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The interface consists of circuitry and connectors that allow the main processor to access all of the operator related functions. It is a cable harness for these components and is unique in its construction. The front bezel board is made with a process called "rigid - flex" allowing the board to act as a flex cable. This board may be flexed for service, however CARE must be taken not to bend this material at a sharp angle. This process allows direct connection to the LCD assembly.

The front end board mates to the main processor via a "floating" 44 pin high density D connector. This connector has a mechanical float to allow the front and back of the unit to be snapped together without concern for a cable between the two halves.

The 44 pin D connector attaches to the processor board with a flex cable. The backlight inverter converts VBUSS power from the main board to the high voltage ac power used by the backlight.

The voltage may be controlled by a digital PWM input supplied by the processor board. Interface The ambient light sensor is a photocell that exhibits a logarithmic change in resistance vs. The rotary knob interface provides a 2-bit encoder output and also a rotary knob push button signal output. Thus, the power switch signal output from the Front Bezel board is pulled up by the power switch interface located in the power supply section.

Both the battery and power led's are green when turned on. Thus, the LED control signals originate in the power supply,. This section also houses the NBP pressure transducer which uses the same acquisition system. See Figure on page The hardware design uses a single oversampling 16 bit converter to measure all of the parameters. This allows bulky analog filters to be replaced by software filters. Careful shielding and filters protect against very high frequency interference from upsetting measurements.

The MultiMed Pod in turn is connected via a 3-meter cable to the MultiMed front end in the main unit where analog ECG, Respiration, Temperature, and SpO2 signals are converted to digital form and sent through isolators for processing.

The ECG section contains RF filters, and overvoltage clamps that include 1k series resistors to limit shunting of defibrillator current. The SpO2 and temperature sections also contain RF filters. Impedance respiration is sensed through the ECG electodes.

Void-free potting and internal shielding enable compact containment of high voltage defibrillator and electrosurgery pulses. The small interconnecting cable to the main assembly is captive at the MultiMed POD but plugs into the MultiMed front end via a specially shielded connector. The data stream is sent to the Main Processor board via an opto-isolator.

Control commands from the Processor are sent out to the front end on a similar isolating link. Isolated DC power is also provided. The ECG signals are conductively coupled to the isolated circuits via current- limiting series resistors, whereas the SpO2 signals are optically isolated at the transducer. Temperature signals are doubly insulated at the patient by disposable boots on the sensors. AC 40kHz excitation currents for respiration monotoring are dc-isolated by high-voltage ceramic capacitors.

The pace signal samples are used directly by the DSP to detect pace pulses. All other signals are decimated and filtered using digital signal processing to the above specifications. Additional filtering is user selectable and invokes additional digital signal processing in the computer section of the board.

The high oversampling rate is required to minimize the requirements and size of the analog anti alias filters. Superior rejection to ESU and other types of interference is achieved with this type of design. See Figure Composite electrocardiographic ECG signals generated by the heart and by a pacemaker are filtered to reduce RF interference from impedance respiration and electrosurgery and then injected with dc lead-off detection currents. Over-voltage clamps protect the semiconductors from the surges passing the sparkgaps in the MultiMed Pod and also reduce the dc current applied to the patient due to a component fault.

Figure Lead Forming Network The Wilson point, "W", the average of the LA, RA, and LL electrode potentials, serves as the negative reference potential for the V and V' lead- pairs and is also used as a measure of the common-mode potential of the patient Figure By driving the isolated common of the front end at the same potential as the Wilson point, the common-mode voltage across the electrodes is reduced nearly to zero and the effective common-mode rejection is improved. As most of the common-mode current is now forced through the neutral electrode, it becomes noisier and hence is not used as part of another signal path.

Switches are provided to select other electrodes to be neutral if the RL electrode is off or missing. If the V' electrode is present, then it can be selected to be neutral so that the three Einthoven and the V lead pairs can still be used. However, the V' lead-pair will be corrupted due to neutral current noise. Similarly the V electrode can be selected to be neutral. Now that the RL is disconnected from the neutral driver, its potential can be monitored to determine whether it has been reconnected to the patient and thus is able to be reselected to be neutral.

If only the three Einthoven LA, RA, and LL electrodes are connected, one is selected as neutral leaving the remaining two electrodes to form one valid lead-pair. The "W" now contains the neutral drive signal which bypasses the neutral electrode and reduces the gain of the neutral driver amplifier. To improve the resulting poor common-mode rejection, a Wilson Grounding "WG" switch is activated to selectively disable the offending input to the "W". Respiration Refer to Figure DC is used for high Z sensing; ac is used for signal acquisition.

The resulting 40kHz voltage drop across those electrodes is proportional to the impedance. The waveform of the current is preemphasized to reduce bypassing effects of cable capacitance. The returning 40kHz differential voltage is amplified, synchronously demodulated, and low-pass filtered. Figure Temperature Functional Block Diagram 8. Temperature is sensed at the patient by a non-linear negative-temperature- coefficient thermistor.

The intensity of light including ambient transmitted through or scattered by the blood is converted to a current by a photodiode in the sensor. The current that appears when both leds are off depends mainly on the ambient light. This ambient contribution is later subtracted to leave only the R or IR signal levels. The large dynamic range of the light intensities requires constant automatic monitoring and adjustment.

The intensities of the R and IR sources are independently controlled by two digital-analog converters attenuating the 2. Attenuated radiation falling on the photodiode in the sensor is converted to a current which passes through an RF filter balun in the HVPOD and enters the current-to-voltage converters in the MultiMed front end.

The resulting unipolar stream of pulses is then ac-coupled to a controllable-gain differential amplifier. The signal is then synchronously demodulated into Red and IRed signals with ambient light subtracted. The calibration of each sensor is coded into the value of a precision resistor built into the sensor. The value of this resistor is sensed by forming a voltage divider. The NBP algorithms are performed in the front end processor.

The NBP circuit contains two pressure transducers which measure the hose pressure. The second redundant pressure sensor is used to measure overpressure for safety. This pressure transducer is mounted in the power section while the other pressure transducer is mounted in the MultiMed front end. A plastic manifold connects the two transducers together and to the pneumatic assembly in the rear case. The manifold provides the interconnection of the air passages between the individual components and provides for their mechanical mounting.

It also provides an acoustic attenuation of the valve and pump noise. The filters prevent contamination from entering the pneumatic system from the cuff hose or ambient air. P1 provides the pressurized air to inflate the blood pressure cuff. V1 and V2 are used to control the air flow during the de-flation phase of a blood pressure measurement. V1 is a normally closed exhaust valve with a relatively small orifice.

V2 is a normally open exhaust valve with a comparatively large orifice. When a blood pressure measurement is initiated V2 is closed, P1 is turned on and the rising cuff pressure is monitored via pressure transducers. When the pressure has reached the target inflation pressure, P1 is turned off. After the inflation, there is a short delay after the pump stops to allow.

Either V1 or V2 is now modulated to control the deflation rate. The choice of V1 or V2 and the initial pulse width is made based on the inflation cycle. The chosen valve is modulated and the pulse width open time is continuously adjusted to provide a constant deflation rate.

If initial deflation was started with V1 the software may determine that it needs to switch to V2 to maintain proper deflation. In any case when the measurement cycle is complete, V2 is opened fully de-energized to allow for rapid deflation.

The overpressure transducer has two threshold settings. Both transducers share a common manifold and are mounted on the main PC board. A relatively high pulse voltage is used to drive V1 and V2 to get quick response.

This pulse lasts for approximately 2 milliseconds after which time the valve voltage is lowered to a holding value. At the end of the valve "on" time period, the valve voltage is allowed to reverse and the energy stored in the solenoid inductance is rapidly released into a relatively high voltage clamp circuit. P1 and V2 are supplied by a redundant power switch so that, under fault conditions, they can be de-energized.

When the safety timer latch has been set, V1 is opened as an additional safety feature. Only recycling the monitor resets the safety timer latch. The safety timer circuit is functionally independent of the logic gate array. When the unit is powered up, the safety timer is de-activated until the pump is started the first time. This feature allows service calibration without triggering the safety timer.

Once the pump has been activated the timer circuit becomes functional. During calibration at production system test and in the field, a 0. The monitor automatically measures the pump and valve flow rates and determines their flow factors for the use in the flow control algorithm. The HemoMed front end may also be used with a single or dual pressure cable instead of using the HemoMed.

Excitation voltage is applied in pairs. Press 1 and 3 share a driver as well as Press 2 and 4. The output signals generated from the pressure sensors are passed through filter and clamp networks which limit and filter RF noise. The pressure excitations are monitored for fault detection. The thermistor signals are filtered and clamped before amplification.

The catheter also has a reference resistor which is read for calibration. In the sensor a thick film infra-red source is pulsed at a rate of approximately 87 Hz, generating a broad- band spectrum of IR. Selective filtering separates this into two narrow regions, one inside and one outside the band of CO2 absorption. The detector associated with the filter outside the band of CO2 absorption records the maximum level of the source energy since the signal it receives is not affected by CO2.

It provides a baseline which serves as a Reference for the level of CO2 in the airway. The other detector senses a filtered energy level modified by the presence of CO2. As the level of CO2 increases, the CO2 gas molecules in the airway absorb more of the light energy and less signal reaches the detector. This signal, converted by the detector, is referred to as the Data signal.

Current through the thick-film source is bidirectional to offset the tendency of particles within the source to migrate when exposed to a strong unidirectional electric field caused by current flow only in one direction. This keeps the structure of the source uniform and enhances system integrity and life of the product. To acquire a precise level of CO2, both channels are simultaneously sampled and the level of CO2 is determined from the ratio of the Data and the Reference channels.

The ratio is compared to a look-up table in memory to establish the correct value in units of mmHg. The module then sends the results to the host system for further processing and display. The Digital Board has two major functional areas: the power supply section and the bulk of the digital control logic. The Analog Board provides for data acquisition and conversion, and contains the servos for controlling the temperature of the case and detector heaters, and the source pulser used to control the probe.

Its contents remain intact even when power is removed from the module. It has been socketed to allow for future program updates, if required.

Besides containing the module's program, it also contains various look-up tables for calculating CO2 parameters and the Interrupt Vector Table. The system's Static RAM functions as a scratch pad to temporarily hold various system variables until they are either no longer needed by the system and are overwritten with new information, or power is removed from the module and the RAM contents are lost.

The EEPROM holds system parameter information that must be retained when power is removed, but must also be modifiable by the processor.

The device contains multiple copies of system information such as calibration factors, sensor serial number, and span cell number, to ensure data integrity. A Supervisor chip performs various monitoring tasks to ensure that the microprocessor and system run properly. When calibrating the accessory assembly, switches inside the sensor, one for the Zero Cell and one for the Span Cell, tell the processor when the assembly has been placed on the proper cell for system calibration.

Excitation voltage is applied, one at a time, to each resistive strain gauge pressure transducers by a single, current limited voltage reference circuit which is time-multiplexed across four pressure sensors. The differential output signals generated by the pressure sensors are passed through filter and clamp networks which limit the differential and common mode voltage swings and filter out RF noise.

Figure IBP Functional Block Diagram Next, the signals enter a functional block that converts the differential signals into single ended signals which are then presented one at a time in a time-multiplexed fashion to a fixed gain single ended amplifier. Calibration voltages for zero and mmHg are periodically switched into the amplifier input to correct errors in amplifier offset and gain respectively.

Timing is coordinated by the logic gate array. This functional block also consists of means for filtering RF noise and limiting the voltage swing. A multiplexer selects one of the two temperatures or one of the two calibration points and connects the voltage to the input of a fixed gain amplifier. The two calibration points are used to correct gain and offset errors in the amplifier circuits. The signal is then further multiplexed with two power supply voltage monitors and Cardiac Output.

The thermistor signals are filtered and clamped then multiplexed to the input of a fixed gain amplifier. Two calibration voltages are also multiplexed in to correct amplifier offset and gain errors. One EEPROM is used for reading and writing data that changes during the operation of the POD, such as pressure offsets, the other stores more permanent information such as POD serial number and is therefore write protected. A mechanism is provided which allows service personnel to disable the write protection of the otherwise write protected EEPROM.

Each pressure channel is allocated 4 LCD characters. Up to three push buttons are provided for user interface. There is one for pressure zero, one for Cardiac Output Start and one spare. The interface of the buttons to the Host is handled by the gate array. Status bits indicate when the remote Hardware device is connected and powered up, and signal validity on the communication link. A current loop is established by current flowing thru the receive lines, opto-isolator and transmit lines.

A time filter is applied to both functions, such that the function must be valid for a minimum of ms before activating. Deactivation is immediate. The serial link functions as a bus master on the local bus. The performs bus arbitration and provides a serial channel for communication with an SC The registers and miscellaneous func-tions are slave devices on the bus and completely accessible to the FLASH memory is used for storage and execution of the software, and also to store care unit specific setups.

External RAM is used for software downloader code, runtime stack, SCC data buffers, monitor configuration data and error logs. Monitor Connection Characteristics The network board communicates with the attached monitor by the high speed serial link or by the serial channel for an SC series monitor.

Because of the different characteristics of each type of link, relays are used to select one or the other. The default selection is the SC link. A time filter is applied to each signal, such that the function must be valid for a minimum of 64 milliseconds before activating. This signal is valid even if the monitor is powered off.

A voltage comparator activates when the loop is sensed. The link is generated when a receive signal is sensed by the T1 receiver. One contains factory- programmed field service data and is read-only in the field. It is a line powered switching power supply capable of operating over the range of international line voltages without having to be reconfigured.

Manual switching or fuse changing are not required. The auxiliary docking station outputs are current limited for fault isolation. A fan speed control circuit is also provided for cooling the CPS unit.

An earth ground connection is made to the monitor at the docking station for EMI suppression via the docking station cable shield. The units connected to the auxiliary docking stations have ground isolation in their DC to DC converters to eliminate ground potential differences. The power supply uses a soft switching quasi-resonant square wave forward converter topology operating at Khz.

No power factor correction is provided. As a docking station, it serves as a secure mount for Patient Monitors in Pick-and-Go operations. After replacing a part or subassembly, always functionally verify proper operation of the monitor, before returning the monitor to clinical service.

Except for specified items, component-level repairs should not be attempted and will void any warranty or exchange allowance for returned subassemblies. A complete list of replaceable components and part numbers is given in Appendix A. Observe standard precautions for protecting the equipment from static electricity.

It must be removed very carefully if it is to be reinstalled. To remove the knob, grip it very firmly with vise-grips or a similar tool, and pull it straight out and off of the metal shaft. Avoid turning the knob. Note: Placing a piece of cloth around the knob should prevent scratching by the vise-grips, and allow the knob to be reused.

To install or reinstall a knob, align and firmly press knob onto shaft. Use extreme care to not damage underlying membrane keypad when replacing Language Label. Label Discard other new label.

Pads are secured in foot wells by adhesive. It is only to replace the main battery. The door. It also secures the battery in the compartment and assures good electrical connection to the battery connector when closed. Numbers in black circles are for text references. Removing Battery To remove installed external battery, open hinged door to lift battery.

An ejector spring pushes the battery partially out of compartment, releasing it from connector. Pull battery out to remove it from compartment. Installing Battery To install external battery, open hinged door and insert battery contact end first, oriented with contacts toward rear of monitor into compartment.

Close hinged door against battery to compress ejector spring and firmly seat battery into battery connector. Assure that door latches securely. Do the following to replace the door: Removing External 1 Remove external battery if installed. Installing External 4 Slide replacement battery compartment door into position in rear Compartment Door housing, and reinstall rear cover. Use the following procedure to remove the main battery. After removing the rear access panel, do NOT cut the ty-wraps securing the Main Battery to the rear housing.

They have been designed to be releaseable, and the monitor must be opened to replace them. Be careful to NOT damage in-line fuse if installed. Note polarity of battery cable wires! Figure Battery Cable Ties 3 Depress release tab on each ty-wrap lock see Figure and pull ty- wrap tongues out of locks to free battery. Installing Main Battery Reverse steps of removal procedure to install main battery.