Monitoring

PATIENT MONITORING

Operator’s Manual
Rev. 1.0 – 09/09

M ODERN S OLUTIONS FOR A NESTHESIA AND I NHALATION

 HEYER VizOR 15

Table of contents
1 Details of the Manufacturer .......................................................................................................................... 5
2 Introduction.................................................................................................................................................... 6
2.1 General Warning...................................................................................................................................... 6
2.2 General information ................................................................................................................................. 7
2.3 Screen Display......................................................................................................................................... 9
2.4 Button Functions.................................................................................................................................... 10
2.5 Interfaces............................................................................................................................................... 11
2.6 Built-in Battery ....................................................................................................................................... 13
3 Configuration ............................................................................................................................................... 14
3.1 SIGMA ................................................................................................................................................... 14
3.2 TREND .................................................................................................................................................. 14
3.3 ALARM .................................................................................................................................................. 16
3.4 SETUP................................................................................................................................................... 16
3.5 PATIENT INFORMATION ..................................................................................................................... 17
3.6 RECORDER .......................................................................................................................................... 17
3.7 ABOUT .................................................................................................................................................. 18
4 Alarm ............................................................................................................................................................ 19
4.1 Alarm Modes ......................................................................................................................................... 19
4.1.1 Alarm Level And Setup .................................................................................................................. 19
4.2 Alarm Modes ......................................................................................................................................... 19
4.3 Alarm Verification During Power On ...................................................................................................... 19
4.4 Alarm Cause.......................................................................................................................................... 19
4.5 Alarm Silence Button Function .............................................................................................................. 19
4.6 Parameter Alarm.................................................................................................................................... 19
4.7 When An Alarm Occurs ......................................................................................................................... 20
5 ECG Monitoring ........................................................................................................................................... 21
5.1 General.................................................................................................................................................. 21
5.2 ECG Window ......................................................................................................................................... 24
5.3 ECG Alarm Message ............................................................................................................................. 25
5.4 ECG Cable Cleaning ............................................................................................................................. 26
6 RESP Monitoring ......................................................................................................................................... 27
6.1 General.................................................................................................................................................. 27
6.2 RESP Window ....................................................................................................................................... 27
6.3 RESP Alarm Message ........................................................................................................................... 28
7 SpO2 Monitoring .......................................................................................................................................... 29
7.1 General.................................................................................................................................................. 29
7.2 SpO2 Window ........................................................................................................................................ 32
7.3 SpO2 Alarm Message ............................................................................................................................ 33
7.4 SpO2 Probe Cleaning ............................................................................................................................ 33
8 NIBP Monitoring .......................................................................................................................................... 34
8.1 General.................................................................................................................................................. 34
8.2 NIBP Window ........................................................................................................................................ 36
8.3 NIBP Alarm Message ............................................................................................................................ 37
8.4 NIBP Cuff Cleaning................................................................................................................................ 37
9 TEMP Monitoring ......................................................................................................................................... 38
9.1 General.................................................................................................................................................. 38
9.2 TEMP Window....................................................................................................................................... 38
9.3 TEMP Alarm Message........................................................................................................................... 39
9.4 TEMP Sensor Cleaning And Storage .................................................................................................... 39
10 IBP Monitoring ............................................................................................................................................. 40
10.1 General.............................................................................................................................................. 40
10.2 IBP Window ....................................................................................................................................... 41
10.3 IBP Alarm Message ........................................................................................................................... 43
10.4 IBP Transducer Cleaning................................................................................................................... 44
11 GAS Monitoring (Mainstream) .................................................................................................................... 45
11.1 General.............................................................................................................................................. 45
11.2 GAS Window ..................................................................................................................................... 49
11.3 GAS Alarm Message ......................................................................................................................... 52
11.4 IRMA Sensor Cleaning ...................................................................................................................... 53
12 Cerebral State Monitoring........................................................................................................................... 54
12.1 General.............................................................................................................................................. 54
12.2 CSM On Patient Monitor.................................................................................................................... 54
13 ST Monitoring .............................................................................................................................................. 56
13.1 General.............................................................................................................................................. 56
13.2 ST Analysis Window .......................................................................................................................... 56
13.3 ST Alarm Message ............................................................................................................................ 58

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14 ARRYTHMIA Monitoring.............................................................................................................................. 58
14.1 General.............................................................................................................................................. 58
14.2 ARR ANALYSIS Window................................................................................................................... 59
15 RECORDING................................................................................................................................................. 62
15.1 General.............................................................................................................................................. 62
15.2 Recording Type ................................................................................................................................. 62
15.3 Recorder Operation And Status Messages ....................................................................................... 62
15.4 Recorder Paper ................................................................................................................................. 63
15.5 Recorder Status Message ................................................................................................................. 63
15.6 Recorder Cleaning............................................................................................................................. 63
16 Patient Safety............................................................................................................................................... 64
17 Care And Cleaning ...................................................................................................................................... 65
17.1 Cleaning ............................................................................................................................................ 65
17.2 Sterilization ........................................................................................................................................ 65
17.3 Disinfection ........................................................................................................................................ 65
18 Getting Started............................................................................................................................................. 66
18.1 Open The Package And Check ......................................................................................................... 66
18.2 Place The Battery Fuse ..................................................................................................................... 66
18.3 Connect The Power Cables............................................................................................................... 66
18.4 Power On The Monitor....................................................................................................................... 66
18.5 Connect Patient Sensors ................................................................................................................... 66
19 Technical Specification............................................................................................................................... 67
20 Trouble Shooting......................................................................................................................................... 71
21 Warranty....................................................................................................................................................... 72
APPENDIX I .......................................................................................................................................................... 73
APPENDIX II ......................................................................................................................................................... 76
APPENDIX III ........................................................................................................................................................ 81

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1 Details Of The Manufacturer

Apparatus: Patient Monitoring System

HEYER VizOR 15

Manufacturer: HEYER Medical AG

Carl-Heyer-Straße 1-3
D-56130 Bad Ems
Germany

Tel.: +49 (0) 2603 / 791-3

Fax: +49 (0) 2603 / 70424

E-Mail: info@heyermedical.de
Internet: http://www.heyermedical.de

Subject to alterations, issued September 2009.

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2 Introduction Warning
To prevent EMC effect on the monitor, the
■ For an overall safety instruction, please refer system should not be used adjacent to or
to 2.1 General Warning. stacked with other equipment and that if
■ For an overall introduction to the monitor, adjacent or stacked use is necessary, the
please refer to 2.2 General Information. equipment should be observed to verify normal
■ For various messages displayed on the operation in the configuration in which it will be
screen, please refer to 2.3 Display Screen. used.
■ For basic operating instructions, please refer
Warning
to 2.4 Button Function And Basic
The user must check that equipment and
Operation.
accessories function safely and see that it is in
■ For allocation of interface sockets, please
proper working condition before being used.
refer to 2.5 Peripheral Interfaces.
■ For important facts to be noted during the Warning
battery recharging procedure, please refer to Alarm must be set up according to different
2.6 Built-in Rechargeable Battery. situation of individual patient. Make sure that
audio sounds can be activated when alarm
2.1 General Warning occurs.

Warning Warning
Portable Patient Monitor is intended for clinical Do not use cellular phone in the vicinity of this
monitoring application with operation only equipment. High level of electromagnetic
granted to appropriate medical staff. radiation emitted from such devices may result
in strong interference with the monitor
Warning performance.
Before use, carefully read this manual,
directions for use of any accessories, all Warning
precautions, and all specifications. Do not touch the patient, table nearby, or the
equipment during defibrillation.
Warning
The vital sign monitor is intended for use only Warning
as an adjunct in patient assessment .It must be The equipment and devices connected to it
used in conjunction with clinical signs and should form an equipotential body to ensure
symptoms. effective grounding.

Warning Warning
If the accuracy of any measurement does not The doctor shall consider all well-known side-
seem reasonable, first check the patient's vital effects when using the patient monitor.
signs by alternate means and then check the
Warning
monitor for proper functioning.
There will be some risks of polluting the
Warning environment associated with the disposal of
Do not use the patient monitor during magnetic the device and cables at the end of their useful
resonance imaging (MRI) scanning. Induced lives. The device and accessories shall be
current could potentially cause burns. The disposed in accordance with national laws after
monitor may affect the MRI image, and the their useful lives. Contact your municipality to
MRI unit may affect the accuracy of monitor check where you can safely dispose of old
measurements. batteries.

Warning Warning
Do not place the monitor in any position that Do not expose the system near any local
might cause it to fall on the patient. heating item such as the direct radiation.

Warning Warning
There could be hazard of electrical shock by Do not use one monitor for two or more patient
opening the monitor casing. All servicing and at the same time.
future upgrading to this equipment must be Warning
carried out by personnel trained and
It is possible to increase leakage current when
authorized by manufacturer.
several systems are connected to the patient
Warning simultaneously.
Equipment not suitable for use in the presence
of a flammable anesthetic mixture with air or
with oxygen or nitrous oxide.

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Warning
Monitor software is designed in a way that
hazards arising from errors in the software
programmed are minimized.
Warning
Do not connect items not specified as parts of
the monitor.
Warning
Vital sign monitor needs to be installed and put
into service according to the EMC information
provided in the APPENDIX III

2.2 General information

Environment:
Temperature
Working 0 to 40ºC
Transport/Storage -20 to 60ºC
Humidity 20-90%
(None condensing)
Altitude -200 to 3000m
Power Supply 200-240VAC, 50/60Hz
PMAX = 75W

General instruction:
Portable Patient Monitor (Figure 1) is
adaptable to adult and neonatal usage. It can
monitor vital signals as ECG, Respiratory Rate,
SpO2, NIBP, Dual IBP, CO2, O2, N2O,
Anesthesia Agent, Dual-TEMP and Cerebral
State Index .It integrates parameter measuring
modules, display and recorder in one device,
featuring in compactness, lightweight and
portability. Built-in battery facilitates
transportation of patient. Large high-resolution
display provides clear view of waveforms.
The POWER switch is on the front panel ( in
Figure 1). Three indicators for power and alarm
and battery are on the front panel of system.
The green indicator lights, when the device is
powered on ( in Figure 1). The ALARM
indicator, flashes or lights when alarm occurs
( in Figure 1).The battery indicator is green,
when the battery is charged otherwise it is
orange. ( in Figure 1). The sockets of the
sensors are at the left side of system. Other
sockets and power plug-in are at the back.

Warning
During the system is powered on, the
indicators light. If all indicators light, it will show
proper functioning of all indicators.

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Fig. 1 - Front view

Portable patient monitor performs monitoring Vital sign monitor provides extensive functions
of: as visible & audible alarm, storage and report
printout, trend data, NIBP measurements
ECG Heart Rate (HR) Depending on customer's order, MASIMO or
ECG Waveforms STANDARD modules can be installed on vital
RESP Respiratory Rate (RR) sign monitor optionally.
Respiration Waveform Depending on customer's order, mainstream or
SpO2 Saturation Pulse oximetery sidstream CO2 module can be installed on
(SpO2), Pulse Rate (PR) system optionally.
SpO2 Plethysmogram Vital sign monitor is a user-friendly device with
NIBP Systolic Pressure, Diastolic operations conducted by a few buttons on the
Pressure, Mean Arterial front panel and a rotary knob. Refer to 2.4
Pressure (MAP) Button Functions for details.
TEMP Channel-1 Temperature (T1),
Channel-2 Temperature (T2),
Differential Temperature
between two channels (DT)
IBP Channel-1 IBP (IBP1), Channel-
2 IBP (IBP2)
CO2 EtCO2, FiCO2, AWRR
Multi-gas EtN2O, FiN2O, EtO2, FiO2,
EtAA, FiAA
AA is included 5 anesthesia
agent (DES, ISO, SEV, HAL,
ENF)
CSM CSI%, BS%, SQI%, EMG%

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2.3 Screen Display The size of the menu is also fixed, covering the
lowest 2, 3, 4 or 5 waveforms.
Vital sign monitor has a color TFT display. The
patient Parameters, waveforms, alarm Parameter Area
messages, bed number, date, system status Parameters are displayed at a fixed position.
and error messages is displayed on the The monitoring results are displayed in the
screen. Parameter Area. The parameters refresh every
The screen is divided into three areas: Header second, except that the NIBP values refresh
Area; Waveform Area; Parameter Area (Figure each time the measurement is over.
2)
Alarm indicator:
In normal mode, the alarm indicator is not lit.
In alarm mode, the alarm indicator lights or
flashes.
Warning
Always verify the audible and visible (LED)
alarms when monitor powers on.
Please refer to chapter 4 for details.

Fig. 2 - Monitor main display

Header Area:
The Header Area is at top of the screen
displaying operating state of the monitor and
status of the patient.
The parameters in Header Area are bed
number, type of patient (adult or neonate),
current date and time
The above messages appear on the screen
throughout the monitoring process.
Other information of the Header Area comes
up only with respective monitoring status.
They are:
■ Signs indicating the remaining battery
charge
■ "ALARM SILENCE" appears when the
alarm silence button is pressed.
■ "NETWORK" appears when the system is
connected to central system.
Waveform / Menu Area:
All waveforms can be displayed at the same
time. The waveforms from top to bottom are:
ECG, SpO2, IBP1, IBP2, EEG (for 12’’ or
larger) and RESP/CO2/Multi-gas (coming from
ECG module or CO2 module or Multi-gas
module).
Gain, filter and lead of the ECG are displayed
as well .The three dotted lines from top to
bottom show the highest scale, reference scale
and lowest scale of IBP waveform. These
values can be manually set.
All menus in monitor always appear at fixed
areas on the screen. When the menu is
displayed, some waveforms become invisible.

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2.4 Button Functions When you move the cursor to a certain item:
1. A menu pops up, by pressing the
All the operations to monitor are executed knob.
through buttons and knob at the right of the 2. You can move the cursor frame to
front panel. The names of the buttons are related parameter in opened menu by
above them. They are (Figure 3): turning the knob.
Rotary Knob 3. You can change the content by
This knob can be used to select and pressing the knob on the special
change settings. Operations can be parameters and choose your setting
performed by turning clockwise, counter and confirm your selection by pressing
clockwise or pressing it down. The square it.
frame that moves with the knob turning is Warning
referred to as “cursor”. Before using the system on the patient, the
user must check the buttons function and be
Power
sure that it is in proper working functionality as
Press to power on or off the system.
described above.
HOME/MENU
Press to call up the HOME WINDOW.
Refer to chapter 3 HOME WINDOW.
START/STOP
Press to inflate the cuff to start a blood
pressure measurement. When measuring,
press again to stop the measurement and
deflate the cuff.
REC/STOP
Press to start a real time recording from
ECG signal and all monitoring parameters.
Press during recording to stop the
recording f.
Freeze
When in normal mode, press to freeze all
waveforms on the screen. When in freeze Fig. 3 - Monitor’s buttons and knob
mode, press to restore the waveform
refreshing.
NOTE:
If new alarm occurs under Alarm Suspension /
Silence state, Suspension / Silence state will
remove.
Alarm Silence
Press to suspend alarm for 120 seconds
and disable all sound signals.
("ALARM SILENCE" appears in the
Header Area). Press this key again to
restore all sound signals and remove the
message.
.
When no menu is displayed, turning the knob
clockwise can locate the cursor at: ECG, NIBP,
SpO2, IBP, EEG and RESP/CO2/Multi gas
Parameter Area of screen.
When the cursor is placed at any area, the
user can change the current setting. When at
any of the last items, related parameters menu
can be called up for setting changes.
Operation is as follows:

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2.5 Interfaces
For the verity of operation, different kinds of
interfaces are in different parts of the monitor.
At the right side is the recorder's paper inlet
cover (if the system has a recorder).
At the left side are the connectors to patient
cables and the sensors, as shown in figure 4.

Connector for TEMP1 probe

Connector for TEMP2 probe
Connector for IBP1 transducer
Connector for IBP2 transducer
Connector for Standard SpO2 sensor
Connector for Masimo SpO2 sensor
Connector for ECG cable
Connector for CO2/Multi-gas sensor
9 Connector for NIBP cuff

Fig. 4 - Side panel

Warning
This symbol means "BE CAREFUL". Refer to
For STANDARD SpO2, the shape of ECG and the manual.
SpO2 connectors are the same. The user
should be note to place the ECG and SpO2 Indicates that the instrument is IEC-601-1 Type
cables in corresponding connectors. CF equipment. The module with this symbol
contains an F-Type isolated (floating) patient
Warning applied part providing a high degree of
protection against shock, and is usable during
It is essential that white sign of ECG connector defibrillation.
on the side panel should be in front of the
white sign of the ECG cable connector. Indicates that the instrument is IEC-601-1 Type
BF equipment which is defibrillator proof. The
Warning module with this symbol contains an F-Type
For STANDARD SpO2, that white sign of SpO2 isolated (floating) patient applied part which
contains an adequate degree of protection
connector on the side panel should be in front against shock, and is suitable for use during
of the white sign of the SpO2 probe connector. defibrillation.

Other symbols in the monitor are explained in

chapter 16.

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2. Plug and insert the connection cable while

the VGA slave monitor is off.
3. Power on at the same time, or power on
the patient monitor after VGA slave
monitor.
4. Adjust brightness and contrast properly.

Warning
If DC-INPUT power supply in cars like
ambulances is used (ambulances with
body that is connected to the negative pole
of the battery), for safety requirements, DC
to DC converter with the isolation of
1500VAC (at least), must be used. Using
220V of power supply in ambulances is
recommended. Preparing mentioned DC to
DC converter, please contact technical
Fig. 5 - Rear panel
department of manufacturer.

Following sockets are on the rear panel as External Alarm

illustrate in figure 5. The output external alarm for warning
devices at nurse station.
Equipotential Jack
Equipotential grounding terminal for FUSE F 3A
connection with hospital’s grounding Warning
system. If you are going to store the patient monitor
or you don't want to use it for along time
Power Supply (more than 10 days), remove the fuse.
90-260 (VAC), 50/60 (Hz).
Network Interfaces
DC INPUT The data transmission technique is full
External power supply (e.g. in duplex and the interfacing standard is
ambulances) RS 422.

VGA SLAVE MONITOR Wired Remote Control

Monitor interface for external standard The user friendly short keys remote
VGA color monitor. control access.
Working mode: 1024x768, 256 colors
Interface: D-sub 15 pins Warning
Pin 1: Red Video Patient monitor must be connected to
Pin 9: NC SC1201 central system only.
Pin 2: Green Video
Pin 10: Ground Warning
Pin 3: Blue Video Use only the recommended central cable
Pin 11: NC for connecting monitor to central system.
Pin 4: Ground
Pin 12: NC
Pin 5: NC
Pin 13: Horizontal Sync
Pin 6: Red Ground
Pin 14: Vertical Sync.
Pin 7: Green Ground
Pin 15: NC
Pin 8: Blue Ground

How to use:
1. Install the VGA slave monitor in the same
room with the patient but keep it away from
the patient for more than 1.5m. The
monitor is intended to be used as an
assistant monitoring device.

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2.6 Built-in Battery

Portable patient monitor is equipped with a
rechargeable battery. The battery will be
automatically recharged when the monitor
connects to the AC INPUT. When the battery is
completely discharged, it takes about 16 hours
to charge it again.
When the AC INPUT is plugged in, turning the
system on or off doesn’t have any effect on the
process of charging the battery. If the battery is
completely charged, the system can work
about 45 minutes without connecting to the AC
INPUT.
A symbol " " is displayed on the Header
Area of the screen to indicate the status of
recharging, in which the yellow part represents
the remaining battery charge. This symbol is
only displayed when the AC INPUT is not
plugged in. If the AC INPUT is plugged in, the
status of charging battery will be shown by
battery indicator at the right side of screen.
When the battery indicator is completely green,
the battery if full charged and when it is
orange, means that the battery is being
charged.
The battery doesn’t charge when the system
connects to the DC INPUT (ambulance
electricity).
The fuse on the rear panel protects the battery
while charging the battery or when the system
is not connected to AC INPUT.
When the fuse is damaged, the system can not
work with battery and if the AC INPUT is
plugged in, the battery indicator will be always
green.
Warning
When you store the system for a long time or
the system is used for the first time, you should
first place the fuse on the rear panel of monitor
and then connect it to the AC INPUT for about
24 hours. During this time you must not use
the patient monitor without AC INPUT.
Warning
The monitor will shut down automatically if the
battery power is low. When the electric energy
is going out, the monitor will sound beeping
and display "BATTERY LOW" in the Header
Area. Connecting the monitor to the AC power
at this moment can recharge the battery while
operating. If you keep on using the battery, the
monitor will shut down automatically.

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3 Configuration
■ For last saved ECG signal, please refer to
3.1 SIGMA
■ For previous value of measured
parameters, please refer to 3.2 TREND.
■ For alarm setting and a alarm volume
adjustment, please refer to 3.3 ALARM
Fig. 6 - HOME window
■ For date and time setting please refer to
3.4 SETUP
Portable patient monitor features flexible
configurations. The configuration is done
through operations on the HOME WINDOW
(figure 6) by pressing the HOME/MENU button
on the front panel of monitor.

3.1 SIGMA
Patient monitor is able to save at the last 160
second ECG signal and it is visible in 10 trace
in SIGMA WINDOW.
Pick "SIGMA" in HOME WINDOW to call up
the following menu: ⇒
In this window there are ECG current settings,
like ECG LEAD, ECG GAIN and SIGMA
SWEEP. Refer to chapter 5 ECG
MONITORING for details.

3.2 TREND Fig. 7 - SIGMA window

The latest 24 hour trend value of parameters is

recorded every 20 seconds. Pick "TREND" in
the HOME WINDOW to call up the following
menu: ⇒
Y-axis stands for related value and X-axis for
time.
■ To select trend graph of a specific
parameter:
Pick parameter name (the most left item)
and select a requested parameter name by
turning the knob. Available options are HR,
SpO2, RESP, T1, T2, IBP1, IBP2, CO2,
Fig. 8 - TREND window
N2O, O2, AA, PVCs and ST.
■ To change the display scale:
Pick "SCALE" (the second left item) to
adjust the Y-axis scale and thus change
the trend curve in proportion.

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SCALE1 SCALE2 SCALE3 SCALE4 SCALE5 SCALE6

PARAMETER
MIN MAX MIN MIN MIN MAX MIN MAX MIN MAX MIN MAX
HR 0 60 0 120 0 240 - - - - - -
SpO2 80 100 60 100 0 100 - - - - - -
RESP 0 60 0 120 0 240 - - - - - -
T1 30 42 24 48 0 48 - - - - - -
T2 30 42 24 48 0 48 - - - - - -
IBP1 -20 50 -20 100 -20 200 -50 300 50 250 - -
IBP2 -20 50 -20 100 -20 200 -50 300 50 250 - -
CO2 0 50 0 100 - - - - - - - -
O2 0 50 0 100 - - - - - - - -
N2O 0 50 0 100 - - - - - - - -
AA 0 1.0 0 2.0 0 3.0 0 5.0 0 10.0 0 20.0
PVCs 0 20 0 50 0 100 - - - - - -
ST -0.2 0.2 -0.5 0.5 -1 +1 -2 2 - - - -

■ To select how long the trend graph is

displayed:
Pick the third left item, available options
are 1, 2, 4, 8, 16 and 24 hours
■ To obtain trend data of a specific time:
Cursor line in trend graph shows specific
time. You can move the cursor line to
change the time by pressing the fourth left
item, when the time interval (the third left
item) is set at 1 or 2 hours and turning the
knob. Parameters at mentioned time are
displayed on the right side of the TREND
WINDOW menu.
■ To select time interval of trend in x-axis
Pick "SHIFT" (the fifth left item) to adjust
the start time and stop time. By every
clicking on the SHIFT, the x scale will be
changed in the extent of the specified time
of the third left item.

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3.3 ALARM 3.4 SETUP

Pick "ALARM" in HOME WINDOW to call up, After choosing "SETUP" in HOME WINDOW
the following menu: menu, the following menu will be called up:

Fig. 9 - Setup window

CALENDAR
Available options are "SOLAR" and
“CHRISTIAN".
DATE
Fig. 8 - Alarm window Set the current date of monitoring

Alarm settings are all together in this menu. TIME

Set the current time of monitoring
■ ALARMS ON/OFF
Pick "ON" to enable the alarm functions. BED NUMBER
Pick "OFF" to disable the alarm functions Patient bed number (1 ... 99)
such as audio alarm, parameters blinking ADULT/NEONATE
and alarm light indicator. In "OFF" mode Available options are "ADULT" and
there will be a beside all parameters. "NEONATE".
This function changes alarm parameters
ON or OFF all together, but you are able to LARGE DISPLAY
change every specified alarm parameters Available options are "PAGE1" and "PAGE2"
separately in its own window. and "OFF"
■ ALARM FREEZE DISPLAY OFF
Pick "ON" to freeze all the related signals Display off, until a button is pressed or an
when parameter's value violates adjusted alarm sounds.
alarm limits alarm is activated. In freeze
LOAD DEFAULT
mode, press "Freeze" button on the front
Pick it to call up the following menu:
panel to release the waveform refreshing.
Pick "OFF" to disable signal freezing when
alarm is activated.
■ ALARM VOLUME
Pick "ALARM VOLUME" to set the volume
of alarm sound. The selection ranges from
1 to 7.
1 represents minimum volume, while 7
Fig. 10 - Setup / Default window
represents maximum volume. Rotating the
knob increases or decreases the volume.
If you choose any options in this window, the
NOTE: system will load the factory settings of related
All other settings in this menu are about parameters (Refer to appendix I for factory
alarm on or off and high or low limit of settings of parameters (default)). Because of
monitor measurable parameters alarm changing all your previous settings, the system
ranges. You are able to set these items in asks if you are sure to change all by this
related parameters menu. Refer to modules message:
chapters for details.
ECG SETTING WILL BE DEFAULT, ARE
YOU SURE?
YES NO

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CLEAR MEMORY BIRTH DATE

You can clear stored parameters in system Date of the birth
such as parameters saved in TREND window,
NIBP LIST window, CSM TREND window and WEIGHT
ARR EVENT LIST window. Available between 0.5 to 300 kg
For each separate window, a message will HEIGHT
appear on the screen which asks you whether Available between 10 to 300 cm
to clear that item or not. These messages are
as a follow: DR. NAME
Doctor name (length: 10 characters)
TREND WILL BE CLEARED, ARE YOU HOSPITAL
SURE? Hospital name (length: 15 characters)
YES NO
WARD
NIBP LIST WILL BE CLEARED, ARE Hospital ward name (length: 10 characters)
YOU SURE?
YES NO 3.6 RECORDER
After choosing "RECORDER" in HOME
CSM LIST WILL BE CLEARED, ARE WINDOW menu, the following menu will be
YOU SURE? called up:
YES NO

ARR LIST WILL BE CLEARED, ARE

YOU SURE?
YES NO

Fig. 13 - Recorder window

3.5 PATIENT INFORMATION
After choosing "PATIENT INFORMATION" in
HOME WINDOW menu, the following menu ■ INTERNAL RECORDER
will be called up: Pick "ON" to enable internal recorder and
record via it.
Pick "OFF" to disable the internal recorder
and record via central system
■ TRACE1
Choose the first trace of print out record
Fig. 11 - Patient information window 1
while manual recording.
Available options are ECG, SpO2, IBP1,
Press "NEW" to enter new patient information. IBP2, and RESP
Press "EDIT" to edit previous patient ■ TRACE2
information. Choose the second trace of print out
The information menu is as a follow: record while manual recording.
Available options are ECG, SpO2, IBP1,
IBP2, RESP and OFF.
■ RECORDER SWEEP
Available options for RECORDER SWEEP
are 12.5, 25 and 50 mm/s.
Fig. 12 - Patient information window 2
■ MANUAL RECORD TIME
Available options for MANUAL RECORD
NAME TIME are "MANUAL" and
Patient name (length: 15 characters) "CONTINUOUS".
PATIENT ID
Hospital ID for patient (length: 15 characters)
GENDER
Available options are MALE and FEMALE

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 HEYER VizOR 15

■ PERIODIC TRACE1
Choose the first trace of print out record
while automatic recording.
Available options are ECG, SpO2, IBP1,
IBP2 and RESP
■ PERIODIC TRACE2
Choose the second trace channel of print
out record while automatic recording.
Available options are ECG, SpO2, IBP1,
IBP2, RESP and OFF.
■ PERIODIC INTERVAL
For choosing interval time in periodic
recording mode .Available selections are
15min, 30min, 1h, 2h, 4h, 8h, 12h, 24h and
OFF.
■ ALARM RECORD
While alarm recording for each parameter
is set ON, it automatically starts recording
when alarms happened.

3.7 ABOUT
After choosing "ABOUT" in HOME WINDOW
menu, the following menu will be called up:

Fig. 14 - About window

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4 Alarm 4.3 Alarm Verification During Power

On
This chapter gives general information about
alarm and corresponding functions. During the monitor is being powered on,
audible and visible (yellow and red indicator)
Warning alarms will be self tested.
Always verify the audible and visible alarms Every time that monitor is powered on, the
when monitor is powered on. system beeps, and yellow and red indicator
light about 2.5 second separately. If no beeps
4.1 Alarm Modes heard or no alarm indicator is lighted, do not
use this device to monitor any patient, and
4.1.1 Alarm Level And Setup notify after sales service.
Portable patient monitor offers three levels of
alarm. 4.4 Alarm Cause
Level I alarm indicates the patient's life is in Alarm occurs when alarm for parameter is
danger or the monitor under use has serious evoked;
problems. It is the most serious alarm.
Conditions that activate the parameter
Level II alarm means serious warning. alarms:
When the measurement value exceeds the
Level III alarm is a general warning. adjusted alarm limits and the alarm is in "ON"
Patient monitor has preset the alarm level for mode.
the parameters. You can also modify the If the monitor detects situations like
classification using the method described in ASYSTOLE or APNEA, alarm occurs.
module's chapters. Alarm will not activate if the alarm is in "OFF"
mode.
4.2 Alarm Modes
4.5 Alarm Silence Button Function
Alarm messages will be prompted through
screen, indicator, and sound according to Pressing the "Alarm Silence" button once can
different levels. suspend all alarm sounds for 2 minutes.
Message "ALARM SILENCE" prompts in the
Screen Display Header Area for 120 seconds. During the 2
When an alarm occurs, the parameter which minutes if new alarm occurs, the Silence status
triggers the alarm, blinks. will be terminated and both audible and visible
alarms are triggered. If within the 2 minutes of
Alarm Indicator
alarm suspension the operator presses "Alarm
Alarm indicator flashes red for Level I alarm;
Silence" button, the alarm suspension status
Alarm indicator flashes yellow for Level II
will be ended and the normal alarm status
alarm; Alarm indicator lights yellow for Level III
resumed immediately.
alarm.
Alarm Sound 4.6 Parameter Alarm
Corresponding alarm sound will be activated, if
the alarm is not silent (i.e. the SILENCE button The setup of the alarm parameters can be
has not been pressed to make SILENCE found in related menus separately. In the menu
state). The sounds of the alarm for the three for a specific parameter, you can check and
levels are different: set the alarm limit and the alarm status.
Level I alarm sounds "DO-DO-DO-DO-DO" When a parameter alarm is 'OFF', this symbol
twice every 10 seconds;
" " is displayed near the parameter.
Level II alarm sounds "DO-DO-DO" every 25 For the parameters of which alarm is set to
seconds; 'ON', the alarm will be triggered when at least
Level III alarm sounds "DO" every 50 seconds. one of them exceeds the alarm limits. The
NOTE: following actions take place:
When alarms of different levels occur at the
1. Alarm message is displayed on the screen.
same time, the monitor prompts the alarm
2. The monitor beeps in its corresponding
of the highest level.
alarm level and volume.
3. Alarm indicator flashes.

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 HEYER VizOR 15

4.7 When An Alarm Occurs

It is needed to identify the alarm and act
appropriately according to the cause of the
alarm.
1. Check the patient's condition.
2. Identify the module in alarm.
3. Identify the cause of the alarm.
4. Silence the alarm, if necessary.
5. When cause of alarm has been over,
check that the alarm is working properly.
You will find the alarm messages for the
individual parameters in each module's
chapter.

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5 ECG Monitoring Warning

Line Isolation Monitor (LIM) transient may
5.1 General resemble actual cardiac waveforms and thus
inhibit heart rate alarms. Such transients may
Monitoring the ECG produces a continuous be minimized by proper electrode and cable
waveform of the patient's cardiac electric placement, as specified in this manual.
activity for an accurate assessment of his
current physiological state. The process of Warning
depolarization and repolarization of the When you connect the cables and electrodes,
myocardium generates electric potential that make sure that no metal part is in contact with
are sensed by ECG electrodes on the skin. the safety ground. Verify that all ECG
These electrodes are typically attached to the electrodes are correctly attached to the patient.
patient's right arm, left arm and left leg. The
NOTE:
monitor processes and amplifies these signals
Interference from a non-grounded
and presents the ECG waveform on the
instrument near the patient and/or ESU
screen. Only proper connection of the ECG
(Electro Surgical Unit) interference can
cables can ensure satisfactory measurement.
cause inaccuracy of the waveform.
- It takes about 6 seconds to change heart
1. Prepare the patient's skin prior to place the
rate from 80 to 120 bpm (Test method is
electrodes.
according to AAMI standard EC13:1993).
■ The skin is a poor conductor of
- It takes about 8 seconds to change heart electricity, therefore preparation of the
rate from 80 to 40 bpm (Test method is patient's skin is important to facilitate
according to AAMI standard EC13:1993). good electrode contact to skin.
■ Shave hair from sites, if necessary.
- When Tachycardia (200 bpm HR) happens, ■ Wash sites thoroughly with soap and
it takes 6 seconds to alarm. In this case the water. (Never use ether or pure
low alarm limit should be set in 60 bpm and alcohol, because this increases skin
high alarm limit on 100 bpm. impedance).
- It takes 10 seconds to alarm after cardiac ■ Rub the skin briskly to increase
arrest (from 80 bpm to 0 bpm). capillary blood flow in the tissues and
remove skin grease.
NOTE: 2. Put the electrodes on the patient. (Figure
The above results are according to HR 15, 16) Before attaching, apply some
average of 4 seconds. conductive jelly on the electrodes if the
electrodes are not self-supplied electrolyte.
- The ECG monitoring is able to reject 1.2 mV
3. Attach clip or snap to electrodes prior to
TALL-T.
placement.
- The current that is applied to the patient for
Warning
lead-sensing is 90nA.
Use only one type of electrode on the same
- Active noise suppression specification: patient to avoid variations in electrical
The common noise signal with maximum resistance. For ECG monitoring, it is
inverse current amplitude of 10µA is recommended to use silver/silver chloride
delivered to the reference lead. electrode. When dissimilar metal are used for
different electrodes, the electrodes may cause
- The ECG patient cable consists of 2 parts: large offset potentials due to polarization, witch
The cable that is connected to the monitor may be severe enough to prevent obtaining an
and the lead set that is connected to the ECG trace. Using dissimilar metals may also
patient. increase recovery time after defibrillation.
Warning
Do not touch the patient, bed, table nearby or
the monitor during defibrillation.
Warning
Use only the recommended manufacturer ECG
cable for monitoring. Other ECG cables and
leads may cause improper performance and/or
provide inadequate protection during
defibrillation

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 HEYER VizOR 15

Electrodes placement for monitoring Right Leg (RL):

Black electrode placed on the right
hypogastrium.
Left Arm (LL):
Green electrode placed on the left
hypogastrium.

NOTE:
To ensure patient safety, all leads must be
attached to the patient.

Fig. 15 - Electrodes placement for 3 lead set

For 5-lead set, attach the C-electrode to one of
the indicated positions as below (Figure 17):
Electrodes placement for 3 lead set ● V1 on 4th intercostal space at the right
sterna margin.
Right Arm (RA): ● V2 on 4th intercostal space at the left
Red electrode placed near the right shoulder, sterna margin.
directly below the clavicle. ● V3 midway between V2 and V4 electrodes.
Left Arm (LA): ● V4 on the 5th intercostal space at the left
Yellow electrode placed near the left shoulder, clavicular line.
directly below the clavicle. ● V5 on the left anterior axillary line,
horizontal with V4 electrode.
Left Arm (LL): ● V6 on the left middle axillary line,
Green electrode placed on the left horizontal with V4 electrode.
hypogastrium. ● V3R-V6R on the right side of the chest in
positions corresponding to those on the
left.
● VE over the xiphoid position.
For posterior C lead placement, place the
C electrode at one of the following
locations.
● V7 on the 5th intercostal space at the left
posterior axillary line of back.
● V7R on the 5th intercostal space at the
right posterior axillary line of back.

Fig. 16 - Electrodes placement for 5 lead set

Electrodes placement for 3 lead set

Right Arm (RA):
Red electrode placed near the right shoulder,
directly below the clavicle.
Left Arm (LA):
Yellow electrode placed near the left shoulder, Fig. 17 - C-electrode placement for 5 lead set
directly below the clavicle.
Chest (C):
White electrode placed on the chest as
illustrated in figure 16.

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 HEYER VizOR 15

Depending on lead type (3 leads or 5 leads), Warning

you can choose different lead I, II, III, aVR, It is possible for the patient to be burnt due to
aVL, aVF, V. an improper connection of the natural
electrode of ESU.
Warning
ECG cable may be damaged if they are
connected to a patient during defibrillation.
Cables that have been connected to a patient
during defibrillation should be checked for
functionality before being used again.
NOTE:
If an ECG waveform is not accurate while
the electrodes are tightly attached, try to
change the lead.
NOTE:
Interference from a non-grounded
instrument near the patient and/or ESU
interference can cause inaccuracy of the
waveform.
Fig. 18 - ECG lead
Normal QRS complex is:
Warning Tall and narrow with no notches.
Check everyday whether there is skin irritation With tall R-wave completely above or below
resulted from the ECG electrodes. If so, the baseline.
replace electrodes every 24 hours or change With T -wave less than one-third of the R-wave
their sites. height.
Warning With P-wave much smaller than the T -wave.
Verify lead fault detection prior to the start of
monitoring phase. Unplug the ECG cable from
the socket, the screen will display the error
message "ECG NO CABLE"
Warning
When using electrosurgery equipment, leads
should be placed in a position in equal
distance from electrosurgery electrotome and
the grounding plate to avoid cautery.
Electrosurgery equipment wire and ECG cable
must not be tangled up. Fig. 19 - Standard ECG waveform

The placing of the ECG leads will depend on Warning

the type of surgery that is being performed. For Do not touch the patient, table nearby, bed or
example, with open chest surgery the the equipment during defibrillation.
electrodes may be placed laterally on the chest Warning
or on the back. In the operating room, artifacts Do not immerse ECG leads completely in
can sometimes affect the ECG waveform due water, solvents, or cleaning solutions because
to the use of ESU (Electro Surgical Unit). To the connectors are not waterproof. Do not
reduce this effect, you can place the electrodes sterilize ECG cable by irradiation, steam, or
on the right and left shoulders and on the left ethylene oxide.
side of hypogastrium. Avoid placing the
electrodes on the upper arms, otherwise the Warning
ECG waveform will be too weak. For the patients with pacemaker, the monitor
may continue to count the pacemaker rate
Warning during occurrences of cardiac arrest or some
When using ESU, never place an electrode arrhythmias. Do not rely entirely upon monitor
near the grounding plate of the electrosurgery alarms. Keep the patients with pacemaker
device, otherwise there will be a great deal of under close surveillance.
interference with the ECG signal.

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 HEYER VizOR 15

5.2 ECG Window ■ HR AVERAGE

Available options for HR AVERAGE are 4, 8
Pick ECG, the following menu will pop up: and 16 sec.
■ HR SOURCE
Heart rate may be derived by ECG or
SpO2.In AUTO mode patient monitor
automatically derives heart rate from ECG
whenever a valid ECG signal is present. If
ECG is not present, but SpO2 is being
Fig. 20 - ECG window monitored, the heart rate value is derived
from the SpO2 signal.
■ ECG LEAD
"І" to count the heart rate and show RA-LA ■ BEAT VOLUME
waveform Range: 1-7;"OFF" indicates silence, while 7
"ІІ" to count the heart rate and show RA-LL indicates maximum volume.
waveform ■ PACE DETECT
"ІІІ" to count the heart rate and show LA-LL "ON" for patient with pacemaker," OFF" for
waveform patient with no pacemaker.
"aVR" to count the heart rate and show When it is "ON", "PACE: ON" will be
LA + LL displayed on the screen.
RA- waveform When PACE DETECT is "ON", the system
2
ECG monitoring detects and rejects
"aVL" to count the heart rate and show
pacemaker-generated signals from ECG
RA + LL signal so that they will be ignored in
LA- waveform
2 determining heart rate.
"aVF" to count the heart rate and show Detected pacemaker signals will be marked
RA + LA on the ECG waveform as 1 centimeter spike.
LL- waveform Monitoring of patients with pacemaker is not
2 generally affected when PACE DETECT is
"V" to count the heart rate and show enable. However, in some instances if the
RA + LA + LL patient does not have a pacemaker, it may
C- waveform be desirable to turn the detection function
3 OFF so that artifacts in the waveform will not
(You can choose aVR, aVL, aVF, V just be mistaken for a pacemaker signal.
when ECG is in 5 lead mode).
Warning
■ ECG GAIN
For patient with pacemaker, the PACE
To adjust the size of ECG waveforms, select DETECT function must be switched "ON",
gain value for each lead from ×0.25, ×0.5, otherwise, the pacing impulse may be counted
×1, ×2, ×4 and AUTO. as normal QRS complex.
In "AUTO" mode, the monitor chooses an
appropriate level automatically. ■ ECG CALIB
When we choose "ON", it means there is
■ ECG SWEEP
1mV calibrated ECG wave. When it is "ON",
Available options for ECG SWEEP are 12.5, the calibration waveform is displayed until
25, and 50 mm/s.
the ECG WINDOW is closed.
■ ECG FILTER ■ LEAD TYPE
For clearer and more detailed waveform To adjust ECG measurement mode to "3
LEAD" or "5 LEAD".
FILTER TYPE FREQUENCY RANGES APPLICATION
■ ALARM
NORMAL 0.5-40Hz In normal use
In diagnostic application,
Pick "ALARM" in ECG WINDOW to call up
but the ECG waveform the following menu:
EXTENDED 0.05-100Hz might have some noises

This mode may reduce

perturbance and
Interference from
MONITOR 0.5-28Hz electrosurgery equipment
or when the system has
high noises or doesn't
have equipotential earth Fig. 21 - ECG / Alarm window

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 HEYER VizOR 15

■ HR ALARM ECG message include:

Pick "ON" to enable alarm functions such as
Message Cause Solution Explanation
parameters blinking, audio alarm and light ECG NO ECG cable is Connect ECG Alarm level 3,
indicator. Pick "OFF" to disable the alarm CABLE not connected cable Pressing ALARM
to the system SILENCE, alarm
functions and there will be a " " symbol will be disable and
ignore this fault.
instead of alarm limits in Parameters Area. ECG Reference lead Make sure that all Alarm level 2,
CHECK or more than electrodes and Pressing ALARM
■ HR LIMIT LEADS one chest lead
is not properly
patient cable are
properly connected
SILENCE, alarm
will be disable and
ECG alarm is activated when the heart rate connected. ignore this fault.
ECG Mentioned Make sure that Alarm level 2,
exceeds adjusted ALARM HIGH value or CHECK leads are not mentioned Pressing ALARM
falls below adjusted ALARM LOW value LA,RA,LL properly electrode is SILENCE, alarm
connected. properly connected will be disable and
(min: 30 and max: 250). ignore this fault.
ECG ECG amplitude Check the situation
SIGNAL is lower than of the chest leads
■ ALARM LEVEL WEAK standard limit
Selectable between 1, 2. Level 1 represents ECG ECG module Power off and then Alarm level 2,
DEFECT failure on the system .If Pressing ALARM
the most serious case. this message is SILENCE, alarm
displayed again the will be disable and
■ ARR ANALYSIS user should
contact local After
ignore this fault.

Pick "ARR ANALYSIS" in ECG WINDOW to Sale Service.

CHECK RL or other Make sure that all Alarm level 2,
call up the window for arrhythmia analysis RL OR leads are not electrodes and Pressing ALARM
setting. This monitor is able to detect up to ALL properly
connected
patient cable are
properly connected
SILENCE, alarm
will be disable and
12 types of arrhythmia. Refer to when ECG lead ignore this fault.
is V, aVR, aVF
chapter 14 ARR MONITORING for complete or aVR.
description of arrhythmia analysis in the CHECK
LL OR
LL or other
leads are not
Make sure that all
electrodes and
Alarm level 2,
Pressing ALARM
system. ALL properly patient cable are SILENCE, alarm
connected properly connected will be disable and
when ECG lead ignore this fault.
■ ST ANALYSIS is I
Pick "ST ANALYSIS" in ECG WINDOW to CHECK LA or other Make sure that all Alarm level 2,
LA OR leads are not electrodes and Pressing ALARM
call up the window for ST analysis setting. ALL properly patient cable are SILENCE, alarm
connected properly connected will be disable and
The system is able to monitor ST segment when ECG lead ignore this fault.
deviation. Refer to chapter 13 ST is II
CHECK RA or other Make sure that all Alarm level 2,
MONITORING for complete description of RA OR leads are not electrodes and Pressing ALARM
ALL properly patient cable are SILENCE, alarm
ST analysis in the system. connected properly connected will be disable and
when ECG lead ignore this fault.
is III
5.3 ECG Alarm Message
Alarm sounds when: Last 4 messages in the table are just for 5 lead
1. The heart rate exceeds adjusted alarm mode.
limits, and/or, After checking the mentioned solution, if above
2. The ECG ASYSTOLE mentioned messages are displayed again, the
ECG cable may be damaged and you should
contact with local After Sales Services.
Audio
Alarm Situation Visual prompts
sound
Heart rate Heart rate violates ● HR value blinks.
alarm adjusted alarm limits ● Alarm indicator Activated
flashes.
ECG Heart beat is not ● HR is "00" and
ASYSTOLE detected in last 10 blinks
seconds. ● "ECG
ASYSTOLE" is Activated
displayed.
● Alarm indicator
flashes.

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 HEYER VizOR 15

5.4 ECG Cable Cleaning

If there is any sign indicating that the ECG
cable may be damaged or deteriorated,
replace it with a new one instead of continuing
its application on the patient.
■ Cleaning
Use soft cloth moistened in mild soap liquid
or cleaning agent containing 70% ethanol to
clean the ECG cable.
■ Sterilization
To avoid extended damage to the
equipment, sterilization is only
recommended when stipulated as necessary
in the Hospital Maintenance Schedule.
Sterilization facilities should be cleaned first.
It is recommended to use 70% alcohol or
isopropanol 70% as sterilization material.
■ Disinfection
To avoid extended damage to the
equipment, disinfection is only
recommended when stipulated as necessary
in the Hospital Maintenance Schedule.
Disinfection facilities should be cleaned first.

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6 RESP Monitoring ■ RESP LEAD

Available options for RESP LEAD are "RA-
6.1 General LA" and "RA-LL"

The monitor measures respiration from the ■ RESP GAIN

amount of thoracic impedance between two To adjust the size of ECG waveforms,
ECG electrodes (RA-LL, RA-LA). The change Select gain value for each channel from
of impedance between the two electrodes, ×0.25,×0.5,×1, ×2 and ×4 .
(due to the thoracic movement), produces a ■ RESP SWEEP
respiratory waveform on the screen.
Available options for RESP SWEEP are
The signal with frequency greater than 62.5 3,6,12, and 25 mm/s.
KHZ is applied to the patient for respiration
■ ALARM LEVEL
measurement.
Selectable between 1 and 2. Level 1
For RESP monitoring, it is not necessary for represents the most serious case.
additional electrodes, however, place of
■ RR ALARM
electrodes is important.
Pick "ON" to enable RESP alarm functions
Some patients, due to their clinical condition, such as parameters blinking, audio alarm
expand their chest laterally, causing a negative and light indicator. Pick "OFF" to disable
intrathoracic pressure. In these cases it is the alarm functions, and there will be a " "
better to place the two RESP electrodes symbol instead of alarm limits in
laterally in the right axillary and left lateral Parameters Area.
chest areas at the maximum point of breathing
movement to optimize the respiratory ■ RR LIMIT
waveform. RESP alarm is activated when the
respiration rate exceeds adjusted ALARM
NOTE: HIGH value or falls below adjusted ALARM
The RESP monitoring is not recommended LOW value (min: 5 and max: 150).
to be used on patients, who are very active,
as this can cause false alarms. ■ APNEA LIMIT
To set the standard of judging an apnea
Checklist for RESP Monitoring case. It ranges from 10 to 40 seconds,
1. Prepare the patient's skin prior to placing increases/decreases by 5s.
the electrodes.
2. Attach the electrodes to the patient and
attach snap or clip to the electrodes.
3. Switch on the monitor.
NOTE:
Place the red and green electrodes
diagonally to optimize the respiration
waveform. Avoid the liver area and the
ventricles of the heart in the line between
the RESP electrodes to prevent cardiac
overlay or artifacts from pulsating blood
flow. This is particularly important for
neonates.

6.2 RESP Window

Pick RESP to call up the following menu:

Fig. 22 - RESP window

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 HEYER VizOR 15

6.3 RESP Alarm Message

Alarm is activated when the respiration rate exceeds
adjusted alarm limits.

Alarm Situation Visual prompt Audio sound

RR Alarm Respiration rate ● RESP value Activated
violates adjusted blinks
alarm limits ● Alarm indicator
flashes.
APNEA Non-respiration ● Alarm indicator Activated
condition overruns flashes
adjusted time ● "RESP APNEA"
blinks

RESP messages include:

Message Cause Solution Explanation

RESP CHECK The RESP leads Make sure that all Alarm level 3,
LEADS are not properly electrodes ,lead the message is
connected. are properly blinking.
connected Alarm is
activated when
RR ALARM is
"ON".
Pressing
ALARM
SILENCE,
alarm will be
disable and
ignore this fault.

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 HEYER VizOR 15

7 SpO2 Monitoring Masimo module

7.1 General The Masimo SET MS-7 pulse oximeter is

based on three principles:
What does it measure?
1. Oxyhemoglobin and deoxyhemoglobin differ
SpO2 Plethysmogram measurement is
in their absorption of red and infrared light
employed to determine the oxygen saturation
(spectrophotometry).
of hemoglobin in the arterial blood. If, for
example, 97% hemoglobin molecules in the 2. The volume of arterial blood in tissue and the
red blood cells of the arterial blood combine light absorbed by the blood changes during
with oxygen, then the blood has a SpO2 the pulse (plethysmography).
oxygen saturation of 97%. The SpO2 value on
the monitor will be 97%. The SpO2 value 3. Arterio-venous shunting is highly variable
shows the percentage of hemoglobin and that fluctuating absorbance by venous
molecules which have combined with oxygen blood is a major component of noise during
molecules to form oxyhemoglobin. The SpO2 the pulse.
module can also provide a pulse rate signal.
Operating Principals The Masimo SET MS-7 pulse oximeter as well
as traditional pulse oximetry determines SpO2
Standard modules by passing red and infrared light into a capillary
bed and measuring changes in light absorption
■ Arterial oxygen saturation is measured by a
during the pulsatile cycle. Red and infrared
method called pulseoximetry. It is a
light-emitting diodes (LEDs) in oximetry
continuous, non-invasive method based on
sensors serve as the light sources, a
the different absorption spectra of reduced
photodiode serves as the photodetector.
hemoglobin and oxyhemoglobin. It measures
how much light sent from light sources on Traditional pulse oximetry assumes that all
one side of the sensor, is transmitted pulsations in the light absorbance signal are
through patient tissue (such as a finger or an caused by oscillations in the arterial blood
ear), to a receiver on the other side. volume. This assumes that the blood flow in
The sensor measurement wavelengths are the region of the sensor passes entirely
nominally 660nm for the Red LED and through the capillary bed rather than through
880nm for Infrared LED. Maximum optical any arterio-venous shunts. The traditional
power output for LED is 5mW. pulse oximeter calculates the ratio of pulsatile
absorbance (AC) to the mean absorbance
■ The amount of light transmitted depends on
(DC) at each of two wavelengths, 660 nm and"
many factors, most of which are constant.
905 nm:
However, one of these factors, the blood
volume in the arteries, varies with time, S (660) = AC (660) / DC (660)
because it is pulsating. Measuring the light S (905) = AC (905) / DC (905)
absorption during a pulsation, derive to The oximeter then calculates the ratio
calculation of the oxygen saturation of the of these two arterial pulse-added
arterial blood. Detecting the pulsation gives absorbance signals:
pulse rate signal. R= S (660) / S (905)
■ The SpO2 value and pulse rate signal
This value of R is used to find the saturation
waveform can be displayed on the main
SpO2 in a look-up table built into the oximeter's
screen.
software. The values in the look-up table are
■ The system SpO2 monitoring is calibrated to based upon human blood studies against a
display functional saturation. This saturation laboratory co-oximeter on healthy adult
given by the oxyhaemoglobin divided by the volunteers in induced hypoxia studies.
sum of the oxyhemoglobin and the
deoxyhemoglobin (HHb), represented The Masimo SET MS-7 pulse oximeter
mathematically as: assumes that arterio-venous shunting is highly
O 2 Hb variable and that fluctuating absorbance by
SPO 2 = × 100 venous blood is the major component of noise
O 2 Hb + HHb
during the pulse. MS-7 decomposes S (660)
and S (905) into an arterial signal plus a noise
component and calculates the ratio of the
arterial signals without the noise:

Rev. 1.0 - 09/09 HEYER VizOR 15, Operator’s manual 29 / 88

 HEYER VizOR 15

S (660) = S1 + N1 NOTE:
S (905) = S2 + N2 A pulseoximetry is a early warning device.
R= S1 / S2 Use lab co-oximeter to understand the
patient's condition completely.
Again, R is the ratio of two arterial pulse-added
absorbance signals and its value is used to Warning
find the saturation SpO2 in an empirically Use only the recommended manufacturer
derived equation into the oximeter's software. SpO2 sensor for monitoring. Other SpO2
The values in the empirically derived equation sensors may cause improper monitor
are based upon human blood studies against a performance.
laboratory co-oximeter on healthy adult
volunteers in induced hypoxia studies. Warning
Regarding the selected module, use
accessories specified for each SpO2 module.
The above equations are combined and a
noise reference (N') is determined: Warning
While choosing sensor, consider sensor
N' =S (660) - S (905) × R direction for use, written on the package such
as patient's age and weight or if the sensor is
If there is no noise N' = 0: then S (660) = S reusable or disposable.
(905) × R which is the same relationship for
the traditional pulse oximeter. Warning
Pulseoximetry can overestimate the SpO2
value in the presence of Hb-CO, Met-Hb or dye
The equation for the noise reference is based
dilution chemicals.
on the value of R, the: value being seeked to
determine the SpO2. The MS-7 software Warning
sweeps through possible values of R that ESU wire and SpO2 cable must not be tangled
correspond to SpO2 values between 1% and. up.
100% and generates an N' value for each of
these R values. The S (660) and S (905) Warning
signals are processed with each possible N' Do not use the sensor on extremities with
noise reference through an adaptive arterial catheter or venous syringe.
correlation canceller (ACC) which yields an
output power for each possible value of R (i.e., SpO2 measurement
each possible SpO2 from 1% to 100%). The
result is a Discrete Saturation Transform 1. Turn on the monitor.
TM
(DST ) plot of relative output power versus 2. Attach the sensor to the appropriate site of
possible SpO2 value as shown in the following the patient finger. Refer to Figure 24 for the
figure where R corresponds to SpO2 = 97%: proper method.
3. Plug the connector of the sensor extension
cable into the SpO2 socket on the left side of
the device.

Warning
High ambient light sources such as surgical
lights (especially those with a xenon light
source), bilirubin lamps, fluorescent lights,
infrared heating lamps and direct sunlight can
interfere with the performance of an SpO2
sensor. To prevent interference from ambient
light, ensure that the sensor is properly applied
.and cover the sensor site with opaque
material. Failure to take this action in high
Fig. 23 - MASIMO energy output ambient light conditions may result in
inaccurate measurements.
The DST plot has two peaks: the peak
corresponding to the higher saturation is NOTE:
selected as the SpO2 value. This entire SpO2 module updates SpO2 parameter
sequence is repeated once every two seconds every 1 sec.
on the most recent four seconds of raw data.
The MS'-7 SpO2 therefore corresponds to a
running average of arterial hemoglobin
saturation that is updated every two seconds.

30 / 88 HEYER VizOR 15, Operator’s manual Rev. 1.0 - 09/09

 HEYER VizOR 15

NOTE: ● Sensor temperature (maintain between 28°C

Do not perform SpO2 and NIBP measuring and 42°C for best operation)
in same arm at simultaneously; because ● External illumination more than 5,000
obstruction of blood flow during NIBP lumens/square meter (typical office lighting)
measuring may adversely affect the SpO2 ● Improper sensor application.
value. ● Venous pulsations
● Cabling entanglement or strangulation
SpO2 Measuring Range 0 - 100 % ● Placement of the sensor on an extremity that
SpO2 Alarm Rang 20 - 100 % has a blood pressure cuff, arterial catheter,
SpO2 Accuracy 70% - 100% 2% or intravascular line
50% - 70% 3% ● Do not use oximeters and oximetry sensors
Pulse Rate Measuring Range 25-240 bpm during magnetic resonance imaging (MRI)
Materials used in our SpO2 sensors are scanning. Induced current could potentially
innoxious. cause burns.
Warning
Prolonged and continuous monitoring may
increase jeopardy of unexpected change of
dermal condition such as abnormal sensitivity,
vesicle, repressive putrescence, and so on. It
is especially important to check the sensor
placement of neonate and patient of poor
perfusion or immature dermogram by light
collimation and proper attaching strictly
Fig. 24 - Placing the SpO2 sensor
according to changes of the skin. Check per 2-
3 hours the sensor placement and move it
when the skin deteriorates. More frequent
NOTE: examinations may be required for different
● Make sure the nail covers the light patients.
window. Warning
● The wire should be on the backside of the
Tissue damage or inaccurate measurement
hand. can be caused by incorrect application or use
NOTE: of an SpO2 sensor, for example by wrapping
SpO2 value always displays at the same the sensor too tightly or by applying
position. Pulse Rate will display only when supplemental tape.
"HR SOURCE" is set at "SpO2" in the ECG Warning
WINDOW menu.
Loss of pulse signal can occur when
● The patient is in cardiac arrest or in shock.
Warning ● The patient has hypotension, severe
Verify sensor cable fault detection before vasoconstriction, severe anemia, or
beginning of monitoring phase. Unplug the hypothermia.
SpO2 sensor cable from the socket, the screen ● There is arterial occlusion proximal to the
will display the error message "SpO2 NO sensor.
PROBE".
Warning
Warning Do not immerse sensor and patient cable
Do not use the sterile supplied SpO2 sensors if completely in water, solvents, or cleaning
the packaging or the sensor is damaged and solutions because the sensor and patient cable
return them to the vendor. are not waterproof.
Warning
Measurement limitations
In operation, the accuracy of oximetry
measurement can be affected by:
● High-frequency electrosurgical interference
and defibrillation.
● Excessive patient movement.
● Injection of intravascular dye such as
indocyanine green or methylen blue.
● Significant concentrations of dysfunctional
hemoglobin, such as carboxyhemoglobin
and methemoglobin

Rev. 1.0 - 09/09 HEYER VizOR 15, Operator’s manual 31 / 88

 HEYER VizOR 15

7.2 SpO2 Window MAX: Recognizing that some clinicians may

want the absolute low perfusion performance
The SpO2 WINDOW menu is as follows: (0.02%) all of the time and may be willing to
sacrifice sensor off detection, Masimo
provides a maximized sensitivity mode. This
mode should be used for the sickest
patients, where obtaining a reading is most
difficult. Maximum Sensitivity is designed to
interpret and display data for even the
weakest of signals. This mode is
Fig. 25 - SpO2 window
recommended during procedures and when
clinician and patient contact is continuous.
■ SpO2 RESPONSE In MAX mode, the message "SpO2 MAX
Available options for SpO2 RESPONSE are SENS." displays on the screen with yellow
"SLOW", "NORMAL" and "FAST" color.
SLOW: least affected by patient motion. APOD (Adaptive Probe Off Detection):
User must be aware that changes in SpO2 This mode is the least sensitive in picking up
are reported more slowly comparing to other a reading on patients with low perfusion but
modes. has the best detection for probe-off
NORMAL: recommended for most clinical conditions. This mode is useful for patients
situations. that are at particular risk of the sensor
FAST: useful for special application such as becoming detached (pediatric, combative,
sleep studies in which the user desired fast etc.)
response mostly affected by patient motion.
■ SpO2 PLETH SWEEP
Available options for SpO2 PLETH SWEEP
are 12.5 and 25 mm/s.
■ ALARM LEVEL
Selectable between 1 and 2. Level 1
represents the most serious case.
■ SpO2 ALARM
Pick "ON" to enable SpO2 alarm functions
such as parameters blinking, audio alarm,
and light indicator. Pick "OFF" to disable the
alarm functions and there will be a " "
symbol instead of alarm limits in Parameters
Area.
■ SpO2 LIMIT
SpO2 alarm is activated when the SpO2
exceeds adjusted ALARM HIGH value or
falls below adjusted ALARM LOW value.
(min: 20 and max: 100).

■ SpO2 SENSITIVITY (MASIMO MODULE)

Available options for SpO2 SENSITIVITY are
NORMAL, MAX and APOD.
NORMAL: The perfusion threshold has
different limits as the perfusion calculation is
data dependent .Specially; there is an
intelligent algorithm which adjusts the low
perfusion limit in accordance with the quality
of the incoming plethysmography waveform
between 0.50% and 0.02%. This mode
provides the best combination of sensitivity
and probe-off detection performance. This
mode is recommended for the majority of
patients

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 HEYER VizOR 15

7.3 SpO2 Alarm Message 7.4 SpO2 Probe Cleaning

Alarm occurs when SpO2 exceeds the alarm To clean the sensor, first remove it from the
limit. patient and disconnect it from the monitor. You
may then clean the probe by wiping it with a
Audio
Alarm Situation Visual prompts
Sound
70% isopropyl alcohol pad. Allow the probe to
SpO2 Alarm SpO2 violates ● SpO2 value Activated dry prior to placement on a patient.
adjusted alarm blinks.
limits ● Alarm indicator
flashes. Warning
SpO2
ASYSTOLE
Pulse beat is not
detected in last
● HR is "0" and
blinks
Activated Do not sterilize the patient cable and probes by
10 seconds. ● Message "SpO2 autoclave, irradiation, steam or ethylene oxide.
ASYSTOLE" is
displayed
● Alarm indicator Warning
flashes. To prevent damage, do not immerse the probe
in any liquid solution.
SpO2 message includes:
Warning
Message Cause Solution Explanation Do not use any probe or cable that may be
SpO2 NO SpO2 probe is Make sure that the Alarm level 3,
PROBE disconnected probe is correctly the message is damaged or deteriorated.
from the connected to the blinking.
monitor. monitor. Pressing ALARM
SILENCE, alarm
will be disabled
and ignore this
fault.
SpO2 The SpO2 Change the SpO2 Alarm level 2,
PROBE probe is probe. the message is
DEFECT damaged blinking.
Pressing ALARM
SILENCE, alarm
will be disabled
and ignore this
fault.
SpO2 SpO2 probe Make sure that Alarm level 2,
PROBE may be SpO2 probe is the message is
OFF detached from properly attached to blinking.
the patient. the patient Pressing ALARM
SILENCE, alarm
will be disabled
and ignore this
fault.
SpO2 SpO2 probe is Make sure that Alarm level 2,
CHECK not properly SpO2 probe is the message is
PROBE positioned to properly connected blinking. Alarm is
the patient to the patient (refer activated when
to page 6-2). SpO2 ALARM is
"ON".
Pressing ALARM
SILENCE, alarm
is suspended for
at least 120s.
SpO2 This may be Make sure that Alarm level 2,
HIGH caused by SpO2 probe is the message is
AMBIENT entering properly connected blinking. Alarm is
LIGHT environmental to the patient (refer activated when
light into the to page 6-2). SpO2 ALARM is
probe "ON".
Pressing ALARM
SILENCE, alarm
is suspended for
at least 120s.
SpO2 SpO2 is not Move the sensor to
SEARCH calculable due another place,
to some provoke blood
reasons such recycle, and calm
as long time the patient.
motions.
SpO2 The SpO2 Change the place of
SIGNAL signal the probe.
WEAK amplitude is
too weak or
undetectable.
SpO2 SpO2 module Power off and then Alarm level 2,
DEFECT failure on the system .If the message is
this message is blinking.
displayed again, the Pressing ALARM
user should contact SILENCE, alarm
local After Sale will be disabled
Service. and ignore this
fault.

After checking the mentioned solution if above

mentioned messages are displayed again, the
SpO2 probe may be damaged and you should
contact with local After Sales Services.

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 HEYER VizOR 15

8 NIBP Monitoring Warning

Use only recommended manufacturer Blood
8.1 General Pressure Cuffs and Hose. Using other cuffs or
hoses may result in inaccuracies.
NIBP (Non-Invasive Blood Pressure)
processing by the monitor uses the Warning
oscillometric measuring technique. A Blood pressure measurement can be affected
motorized pump inflates the cuff initially, until by the position of the cuff and patient's
the pressure effectively occludes flow of blood physiological condition.
in the extremity. Then, under monitor control,
Warning
the pressure in the cuff is gradually reduced,
According to general requirement for safety,
while a pressure transducer detects air
Luer lock connectors are not used. Don't use
pressure and transmits a signal to the NIBP
NIBP cuff with Luer lock connector because if
circuit.
Luer lock connector is used, there is a
As the cuff pressure is reduced, blood flows in
possibility that they might be inadvertently
the previously occluded artery and changes
connected to intravascular fluid systems,
the measured pressure values sensed by the
allowing air to be pumped in to blood vessel.
transducer. The point at which oscillation
increases sharply is defined as systolic Warning
pressure. As the cuff continues to deflate, Make sure that the air conduit connecting the
oscillation amplitude increases to a maximum, blood pressure cuff and the monitor is
and then decreases. The peak oscillation neither blocked nor tangled.
amplitude is defined as the mean arterial
pressure. The point at which the system 1. Plug in the air hose and switch on the
detects a loss of oscillation is defined as the system.
diastolic pressure. 2. Apply the blood pressure cuff to the patient's
■ According to the European standard EN arm or leg following the instructions below
1060-1: Specification for non-invasive (Figure 26).
sphygmomanometers Part 1, General ■ Ensure that the cuff is completely deflated.
requirements. ■ Apply the appropriate size cuff to the patient.
■ It is applicable for adults and neonates. Ensure that the cuff is not wrapped too
■ There are two modes of measurement tightly around the limb. Excessive tightness
available: manual and automatic. may cause discoloration and eventual
Each mode displays the systolic, diastolic ischemia.
and mean blood pressure.
■ In the MANUAL mode, only one
measurement is performed.
■ In the AUTO mode, the measurement is
cycled. You can set the interval time to 5, 10,
15, 30 minutes and 1, 2, 4 hours
Warning
1. You must not perform NIBP measurements
on patients under any condition which the
skin is damaged or expected to be damaged.
2. Ensure that the correct setting is selected
when performing measurements on children.
It may be dangerous for the children to use
an over pressure level. Fig. 26 - Applying cuff

NIBP Measuring
NOTE:
Warning The width of the cuff should be either 40%
■ Before starting a measurement, verify that of the limb circumference (50% for
you have selected a setting appropriate for neonates) or 2/3 of the upper arm length.
your patient (adult or neonate.) The inflatable part of the cuff should be
■ Do not apply the cuff to a limb that has an long enough to encircle 50-80% of the limb.
intravenous infusion or catheter in place. The wrong size of cuff can cause
This could cause tissue damage around the erroneous measurement. If the cuff size is
catheter when infusion is slowed or blocked in question, then use a larger cuff.
during cuff inflation.

34 / 88 HEYER VizOR 15, Operator’s manual Rev. 1.0 - 09/09

 HEYER VizOR 15

3. Connect the cuff to the air hose. The limb Measurement Limitations
chosen for taking the measurement should In different patient conditions, the oscillometric
be placed at the same level as the patient's measurement has certain limitations. The
heart. measurement is in search of regular arterial
pressure pulse. In those circumstances, when
4. Check whether the patient mode is the patient's condition makes it difficult to
appropriately selected. To change the detect, the measurement becomes unreliable
patient mode, choose SETUP from the and measuring time increases. The user
HOME WINDOW, the HOME/SETUP should be aware that the following conditions
WINDOW menu will pop up. Pick could interfere the measurement and make the
ADULT/NEONATE to make necessary measurement unreliable or longer. In some
changes. cases, the patient's condition will make a
5. Select a measurement mode in the NIBP measurement impossible.
WINDOW menu. Refer to the following ● Patient Movement
instructions, "Operation Hints", for details. Measurements will be unreliable or may not be
6. Press the START/STOP button on the front possible if the patient is moving, shivering or
panel to start a NIBP measurement. having convulsions. These motions may
interfere the detection of the arterial pressure
Operation Hints pulses. In addition, the measurement time will
be prolonged.
1. To start a MANUAL measuring:
Press the START/STOP button on the front ● Cardiac Arrhythmia's
panel Measurements will be unreliable and may not
be possible if the patient's cardiac arrhythmia
2. To stop a MANUAL measuring causes an irregular heart beat. Thus the
Repress the START/STOP button on the measuring time will be prolonged.
front panel
● Heart-lung Machine
3. To start AUTO measuring: Measurements will not be possible if the
Select NIBP WINDOW menu and pick AUTO patient is connected to a heart-lung machine.
for measuring interval setting, then press
START/STOP button on the front panel. ● Pressure Changes
Measurements will be unreliable and may not
Warning be possible if the patient's blood pressure
Prolonged non-invasive blood pressure changes rapidly over the period of time during
measurements in Auto mode may be which the arterial pressure pulses are being
associated with ischemia and neuropathy in analyzed to obtain the measurement.
the limb wearing the cuff. When monitoring a
patient, examine the limb frequently for normal ● Severe Shock
color, warmth and sensitivity. If any If the patient is in severe shock or
abnormality is observed, stop the blood hypothermia, measurements will be unreliable
pressure measurements. because of reduced pulsation of the arteries.

4. To start a MANUAL measuring during the ● Heart Rate limits

AUTO mode: Measurements can not perform at a heart rate
Press START/STOP button on the front of less than 40 bpm and greater than 240 bpm.
panel.
5. To stop AUTO measuring:
Select the NIBP menu and set AUTO
/MANUAL to MANUAL mode.
NOTE:
If you are in doubt about the accuracy of
any measurement(s), check the patient's
vital signs by an alternative method before
checking the functionality of the monitor.
Warning
If liquid is inadvertently splashed on the
equipment or its accessories, turn off the
system and dry it with soft cloth and then use it
again.

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 HEYER VizOR 15

8.2 NIBP Window ■ AUTO/MANUAL

There are two modes of measurement
NIBP measurement result is displayed as available: MANUAL and AUTO. In the
follows: MANUAL mode, only one measurement is
performed. In the AUTO mode, the
measurement is cycled;
Available selections are 3, 5, 10, 15, 30
minutes and 1, 2, 4 hours.
■ <MODULE START>
To start measurement.

Fig. 27 - NIBP window menu ■ <MODULE STOP>

To stop measurement.
■ NIBP LIST
Patient monitor can review the latest 100
NIBP measurement data.
Pick "NIBP LIST" in the NIBP WINDOW to
invoke the result and time of the latest NIBP
measurements, as shown in figure 29.

Fig. 28 - NIBP window

■ NIBP UNIT
Pick this item to adjust measurement unit
(Options: mmHg or kPa).
■ ALARM LEVEL
Selectable between 1 and 2. Level 1
represents the most serious case.
■ NIBP ALARM
Pick "ON" to enable NIBP alarm functions Fig. 29 - NIBP list window
such as parameters blinking, audio alarm
and light indicator. Pick "OFF" to disable the By pressing the first left item you can select
alarm functions and there will be a a line of NIBP recorded data and you will be
" "symbol instead of alarm limits in able to delete a line of data in NIBP LIST by
Parameters Area. pressing the "DELETE" (second left item).
■ SYS LIMIT ■ MODULE CHECK
SYS alarm is activated when the systolic Available options are "NIBP MANOMETER",
pressure exceeds adjusted ALARM HIGH "NIBP LEAKAGE", "MODULE SELF TEST",
value or falls below adjusted ALARM LOW "MODULE STOP".
value (min: 30 and max: 240).
NIBP MANOMETER
■ DIA LIMIT Wrap the cuff around a rigid cylinder. Connect
DIA alarm is activated when the diastolic a calibrated reference manometer and a ball
pressure exceeds adjusted ALARM HIGH pump by means of a T-piece connector and
value or falls below adjusted ALARM LOW hoses to the monitor. Set the monitor in "NIBP
value (min: 20 and max: 180). MANOMETER" mode. Inflate the pneumatic
system to 0, 50 and 200 mmHg by ball pump
■ MAP LIMIT
separately. The difference between the
MAP alarm is activated when the mean
indicated pressure of the reference manometer
arterial pressure exceeds adjusted ALARM
and the indicated pressure of the monitor
HIGH value or falls below adjusted ALARM
should not exceed ±3 mmHg.
LOW value (min: 25 and max: 200).
NIBP LEAKAGE
Wrap the cuff around a cylinder of an
appropriate size, and the circumference of the
applied cuff does not exceed that of the

36 / 88 HEYER VizOR 15, Operator’s manual Rev. 1.0 - 09/09

 HEYER VizOR 15

cylinder more than 7%. Set the monitor in 8.4 NIBP Cuff Cleaning
"NIBP LEAKAGE" mode.
The monitor inflates the cuff up to 170mmHg Warning
and keeps it constant for 15 sec. If air leakage Do not press the cuff and tubing with a hot
result is satisfactory, "NIBP LEAK OK" iron.
message is displayed; otherwise you will ■ Cleaning
receive "PNUMATIC LEAK" message. Durable one-piece cuffs may be safely
NOTE: cleaned with a damp cloth (70% alcohol or
These test must only done by personnel 0.5% bleach solution may be used) or
trained and authorized by manufacturer. washed in water (140ºF, 60ºC maximum)
with soap or detergent.
8.3 NIBP Alarm Message ■ Sterilization
Do not use steam or heat to sterilize the cuff.
Alarm occurs when the pressure (SYS. DIA or Gas sterilization may be used if necessary.
MAP) exceeds the alarm limit
■ Disinfection
Audio
Alarm Situation Visual prompt
sound
Glutaraldehyde type liquid disinfectants may
SYS violates ● SYS value be used on durable cuffs. Prolonged used of
adjusted alarm limits blinks
SYS ALARM
or violates lower than ● alarm indicator
Activated these disinfectants at full strength may cause
50mmHg flashes.
● DIA value
discoloration of the white cuff marking.
DIA violates adjusted blinks
DIA ALARM Activated
alarm limits ● alarm indicator
flashes.
MAP violates ● MAP value
adjusted alarm limits blinks
MAP ALARM Activated
or violates lower than ● alarm indicator
30mmHg flashes.

NIBP messages include:

Message Cause

SELF-TEST NIBP hard ware module failure.

FAILED
LOOSE CUFF Cuff is completely unwrapped, no cuff attached.
MODE ERROR Use adult cuff instead of neonate cuff or occlusion
happened in air way.
AIR LEAK Air leak in cuff, hose or connector.
AIR PRESSURE Unstable pressure value (e.g. kinked hoses)
ERROR because valve cannot open normally.
SIGNAL WEAK Very weak patient signal due to a loosely wrapped
cuff or extremely weak pulse from patient.
RANGE EXCEED Measuring pressure is more than upper limit
(255mmHg) for adult or (135mmHg) for neonate.
EXCESSIVE Arm movement, noisy signal or irregular pulse (e.g.
MOTION arrhythmia).
OVER PRESSURE Measuring pressure exceeded safe software limit,
SENSED 290 mmHg for adult and 145mmHg for neonate.
SIGNAL Large motion artifact that saturates the amplifier's
SATURATED amplitude handling capability.
PNEUMATIC LEAK Leakage during leak test.
TIME OUT Measuring time exceeds 120 seconds (adult) or 90
seconds (neonate).
SYSTEM FAILURE Error occurs in pump, A/D sampling, pressure
transducer or software.
NIBP DEFECT NIBP module failure.
LOW BATTERY The Charge of battery is low so NIBP measurement
is not possible (while the monitor is working with
battery).
NIBP NO MODULE No NIBP module is installed.
STOP PRESSED NIBP stop key has been pressed during
measurement.
NIBP STOP Measurement is stopped by NIBP module because
of special reason.
NIBP LEAKAGE Successful leakage test.
O.K

All alarm level for these messages (except the

last third message) is set in NIBP WINDOW.
Pressing ALARM SILENCE, alarm will be
disabled and ignore this fault.

Rev. 1.0 - 09/09 HEYER VizOR 15, Operator’s manual 37 / 88

 HEYER VizOR 15

9 TEMP Monitoring Warning

The temperature probes carry a one-year
9.1 General warranty on workmanship, components and
accuracy tolerances. Probe life with normal
Measurement of patient temperature is use should exceed one year.
accomplished by processing the signal from a
probe containing temperature dependent Warning
resistor called thermistor. Value of this resistor Using ESU with temperature measurement
is measured by the monitor continuously and simultaneously, may cause patient burn. If
displayed on screen. Patient monitor has two possible, remove the probe from patient
different kind of temperature probe, a probe for contact before activating the surgical unit or
esophageal /rectal temperature measurement other RF source. If probe must be used
and other for skin temperature measurement. simultaneously with electrosurgical apparatus,
hazards can be reduced by selecting a
Specification: temperature monitoring point which is remote
Measuring and Alarm Range 0~50 ºC from the expected RF current path to the
Accuracy ± 0.2 º C ground return pad.
Delay time
For rectal/esophageal probe 50sec Warning
For skin probe 20sec The calibration of the temperature
measurement is necessary every two years (or
Two TEMP probes can be used together to as frequently as dictated by your Hospital
obtain 2 temperature data and compare them Procedures Policy). When you need to
to determine the temperature difference. calibrate the temperature measurement,
TEMP monitoring setup: contact the local after sale service.
■ Plug TEMP probe directly into the monitor.
■ Attach the TEMP probe(s) properly to the 9.2 TEMP Window
patient.
The TEMP WINDOW menu is as follows:
■ Switch on the system.
Inspection and recalibration
Visually inspect the probe for cracks, holes,
crazing etc., prior to each use. If any such
degradation in the cable jacket is discovered,
discard probe according to your hospital's
procedure for medical waste. When using
Fig. 30 - TEMP window
temperature probe, the user must determine
that a probe style is suitable and sufficiently
■ UNIT
flexible for esophageal or rectal use.
Pick this item to set measurement unit.
Probe cannot be "recalibrated" per se, but
should be inspected monthly by the hospital (options: ºC or ºF)
Biomedical Equipment group to ensure they ■ ALARM LEVEL
are working properly. Probes can be tested by Selectable between 1 and 2. Level 1
plugging into a patient monitor and looking for represents the most serious case.
an electrical open or short–circuit, Intermittent
reading or extremely inaccurate readings ■ TEMP ALARM
which would indicate probe wire damage. The Pick "ON" to enable TEMP alarm functions
sensor stability is well-documented; Probe such as parameters blinking, audio alarm,
accuracy should not drift out of tolerance over and light indicator. Pick "OFF" to disable the
the normal life of probe. alarm functions and there will be a " "
symbol instead of alarm limits in Parameters
NOTE: Area.
Please be note that the metal side should
be used for making measurements. ■ T1 LIMIT
T1 alarm is activated when the channel-1
Warning temperature exceeds adjusted ALARM HIGH
Handle the TEMP probes with due care. The value or falls below adjusted ALARM LOW
probe and cable should be rolled up to a loose value (min: 0 and max: 50).
loop when not in use. Over straining will result
in mechanical damage of the probes.

38 / 88 HEYER VizOR 15, Operator’s manual Rev. 1.0 - 09/09

 HEYER VizOR 15

■ T2 LIMIT dissipate residual EtO in probe below

T2 alarm is activated when the channel-2 250ppm.
temperature exceeds adjusted ALARM HIGH
value or falls below adjusted ALARM LOW ■ Disinfection
value (min: 0 and max: 50). Probes may be disinfected by washing with
70% isopropanol, activated dialdehyde
■ DT LIMIT (Cidex) or sodium hypochlorite (bleach
DT alarm is activated when the different diluted 1:10 minimum in water). After
between channel-1 and channel-2 exceeds washing probes should be rinsed thoroughly
adjusted ALARM HIGH value or falls below with water. Brief immersion of the probe in
adjusted ALARM LOW value (min: 0 and detergent solutions is not harmful.
max: 50). Manufacturer does not make any claim as to
the efficacy of these chemicals for infection
T1 is Channel-1 of temperature. control. Please consult your hospital's
T2 is Channel-2 of temperature. Infection Control Officer for the applicable
DT is the temperature difference between the disinfection policies.
above two.
Warning
9.3 TEMP Alarm Message Never boil the standard YSI400 or YSI700
series temperature probe.
Alarm occurs when:
The Alarm function is "ON" and temperature Storage and Handling
exceeds adjusted alarm limits. When not in use, probes and leads should be
loosely coiled and stored at room temperature.
Do not wrap probes around equipment cases
9.4 TEMP Sensor Cleaning And to avoid damaging internal wires.
Storage
To clean the temp sensor, first remove it from
the patient and disconnect it from the monitor.
NOTE:
Reusable temperature probes are sold non-
sterile.
■ Cleaning
Probe should be cleaned of bioburden prior
to disinfection or sterilization to improve the
effectiveness (as recommended in
ANSI/AAMI ST35: Good Hospital Practice:
Handling and Biological Decontamination of
Reusable Medical Device, 1991)
When wiping clean, hold the probe in one
hand at the sensing tip and wipe the probe
and lead wire toward the plug. Excessive
pressure could stretch the cable jacket and
break the internal wires, destroying the
probe .Continued flexing of lead wires in use
and cleaning can also break the internal
wire.
Avoid contact with strong, aromatic,
chlorinate, ketone, ether or ester solvents.
Prolonged immersion in alcohols or mild
organic solvents, detergent solutions or
highly alkaline solutions will cause the vinyl
to lose flexibility. The probe plugs should not
be immersed.
■ Sterilization
Ethylene oxide is the preferred sterilization
method. After sterilization, probes must be
safely and thoroughly ventilated before
handling or use. Using a generic EtO
sterilizing procedure, YSI recommends an
aeration time of 12 hours minimum to

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 HEYER VizOR 15

10 IBP Monitoring activated with level 3. Next channel is the

same.
10.1 General Preparatory steps for IBP measurement:
Specification: 1. Plug the pressure cable into corresponding
Displaying and measuring socket.
ranges (for all labels) -50~300 (mmHg) 2. Prepare the pressure tube and transducer
Alarm ranges by flushing through the tubing system with
IBP -50~300 (mmHg) normal saline solution. Ensure that the
ART -50~300 (mmHg) tubing system is free of air bubbles.
LVP -50~300 (mmHg) 3. Connect the patient catheter to the
PAP -50~120 (mmHg) pressure line, making sure that there is no
RVP -50~100 (mmHg) air present in the catheter or pressure line.
CVP -50~100 (mmHg)
Warning
LAP -50~100 (mmHg)
If there are air bubbles in the pressure line or
RAP -50~100 (mmHg)
the transducer, you should flush the solution to
Resolution 1 (mmHg)
the system.
Accuracy 2 % or 2 mmHg
each one is greater 4. Place the transducer at the same level with
the patient's heart.
Patient monitor measures direct blood
5. Check if you have selected the correct
pressure (SYS, DIA and MEAN) of the
label name. See the next chapter for
selected blood vessel through two channels,
details.
and displays two BP waveforms.
6. Zero the transducer. See the next section
Warning for details.
The operator should avoid contacting with to 7. Calibrate the IBP monitor with a reference
the conductive parts of the system when being pressure if you have changed the
applied. transducer or if you are not sure about the
accuracy.
Warning
When using ESU (Electrosurgery equipment), See the next section for details.
the transducer and the cables should not be
contacted with the conductive part of ESU to
protect patient against burns.
Warning
Disposable IBP transducer or domes should
not be reused.
Warning
Be careful that all packages are safe before
using domes, and make sure that they are
sterilized and pay attention to the expiry date.
Warning
Use only the pressure transducer listed in the
Fig. 31 - IBP monitoring
accessories list.
The specified transducer are designed to have
the special ability to protect patient against the
electrical shock (especially for the leak current
allowed), and it is protected against the effects
of a discharge of a cardiac defibrillator. It can
be used in the surgical operation. During
defibrillation, the IBP waveform may be
distorted temporarily.
Warning
Verify transducer cables fault detection prior to
the start of monitoring phase. Unplug the
transducer of the channel 1 from the socket,
the screen will display the error message
"IBP1 NO SENSOR" and the audible alarm is

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 HEYER VizOR 15

10.2 IBP Window

The IBP WINDOW menu is as follows:

Fig. 33 - IBP alarm window

■ IBP1/IBP2 ALARM
Pick "ON" to enable alarm functions such as
Fig. 32 - IBP window parameters blinking, audio alarm and light
indicator. Pick "OFF" to disable the alarm
functions and there will be a " " symbol
■ IBP1/IBP2 UNIT
instead of alarm limits in Parameters Area.
Pick this item to adjust measurement unit.
(Options: mmHg, kPa, cmH2O) ■ IBP1/IBP2 ALARM LEVEL
Selectable between 1, 2. Level 1 represents
■ IBP1/IBP2 LABLE
the most serious case.
Suitable label should be selected, regarding
the place of measurement. The available ■ SYS LIMIT
pressure labels are: SYS alarm is activated when the systolic
pressure exceeds adjusted ALARM HIGH
Label Definition
ART Arterial Blood Pressure
value or falls below adjusted ALARM LOW
LVP Left Ventricle Pressure value.
PAP Pulmonary Artery Pressure
RVP Right Ventricle Pressure
CVP Central Venous Pressure
■ DIA LIMIT
LAP Left Atrium Pressure DIA alarm is activated when the diastolic
RAP Right Atrium Pressure
pressure exceeds adjusted ALARM HIGH
value or falls below adjusted ALARM LOW
Warning
value.
IBP algorithm will vary according to the
selected label. Therefore in the case of ■ MEAN LIMIT
improper label selecting, the accuracy of the MEAN alarm is activated when the mean
measurement may be decreased. pressure exceeds adjusted ALARM HIGH
value or falls below adjusted ALARM LOW
■ IBP SWEEP
value.
Available options for IBP SWEEP are 3, 6,
12.5 and 25mm/s. NOTE:
The alarm High/Low limits for SYS, DIA and
■ IBP GRID
MEAN of ART, LVP, PAP, RVP, CVP, LAP,
Select "ON" to divide each IBP signal to 5
RAP are listed as follow. Note that the CVP,
parts with white dot lines.
LAP and RAP only have MEAN pressure,
■ IBP FILTER therefore the alarm limit are only for MEAN.
In order to have a more clear and detailed
The alarm occurs when the value exceeds the
waveform, 3 filter types can be selected:
set limits.
Available options are 22Hz, 16Hz, and 8Hz.
22Hz: Recommended in normal use and the Min Alarm High Min Alarm High Step
Lable
most clinical situation. It has the most (mmHg) (mmHg) (mmHg)
IBP -50 300 5
measuring accuracy among the called filters. ART -50 300 5
16Hz: When the signal is a bit noisy. LVP -50 300 5
PAP -50 120 1
8Hz: This mode is recommended to reduce RVP -50 100 1
CVP -50 100 1
noise and interface resulted from ESU and LAP -50 100 1
also when the system has a high noise level RAP -50 100 1
or doesn’t have equipotential earth. While
using this filter the measuring accuracy
might be decreased.
■ ALARM
Pick "IBP ALARM" in IBP WINDOW to call
up the following menu:

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 HEYER VizOR 15

■ IBP SCALE The message "PLEASE WAIT" will display

Pick "IBP SCALE" in IBP WINDOW to call up during the procedure. When the procedure
the following menu: finished successfully the message
"IBP1/IBP2 OK" appears.
The last zeroing time will be saved and
displayed in its corresponding place.
5-turn stopcock to patient on and the other
stopcock to atmospheric pressure off.
Fig. 33 - IBP/ scale window
The following messages may prompt up in
The waveform and corresponding scale ZERO WINDOW:
appears in the IBP waveform area with 3
dotted lines representing HIGH limit scale, ■ "IBP1/IBP2 NO SENSOR, UNABLE TO
SIGN cursor, and LOW limit scale from the ZERO"
top to the bottom values of the three scales Make sure that the transducer is connected
can be manually set or automatically by Auto or not, then start zeroing.
scale. You can change the scales for IBP, ■ "IBP1/IBP2 OVERANGE, FAILED
ART and LVP labels by step of 10 and for ZEROING"
PAP, RVP, CVP, LAP and RAP labels by Make sure that the stopcock is vented to
step of 5. atmosphere. If the problem persists, contact
■ AUTO SCALE after sale service.
Pick <AUTO SCALE>in IBP WINDOW to ■ "IBP1/IBP2 UNSTABLE PRESSURE,
adjust the scale automatically. Scales are UNABLE TO ZERO"
adjusted in a way that signal occupied Make sure that the transducer is not
approximately 80% of IBP waveform area. attached to the patient and that the stopcock
■ IBP ZERO is vented to atmosphere or perhaps the
Pick < ZERO> in IBP WINDOW to call up the tubing system is hited accidentally. If the
following menu: problem persists, contact after sales service.
■ IBP CALIB
Pick < CALIB> in IBP WINDOW to call up
the following menu:

Fig. 34 - IBP / zero window

NOTE:
Since transducers need to be warmed to
achieve the best accuracy it is Fig. 35 - IBP / calib window
recommended to zero the system at least
15 minutes after connecting the IBP
transducer to the system.
NOTE:
Zero procedure should be performed before
starting the monitoring and at least once a
day after each disconnection and
connection of the cable.
Zero the transducer:
1 The transducer should be placed at mid-
heart level.
2 Turn off patient stopcock.
3 The transducer must be vented to
atmospheric pressure.
Fig. 36 - IBP calibration
4 Select < IBP1/IBP2 ZERO > to start
zeroing procedure for each channel.

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 HEYER VizOR 15

■ Mercury calibration should be performed by 10.3 IBP Alarm Message

the biomedical engineering department
either whenever a new transducer is used, or Alarm occurs when the pressure (SYS, DIA or
as frequently as dictated by your Hospital MEAN) exceeds the alarm limit.
Procedures policy. Alarm Situation Visual prompt Audio sound
SYS SYS violates ● SYS value Activated
■ The purpose of the calibration is to ensure ALARM adjusted alarm limits blinks
● alarm indicator
that the system gives you accurate flashes.
measurements. DIA DIA violates adjusted ● DIA value Activated
ALARM alarm limits. blinks
● alarm indicator
■ Before starting a mercury calibration, a zero flashes.
procedure must be performed. MEAN MEAN violates ● MEAN value Activated
ALARM adjusted alarm limits. blinks
● alarm indicator
Warning flashes.

You must never perform this procedure while

patient is being monitored. IBP message include:
1. Attach the tubing to the Message Cause Solution Explanation
IBP1/IBP2 Channel 1 or 2 Check the Alarm level 3,
sphygmomanometer. NO transducer is not transducer the message is
2. Ensure that connection that would lead to SENSOR connected. connection. blinking.
Pressing
patient is off. ALARM
SILENCE,
3. Connect the 3-way connector to the 3-way alarm will be
stopcock that is not connected to the disabled and
ignore this fault.
patient catheter. IBP1/IBP2 IBP1 or IBP2 signal is Press <AUTO
ADJUST in out of display range SCALE> in IBP
4. Open the port of the 3-way stopcock to the SCALE for about 5 seconds. WINDOW menu.
sphygmomanometer. IBP1/IBP2 This condition occurs ● Check patient Alarm level 3,
STATIC when the maximum and do the message is
5. Raise the sphygmomanometer to set value PRESSURE and minimum values necessary blinking.
that you adjusted in CALIB WINDOW of a pulsatile pressure treatment Pressing
signal (Just for IBP, ● Turn on the ALARM
menu. ART, PAP, RVP and stopcock to SILENCE,
LVP labels) differ by patient and turn it alarm will be
6. Choose a CAL-> in the CALIB WINDOW less than 3mmHg. In off to the disabled and
menu. this case, only Mean
pressure is displayed
atmospheric
pressure.
ignore this fault.

7. Press the rotary knob to start the in this state. ● Follow hospital
This message can be procedure for
calibration. caused by the dislodging
following reason: catheter.
The message "PLEASE WAIT" will display ● A physiological
condition e.g.
● Follow hospital
procedures for
during the procedure. "IBP1/IBP2 asystole. clotted catheters.
● Transducer turned
CALIBRATION OK" indicates that the off to the patient.
calibration procedure is completed ● A catheter tip lodged
against a vessel
successfully. The last calibration time will be wall.
● A clot on the
saved and displayed in its corresponding catheter tip.
place. IBP1/IBP2
SEARCH
IBP signal can’t be
processed by the
● Check all IBP
measurement
software because the setup is suitable
The following messages may prompt up in signal is weak or less or not.
pulsatile. ● Check patient
CALIB WINDOW: and treat if
necessary.
■ "IBP1/IBP2 NO SENSOR, UNABLE TO
CALIBRATE"
Make sure that the transducer is connected
or not, then start calibration procedure.
■ "IBP1/IBP2 OVERANGE, UNABLE TO
CALIBRATE"
Verify that adjusted pressure in menu and
sphygmomanometer pressure are equal. If
the problem persists, contact after sale
service.
■ "IBP1/IBP2 UNSTABLE PRESSURE,
UNABLE TO CALIBRATE"
Make sure that the transducer is not
attached to the patient or perhaps the tubing
system is hited accidentally .If the problem
persists, contact after sales service.
8. Remove the sphygmomanometer tubing
and extra connector.

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 HEYER VizOR 15

10.4 IBP Transducer Cleaning

Clean all blood and other outer materials from
the external surface of the transducer and
cable using a slightly damp cloth and a mild
detergent solution. Do not immerse. Do not
use alcohol or solvents on the clamps. Rinse
thoroughly.
NOTE:
The disposable transducers or domes must
not be re-sterilized or re-used.
NOTE:
For protecting environment, the disposable
transducers or domes must be recycled or
disposed properly.
Warning
Does not autoclave or ETO sterilize the
transducer?

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 HEYER VizOR 15

11 GAS Monitoring (Mainstream) The oxygen measurements are obtained

through an oxygen port at the top of the airway
11.1 General adapter. Oxygen does not absorb infrared light
to the same extent as other breathing gases
Patient monitor provides mainstream method and is therefore measured using an ultra rapid
for gas measurement. response time oxygen sensor.
The mainstream multi-gas probe is intended to
be connected to a patient breathing circuit for The measured parameters are EtCO2 , EtN2O,
monitoring of inspired/expired gases of adults, EtO2, EtAA (End Tidal CO2 / N2O / O2,
pediatrics and infant patient during anesthesia, Anesthesia Agent), FiCO2, FiN2O, FiO2 , FiAA
recovery and respiratory care. It may be used (Fraction Inspiratory CO2 / N2O / O2 /
in the operating suite, intensive care unit, Anesthesia Agent) and AWRR (Air Way
patient room and emergency medicine Respiratory Rate).
settings.
Warning
The sensor head is available in various
The IRMA probe is intended for use only as an
configurations for ICU and OR applications.
adjunct in patient assessment .It must be used
Concentrations of carbon dioxide (CO2),
in conjunction with clinical signs and
nitrous oxide (N2O), halothane (HAL),
symptoms.
enflurane (ENF), isoflurane (ISO), sevoflurane
(SEV) and desflurane (DES) in different Oxygen sensor:
combinations are determined together with IRMA mainstream multi-gas probe consists of
derived parameters such as respiratory rate, an O2 sensor cell as an option.
waveform and inspired/expired concentrations IRMA oxygen sensor is specially designed to
of all gases. provide an ultra fast response time, thus
allowing a breath-by-breath analysis of the
It is available in various parameter
oxygen waveform at a proximal location (i.e.
configurations as follow:
between the patient's endotracheal tube and
CO2 only sensor: CO2 the Y-piece of the breathing circuit). The vast
OR sensor: CO2, N2O, O2, one majority of oxygen sensors available on the
anesthesia agent (HAL, market are normally too slow for a breath-to-
ISO, ENF, SEV, DES) breath gas analysis.
AX+ sensor: CO2, N2O, one
For anesthesia machines and ventilators
anesthesia agent
already equipped with oxygen measuring
(HAL, ISO, ENF, SEV,
devices, the IRMA sensor is available with an
DES), automatic gas
O2 sensor dummy instead of the normal
detection
oxygen sensor. Figure 11-1 shows both the
Measuring principle normal O2 sensor and the oxygen sensor
The IRMA sensor head snaps in place on the dummy.
top of the airway adapter that includes the
The ultra fast response time oxygen sensor is
optical components for measuring all gases.
normally integrated in the IRMA sensor head
The airway adapter is inserted between the
allowing proximal measurement of INSP/EXP
endotracheal tube and the Y-piece of the
oxygen concentrations.
breathing circuit. The respiratory gas
measurements are obtained by continuously
measuring the infrared gas absorption through
the XTP windows in the gas flow through the
adapter.
Fig. 37 - Oxygen sensor dummy and oxygen sensor
To measure the concentrations and identify the
gases, absorption of up to nine different
wavelengths of infrared light is measured. The oxygen sensor dummy can be replaced at
The measurement of CO2, N2O and anesthetic any time by a normal sensor to allow oxygen
agents in the breathing gas mixture is based measurements with the IRMA sensor.
on the fact that the different gas components To replace the oxygen sensor, remove the
absorb infrared light at specific wavelengths. A depleted oxygen sensor by using a screwdriver
microprocessor continuously calculates the or other suitable tool and turn in a
CO2, N2O and anesthetic agent concentrations counterclockwise direction. Remove the
from the infrared light absorption depleted sensor and carefully screw the new
measurements. Using matrix calculations to oxygen sensor into position.
identify which anesthetic agents are present in
the gas mixture.

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 HEYER VizOR 15

Warning Warning
Oxygen sensor for replacement should be Do not use the IRMA adapter if adapter or its
stored in a cold environment (+2°C ~ +8°C) package is damaged and return it to the
and should be taken into operation before the vendor.
expired date printed on the package.
Warning
Replace the oxygen sensor every four months, Use only the recommended IRMA airway
when the system warns to change the sensor adapters for monitoring .Other airway adapters
with "REPLACE O2 SENSOR" message or may cause improper performance. (Refer to
when the oxygen readings are questionable. chapter 20 for detail)
Warning Warning
Use only the recommended oxygen sensor for Do not use the adult/pediatric airway adapter
O2 monitoring .Other oxygen sensors may with infants as the adapter adds 6ml dead
cause improper performance. (Refer to chapter space to the patient circuit.
20 for detail)
Warning
Warning Do not use the infant airway adapter with
Depleted oxygen sensors shall be disposed of adults as this may cause excessive flow
in accordance with local regulations for resistance.
biologically hazardous materials.
The infant airway adapter has specially
Warning designed connectors for minimizing the dead
Do not leave depleted oxygen sensors space and can be used even for very small
mounted in the IRMA probe, even if the probe patients. The infant adapter is available without
is not in use. an oxygen port only.
Warning
Do not try to open the oxygen sensor Preparatory steps for gas measurement
assembly. The oxygen sensor is a disposable (Figure 39-44):
product and contains a caustic electrolyte and 1. Plug the IRMA connector into the bedside
lead. monitor side panel.

Airway adapter: 2. Snap the IRMA sensor head on top of the

The airway adapter is designed as a IRMA airway adapter. It will click into place
disposable for both adult/pediatric and infant when properly seated.
applications. The adult/pediatric adapter is
available with or without an oxygen port.
The airway adapter with an oxygen port is
equipped with a hydrophobic bacteria filter to
protect the oxygen sensor from contamination.
For anesthesia machines and ventilators
already equipped with oxygen measuring
device, the airway adapter is available without
an oxygen port.
Fig. 39 - Preparatory step 1

3. A green indicator indicates that the IRMA

sensor is ready for use.

Fig. 38 - IRMA airway adapters:

Adult/pediatric with and without an oxygen port and infant adapter

Warning
Disposable airway adapters shall not be
reused. Used disposable airway adapters shall
be disposed of in accordance with local
regulations for contaminated and biologically
hazardous fluids.

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 HEYER VizOR 15

6. Unless the IRMA probe is protected with

an HME always position the IRMA sensor
with the indicator pointing upwards.

Fig. 40 - Preparatory step 2

4. Connect IRMA airway adapter 15 mm

male connector to the breathing circuit Y-
piece.
Fig. 44 - Preparatory step 5

Pre-use check:
Before connecting the IRMA airway adapter to
the breathing circuit, verify the O2 calibration
by checking that the O2 reading on the monitor
is correct (21%). See Room air calibration
section for instructions on how to perform room
air calibration.
Perform the tightness check of the patient
circuit with the IRMA sensor head snapped on
Fig. 41 - Preparatory step 3
the IRMA airway adapter.
Verify that there has not been any
5. Connect the IRMA airway adapter 15 mm accumulation of gas between the IRMA sensor
female connector to the patient’s endo- head and the XTP windows by checking that
tracheal tube. the CO2 readings on the monitor are correct
before connecting a patient to the breathing
circuit.
Check that the connections have been made
correctly by verifying an actual CO2 waveform
on the monitor display.
NOTE:
There is no drift of measurement accuracy.
NOTE:
Variations in barometric pressure do not
have any effects due to internal barometric
Fig. 42 - Preparatory step 4 pressure compensation.
NOTE:
NOTE: There are no adverse effects on stated
Alternatively, connect an HME (Heat performance due to cycling pressure of up
Moisture Exchanger) between the patient’s to 10 kPa.
endotracheal tube and the IRMA probe. Room air calibration of oxygen sensor:
Placing an HME in front of the IRMA probe Room air calibration of oxygen sensor will be
protects the airway adapter from secretions performed automatically at regular intervals
and effects of water vapour and eliminates whenever the IRMA sensor head is
the need of changing the adapter. It allows disconnected from the IRMA airway adapter.
free positioning of the IRMA probe as well. If IRMA sensor is kept in operation for a long
time period without being disconnected from
the airway adapter, or if the operating
temperature for oxygen sensor changes
significantly, the IRMA sensor will indicate that
a new room air calibration is required and the
message will appear on the screen.
Use the following procedure to perform a room
air calibration of the sensor:
Fig. 43 - HME option

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 HEYER VizOR 15

1. Disconnect the IRMA sensor from the Warning

airway adapter. To keep secretions from pooling on the
2. Wait until the indicator starts blinking windows, position the IRMA airway adapter
with red light. with its windows in a vertical position and not in
3. Snap the IRMA sensor back on the a horizontal position.
airway adapter.
4. Check that the indicator turns green.
5. While not connected to the breathing
circuit, check that the O2 reading on
the monitor is 21%.
Gas span check:
Gas reading should be verified at regular
intervals with a reference instrument. (It should
be done just by trained and authorized Fig. 46 - IRMA airway adapter position

personnel of manufacturer.)
NOTE:
Warning Do not use the IRMA airway adapter with
The device can only be operated by personnel nebulized medications because this may
who have passed professional training and are affect the light transmission of the airway
familiar with this manual. adapter windows.
Warning NOTE:
Don’t use the device in the environment which Do not apply tension to the sensor cable.
contains flammable anesthetic gas.
NOTE:
Warning Do not operate the device at temperature
Before any interpretations are made of outside operating range as a below:
parameters readings and waveforms one, IRMA ICU/OR/OR+: 10~35°C
assure that the multi-gas probe is functioning IRMA AX/AX+: 10~40°C
correctly. Partial obstruction of airway with IRMA CO2: 0~40°C
water can result in distorted waveforms. A leak
in the airway may result in low parameters Warning
measurements. Check the monitor to see if it is Verify sensor detection before starting GAS
functioning properly. monitoring. Unplug the sensor from IRMA
connector to verify that the error message "NO
Warning SENSOR "is displayed.
Measurements can be affected by mobile and
RF communications equipment. It should be
assured that the IRMA sensor is used in the
electromagnetic environment specified.
Warning
Do not place the IRMA airway adapter
between the ET tube and an elbow, as this
may allow patient secretions to block the
adapter windows.

Fig. 45 - Airway adapter connection

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 HEYER VizOR 15

11.2 GAS Window device like anesthesia machines and

ventilators already equipped with O2
The GAS WINDOW menu is as follows: measuring devices, the current oxygen
concentration should be transmitted to the
sensor.
Available options for COMPENSATE are
OFF, 1-100% O2 when O2 sensor is
available, it is "AUTO" and it doesn't change
when O2 sensor is available.
Fig. 47 - GAS window ■ GAS UNIT
Pick this item to adjust measurement unit for
■ CO2 UNIT O2, N2O, AA (DES, HAL, ISO, ENF, SEV)
Pick this item to adjust measurement unit (options: kPa, %V).
(options: mmHg, kPa, %V).
CO2 in %V is the CO2 value (in mmHg) ■ AGENT
divided by ambient barometric pressure (in In IRMA OR, Pick this item to select which
mmHg) which is a percentage of the anesthesia agent values display on the
barometric pressure. screen. Available Options are DES, HAL,
ISO, SEV and ENF.
PEtCo 2 ( mmHg ) In IRMA OR+, there is automatic
EtCo2(%V) = identification of anesthesia agent and it is
p Brometric ( mmHg ) "AUTO" in menu and couldn't change.
NOTE:
133.322 × PEtCo 2 ( mmHg ) In IRMA OR system will be able to monitor
EtCo2(KPa) = the anesthesia agent value when it exceeds
1000 0.2%.
NOTE:
In IRMA OR+, if the concentration of
■ SIGNAL SWEEP anesthesia agent doesn’t exceed agent
Available options for SIGNAL. SWEEP are 3, detection threshold, "AA?" will be
6, 12 and 25 mm/s. displayed instead of the name of
■ SIGNAL SCALE anesthesia agent in Multi-gas parameters
Depending on selected signal chooses by window.
user different scale options is available as NOTE:
following table: In IRMA OR+, if there is two anesthesia
O2 Waveform N2O Waveform AA Waveform agent mixtures in patient airway and their
CO2 Waveform Scale
0-50 mmHg , 0-6%
Scale
0-50%
Scale
0-50%
Scale
concentration exceed agent detection
1,2,3,5,10,20%
0-100 mmHg , 0-10%
<AUTOSCALE>
0-100%
<AUTOSCALE>
0-100%
<AUTOSCALE>
<AUTOSCALE> thresholds, the message "AA1, AA2 AGENT
MIXTURE" is displayed on the screen and
AUTOSCALE is an option to adjust the scale "MIX" is displayed instead of the name of
automatically to display waveform in the best anesthesia agent in Multi-gas parameters
way. window.

■ WAVEFORM ■ WORK MODE

Pick this item to select which gas waveform Available options for WORK MODE are
displays on the screen. Available options are "standby" and "measurement".
CO2, N2O, O2, and AA. The default is "measurement" mode. When
gas monitoring is required, select
■ COMPENSATE "measurement" mode. "Standby" mode
The presence of oxygen and nitrous oxide disables monitoring to decrease the power
can cause some interference in CO2 consumption and extend the life cycles of IR
measurement. This is known as spectral source and IRMA sensor.
broadening, and must be compensated.
N2O is measured and automatically
compensated for in all IRMA sensors. The
O2 compensation is performed automatically
for all IRMA sensors with the oxygen sensor
available on it. When using an IRMA without
an oxygen sensor, i.e. when oxygen
measurement is performed by the other

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 HEYER VizOR 15

NOTE: ■ ALARM LEVEL

When not using gas monitoring functions, Selectable between 1, 2. Level 1 represents
it is suggested to disconnect the sensor. the most serious case.
NOTE: ■ EtCO2 LIMIT
If the monitor doesn’t detect any CO2 signal Alarm is activated when the EtCO2 exceeds
for 30 minutes, after connecting IRMA adjusted ALARM HIGH value or falls below
sensor, the monitor automatically disables adjusted ALARM LOW value.
gas monitoring to decrease the power (Range: 0.4~13%V - step0.1%V)
consumption and extend the life cycles of Default for upper limit is 6.5%V and for lower
IR source and sensor. The monitor will be limit is 2.6%V.
set in "standby" mode.
■ AWRR LIMIT
NOTE: Alarm is activated when the AWRR exceeds
If the monitor doesn’t detect adapter of adjusted ALARM HIGH value or falls below
IRMA sensor for 10 minute, after adjusted ALARM LOW value.
connecting IRMA sensor, the monitor (Range: 1-120BrPM - step 1 BrPM)
automatically disables monitoring to Default for upper limit:
decrease the power consumption and Adult: 30 BrPM
extend the life cycles of IR source and Neonate: 60 BrPM
sensor. The monitor will be set in "standby" Default for lower limit:
mode. Adult: 5 BrPM
Neonate: 15 BrPM
NOTE:
When the system is in standby mode, you ■ FiCO2 HIGH
can enable GAS monitoring in GAS window Alarm is activated when the FiCO2 exceeds
by setting work mode in measurement. adjusted ALARM HIGH value.
(Range: 0.4~13 %V step 0.1%V)
■ GAS/RESP Default for upper limit is 1.3%V.
Available options are "GAS" and "RESP" to
select GAS or RESP as mode to monitor ■ APNEA LIMIT
RESP parameters. When selecting "GAS", Pick it to set the standard of judging an
the system will keep the current status. apnea case. It ranges from 10 to 40
When selecting "RESP", the system seconds, increases / decreases by 5s. When
switches GAS module to standby mode, and we choose "OFF", in apnea case alarm will
toggle to display RESP waveform and be deactivated.
parameters.
■ EtN2O LIMIT
■ FILL SIGNAL Alarm is activated when the EtN2O exceeds
Pick "ON" to show the waveform in a filled adjusted ALARM HIGH value or falls below
form. adjusted ALARM LOW value.
(Range: 1~100%V - step1%V)
■ ALARM Default for upper limit is 75%V and for lower
Pick "ALARM" in GAS WINDOW to call up limit is 35%V.
the following menu:
■ FiN2O LIMIT
Alarm is activated when the FiN2O exceeds
adjusted ALARM HIGH value or falls below
adjusted ALARM LOW value.
(Range: 1~100%V - step1%V)
Default for upper limit is 75%V and for lower
limit is 35%V.
Fig. 48 - GAS/ALARM window
■ EtAA LIMIT
■ GAS ALARM Alarm is activated when the EtAA exceeds
Pick "ON" to enable alarm functions such as adjusted ALARM HIGH value or falls below
parameters blinking, audio alarm and light adjusted ALARM LOW value
indicator. Pick "OFF" to disable the alarm
functions and there will be a " " symbol ■ FiAA LIMIT
instead of alarm limits in Parameters Area. Alarm is activated when the FiAA exceeds
adjusted ALARM HIGH value or falls below
adjusted ALARM LOW value.

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 HEYER VizOR 15

NOTE: Warning
FiAA and EtAA have different alarm ranges For accurate measurements, IRMA sensor
for every anesthesia agent as a follow: should be set zero to room air.

Anesthesia Alarm Step Alarm Warning

agent range limit Incorrect probe zero calibration will result in
default false gas readings.
HAL 0.1~5% 0.1% 0.5~1.5% 1. Select well ventilated room to perform the
DES 0.1~18% 0.1% 5~15% calibration.
ISO 0.1~5% 0.1% 0.8~3% 2. Make sure the sensor is connected to
SEV 0.1~8% 0.1% 1~3% system and no error message is displayed
ENF 0.1~5% 0.1% 0.5~1.5% (except APNEA)
3. Choose a < ZERO> in the ZERO WINDOW
■ EtO2 LIMIT menu.
Alarm is activated when the EtO2 exceeds 4. Press the rotary knob to start zeroing.
adjusted ALARM HIGH value or falls below The message "PLEASE WAIT" will be
adjusted ALARM LOW value. displayed during the procedure. "ZERO IS
(Range: 18~105%V - step1%V) OK." indicates that the zeroing procedure is
Default for upper limit is 50%V and for lower completed successfully. The last zeroing
limit is 100%V. time will be saved and displayed in its
corresponding place. If an error happened
■ FiO2 LIMIT during zeroing the error message will be
Alarm is activated when the FiO2 exceeds displayed in ZERO WINDOW.
adjusted ALARM HIGH value or falls below Special care should be taken to avoid
adjusted ALARM LOW value. breathing into the adapter during the zero
(Range: 18~105%V - step1%V) reference calibration procedure. The
Default for upper limit is 50%V and for lower presence of ambient air (21% O2 and 0%
limit is 100%V. CO2) in the IRMA airway adapter is of crucial
■ ZERO importance for a successful zero reference
Pick "ZERO" in GAS WINDOW to call up the calibration. Always perform a pre-use check
following menu: after performing zero reference calibration.

Fig. 49 - GAS/ZERO window

A zero reference calibration of the IR

measurement should be performed whenever
an offset in gas reading is discovered or if
"CO2 INVALID, PLEASE ZERO" alarms
appear.
NOTE:
Zero reference calibration should only be
performed by qualified service technicians,
and should NOT be a part of normal
operating procedures.
The probe must work at least 15 minutes in
measurement mode for warming up. Pressing
zero before passing this time, the message
“UNABLE TO ZERO, SENSOR WARMING
UP” will be shown and zeroing procedure won’t
be done.

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 HEYER VizOR 15

AGENT Agent Zero the sensor, if Alarm level 2.

11.3 GAS Alarm Message INVALID. outside the problem exists Pressing alarm
PLEASE specified again turn off and silence, alarm will
Alarm is activated when parameters exceed ZERO accuracy
range.
on the system and
if again this
be disabled and
ignore this fault.
adjusted alarm limits: message appears
contact after sales
service of
Audio manufacturer.
Alarm Situation Visual prompt
sound ACCUTACY Two or more Zero the sensor, if Alarm level 2.
Respiration rate ● AWRR value INVALID, agent are the problem exists Pressing alarm
AWRR violates adjusted blinks. PLEASE out of again turn off and silence, alarm will
alarm limits Activated ZERO. accuracy on the system and be disabled and
Alarm ● Alarm indicator
flashes. range if again this ignore this fault.
except O2. message appears
End Tidal CO2 ● EtCO2 value
contact after sales
EtCO2 violates adjusted blinks.
Activated service of
Alarm alarm limits ● Alarm indicator
manufacturer.
flashes.
INVALID Ambient Turn the system off Alarm level 2.
FiCO2 violates ● FiCO2 value
AMBIENT pressure and on and if Pressing alarm
FiCO2 High adjusted high alarm blinks.
Activated PRESSURE outside problem exist silence, alarm will
Alarm limits ● Alarm indicator
flashes operating again, contact after be disabled and
range. sales service of will ignore this
Non-respiration ● Alarm indicator
manufacturer. fault.
RESP condition overruns flashes.
Activated INVALID Internal Turn the system off Alarm level 2.
APNEA adjusted time ● "RESP
AMBIENT temperature and on and if Pressing alarm
APNEA" blinks.
TEMPERAT outside problem exist silence, alarm will
End Tidal CO2 ● EtN2O value
URE operation again, contact after be disabled and
EtN2O violates adjusted blinks.
Activated range. sales service of will ignore this
Alarm alarm limits ● Alarm indicator
manufacturer. fault.
flashes.
End Tidal CO2 ● FiN2O value
FiN2O violates adjusted blinks.
Activated
Alarm alarm limits ● Alarm indicator
flashes. O2 PORT Adapter O2 Change the Alarm level 2.
End Tidal CO2 ● EtAA value FAILURE port adapter. Pressing alarm
violates adjusted blinks. Clogged or silence, alarm is
EtAA Alarm Activated
alarm limits ● Alarm indicator plugged. suspended for at
flashes. least 120S.
End Tidal CO2 ● FiAA value REPLACE O2 sensor Place new O2 Alarm level 2.
violates adjusted blinks. O2 SENSOR lifetime is sensor. Pressing alarm
FiAA Alarm Activated
alarm limits ● Alarm indicator passed. silence, alarm will
flashes. be disabled and
End Tidal CO2 ● EtO2 value will ignore this
violates adjusted blinks. fault.
EtO2 Alarm Activated
alarm limits ● Alarm indicator ROOM AIR If the sensor Perform room air Alarm level 2.
flashes. CALIB operate for a calibration. Pressing alarm
End Tidal CO2 ● FiO2 value REQUIRED long time silence, alarm is
violates adjusted blinks. period suspended for at
FiO2 Alarm Activated without least 120S.
alarm limits ● Alarm indicator
flashes. being
disconnecte
d from the
GAS messages include: adapter or
the
operating
Message Cause Solution Explanation temperature
Turn the system off for oxygen
Alarm level 2. sensor
and on and if
Pressing alarm changes
SYSTEM problem exist
Sensor error silence, alarm will significantly.
FAULT again, contact after
be disabled and NO Sensor is Connect sensor if Alarm level 3
sales service of
ignore this fault. SENSOR disconnect- problem exist Pressing alarm
manufacturer.
Alarm level 2. ed from again, contact after silence, alarm will
Pressing alarm system sales service of be disabled and
REPLACE manufacturer. ignore this fault.
IR signal low Change adapter silence, alarm is
ADAPTOR
suspended for at SENSOR Manual
least 120S STANDBY setting and if
Alarm level 3. MODE no breath is
There is no
Pressing alarm detected for
NO adaptor
Connect adapter silence, alarm will 30 min and
ADAPTOR connect to
be disabled and ETCO2 is
the sensor.
ignore this fault. less than 4
mmHg for
Zero the sensor, if
more than
the problem exists
30 min or
again turn off and Alarm level 2.
CO2 CO2 outside when the
on the system and Pressing alarm
INVALID. specified monitor
if again this silence, alarm will
PLEASE accuracy does not
message appears be disabled and
ZERO range. detect
contact after sales ignore this fault.
adapter of
service of
IRMA
manufacturer.
sensor for
Zero the sensor, if 10 min.
the problem exists
again turn off and Alarm level 2.
O2 outside
O2 INVALID.
PLEASE
specified
on the system and
if again this
Pressing alarm
silence, alarm will
Indicator status on the IRMA sensor head:
accuracy
ZERO message appears be disabled and
range.
contact after sales ignore this fault.
service of Steady green light System OK
manufacturer.
N2O N2O outside Zero the sensor, if Alarm level 2.
Steady red light Sensor error
INVALID. specified the problem exists Pressing alarm Blinking red light Check adapter
PLEASE accuracy again turn off and silence, alarm will
ZERO range. on the system and be disabled and Blinking green light Standby mode
if again this ignore this fault.
message appears
contact after sales
service of
manufacturer.

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 HEYER VizOR 15

11.4 IRMA Sensor Cleaning

1.The IRMA sensor can be cleaned
using a cloth moistened with ethanol
or isopropyl alcohol.
2.Do not reuse, sterilize, or clean
airway adapter on another patient as
they are designed for single use.
Warning
The IRMA oxygen sensor cell and
IRMA airway adapters are non-sterile
devices. Do not autoclave the devices
as this will damage them.
Warning
Never sterilize or immerse the IRMA
sensor in liquids.

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 HEYER VizOR 15

12 Cerebral State Monitoring ■ To enable or disable trend graph of SQI

parameter:
12.1 General Pick the second left item to enable or disable
the SQI trend.
The Cerebral State Monitor (CSM) is a non-
invasive measurement tool for use by trained ■ To enable or disable trend graph of EMG
professionals to measure the level of parameter:
consciousness (LOC) in all area of the Pick the third left item to enable or disable
hospital. Based on EEG, an index (CSI) is the EMG trend.
calculated, which is used in the estimation of NOTE:
LOC. The CSM module displays the CSI but The CSI parameter trend always shows on
does not perform any data interpretation. All this page and the user is not able to disable
data interpretation is performed by a physician. displaying of it.
The monitor is intended for use in monitoring
the hypnotic state of the brain by data ■ To select how long the trend graph is
acquisition of EEG signals of the anesthetized displayed:
or sedated patient in all areas of the hospital. Pick the forth left item, available options are
15min, 30min and 1-24H by the step of 1H.
12.2 CSM On Patient Monitor While the cursor line has not moved in CSM
large page ,every click on forth left item, the
1. Turn on the CSM module. x scale will be displayed based on the
2. The CSM module shows a list of monitor chosen trend interval till current time.
with CSM wireless card found. Select the ID Moving the cursor to chose a specific time
of desired monitor with the Event key on the and pressing trend time interval item (the
CSM module and the “CSM LINK” status forth left item), x scale will be zoomed in and
indicator at right side of panel flashes. zoomed out equal to the trend interval
3. Accept the desired monitor by pressing the according to the specific time the cursor line
Set key. When link has been established the shows.
“CSM LINK” status indicator will show a
constant light. ■ To obtain trend data of specific time:
4. The communication is performed and you Cursor line in trend graph shows specific
can see CSM parameters like CSI%, BS%, time. You can move the cursor line to
SQI%, EMG% and also EEG signal on the change the time by pressing the fifth left
patient monitor display. item, when trend time interval (the forth left
item) is set at 15 min, 30 min, 1H and 2H
CSM patient monitor display and turning the knob. Parameters at
When highlight is place at CSM area, press the mentioned time are displayed on the right
knob, the following window (CSM large page) side of the CSM large page with its specific
will pop up: color.
■ To select time interval of trend in x-axis:
Pick” “(the sixth left item) to adjust the
start time and stop time of x-axis. By every
clicking on the “ ”, the x scale will be
changed in extend of the specified time of
forth left item
■ To change EEG gain:
Pick “EEG GAIN” (the seventh item left) to
adjust the Y scale of EEG signal and thus
change the EEG signal in proportion.
Fig. 50 - CSM large page Available options are 50µV and 100-500µV
by step 100µV.
This window is a special page for CSM display
to show detail information of CSM parameters ■ To review the event:
in lager area and also you can change the Patient monitor can review the 255 CSM
different settings of CSM on it. event data.
Pick “EVENT LIST” to invoke the result and
■ To enable or disable trend graph of BS time of latest event data, CSM/EVENT LIST
parameter: WINDOW will pops up as shown in figure
Pick the most left item to enable or disable below:
the BS trend.

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 HEYER VizOR 15

Fig. 51 - CSM/EVENT LIST window

By pressing the first left item of EVENT LIST

WINOW, you can select a line of event
recorded data and you will be able to delete
a line of data in EVENT LIST WINDOW by
pressing “DELET”. And all event list for new
patient bye pressing “DELETE ALL”
NOTE:
For every event there is an event mark at
specific time of trend when trend time
interval is set at 15 min, 30 min, 1H and 2H.
■ To enable or disable the CSM alarm limit:
Pick “CSM ALM ON/OFF” to enable CSI
alarm function such as parameters blinking,
audio alarm and light indicator. Pick ”OFF” to
disable the alarm functions and there will be
a will be a " " symbol instead of alarm limits
in Parameters Area.
■ To set the CSI alarm limit:
th
Press the 10 left item to set the CSI limit.
Alarm is activated when the CSI parameter
exceeds adjusted ALARM HIGH value or
falls below adjusted ALARM LOW value
(Default: min=40, max=60).
NOTE:
CSI alarm level is always in level II.
NOTE:
Every change in CSM large page setting is
seen in CSM window in normal state.

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 HEYER VizOR 15

13 ST Monitoring NOTE:
If there are not at least 5 normal complexes
13.1 General in the last 50 beats of ECG signal, the ST
value will not be displayed.
ST segment deviation is defined as the
displacement above or below the isoelectric ST monitoring function is “OFF” as a default.
level. The measurement of deviation compares You can switch it “ON”, when this monitoring is
the isoelectric point to the ST measurement necessary.
point.
When ST monitoring is enabled, current ST
The isoelectric point defines the point of zero
values are trended and can be reviewed on the
voltage (no electrical activity) with a default
TREND window.
position of 80ms from R wave as 0msec in the
horizontal (time) axis. The ST point occurs in NOTE:
the ST segment between J-point and the T Measurement unit of ST segment is “mV”.
wave, at a default position of 110 ms after R
wave. The following figure illustrates a typical
QRS complex.

Fig. 53 - ST value in ECG parameters area

Measurement range of ST segment is between

-2.0mV to +2.0mV.
Measurement symbol of ST segment “+”
means elevating and “-“means depressing.

Fig. 52 - ST measurement algorithm

13.2 ST Analysis Window
The ST measurement for each beat complex is Pick "ST ANALYSIS “in the ECG WINDOW to
vertical difference between the two call up the following menu:
measurement points, ST and ISO.
The ST analysis examines QRS complexes
classified as normal beats (beat detection and
classification information provided by the
arrhythmia algorithm are used to eliminate beat
that are ventricular in origin). The monitor
combines the measurements and features of
normal beats into a composite (or average) Fig. 53 - ST ANALYSIS window
QRS complex. It derives the ST segment
deviation from this average. ■ ST ANALYSIS
Pick this item to enable or disable ST
The ST segment algorithm documents
monitoring. The default is OFF. When the ST
changes in ST segment in adult patients that
monitoring is disabled “ST OFF” is displayed
can be indicative of the severity and duration of
in ECG parameter area.
myocardial ischemia. Since many ischemic
episodes are silent or painless, continuous ■ ST ALARM
monitoring of ST segment changes can Pick "ON" to enable alarm functions such as
provide the earliest warning of ischemic parameters blinking, audio alarm and light
events. Indicator. Pick "OFF" to disable the alarm
NOTE: functions and there will be a " " symbol
ST monitoring is available for adult and instead of alarm limits in Parameters Area.
pediatric patient and it is not recommended ■ ALARM LEVEL
for neonates. Selectable between 1,2. Level 1 represents
the most serious case.

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 HEYER VizOR 15

■ ST LIMIT
ST alarm is activated when the ST segment
value exceeds adjusted ALARM HIGH value
or falls below adjusted ALARM LOW value.
(Range: -2 ~ +2 - step 0.1)
Default for upper limit is +0.2 and for lower
limit is -0.2.
■ EVENT DURATION
Pick this item to determine the time that a
potential ST alarm condition must persist on
ECG waveform before the monitor classifies
it as a valid alarm condition. Fig. 54 - ECG/ST ANALYSIS/DEFAULT POINT window
Available options for EVENT DURATION are
OFF, 15s, 30s, 45s and 60s. The default is As shown above, the DEFAULT POINT
OFF and alarm will be activated immediately WINDOW shows the dominant QRS
if alarm condition happens. complex template. Two vertical lines indicate
the positions of the ISO and ST points.
■ ST REALERN
Pick to start a learning procedure. The ISO: It is the base point, used to indicate the
“RELEARN” message is displayed in the baseline point of the ST analysis. The default
ECG waveform area of the screen. It takes is 80ms.
usually about 20 seconds ST: It is the ST measurement point. The
default is 110ms.
During relearn procedure the following action (Selectable between 5 to 400 ms by step of
will be done: 5ms)
- Blanks average stored dominant QRS The reference point is the position where the
complex currently displayed on the peak of R-wave locates.
DEFAULT POINT Window.
- Learns and identifies the new dominant NOTE:
QRS complex template. It is good clinical practice to check the
- New complex is displayed on DEFAULT position of ISO and ST measuring points
POINT Window. before starting ST monitoring and finishing
learning procedure.
NOTE:
You can do relearn procedure by selecting NOTE:
<ARR RELEARN> in ECG/ARR ANALYSIS In practice, the accurate determination of
window. ISO and ST measuring points requires
careful clinical evaluation.
NOTE:
The monitor automatically begins to learn a NOTE:
reference template whenever you execute The ST measurement point should be
any of the following tasks (If ST ANALYSIS adjusted if patient’s HR or ECG morphology
is ON and there is no technical ECG alarm changes significantly.
active, like CHECK LEAD):
- Turning on the monitor If the template is not established, a horizontal
- Connecting ECG cable. line will display. And if the ST ANALYSIS is
- Changing an ECG lead configuration. “OFF”, the message “ST ANALYSIS KEY IS
OFF” appears in this window.
NOTE: You may select ISO or ST, and then switch the
A yellow vertical marker with “LRN” label knob left or right to move the cursor line. When
On ST in TREND window shows the time in the cursor is at the required position, you may
which the learning procedure has been select the base point or the measurement
done. point.
■ DEFAULT POINT NOTE:
Pick "DEFAULT POINT" in the ST Abnormal QRS complex is not considered
ANALYSIS WINDOW to adjust the position in ST segment analysis.
of both ISO and ST measurement points.
When you change the ST and ISO NOTE:
measuring point on the DEFAULT POINT If pace is on (for patient with pacemaker) or
Window, the monitor recomputes the ST while learning procedure, there is no
deviation value accordingly. waveform in DEFAULT POINT Window and
you can see just ISO and ST line. In this
condition, ST value will not be measured.

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 HEYER VizOR 15

NOTE: NOTE:
A red vertical marker with “CHG” label On Arrhythmia monitoring is available for adult
ST in TREND window shows the time in and pediatric patient and it is not
which the measuring point has been recommended for neonates.
changed.
Warning
The ARR monitor can only be operated by
13.3 ST Alarm Message personnel who have passed professional
Alarm limit is activated as a follow: training and are familiar with this manual.

Alarm Situation Visual prompt Audio sound

Warning
The ARR monitor is intended for use only as
ST segment value ● ST value blinks.
ST Alarm violates adjusted ● Alarm indicator Activated an adjunct in patient assessment .It must be
alarm limits flashes.
used in conjunction with clinical signs and
symptoms.
ST messages on patient monitor include:
NOTE:
Message Cause Solution It is recommended to use ECG lead I or II to
The ST algorithm
have the best accuracy of ARR software.
has calculated
● Check the isoelectric and ST
Arrhythmia detection algorithm principle
ST OUT OF value +1mV
measuring points.
RANGE outside the high
HIGH end of the ST
● Observe the patient and treat if The arrhythmia algorithm is based on template
clinically indicated.
measurement
range.
matching. (A template is a group of beats
matching the same morphology.)The algorithm
detects QRS complexes, generates QRS
The ST algorithm
ST OUT OF
has calculated ● Check the isoelectric and ST templates and performs beat labeling. This
value -1mV outside measuring points.
RANGE
the low end of the ● Observe the patient and treat if algorithm is divided into three parts: detector,
LOW
ST measurement clinically indicated. classifier and labeling.
range.
The detector algorithm detects waves in ECG
signal that could be QRS complexes.
All alarm level for these messages is set in ST The classifier algorithm forms templates of
WINDOW. Pressing alarm silence, alarm is similar QRS complexes. During the learning
suspended for at least 120 sec. phase an initial set of QRS template is built.
Then the monitor creates a reference template
based on its identification of the patient’s
14 ARRYTHMIA Monitoring dominant QRS pattern. When a new true QRS
complex is detected, it is compared with the
14.1 General existing templates. If no match is found, a new
Arrhythmia means any disturbance or QRS template is added to the template set.
irregularity of cardiac rhythm. Stability of the The labeling algorithm analyses all templates.
cardiac rhythm is essential for sufficient Each template and the beats belonging to it
pumping function of the heart and adequate are labeled with one of the following names:
cardiac output. Maintaining adequate cardiac normal beats, ventricular beats and
output is vital for organ perfusion and survival. questionable beats.
Arrhythmia can cause a decrease in cardiac Through this process, the monitor can verify an
output. Therefore fast and accurate detection arrhythmia event’s occurrence.
of arrhythmia is critical. Parallel to this process there is an algorithm for
detection of ventricular fibrillation. Detection of
The medical professionals can use the ventricular fibrillation is based on waveform
arrhythmia analysis to evaluate patient’s analysis.
condition (such as heart rate, PVCs frequency,
rhythm and ectopic beat) and give proper
treatment.
NOTE:
If arrhythmia monitoring is “ON”, the heart
rate is calculated by the arrhythmia
software.
NOTE:
This monitor can detect up to 12 types of
arrhythmia.

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 HEYER VizOR 15

Beat and rhythm classification

Beat classification refers to the analysis of
individual beats. If the new beat’s features do
not match those of the normal template, the
new beat is classified as premature or
questionable.
The monitor uses all detected beats to
calculate the heart rate, eliminating
questionable beats from arrhythmia
Fig. 55 - PVC value in ECG parameters area
classification.
Rhythm classification refers to analysis of
sequences of beats. The monitor compares the NOTE:
sequence of the last twelve beats with the When PACE is turned ON, for patient with
sequences stored in the monitor’s memory. If it pacemaker, the system will not detect the
detects two or more events simultaneously, the arrhythmia relating to premature ventricular
monitor alarms in order of event priority. beats (including PVCs counting).

The following table describes available beat 14.2 ARR ANALYSIS Window
classifications:
Pick "ARR ANALYSIS“in the ECG WINDOW to
Arrhythmia Event and Beat Classification call up the following menu:
5 seconds pass without the detection of valid
ECG ASYSTOLE
QRS complex.
Ventricular Fibrillation: The monitor identifies
a sinusoidal waveform with fibrillation
characteristics. (Certain ventricular
tachycardias have sinusoidal waveforms
VFIB ARRHYTHMIA closely resembling those of ventricular
fibrillation. Because of the similarity of these
waveforms, the monitor may classify such
types of ventricular tachycardia as
ventricular fibrillation.)
Ventricular Tachycardia: N or more PVC’s
are detected in a time interval T= (60*(N-
VTAC ARRHYTHMIA
1))/R, where N is defined as the VTAC count
Fig. 56 - ECG/ARR ANALYSIS WINDOW
and R is defined as the VTAC rate.
Ventricular Run: Series of 3 to N-1
RUN ARRHYTHMIA consecutive PVCs with a beat to beat rate ≥
the VTAC rate. ■ ARR ANALYSIS
Accelerated Idioventricular Rhythm: Series Pick this item to enable or disable arrhythmia
AIVR ARRHYTHMIA of 3 or more PVCs with a beat to beat rate
less than the VTAC rate. monitoring. The default is “OFF”. When the
Ventricular Bigeminy: Sequence of beats
BIGEMINY ARRHYTHMIA with the pattern : normal ,PVC ,normal ,PVC,
Arrhythmia monitoring is disabled “PVCs
normal, PVC OFF” is displayed in ECG parameters area.
Ventricular Trigeminy: Sequence of beats
TRIGEMINYARRHYTHMIA with the pattern : normal , normal ,PVC
,normal , normal ,PVC ■ ARR SETUP
COUPLET ARRHYTHMIA
Ventricular Couplet: Sequence of beats with
the pattern : normal, PVC, PVC, normal,
Pick “ARR SETUP” in ARR ANALYSIS
PVC, PVC Window to call up the following menu:
Sinus Tachycardia: N or more consecutive
normal beats, with a beat to beat rate ≥
TACHY rate setting. “N” is the event count
TACHY ARRHYTHMIA
set in the ARR SETUP WINDOW.A PVC or
other abnormal beat breaks the analysis
sequence and restarts analysis.
Sinus Bradycardia: N or more consecutive
normal beats, with an average rate ≤ to
sinus bradycardia rate setting. N” is the
BRADY ARRHYTHMIA event count set in the ARR SETUP
WINDOW. A PVC or other abnormal beat
breaks the analysis sequence and restarts
analysis.
PAUS ARRHYTHMIA Actual R-R interval more than 2.1 times of
the average R-R interval.
FREQUENT PVCs More than N (event count set in the ARR
SETUP WINDOW) PVC per minute.

Premature Ventricular Contraction (PVC) is

ectopic impulse originating from ventricles,
before the normal electrical activation
sequence of the heart has occurred.
The PVC value is shown in ECG parameter
window and updated every 5 seconds. Fig. 57 - ECG/ARR ANALYSIS /ARR SETUP WINDOW

When ARR analysis is enabled, current PVC The ARR SETUP table allows you to
values are trended every 20 second and can configure arrhythmia monitoring accordingly
be reviewed on the TREND window. to your patient’s needs. All detectable
arrhythmia events listed in the first column of

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 HEYER VizOR 15

the table .Using the remaining columns, you TACHY: Selectable between 5 and 12 by
can modify the attributes of each event. step of 1.
Fields that are not applicable for certain BRADY: Selectable between 5 and 12 by
event category are shown with dash symbol, step of 1.
while those that cannot be modified are FREQUENT PVCs: Selectable between 1
ghosted. and 15 by step of 1.
Modifying arrhythmia settings: ● ARCHIVE
1. Scroll the cursor frame to parameters You can determine whether the selected
whose arrhythmia functions you wish to event is stored, recorded automatically or
configure and click. both. You can view stored events on ARR
2. Scroll to the function you wish to modify. EVENT RECALL Window.
(The first column, “ALARM LEVEL “, is STR: Stores selected arrhythmia event.
highlighted when you first click on a REC: Automatically generates a recording of
parameter.) selected event.
3. Click to access settings of the selected STR/REC: Event stored and recorded.(even
arrhythmia function. when event alarm is turned off)
4. Dial through settings and click to confirm OFF: No action if arrhythmia event activates.
your selection.
5. Repeat step 1-4 to configure additional ● ALL ALARM LEVEL
arrhythmia functions or parameters. Press to set the level of all arrhythmia alarms
to the same value.
● ALARM LEVEL
Available options are 1, 2 and OFF to set the ● ALL ARCHIVE
grade of alarm for every arrhythmia event. Press to set all arrhythmia ARCHIVE
(For more detail about alarm levels refer to condition to the same state.
chapter 3.)
Pick "OFF" to disable the alarm functions of ■ ARR EVENT RECALL
selected arrhythmia. Pick " ARR EVENT RECALL” in ARR
ALARM LEVEL for “ASYSTOLE” cannot be ANALYSIS WINDOW to call up the following
modified and always is in level 1. menu:

● RATE
With count, you can determine the point at
which an event call is triggered.
You can’t modify the rate for “ASYSTOLE”
,”VFIB”, ”COUPLET”, ”BIGEMINY”
,”TRIGEMINY”, “PAUS” and “FREQUENT
PVCs”.
“RUN” and “AIVR” derive their settings from
“VTAC” and cannot be modified. They are
included to quantify their derivation, based
on current “VTAC” values.
VTAC: Selectable between 100 and 200 by
step of 10.
RUN: Same as VTAC rate
Fig. 58 - ECG/ARR ANALYSIS /ARR EVENT RECALL
AIVR: ≤ VTAC rate-1
TACHY: Selectable between 100 and 200 by You can review any stored arrhythmia event
step of 10. (maximum 80 events) in this menu.
BRADY: Selectable between 30 and 105 by
step of 5. ■ To review different event pages:
Maximum of 8 arrhythmia events can be
● COUNT displayed in the window simultaneously.
With rate, you can determine the point at When there is more than 8 events, different
which an event call is triggered. pages are available. Pick the most left item
You can’t modify the count for “ASYSTOLE”, to review different pages.
”VFIB”, ”COUPLET”, ”BIGEMINY”,
”TRIGEMINY” and “PAUS”. ■ To select an arrhythmia event:
VTAC: Selectable between 5 and 12 by step Pick the second left item to select an
of 1. arrhythmia event displayed in the window.
RUN: Selectable between 3 and VTACcount
-1 by step of 1.
AIVR: Count≥3

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 HEYER VizOR 15

■ To delete an arrhythmia event: NOTE:

Pick the forth left item to choose an If the monitor couldn’t find 6 matching
arrhythmia event for removing from list. beats after 20 seconds, the relearn
When you use this item the selected event procedure is continuing and the
will be highlighted, and removed if you exit “RELEARN” message is remaining on
the window. display, till acceptable condition is
happened.
NOTE:
To ignore deleting a selected item, click on NOTE:
the “DEL/UNDEL” key one more time before While the monitor is in learning phase, all
exiting from this window. arrhythmia alarms and trend collection are
■ To see detail information of arrhythmia suspended.
event:
Pick the third left item to call up the following NOTE:
window: Before starting learning procedure, verify
the quality of the ECG signal and ensure
that the patient’s ECG displays a normal
reference pattern.

NOTE:
The monitor automatically begins to learn a
reference template whenever you execute
any of the following tasks (If ARR
ANALYSIS is ON and there is no technical
ECG alarm active, like CHECK LEAD):
- Turning on the monitor
- Connecting ECG cable.
- Changing an ECG lead configuration.

NOTE:
Fig. 59 - ECG/ARR ANALYSIS /ARR EVENT RECALL/WAVE window
It is recommended to perform relearn
In this window, waveform and time of procedure under the following conditions:
selected arrhythmia event are displayed as - A lead is reconnected or electrodes
well as the parameter values at the event are repositioned.
time. - Eight hours have passed since last
reference complex learned.
● UP-DOWN - Other significant changes appear on
This option allows you to page up and down the morphology of the patient’s ECG.
to review the waveform and the parameters
of other arrhythmia events.

■ ARR RELEARN
Pick to start a learning procedure. The
“RELEARN” message is displayed in the
ECG waveform area of the screen.

NOTE:
You can do relearn procedure by selecting
<ST RELEARN> in ECG/ST ANALYSIS
window.
NOTE:
In most situations the learning phase takes
about 20 second.

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 HEYER VizOR 15

15 RECORDING system has internal recorder option and it is

enabled).
15.1 General Freeze Waveform Recording
The bedside monitor has an option of thermal The monitor prints out 20 seconds of the
dot matrix recorder. Depending on customer's selected waveforms and numeric parameters
order, a recording module can be installed on in FROZEN mode. So you can freeze the
vital sign monitor optionally. abnormal waveforms on the screen and record
it.
Performance of the Recorder
■ Recorder sweep is selectable between TREND Recording
12.5, 25 and 50 mm/s. The monitor can print out the trend graph and
■ Up to 2 selectable waveforms recording. numeric parameters in the current TREND
■ The real time and freeze recording. WINDOW. Pick "RECORD" in TREND
■ The selectable automatic time interval WINDOW to start recording.
recording. NIBP LIST Recording
■ The selectable automatic alarm recording.
The monitor can print out entire of the list in
NIBP LIST WINDOW. Pick "RECORD" in NIBP
15.2 Recording Type LIST WINDOW to start recording.
Monitor provides several recording types: ARR EVENT LIST Recording
■ Continuous real-time recording The monitor can print out entire of the list in
■ 20 seconds real-time recording. ARR EVENT LIST WINDOW. Pick "RECORD"
■ 10 seconds automatic recording. in ARR EVENT LIST WINDOW to start
■ Parameters alarm recording. recording.
■ Arrhythmia alarm recording.
■ Frozen waveform recording. ARR WAVEFORM Recording
■ TREND recording. The monitor can print out stored arrhythmia
■ NIBP LIST recording. waveforms in ARR WAVE/ARR EVENT LIST
■ ARR EVENT LIST recording. WINDOW. Pick "RECORD" in this window to
■ ARR WAVE recording. start recording.

Manual recording 15.3 Recorder Operation And Status

Continuous real-time recording starts from last
Messages
5 seconds when you press the “Rec/Stop” key
and stops when you press it again. Notes on Recording
20 seconds real time recording starts from last ■ Recording Type:
5 seconds when you press “Rec/Stop” and it MANUAL RECORD
will automatically stops after 20 seconds. PERIODIC RECORD
ALARM RECORD (name of the alarm
Automatic Recording
parameter)
The monitor starts the recording for 10
FREEZE RECORD
seconds according to interval time set in the
(Parameter) TREND RECORD
"PERIODIC INTERVAL" of the "RECORDER
NIBP LIST RECORD
WINDOW" menu. Refer to 3.6 Recorder for
ARR EVENT LIST RECORD
details.
ARR WAVEFORM RECORD
Alarm Recording ■ Recording Date and Time
If “ALARM REC” is set ”ON” in each ■ Bed number
parameter’s window, the system automatically ■ Patient name, Patient ID, Gender, Height,
starts recording when an alarm occurs. Alarm Weight, Date of birth
recording is activated when the numeric ■ Parameter name and value
parameters violate adjusted alarm limits or ■ Sweep Speed
when an arrhythmia event occurs. ■ ECG lead and gain or RESP lead on the
When an alarm of parameters has occurred waveform
only numeric parameters will be recorded and ■ Hospital and ward name
parameter’s value that triggered the alarm ■ Dr Name
record, marked with an arrow.
During HR alarm recording, the monitor also
records 20 seconds ECG waveform.
You can ”ON” or ” OFF” alarm recording in
HOME /RECORDERWINDOW and also it can
be set in each parameters menu (When the

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 HEYER VizOR 15

15.4 Recorder Paper NOTE:

Be careful when inserting paper. Avoid
You should use 50mm paper for recorder. damaging the thermo sensitive print head.
NOTE: Do not touch thermo sensitive print head.
Use only manufacturer recommended white NOTE:
thermo sensitive record paper, otherwise It is recommended to use the paper with
the recording quality may be poor and the colored marks intended to aware that the
thermo sensitive print head may be paper is near to finish. Otherwise, the
damaged. operator should be sure about sufficient
NOTE: paper for recording.
Do not use grid paper.
15.5 Recorder Status Message
NOTE:
Do not use paper with edges that are Message Cause Solution
pasted or have turnups at the start of the Rec. Software
Turning the system off and then on
Software error if problem exist again contact to
roll. If they need to be used unavoidably, Error
after sales service of manufacturer.
replace with new paper roll as soon as Recorder
Turning the system off and then on
Hardware error if problem exist again contact to
possible before entire roll is used up. Fault
after sales service of manufacturer.

The recorder door is

Warning Door Open
open
Close the recorder door.

Do not touch the recorder head while recording

and immediately after recording because it is Out of Paper Record paper finished. Insert recorder paper.
so hot and may lead to personal injury
including burns. Print head The thermal head is
Stop operation for some minutes.
High Temp too hot.
Warning
Turning the system off and then on
While the recorder is working, the record paper Print head Print head voltage is
if problem exist again contact to
High Vol. high.
after sales service of manufacturer.
goes out steadily. By pulling the paper, the Turning the system off and then on
Print head Print head voltage is
recorder will be damaged. Low Vol. low.
if problem exist again contact to
after sales service of manufacturer.
Turning the system off and then on
Loading the paper: Time out Error
The recorder could not
record.
if problem exist again contact to
after sales service of manufacturer.
■ Pull down the switch on the recorder case.
■ Insert a new roll of paper into the paper
cassette. Printing side of the paper should 15.6 Recorder Cleaning
face the thermo sensitive print head.
■ Close the recorder door. When foreign matter adheres between the
thermal head and platen roller, it may cause
NOTE: print failure. If accumulation of paper powder or
Thermo sensitive surface of paper should foreign matter is seen, or print quality seems to
be placed facing the head. Be sure to place have deteriorated, clean the thermal head and
the paper correctly. platen roller.
Clean the head elements and platen roller
surface using alcohol and a cotton swab. Wait
until the alcohol dries then close the recorder
door.
Warning
Do not clean the printer immediately after
printing because thermal head and its
a. incorrect placement b. correct placement
periphery are hot during and after printing.
Fig. 60 - Recorder paper placement
NOTE:
NOTE: Do not use sandpaper, cutter knifes etc.
The paper detector may not operate when cleaning. They will damage the heat
properly if covered with foreign matter. element.
Therefore, if you find foreign matter on the
sensor, remove it and clean the sensor.
NOTE:
If the paper is jammed, open the recorder
door and remove the paper. Do not pull the
paper by force.

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 HEYER VizOR 15

16 Patient Safety of the protective grounding wire, the equipment

must be operated with internal battery or DC
The Patient Monitor is designed to comply with input.
the international safety standard requirements
Equipotential Grounding
for medical electrical equipment. This device
Protection class I instruments are already
has floating inputs and is protected against the
included in the protective grounding (protective
effects of defibrillation and ESU. If the correct
earth) system of the room by way of grounding
electrodes are used and applied in accordance
contacts in the power plug. For internal
with the manufacturer instructions, the screen
examinations on the heart or the brain, the
display will recover within 10 seconds after
portable Patient Monitor must have a separate
defibrillation.
connection to the equipotential grounding
system. One end of the equipotential
grounding cable (potential equalization
conductor) is connected to the equipotential
This symbol indicates that the monitor is CF
grounding terminal on the rear panel of the
type according to IEC-601-1. The module with
monitor and the other end to one point of the
this symbol contains an F- Type isolated
equipotential grounding system.
(floating) patient applied part providing a high
The equipotential grounding system is for the
degree of protection against shock, and is
safety function of the protective grounding
usable during defibrillation.
conductor if ever there is a break in the
protective grounding system. Examinations in
or on the heart (or brain) should only be carried
out in medically used rooms incorporating an
This symbol indicates that the monitor is BF
equipotential grounding system. Check each
type according to IEC-601-1. The module with
time before use that the instrument is in perfect
this symbol contains an F- Type isolated
working order.
(floating) patient applied part which contains an
adequate degree of protection against shock, Warning
and is usable during defibrillation Possible explosion hazard if used in the
presence of flammable anesthetics.
Note:
Type BF applied parts are not suitable for
Explanation of Symbols in the Monitor
direct cardiac application.
Warning
Do not touch the patient, bed or instrument
during defibrillation. This symbol means "BE CAREFUL". Refer to
the manual.
Follow the instructions below to ensure a
completely safe electrical installation.
The environment where the Portable Patient
Monitor will be used should be reasonably free Equipotential grounding system.
from vibration, dust, corrosive or explosive
gases, extremes of temperature, humidity and
so on.
The Patient Monitor operates within
specifications at ambient temperatures
between 0ºC and 40ºC. Ambient temperatures
that exceed these limits could affect the
accuracy of the monitor and cause damage to
the modules and circuits.
Grounding the patient monitor
To protect the patient and hospital personnel,
the case of patient monitor must be grounded.
The patient monitor is equipped with a
detachable 3-wire cable which grounds the
instrument to the power line ground (protective
earth) when plugged into an appropriate 3-wire
receptacle. If a 3-wire receptacle is not
available, consult the hospital electricians. If
there is any doubt regarding the completeness

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 HEYER VizOR 15

17 Care And Cleaning 3. Don't let the cleaning agent enter into
the chassis of the system.
Before using the monitor, do the following: 4. Don't leave the cleaning agents on any
■ Check if there is any mechanical damage on part of the equipment.
the system and accessories.
The monitor and sensor surface can be
■ Check if all the power cable and accessories
cleaned with hospital-grade ethanol and dried
are firmly connected.
in air or with a clean cloth.
■ Check if all the functions of keyboard and
modules to make sure that the monitor is in
proper condition. 17.2 Sterilization
If you find any damage on the monitor, stop To avoid extended damage to the equipment,
using the monitor on patient, and contact the sterilization is only recommended when
biomedical engineer of the hospital or local stipulated as necessary in the Hospital
after sale service. Maintenance Schedule.
The overall check of the monitor, including the Recommended sterilization material: Activated
safety check, should be performed only by dialdehyde (Cidex).
qualified personnel.
All the checks that need to open the monitor Caution
and the safety check and maintenance should ■ Do not let liquid enter the monitor.
be performed by after sales service. ■ No part of the monitor can be subjected
to immersion in liquid.
Note: ■ Do not pour liquid onto the monitor
It is recommended to calibrate the system during sterilization.
by manufacturer every 2 years. The IBP and ■ Use a moistened cloth to wipe up any
capnography modules should be calibrated agent remaining on the monitor.
every 6 month.
Warning 17.3 Disinfection
If users do not follow a satisfactory
Examples of disinfectants that can be used for
maintenance schedule, the monitor may
the case of monitor are listed below:
become invalid, and human health may be
■ Hydrogen Peroxide 3%
endangered.
■ Alcohol 70%
Note: ■ Isopropanol
To ensure maximum battery life, it is ■ Enpropanol
recommended that, at least once a month,
To avoid extended damage to the equipment,
the monitor be run on battery until it turns
disinfection is only recommended when
itself off and then recharged (for details
stipulated as necessary in the Hospital
about battery care see 2.6).
Maintenance Schedule.

17.1 Cleaning Caution

Do not use EtO gas to disinfect the monitor.
Warning
Before cleaning the monitor or the sensor, NOTE:
make sure that the equipment is switched off Manufacturer has no responsibility for the
and disconnected from the power line. effectiveness of controlling infectious
disease using these chemical agents.
The patient monitor must be kept dust-free. Please contact infectious disease experts
Regular cleaning of the monitor shell and the in your hospital for details.
screen is strongly recommended. Use
detergents such as soap and water to clean NOTE:
the monitor shell. Do cleaning, sterilization and disinfection
of slave monitor same as the bed side
NOTE: monitor.
Please pay special attention to the
following items: Appropriate cleaning, sterilization and
1. Most cleaning agents must be diluted disinfection materials for accessories are
before use. Follow the manufacturer's introduced in each module's chapters.
direction carefully to avoid damaging
the monitor.
2. Don't use rough material, such as steel
wool etc.

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 HEYER VizOR 15

18 Getting Started NOTE:

The battery must be recharged after each
18.1 Open The Package And Check use to ensure adequate electricity reserve.
To do so, you only connect the system to
Open the package and take out the monitor AC INPUT.
and accessories carefully. Keep the package
for possible future transportation or storage. Warning
If any sign of damage is detected, or the
■ Check for any mechanical damage. monitor displays any error messages, do not
■ Check for the existence of the power cable use it on any patient. Contact biomedical
and accessories. engineer in the hospital or local after sale
If there is any problem, contact the distributor service immediately.
immediately.
18.5 Connect Patient Sensors
18.2 Place The Battery Fuse Connect all the necessary accessories
When you use the system for the fist time, you between the monitor and the patient.
should place the fuse on the rear panel. NOTE:
For information on correct connection,
18.3 Connect The Power Cables refer to each module's chapter.
Connection procedure of the AC power line:
■ Make sure the AC power supply complies
with following specification: 200-240 VAC,
50 /60Hz
■ Apply the power cable provided with the
monitor. Plug the power cable to power
supply socket of the monitor. Connect the
other end of the power cable to a grounded
3-wire power receptacle.
NOTE:
Make sure that the battery indicator lights.
If it does not light, check your local power
supply and power cable connection. If the
problem still exists, contact the local after
sale service.
NOTE:
The battery needs to be charged after
transportation or storage. If the power
supply is not properly connected before
turning on the monitor, it may not work
properly because of insufficient power.
Connect the power supply to charge the
battery for about 24 hours.

18.4 Power On The Monitor

Press POWER to power on the monitor. At the
same time a beep will be heard and yellow and
red indicator light about 2.5 seconds
separately. After 30 seconds or so, the system
will display the monitoring screen after self-
test, and you can perform normal monitoring
now.
NOTE:
Check all the functions of modules that
may be used and make sure that the
monitor is in good connection.

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19 Technical Specification
CLASSIFICATION

Protection against electroshock Class I, Type CF for all modules (except Multi-gas module that is BF)
(based on IEC 60601-1)
Mode of operation Continues operation equipment
Harmful liquid proof degree Ordinary equipment (without liquid proof)
Method of sterilization and disinfection Refer to each module's chapters and chapter 17 for detail.
Safety of anesthetic mixture Not suitable for use in the presence of a flammable anesthetic mixture
with air or with oxygen or nitrous oxide.

DISPLAY

VizOR display TFT COLOR 1024 × 768, 15”

Waveforms ECG, SPO2, IBP1, IBP2, RESP/GAS, EEG (freezable)
Numeric parameters HR,PVCs,ST,SPO2, NIBP (SYS, DIA, MAP) , IBP1 (SYS, DIA, MAP),
IBP2 (SYS, DIA, MAP), RR, T1, T2, DT, EtCO2, FiCO2, AWRR, EtN2O,
FiN2O, EtO2, FiO2, EtAA, FiAA, CSI, BS%, EMG%, SQI%
Operation method Membrane and rotary knob

ECG

Leads Selectable 3 or 5 wires

For 3 wire: I, II, III
For 5 wire :I, II, III, V, aVR, aVF, aVL
Dynamic range ± 5 mV
Leakage current < 10 µA
Lead off current < 90 nA
Gain 4, 2, 1, 1/2, 1/4, Auto
Calibration 1mV, 0.5 sec
Filters “MONITOR” (0.5 - 28 Hz)
“NORMAL” (0.5 - 40 Hz)
“EXTENDED” (0.05-100 Hz)
CMRR > 98 dB
Internal noise < 30 µV RTI
Input impedance > 5 MOhm
QRS detection Duration: 40 to 120 msec
Amplitude: 0.3 to 5 mV for adult
0.2 to 5 mV for neonate
Heart rate range 15 - 300 bpm for adult
15 - 350 bpm for neonate
Accuracy ±1% or 2 bpm
Tall T-wave Reject up to 1.2 mV Amp.
Pacer detection/rejection Duration: 0.1 - 2 msec
Amp: ±2 to ± 700 mV (without over/undershoot)
Reject from heart rate counter
Re-insert into ECG to display on screen
Protection Defibrillator and electrosurgery
Standards ANSI/AAMI EC-13

ARRHYTHMIA ANALYSIS

Type ASYS, VFIB, VTAC, RUN, AIVR, COUPLET, BIGEMINY, TRIGEMINY,

TACHY, BRADY, PAUS, FREQUENT PVCs
Learning Rapid learning: only 20 seconds required for recognition of dominant
rhythm.
Method Real time arrhythmia detection with innovative feature.
Memory Capability of storing the latest 80 ARR event (waveform and
parameters).

ST ANALYSIS

Display resolution: 0.01 mV

Measurement range -2mv to +2mv
Alarm range: -2mv to +2mv
Features: User adjustable Isoelectric and ST Point Trending of ST Values
Update period: 5 Sec.

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 HEYER VizOR 15

NIBP

Measurement method Oscillometric

Measurement mode Manual / automatic
Measurement time 18-26 sec (excluding cuff pressurization time)
Measurement range Adult: SYS 25 ~ 250 mmHg
DIA 10 ~ 220 mmHg
MAP 15 ~ 250 mmHg
Neonate: SYS 25 ~ 135 mmHg
DIA 10 ~ 110 mmHg
MAP 15 ~ 125 mmHg
Pressure transducer accuracy ±3 mmHg full range
Initial inflation target Adult 150 mmHg , Neonate 70 mmHg
Overall system efficacy Meet ANSI/AAMI SP-10/1992
Memory 100 records

SpO2 (Pulse Oximetry)

Method 2 wave length pulse wave type

Range 50 to 100 %
Accuracy 2% (SpO2 71 ~ 100%)
3% (SpO2 50 ~ 70%)
Pulse rate range 25 - 250 BPM

TEMPERATURE

Probe type YSI-700/ YSI 400 Compatible

Range 0 - 50 °C
Accuracy ± 0.2 °C

RESPIRATION

Method Impedance
Base resistance 250 -1250 Ohm
Dynamic range 0.2 - 2 Ohm
Breath rate range 6 - 150 BrPM
Accuracy ±2% or 2 BrPM

IBP

Channel 2
Measurement Range SYS -50 ~ 300 mmHg
DIA -50 ~ 300 mmHg
MAP -50 ~ 300 mmHg
Pressure Filter 8 Hz,16 Hz, 22Hz selectable
Press Sensor Sensitivity 5 µV / V / mmHg
Press Sensor Impedance 300 ~ 2500 Ohm
Resolution 1 mmHg
Accuracy 2 % or 2 mmHg each one is greater

Multi-gas (Mainstream)

Method Infrared absorption

Measuring mode Mainstream
IRMA harmful liquid proof degree IPX1
Et and Fi parameters
IRMA CO2: CO2 ,CO2 waveform
IRMA OR: CO2, O2, N2O, Anesthesia Agent (HAL, ISO, ENF, SEV,
DES) 5 selectable waveform
IRMA AX+: CO2, N2O, Anesthesia Agent (HAL, ISO, ENF, SEV, DES), 5
selectable waveform, automatic agent identification
Sensor head 3-10 channel NDIR type gas analyzer measuring at 4-10µm.
Pressure, temperature and full spectral interference correction.
Sensor dimension (W×D×H) 37×27×25 mm
Sensor weight < 30g (cable exclude)
Oxygen sensor integrated ultra-fast response time galvanic oxygen sensor.
> 62500 oxygen hours
Calibration No routine calibration required.
Room air calibration of O2 sensor performed automatically when
changing airway adapter (< 5 sec)
Warm-up time Concentrations reported in less than 10 sec, full accuracy with in 1
minute

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 HEYER VizOR 15

Rise time (@10 l/min) CO2 ≤ 90ms

O2 ≤ 300ms
N2O ≤ 300ms
HAL, ISO, SEV, ENF, DES ≤ 300ms
Delay time ≤ 140ms
Primary agent threshold 0.2 % V/V
Secondary agent threshold 0.2 % +10 % of total agent concentration
Agent identification time < 20 seconds
Total system response time < 1 second
AWRR measuring range 3~100BrPM
Accuracy specifications-during standard conditions:
Gas measuring range accuracy
CO2 0~10% ±(0.2%ABS+2%REL)
10~20% Unspecified
N2O 0-100% ±(0.2%ABS+2%REL)
HAL, ISO, ENF 0-5% ±(0.15%ABS+5%REL)
5-12% Unspecified
SEV 0-8% ±(0.15%ABS+5%REL)
8-15% Unspecified
DES 0-18% ±(0.15%ABS+7%REL)
18-22% Unspecified
O2 0-10% Unspecified
10-100% ±(1%ABS+2%REL)
Accuracy specification-during all condition
CO2 ±(0.3%ABS or ±4%REL)
N2O ±(2%ABS or ±5%REL)
Single agent ±(0.2%ABS or ±10%REL)
Dual agent ±(0.2%ABS or ±10% of total agent
concentration)
O2 ±(2%ABS+2%REL)

Note 1: The accuracy specification is valid for all specified environment conditions, and includes effects from the following
interfering gases: N2O, O2, HAL, ISO, ENF, SEV, DES, Ethanol, Isopropyl alcohol, Acetone, Methane, He. See Appendix IV for
effects from water vapour partial pressure on gas reading.
Note 2: The accuracy specification is not valid if more than one gas for IRMA OR and more than two gases for IRMA AX+ are in
the gas mixture.

RECORDER

Model Thermal Printer

Printing speed 12.5, 25, 50 mm/sec
Paper 58mm by 20 m roll

ALARM

Sources Error messages, all other parameter limits

Alarm on/off Selectable for all parameters
Alert Blinking on display
Volume selectable audio alarms
Light indicator

TREND

Sources HR, PVCs, ST, SPO2, NIBP, RR, T1, T2, IBP1 (SYS, DIA, MAP), IBP2
(SYS, DIA, MAP), EtCO2, FiCO2, AWRR (sidestream, mainstream),
EtN20, FiN2O, EtO2, FiO2, EtAA, FiAA (ISO, DES, ENF, HAL, SEV)
Trend time 1, 2, 4, 8, 16, 24 hours
Resolution 20 sec

INPUT/OUTPUT

Network Digital, Serial, RS422, Full Duplex

Connection 8/12 BED to One CENTRAL system

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 HEYER VizOR 15

GENERAL

Safety Based on IEC 60601-1, Class I

Protection Against electro surgery and defibrillator
AC Power 90 - 260 VAC, 50/60 Hz
Internal Battery Sealed lead acid, rechargeable, 12 V, 3.3 AH
Usage: 80 min (Full Charge)
DC Power Plug 12-14 V, maximum 3 A (without recorder)
Maximum 6 A (With Recorder)
VizOR 15 Dimension 42 (W) × 36 (H) × 17 (D)
Weight 6 kg (approximately)

ENVIRONMENTAL

Temperature Operating: 5 to 40 °C
Storage: -20 to 60 °C
For gas module Operating: 10-35 °C
Storage: -20 to 50 °C
Humidity 20-90 % (non condensing)
Altitude -200 to 3000 m

0044

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 HEYER VizOR 15

20 Trouble Shooting
Repairing the internal parts of the monitor must be only done by trained and authorized personnel
of after sale service; otherwise manufacturer will not take any responsibility for any possible
hazard to the patient and the monitor.
Troubleshooting guide is intended to help users to solve minor problems caused by incorrect use
of the monitor or failure of accessories.
When you face any problem, please be sure that you have followed all procedure mentioned in
correct action column before you contact with after sale service.

Fault Symptoms Possible Cause Correct Action

Not to be turned on ● Check POWER AC path
● Call for service
Unable to work with ● Battery is discharged ● Charge the battery for 10 hours
battery ● Fuse of battery is faulty ● Check fuse existence
● Others ● Call for service
NO ECG waveform ● ECG cable is not connected correctly ● Connect ECG cable correctly
● Bad placement of leads and electrodes ● Check leads and electrodes.
● Others ● Don’t use old and faulty electrodes
● Call for service
Noisy ECG waveform ● Loose connection of electrodes ● Check electrodes and leads
● Earth connection failure ● Check earth
● Wrong ECG filter ● Set filter mode correctly
● Others ● Call for service
Spike on ECG ● If "PACE ON" for patient without pace ● Turn “Paced detect” OFF in ECG menu
waveform marker, ECG noise will be received as
PACE.
● Others
Unstable HR ● ECG signal is noisy or isn’t suitable ● Check leads and electrodes.
● Others ● Change lead to display the best ECG signal
● Call for service
No “RESP” signal ● Electrodes are not connected correctly ● Check leads and electrodes.
No good waveform ● Patient move during measurement ● Change RESP lead
Unstable RR ● Others ● Calm patient
● Call for service
Strange T1,T2 ● Location of sensor isn’t suitable ● Put the sensor in suitable place
● Faulty sensor ● Change sensor
● Others ● Call for service
No SPO2 waveform ● SPO2 probe in an unsuitable place ● Change the place of probe on patient
Noisy waveform ● Faulty sensor ● Change probe
● Others ● Call for service
Strange SPO2 value ● Patient movement during measurement ● Calm patient
● Probe is in an unsuitable place. ● Change the place of probe
● Others ● Call for service
NIBP can not inflate ● Incorrect air hose connection. ● Check connection
● Air hose occluded or tangled. ● Check air hose
● Air hose or cuff leakage ● Change faulty accessory
● Others ● Call for service
NIBP measurement is ● No cuff or air hose is connected ● Check cuff and air hose
not successful strange ● Wrong cuff placement ● Change cuff placement
NIBP value. ● Patient movement during measurement ● Calm patient
● Others ● Call for service
Strange IBP value ● No zeroing before use ● Zeroing
Noisy IBP signal ● Noisy source exists near by system or ● Keep system and cable away from noise
accessories source
● faulty sensor ● Change sensor
● Others ● Call for service

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 HEYER VizOR 15

21 Warranty

Warranty declaration by HEYER Medical AG

In addition to the legal warranty acc. to HBG §377, HEYER MEDICAL AG shall grant a warranty of 12
months for the purchase of a new apparatus from the HEYER product range. The warranty period
begins with the date of invoice and is subject to the following conditions:

1. Within the warranty period we will eliminate free of charge any defects or damages on the device that are shown to be
caused by a manufacturing or material error. The warranty does not include easily breakable parts, e.g. glass or
consumable parts.

2. Warranty services can only claimed upon submission of a delivery note (bill of delivery or invoice); the type and method
of damage remedy (repair or replacement) shall be at the discretion of HEYER MEDICAL AG. Warranty services do not
result in an extension of the warranty period, nor do they entail a new warranty being granted. There is no independent
warranty period for installed spare parts.

3. Excluded from the warranty are: Damages caused by improper use, operating errors, mechanical stress or non-
observance of the operating instructions, as well as damages caused by force majeure or by extraordinary
environmental conditions.

4. Warranty services may only be claimed if proof is submitted to confirm that all service and maintenance work has been
carried out by authorized staff.

5. The warranty includes all faults that impair a faultless functioning of the device on the basis of technical defects of
individual components. The warranty obligation can only be recognized by us if the device has been used properly and
according to its intended use and no repair attempts have been undertaken by the client himself or by third parties. The
warranty claim does not include faults caused by mechanical damages or if the device is being operated with
accessories originating from third parties.

6. The warranty is also void if changes, alterations or repairs are made to the device by persons not authorized to do this.

7. The warranty claim only applies to customers of HEYER MEDICAL AG; it cannot be transferred to third parties.

8. The rejected device is to be shipped back to our plant postage free. In case of a request by our customer service
department, the costs for shipping to the plant are to be initially generally borne by the customer. After successful repair,
we will send the device back freight collect. If HEYER MEDICAL AG confirms the existence of a warranty claim, the
customer will receive reimbursement for the costs of delivery and/or transport of the apparatus. Repair parts that do not
fall under the warranty claim will be billed by us. The shipping of the device to us always counts as a complete
assignment to eliminate all faults and/or replace missing parts, unless the customer expressly excludes partial services.
Additional claims to transfer or reduce and replace damages of any kind in particular also of damages not incurred on
the object of delivery itself are excluded.

Our service address: HEYER Medical AG

Carl-Heyer-Straße 1-3
D-56130 Bad Ems / Germany
Tel.: +49 (0) 2603 791-3
Fax: +49 (0) 2603 70 424

Subject to technical changes!

Rev. No.: 1.0 dated 04.2008

72 / 88 HEYER VizOR 15, Operator’s manual Rev. 1.0 - 09/09

 HEYER VizOR 15

APPENDIX I
List of monitor’s parameters (selection and defaults)

Menu item Selection Default

The parameters in ECG menu
ECG LEAD I,II,III,V,aVR,aVF,aVL II
ECG GAIN ×0.25,×0.5,×1,×2,×4,AUTO AUTO
ECG SWEEP 12.5,25,50mm/s 25
ALARM LEVEL 1,2 1
HR ALARM ON,OFF OFF
HR HIGH ALARM HR LOW ALARM +5 to 250 150Bpm
HR LOW ALARM 30 to HR HIGH ALARM -5 50Bpm
ECG FILTER MONITOR,NORMAL,EXTENDED NORMAL
HR SOURCE ECG,SPO2,AUTO AUTO
BEAT VOLUME 1,2,3,4,5,6,7,OFF 2
PACE DETECT ON,OFF OFF
ECG CALIB ON,OFF OFF
ECG AVERAGE 4,8,16SEC 8SEC
LEAD TYPE 3LEAD,5 LEAD 3LEAD
The parameters in RESP menu
RESP LEAD. RA-LA,RA-LL RA-LA
RESP GAIN ×0.25,×0.5,×1,×2,×4 ×1
RESP SWEEP 3,6,12,25mm/s 12mm/s
ALARM LEVEL 1,2 1
RR ALARM ON ,OFF OFF
RR HIGH ALARM RR LOW ALARM +1 to 150 25Brpm
RR LOW ALARM 5 to RR HIGH ALARM -1 5Brpm
APNEA LIMIT 10 to 40S 10S
The parameters in SPO2 menu
SPO2 RESPONSE SLOW ,NORMAL,FAST NORMAL
SPO2 PLETH SWEEP 12.5,25mm/s 25mm/s
ALARM LEVEL 1,2 1
SPO2 ALARM ON,OFF OFF
SPO2 HIGH ALARM SPO2 LOW ALARM +1 to 100 100
SPO2 LOW ALARM 20 to SPO2 HIGH ALARM -1 85
SPO2 SENSITVITY NORMAL , MAX NORMAL
The parameters in NIBP menu
NIBP UNIT mmHg , KPa mmHg
ALARM LEVEL 1,2 1
NIBP ALARM ON,OFF OFF
SYS HIGH ALARM SYS LOW ALARM +5 to 240 150 mmHg
SYS LOW ALARM 30 to SYS HIGH ALARM -5 80 mmHg
DIA HIGH ALARM DIA LOW ALARM +5 to 180 120 mmHg
DIA LOW ALARM 20 to DIA HIGH ALARM -5 60 mmHg
MAP HIGH ALARM MAP LOW ALARM +5 to 200 150 mmHg
MAP LOW ALARM 25 to MAP HIGH ALARM -5 80 mmHg

3min,5min,10min,15min,30min,1hr
AUTO/MANUAL MANUAL
2hr,4hr,MANUAL

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 HEYER VizOR 15

The parameters in TEMP menu

TEMP UNIT ºC,ºF ºC
ALARM LEVEL 1,2 1
TEMP ALARM ON ,OFF OFF
T1 HIGH ALARM T1 LOW ALARM +1 to 50 39
T1 LOW ALARM 0 to T1 HIGH ALARM -1 35
T2 HIGH ALARM T2 LOW ALARM +1 to 50 40
T2 LOW ALARM 0 to T2 HIGH ALARM -1 36
DT HIGH ALARM DT LOW ALARM +1 to 50 50
DT LOW ALARM 0 to DT HIGH ALARM -1 0
The parameters in IBP menu
IBP UNIT mmHg , KPa,cmH2O mmHg
ALARM LEVEL 1,2 1
IBP ALARM ON,OFF OFF
ART HIGH ALARM ART LOW ALARM +5 to 300 200 mmHg
ART LOW ALARM -50to ART HIGH ALARM -5 40 mmHg
LVP HIGH ALARM LVP LOW ALARM +5 to 300 200 mmHg
LVP LOW ALARM -50 to LVP HIGH ALARM -5 -20 mmHg
PAP HIGH ALARM PAP LOW ALARM +1 to 120 80 mmHg
PAP LOW ALARM -50 to PAP HIGH ALARM -1 -10 mmHg
RVP HIGH ALARM RVP LOW ALARM +1 to 100 80 mmHg
RVP LOW ALARM -50 to RVP HIGH ALARM -1 -10 mmHg
CVP HIGH ALARM CVP LOW ALARM +1 to 100 30 mmHg
CVP LOW ALARM -50 to CVP HIGH ALARM -1 -10 mmHg
LAP HIGH ALARM LAP LOW ALARM +1 to 100 40 mmHg
LAP LOW ALARM -50 to LAP HIGH ALARM -1 -10 mmHg
RAP HIGH ALARM RAP LOW ALARM +1 to 100 30 mmHg
RAP LOW ALARM -50 to RAP HIGH ALARM -1 -10 mmHg
The Parameters in GAS WINDOW (mainstream)
CO2 UNIT KPa ,%V ,mmHg mmHg
GAS UNIT KPa ,%V %V
ALARM LEVEL 1,2 2
GAS/RESP GAS, RESP GAS
COMP. O2 1-100%,OFF 21%,AUTO
CO2 SCALE 6%,10%,Auto scale 10%
O2/N2O SCALE 0-50%,0-100%, Auto scale 100%
AA SCALE 1,2,3,5,10,20%, Auto scale 20%
SIGNAL SWEEP 3mm/s, 6mm/s, 12mm/s, 25mm/s 12mm/s
WORK MODE MEASUREMENT, STANDBY MEASUREMENT
GAS ALARM ON,OFF OFF
ADULT NEONATE
APNEA ALARM 10s,15s,20s,25s,30s,35s,40s,OFF
30S 15S
AWRR LOW 2~(HIGH-1) 5 BrPM 15 BrPM
AWRR HIGH (LOW+1) ~120 30 BrPM 60 BrPM
EtCo2 LOW 0.4~(HIGH-0.1) (%V) 2.6%V
EtCo2 HIGH (LOW+0.1)~13(%V) 6.5%V
FiCo2 HIGH 0.4~ 13(%V) 1.3%V
EtO2,FiO2 LOW 18~(HIGH-1) (%V) 50%

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 HEYER VizOR 15

EtO2, FiO2 HIGH (LOW+1)~105(%V) 100%

EtN2O, FiN2O LOW 1~(HIGH-1) (%V) 35%
EtN2O, FiN2O HIGH (LOW+1)~100(%V) 75%
EtDES, FiDES LOW 0.1~(HIGH-0.1) (%V) 5%
EtDES, FiDES HIGH (LOW+0.1)~18(%V) 10%
EtISO, FiISO LOW 0.1~(HIGH-0.1) (%V) 0.8%
EtISO, FiISO HIGH (LOW+0.1)~5(%V) 2%
EtENF, FiENF LOW 0.1~(HIGH-0.1) (%V) 0.5%
EtENF, FiENF HIGH (LOW+0.1)~5(%V) 1.5%
EtSEV, FiSEV LOW 0.1~(HIGH-0.1) (%V) 1%
EtSEV, FiSEV HIGH (LOW+0.1)~8(%V) 3%
EtHAL, FiHAL LOW 0.1~(HIGH-0.1) (%V) 0.5%
EtHAL, FiHAL HIGH (LOW+0.1)~5(%V) 1.5%
WAVEFOEM CO2,N2O,O2,AA CO2
AGENT ISO, ENF, HAL, DES, SEV, AUTO HAL,AUTO
FILLED SIGNAL ON, OFF OFF
ZERO
The Parameters in CSM WINDOW
EEG Gain 50uV,100uV,200uV,300uV,400uV,500uV 100uV
CSM ALARM ON, OFF OFF
CSI LOW 1~(HIGH-1) 35%
CSI HIGH (LOW+1)~100 60%
SYSTEM DEFUALT
ALARM VOLUME 1,2,3,4,5,6,7 1
CALENDAR SOLAR, CHRISTIAN CHRISTIAN
ADUL\NEONATE ADUL,NEONATE ADULT
BED NUMBER 1..99 1

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 HEYER VizOR 15

APPENDIX II
Monitor error messages

Message cause Alarm indication explanation

ECG ERROR MESSAGES
ECG NO ECG cable is not connected Alarm level 3 Pressing ALARM SILENCE, alarm
CABLE to the system. The message is blinking will be disabled and ignore this fault.
ECG CHECK Reference lead or more than Alarm level 2 Pressing ALARM SILENCE, alarm
LEADS one chest lead is not properly The message is blinking will be disabled and ignore this fault.
connected.
ECG CHECK Mentioned leads are not Alarm level 2 Pressing ALARM SILENCE, alarm
LA, RA, LL, RL, properly connected. The message is blinking will be disabled and ignore this fault.
C
ECG SIGNAL ECG amplitude is lower than
WEAK standard limit.

ECG DEFECT ECG module failure Alarm level 2 Pressing ALARM SILENCE, alarm
The message is blinking will be disabled and ignore this fault.

ECG Heart beat is not detected in Alarm level 1 Pressing ALARM SILENCE, alarm is
ASYSTOLE last 10 seconds. The message is blinking suspended for at least 120s.

CHECK RL OR RL or other leads are not Alarm level 2 Pressing ALARM SILENCE, alarm
ALL properly connected when The message is blinking will be disabled and ignore this fault.
ECG lead is V, aVR, aVF or
aVR.
CHECK LL OR LL or other leads are not Alarm level 2 Pressing ALARM SILENCE, alarm
ALL properly connected when The message is blinking will be disabled and ignore this fault.
ECG lead is I
CHECK LA OR LA or other leads are not Alarm level 2 Pressing ALARM SILENCE, alarm
ALL properly connected when The message is blinking will be disabled and ignore this fault.
ECG lead is II
CHECK RA OR RA or other leads are not Alarm level 2 Pressing ALARM SILENCE, alarm
ALL properly connected when The message is blinking will be disabled and ignore this fault.
ECG lead is III
RESP ERROR MESSAGES
RESP CHECK The RESP leads are not Alarm level 3 Alarm is activated when RR ALARM
LEADS properly connected. The message is blinking is "ON". Pressing ALARM SILENCE,
alarm will be disabled and ignore
this fault.
APNEA Non-respiration condition Alarm level 1 Pressing ALARM SILENCE, alarm is
overruns adjusted time The message is blinking suspended for at least 120s.
SPO2 ERROR MESSAGES
SPO2 NO SPO2 probe is disconnected Alarm level 3 Pressing ALARM SILENCE, alarm
PROBE from the monitor. The message is blinking will be disabled and ignore this fault.
SPO2 PROBE SPO2 probe may be Alarm level 2 Pressing ALARM SILENCE, alarm
OFF detached from the patient The message is blinking will be disabled and ignore this fault.
SPO2 CHECK SPO2 probe is not properly Alarm level 2 Alarm is activated when SPO2
PROBE positioned to the patient The message is blinking ALARM is "ON". Pressing ALARM
SILENCE, alarm is suspended for at
least 120s.

SPO2 HIGH This may be caused by Alarm level 2 Alarm is activated when SPO2
AMBIENT entering environmental light The message is blinking ALARM is "ON". Pressing ALARM
LIGHT into the probe SILENCE, alarm is suspended for at
least 120s.
SPO2 SEARCH SPO2 is not calculable due to
some reasons such as long
time motions.
SPO2 SIGNAL The SPO2 signal amplitude is Alarm level 2 Pressing ALARM SILENCE, alarm is
WEAK too weak or undetectable. The message is blinking suspended for at least 120s.

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 HEYER VizOR 15

SPO2 PROBE The SPO2 probe is damaged Alarm level 2

DEFECT The message is blinking.
SPO2 DEFECT SPO2 module failure Alarm level 2 Pressing ALARM SILENCE, alarm
The message is blinking will be disabled and ignore this fault.
SPO2 Pulse beat is not detected in Alarm level 1 Pressing ALARM SILENCE, alarm is
ASYSTOLE last 10 seconds The message is blinking suspended for at least 120s.

SPO2 PROBE The SPO2 probe is damaged Alarm level 2 Pressing ALARM SILENCE, alarm
DEFECT The message is blinking. will be disabled and ignore this fault.
NIBP ERROR MESSAGES
SELF-TEST NIBP hard ware module Alarm level is set in Pressing ALARM SILENCE, alarm
FAILED failure NIBP WINDOW. will be disabled and ignore this fault.
The message is blinking

LOOSE CUFF Cuff is completely Alarm level is set in Pressing ALARM SILENCE, alarm
unwrapped, no cuff attached NIBP WINDOW. will be disabled and ignore this fault.
The message is blinking

MODE ERROR Use adult cuff instead of Alarm level is set in Pressing ALARM SILENCE, alarm
neonate cuff or occlusion NIBP WINDOW. will be disabled and ignore this fault.
happened in air way The message is blinking
AIR LEAK Air leak in cuff, tube or Alarm level is set in Pressing ALARM SILENCE, alarm
connector NIBP WINDOW. will be disabled and ignore this fault.
The message is blinking
AIR PRESSURE Unstable pressure value (e.g. Alarm level is set in Pressing ALARM SILENCE, alarm
ERROR kinked hoses) because valve NIBP WINDOW. will be disabled and ignore this fault.
cannot open normally. The message is blinking

SIGNAL WEAK Very weak patient signal due Alarm level is set in Pressing ALARM SILENCE, alarm
to a loosely wrapped cuff or NIBP WINDOW. will be disabled and ignore this fault.
extremely weak pulse from The message is blinking
patient.
RENG Measuring pressure is more Alarm level is set in Pressing ALARM SILENCE, alarm
EXCEEDED than upper limit (255mmHg) NIBP WINDOW. will be disabled and ignore this fault
for adult or (135mmHg) for The message is blinking
neonate
EXCESSIVE Arm movement, noisy signal Alarm level is set in Pressing ALARM SILENCE, alarm
MOTION or irregular pulse(e.g. NIBP WINDOW. will be disabled and ignore this fault.
arrhythmia) The message is blinking
OVER Measuring pressure Alarm level is set in Pressing ALARM SILENCE, alarm
PRESSURE exceeded safe software limit, NIBP WINDOW. will be disabled and ignore this fault.
SENSED 290 mmHg for adult and The message is blinking
145mmHg for neonate.
SIGNAL Large motion artifact that Alarm level is set in Pressing ALARM SILENCE, alarm
SATURATE saturates the amplifier's NIBP WINDOW. will be disabled and ignore this fault.
amplitude handling capability The message is blinking
PNEUMATIC Leakage during leak test Alarm level is set in Pressing ALARM SILENCE, alarm
LEAK NIBP WINDOW. will be disabled and ignore this fault.
The message is blinking
TIME OUT Measuring time exceeds 120 Alarm level is set in Pressing ALARM SILENCE, alarm
seconds for adult or 90 NIBP WINDOW. will be disabled and ignore this fault.
seconds for neonate The message is blinking

SYSTEM Error occurs in pump, A/D Alarm level is set in Pressing ALARM SILENCE, alarm
FAILURE sampling, pressure NIBP WINDOW. will be disabled and ignore this fault.
transducer or software. The message is blinking
NIBP DEFECT NIBP module failure Alarm level is set in Pressing ALARM SILENCE, alarm
NIBP WINDOW. will be disabled and ignore this fault.
The message is blinking
STOP NIBP stop key has been
PRESSED pressed during
measurement.

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 HEYER VizOR 15

NIBP STOP Measurement is stopped by

NIBP module because of
special reason.
NIBP LEAKAGE Successful leakage test
O.K
LOW BATTERY The charge of battery is low Alarm level is set in Pressing ALARM SILENCE, alarm
so NIBP measurement is not NIBP WINDOW. will be disabled and ignore this fault.
possible (while the monitor is The message is blinking
working with battery

NIBP NO No NIBP module is installed.

MODULE
IBP ERROR MESSAGES
IBP1/IBP2 NO Channel 1 or 2 transducer is Alarm level 3 Pressing ALARM SILENCE, alarm
SENSOR not connected. The message is blinking will be disabled and ignore this fault.

IBP1/IBP2 IBP1 or IBP2 signal is in out The message is blinking

ADJUST of display range for about 5
SCALE seconds.

IBP1/IBP2 This condition occurs when Alarm level 3 Pressing ALARM SILENCE, alarm
STATIC the maximum and minimum The message is blinking will be disabled and ignore this fault.
PRESSURE values of a pulsatile pressure
signal (Just for IBP, ART,
PAP, RVP and LVP labels)
differ by less than 3mmHg.In
this case, only Mean
pressure is displayed in this
state.
This message can be caused
by the following reason:
● A physiological condition
e.g. asystole
● Transducer turned off to
the patient.
● A catheter tip lodged
against a vessel wall.
● A clot on the catheter tip.
IBP1/IBP2 IBP signal can’t be The message is blinking
SEARCHING processed by the software
because the signal is weak
or less pulsatile.

GAS MAINSTREAM ERROR MESSAGES

SYSTEM FAULT Sensor error Alarm level 2. Pressing alarm silence, alarm will
The message is blinking be disabled and ignore this fault.

REPLACE IR signal low Alarm level 2. Pressing alarm silence, alarm is

ADAPTOR The message is blinking suspended for at least 120s.

NO ADAPTOR There is no adaptor connect Alarm level 3. Pressing alarm silence, alarm will
to the sensor. The message is blinking be disabled and ignore this fault.

CO2 INVALID. CO2 outside specified Alarm level 2. Pressing alarm silence, alarm will
PLEASE ZERO accuracy range. The message is blinking be disabled and ignore this fault.

O2 INVALID. O2 outside specified Alarm level 2. Pressing alarm silence, alarm will
PLEASE ZERO accuracy range. The message is blinking be disabled and ignore this fault.

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 HEYER VizOR 15

N2O N2O outside specified Alarm level 2. Pressing alarm silence, alarm will
INVALID.PLEAS accuracy range. The message is blinking. be disabled and ignore this fault.
E ZERO
AGENT Agent outside specified Alarm level 2. Pressing alarm silence, alarm will
INVALID. accuracy range. The message is blinking. be disabled and ignore this fault.
PLEASE ZERO
ACCURACY Two or more agent are out Alarm level 2. Pressing alarm silence, alarm will
INVALID. of range except O2 The message is blinking. be disabled and ignore this fault.
PLEASE ZERO
O2 PORT Clogged or plugged Alarm level 2. Pressing Alarm silence, alarm is
FAILURE The message is blinking. suspended for at least 120S

REPLACE O2 Replace O2 sensor every 4 Alarm level 2. Pressing alarm silence, alarm will
SENSOR month. The message is blinking. be disabled and ignore this fault.

INVALID Ambient pressure outside Alarm level 2. Pressing alarm silence, alarm will
AMBIENT operating range. The message is blinking. be disabled and ignore this fault.
PRESSURE
INVALID Internal temperature outside Alarm level 2. Pressing alarm silence, alarm will
AMBIENT operation range. The message is blinking. be disabled and ignore this fault.
TEMPERATURE
AA1,AA2 Anesthetic mixture detected Alarm level 2. Pressing Alarm silence, alarm is
AGENT by module The message is blinking. suspended for at least 120s.
MIXTURE
APNEA No breath detect Alarm level 1. Pressing Alarm silence, alarm is
The message is blinking. suspended for at least 120s.

ROOM AIR If the sensor operate for a Alarm level 2. Pressing alarm silence, alarm will
CALIB long time period without The message is blinking. be disabled and ignore this fault.
REQUIRED being disconnected from the
adapter or the operating
temperature for oxygen
sensor changes significantly
NO SENSOR Sensor is disconnected from Alarm level 3. Pressing alarm silence, alarm will
system The message is blinking. be disabled and ignore this fault.
SENSOR Manual setting and if no
STANDBY breath is detected for 30 min
MODE and EtCO2 is less than 4
mmHg for more than 30 min

CSM ERROR MESSAGES

CSM ARTIFACT Alarm level 3. Pressing alarm silence, alarm will
DETECT The message is blinking. be disabled and ignore this fault.
CSM Placement of neuro sensors Alarm level 3. Pressing alarm silence, alarm will
ELECTROD and their connections might The message is blinking. be disabled and ignore this fault.
ALARM be in problem. This alarm
can also be caused by high
frequency instrument.

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 HEYER VizOR 15

CSM SQI LOW If the impedance of the white Alarm level 3. Pressing alarm silence, alarm will
or black sensors exceeds The message is blinking. be disabled and ignore this fault.
1kΩ, the SQI will fall
gradually. Poor impedance
conditions may cause the
SQI to fall to 50%. Artefacts
can have many causes: high
frequency instrument, EMG,
etc. are typical causes. If
SQI falls because of
extensive use of high
frequency instrument, it will
rise as soon as the high
frequency instrument is
stopped
CSM If sensor impedance is > Alarm level 3. Pressing alarm silence, alarm will
IMPEDANCE 5kΩ the CSI, BS and EMG The message is blinking. be disabled and ignore this fault.
HIGH will be blanked
CSM LINK OFF CSM module is off or it is on Alarm level 3. Pressing alarm silence, alarm will
but wireless communication The message is blinking. be disabled and ignore this fault.
is not established.

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 HEYER VizOR 15

APPENDIX III
EMC

Warning
Use only the recommended bedside monitor accessory. Using the accessory other than in relevant
chapter may cause to increase the EMISSION or decrease the IMMUNITY of system.

Warning
Measurements can be affected by mobile and RF communications equipment. It should be assured
that the bedside monitor is used in the electromagnetic environment specified.

Warning
To prevent EMC effect on the monitor, the system should not be used adjacent to or stacked with
other equipment and that if adjacent or stacked use is necessary, the equipment should be observed
to verify normal operation in the configuration in which it will be used.

Warning
Do not use cellular phone in the vicinity of this equipment. High level of electromagnetic radiation
emitted from such devices may result in strong interference with the monitor performance.

Guidance and manufacturer's declaration – electromagnetic

emissions
The VizOR Patient Care Monitor is intended for use in the electromagnetic environment specified below.
The customer or the user of the VizOR should assure that it is used in such an environment.

Emissions test Compliance Electromagnetic environment - guidance

The VizOR uses RF energy only for its internal function.

RF emissions Therefore, its RF emissions are very low and are not
Group 1
CISPR 11 likely to cause any interference in nearby electronic
equipment.

RF emissions
Class B
CISPR 11
The VizOR is suitable for use in all establishments,
Harmonic emissions including domestic establishments and those directly
Class A connected to the public low-voltage power supply
IEC 61000-3-2
network that supplies buildings used for domestic
Voltage fluctuations/ purposes.
flicker emissions Complies
IEC 61000-3-3

Rev. 1.0 - 09/09 HEYER VizOR 15, Operator’s manual 81 / 88

 HEYER VizOR 15

Guidance and manufacturer's declaration – electromagnetic

immunity
The VizOR Patient Care Monitor is intended for use in the electromagnetic environment specified
below. The customer or the user of the VizOR should assure that it is used in such an environment.

IEC 60601 Compliance Electromagnetic environment -

Immunity test
test level level guidance

Floors should be wood, concrete or

Electrostatic ±6 kV contact
ceramic tile. If floors are covered with
discharge (ESD)
synthetic material, the relative humidity
IEC 61000-4-2 ±8 kV air
should be at least 30%.

±2 kV for power supply

Electrical fast lines Mains power quality should be that of a
transient/burst typical commercial or hospital
IEC 61000-4-4 ±1 kV for input/output environment.
lines

±1 kV differential mode Mains power quality should be that of a

Surge
typical commercial or hospital
IEC 61000-4-5 ±2 kV common mode environment.

<5% UT
(>95% dip in UT)
for 0.5 cycle
40% UT Mains power quality should be that of a
Voltage dips, short
(>60% dip in UT) typical commercial or hospital
interruptions and
for 5 cycles environment. If the user of the VizOR
voltage variations
requires continued operation, it is
on power supply 70% UT recommended that the VizOR be
input lines (30% dip in UT) powered from an uninterruptible power
IEC 61000-4-11 for 25 cycles supply or a battery.
<5% UT
(>95% dip in UT)
for 5 sec

Power frequency Power frequency magnetic fields

(50/60 Hz) should be at levels characteristic of a
3 A/m
magnetic field typical location in a typical commercial
IEC 61000-4-8 or hospital environment.

NOTE UT is the a.c. mains voltage prior to application of test level.

82 / 88 HEYER VizOR 15, Operator’s manual Rev. 1.0 - 09/09

 HEYER VizOR 15

Guidance and manufacturer's declaration – electromagnetic immunity

The VizOR Patient Care Monitor is intended for use in the electromagnetic environment specified below.
The customer or the user of the VizOR should assure that it is used in such an environment.

IEC 60601 Compliance Electromagnetic environment –

Immunity test
test level level guidance
Portable and mobile RF communications
equipment should be used no closer to any
part of the VizOR including cables, than the
recommended separation distance
calculated from the equation applicable to
the frequency of the transmitter.

Recommended separation distance

d = 1.17 P

d = 1.17 P 80 MHz to 800 MHz

Conducted RF 3 Vrms
3V
IEC 61000-4-6 150 kHz to 80 MHz d = 2.33 P 800 MHz to 2.5 GHz
Radiated RF 3 V/m Where P is the maximum output power
3 V/m
IEC 61000-4-3 80 MHz to 2.5 GHz rating of the transmitter in watts (W)
according to the transmitter manufacturer
and d is the recommended separation
distance in meters (m).
Field strengths from fixed RF transmitters, as
determined by an electromagnetic site
a
survey, should be less than the compliance
b
level in each frequency range.
Interference may occur in the vicinity of
equipment marked with the following symbol:

NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios,
amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the
electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured
field strength in the location in which the VizOR is used exceeds the applicable RF compliance level above, the VizOR should be
observed to verify normal operation. If abnormal performance is observed, additional measures may necessary, such as reorienting
or relocating the VizOR.
b
Over the frequency range 150kHz to 80 MHz, field strengths should be less than 3 V/m.

Rev. 1.0 - 09/09 HEYER VizOR 15, Operator’s manual 83 / 88

 HEYER VizOR 15

Recommended separation distances between

Portable and mobile RF communications equipment and the VizOR
The VizOR Patient Care Monitor is intended for use in the electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the VizOR can help prevent electromagnetic
interference by maintaining a minimum distance between portable and mobile RF communications equipment
(transmitters) and the VizOR as recommended below, according to the maximum output power of the
communications equipment.
Rated maximum Separation distance according to frequency of transmitter
output power of m
transmitter 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.5 GHz
W
d = 1.17 P d = 1.17 P d = 2.33 P
0.01 0.12 0.12 0.23
0.1 0.37 0.37 0.74
1 1.17 1.17 2.33
10 3.70 3.70 7.37
100 11.7 11.7 23.3
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in
meters (m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the
maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.
NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption
and reflection from structures, objects and people.

84 / 88 HEYER VizOR 15, Operator’s manual Rev. 1.0 - 09/09

 HEYER VizOR 15

Notes:

Rev. 1.0 - 09/09 HEYER VizOR 15, Operator’s manual 85 / 88

 HEYER VizOR 15

Notes:

86 / 88 HEYER VizOR 15, Operator’s manual Rev. 1.0 - 09/09

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