 僅僅需要5個(gè)電極 BIS技術(shù)的關(guān)鍵：收集數(shù)千患者EEG資料建庫(kù)，以統(tǒng)計(jì)學(xué)為基礎(chǔ)，經(jīng)驗(yàn)地運(yùn)用描記波組合，而不是單個(gè)描記波。ConfidentialPCCI, Guan Wei, 2012-12-13BIS模

25、塊及電纜模塊及電纜ConfidentialPCCI, Guan Wei, 2012-12-13BIS應(yīng)用應(yīng)用5cmConfidentialPCCI, Guan Wei, 2012-12-13BIS 在在 ICU鎮(zhèn)靜治療中的作用鎮(zhèn)靜治療中的作用BIS反應(yīng)鎮(zhèn)靜程度100病人清醒100-80對(duì)平常聲音有反應(yīng)焦慮80-60對(duì)強(qiáng)聲音有反應(yīng) 搖晃和溫和刺激病人有 反應(yīng)中度鎮(zhèn)靜60-40對(duì)外界刺激反應(yīng)低下唇刺激遲鈍重度鎮(zhèn)靜40-20大腦去皮層狀態(tài)重度鎮(zhèn)靜0腦電圖直線死亡ConfidentialPCCI, Guan Wei, 2012-12-13BIS 阻抗指示器阻抗指示器ConfidentialPCCI,

26、Guan Wei, 2012-12-13BIS 傳感器接觸檢查窗口傳感器接觸檢查窗口ConfidentialPCCI, Guan Wei, 2012-12-13110 操作步驟：用酒精擦拭皮膚并晾干將傳感器的標(biāo)記1貼于前額（前額中央，鼻上5厘米）處將傳感器的標(biāo)記3貼于太陽(yáng)穴處輕壓傳感器的邊緣保證粘貼牢固輕壓傳感器的標(biāo)記1，2，3持續(xù)5分鐘將傳感器和病人連接電纜線相連更換新傳感器時(shí)，按壓病人連接電纜上的按鍵使之和電纜脫離ConfidentialPCCI, Guan Wei, 2012-12-13111BIS bispectral index 雙頻指數(shù)雙頻指數(shù)SR suppression ratio抑制比抑制比 抑制比是最后抑制比是最后63秒內(nèi)腦電信號(hào)處于被抑制秒內(nèi)腦電信號(hào)處于被抑制 狀態(tài)的時(shí)間百分比狀態(tài)的時(shí)間百分比SQI signal quality index信號(hào)品質(zhì)指數(shù)信號(hào)品質(zhì)指數(shù) 表示被接收并處理的腦電信號(hào)的質(zhì)量表示