Instructions for Use

Infinity Gamma Series

Infinity Configured Monitoring Series

Infinity Configured Monitoring Series

Infinity Gamma Series

Instructions for Use

WA R N I NG : Fo r a f u l l u n d e r s tan d i n g o f t h e p e r f o r m a n c e
characteristics of this equipment, the user should carefully
read this manual before operating.
 Manufactured by: reviews and scientific papers, is
Draeger Medical Systems, Inc. prohibited without prior written
3135 Quarry Road permission of Dräger Medical GmbH
Telford, PA 18969 .
USA
Dräger devices are intended for use by
Authorized EC representative: qualified medical personnel only.
Dräger Medical GmbH Before using Dräger devices, read all the
Moislinger Allee 53-55 manuals that are provided with each
23558 Lübeck device carefully. Patient monitoring
Germany equipment, however sophisticated,
Infinity Gamma Series Instructions for Use
should never be used as a substitute for
Software Version VF6 the human care, attention, and critical
judgment that only trained health care
This product is covered by one or more professionals can provide.
of the following patents: 5,224,484;
5,224,740; 5,240,008; 5,285,791; This device is subject to EU Directive
5,355,890; 5,337,751; 5,375,604. 2002/96/EC (WEEE). It is not registered
for use in private households, and may
This device bears the Q label in not be disposed of at municipal
accordance with the provisions of the collection points for waste electrical and
Directive 93/42/EEC of June 14, 1993 electronic equipment. Dräger Medical
concerning medical devices. has authorized a firm to dispose of this
device in the proper manner: for more
Q0123 detailed information, please contact your
local Dräger Medical organization.
© Dräger Medical GmbH.
All rights reserved. ACE, MultiMed, NeoMed, MultiView
WorkStation, Infinity, Infinity Docking
Printed in the United States of America. Station and Infinity Network are
Dräger reserves the right to modify the registered trademarks of Dräger Medical
design and specifications contained GmbH.
herein without prior notice. Please CAPNOSTAT is a registered trademark
contact your local Dräger Sales of Novametrix Medical Systems, Inc.
Representative for the most current
information. Masimo, Masimo SET and Signal
Reproduction in any manner, in whole or Extraction Technology (SET) are
in part, in English or in any other registered trademarks of Masimo
languages, except for brief excerpts in Corporation.
CAUTION: Federal Law in the United States restricts these devices to sale by, or on
the order of a physician.

ii Gamma/Gamma XL VF6
 INSTRUCTIONS FOR USE

Infinity Gamma Series Software Release Notes

Software Version VF6
z Wireless network operation requires special configurations of the monitoring
network and the MULTIVIEW WORKSTATION (a service function). If you
experience problems with wireless network operations, contact your Service
personnel.
z When moving and assigning a wireless monitor to a different central station,
the original central station may emit a brief network error tone and display an
Offline message instead of the message Bed Disconnected. However, there is
no disruption of network monitoring and the Offline message clears as soon as
you assign a new bedside monitor to the central viewport.
z When you change the units of measure at the bedside monitor and the central
station is showing the monitor’s bed view, you must first exit the central bed
view, before the change of units appears at the central station.
z For network and card data transfer:
— Occasionally, after a data transfer from an Infinity Delta Series monitor, you
may see three or four ST trends instead of the two ST leads monitored by the
Infinity Gamma Series monitor.
z For network data transfer only:
— If ST is enabled, the ST data transferred from an Infinity Delta Series monitor
(VE0) or from a MULTIVIEW Telemetry System (VE0) is ST lead I and II,
regardless of the ST leads selected on the Infinity Gamma Series monitor.
Note: Other ST data is permanently lost.
— After a network transfer of telemetry data to an Infinity Gamma Series moni-
tor, ST trend points may appear two minutes apart.
— The IBP data transferred from an Infinity Delta Series monitor (VE0) to an
Infinity Gamma Series monitor is labelled GP1 and GP2.
z NBP parameter values transferred from an Infinity Gamma Series monitor to
an Infinity Delta Series monitor are displayed in the trend graphs rather than
in the trend tables of the destination monitor.
z On rare occasions, a docked monitor may reset when entering the Transfer
Menu under certain network conditions. The monitor returns to the state prior
to the reset within 30 seconds.
z When power-cycling the monitor or admitting a new patient, saved
monitoring settings may occasionally return to default settings. Check
monitoring settings after these events.
z If the Scio module is unable to measure the concentration of N2O, the monitor
may enter the error code *A* (artifact) instead of *F* (failure) into the trend
storage.

VF6 Gamma/Gamma XL iii

 z Occasionally, the ECG waveform is not displayed in the second waveform
channel, when you assign SpO2 to the first waveform channel. In this case,
click on the second waveform channel and select the desired ECG lead again.
z When the values of an anesthetic agent exceed the measuring range, the
monitor displays +++ in the agent parameter box and cycles two out-of-range
error messages, one correctly identifying the agent with out-of-range values,
the other showing a previously monitored agent.
z If two wireless bedside monitors are given the same bed label or IP address
during manual network configuration (a Biomed function), their connection to
the central station alternates between online/offline. In this case, change one
monitor’s bed label in the Admit menu or contact your Biomed technician to
change one monitor’s IP address.
z During zeroing of the Scio Multigas Module, the monitor sounds a false apnea
alarm when the following is true: Respiration alarms are ON, the respiration
rate was zero just before the start of Scio zeroing and the apnea time expires
before Scio zeroing is complete.
z When you change parameter colors at a networked bedside monitor, the
monitor temporarily goes offline at the central station in order for the color
change to take effect.
z If the monitor reports a Multigas hardware failure, displayed Multigas
parameter values might not be accurate. In this case, contact your Biomedical
Engineering department.

iv Gamma/Gamma XL VF6
 INSTRUCTIONS FOR USE

Intended Use
The intended use of this device is to monitor heart rate, respiration rate, invasive
pressure, non-invasive pressure, arrhythmia, temperature, arterial oxygen saturation
and pulse rate, central apnea, end-tidal carbon dioxide, and ST Segment Analysis.
The device is intended to be used in an environment where patient care is provided by
Healthcare Professionals, i.e. physicians, nurses, and technicians, trained on the use of
the device, who will determine when use of the device is indicated, based upon their
professional assessment of the patient’s medical condition.
The devices are intended for use in the Adult, Pediatric and Neonatal populations,
with the exception of Arrhythmia and ST Segment Analysis which are not intended
for the neonatal population.
WA R N I N G : T h e I N F I N I T Y M o d u l a r M o n i t o r s h a v e n o t b e e n
tested and are not approved for use within the MRI
e n v i r o n me n t s i n c e t h e i r f u n c t i o n c o u l d b e c o m p r o m i s e d ,
p o s s i b l y l e a d i n g t o pa t i e n t i n j u r y.

Indications for Use

These devices are capable of monitoring:
z Heart Rate
z Respiration Rate
z Invasive Pressure
z Non-Invasive Pressure
z Arrhythmia
z Temperature
z Arterial oxygen saturation
z Pulse rate
z Central apnea
z End-tidal CO2
z ST Segment Analysis
This device will produce visual and audible alarms if any of these parameters vary
beyond preset limits and produce timed or alarm recordings. The devices will connect
to R50 recorders either directly or via the Infinity network.
When a GammaXL is connected to a Scio module sampled breathing gases from
adults and pediatrics can be displayed. The gas module continuously measures the
content of CO2, N2O, O2 and one of the anesthetic agents, Halothane, Isoflurane,
Enflurane, Sevoflurane and Desflurane in any mixture and communicates real time
and derived gas information to the GammaXL.

VF6 Gamma/Gamma XL v
 Documentation Features

Warnings, Cautions, Notes

WA R N I N G : A WA R N I N G s ta t e m e n t p r o v i d e s i m p o r ta n t
i n f o r m a t i o n a b o u t a p o t e n t i a l l y h a z a r d o u s s i t u ta t i o n w h i c h , i f
n ot a v oi d e d, c ou l d re s ul t in de a t h o r s e ri o us i nj ur y.

CAUTION: A CAUTION statement provides important information about a potentially

hazardous situation which, if not avoided, may result in minor or moderate injury to the
user or patient or in damage to the equipment or other property.

NOTE: A NOTE provides additional information intended to avoid inconveniences

during operation.

Applicability
NOTE: Software functionality is identical between the following products, unless
otherwise noted:
z Infinity Gamma XL = SC 6802XL

NOTE: The hardware of SC 6000 series monitors differs from Gamma series
monitors as follows:
z SC 6000 series monitors do not have external alarm lights
z SC 6000 series monitors do not have a USB connector
z The Fast Access fixed key on SC 6000 series monitors is called Zoom
z SC 6000 series monitors have a different size and weight (see Technical Data)

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 INSTRUCTIONS FOR USE

Chapter Overview
Chapters
Overview ....................................................................................................1
Monitor Setup............................................................................................ 2
Network Applications ...............................................................................3
Admission, Discharge, Transfer .............................................................. 4
Alarms and Messages .............................................................................. 5
Trends ........................................................................................................ 6
Recordings ................................................................................................ 7
ECG and Heart Rate.................................................................................. 8
Arrhythmia................................................................................................. 9
ST-Segment Analysis .............................................................................10
Respiration .............................................................................................. 11
Pulse Oximetry........................................................................................ 12
End-Tidal CO2 ......................................................................................... 13
Scio Multigas Module .............................................................................14
Non-Invasive Blood Pressure ................................................................ 15
Invasive Blood Pressure ........................................................................ 16
Temperature ............................................................................................ 17

Appendices
Options and Accessories........................................................................ A
Cleaning, Disinfecting, Sterilizing .......................................................... B
Default Settings and Biomedical Support ............................................. C
Technical Data .......................................................................................... D
Glossary
Index

VF6 Gamma/Gamma XL vii

 Table of Contents
Infinity Configured Monitoring Series.....................................................................i-i
Infinity Gamma Series Software Release Notes
Software Version VF6..........................................................................................i-iii
Intended Use ...................................................................................................................i-v
Indications for Use .........................................................................................................i-v
Documentation Features ..............................................................................................i-vi
Warnings, Cautions, Notes ....................................................................................i-vi
Applicability.............................................................................................................i-vi
Chapter Overview .........................................................................................................i-vii
Table of Contents ........................................................................................................i-viii

CHAPTER 1: Overview
Important General Safety Considerations...................................................................1-2
Electromagnetic Compatibility ..............................................................................1-2
Reducing EMI ..........................................................................................................1-3
Site of Operation .....................................................................................................1-3
Electrical Safety ......................................................................................................1-4
Connections to Peripheral Devices.......................................................................1-4
Safety, Inspection, and Maintenance ....................................................................1-5
Electrosurgery and Defibrillation Safety...............................................................1-6
Pacemaker Safety ...................................................................................................1-6
Device Markings......................................................................................................1-7
General Description ......................................................................................................1-8
Front Panel...................................................................................................................1-10
Back Panel ...................................................................................................................1-11
Left Side Panel.............................................................................................................1-12
Right Side Panel ..........................................................................................................1-13
Interface Plate (optional).............................................................................................1-14
Gamma/Gamma XL Display........................................................................................1-15
Alarm Colors .........................................................................................................1-15
Parameter Colors ..................................................................................................1-16
Rotary Knob .................................................................................................................1-17
Fixed Keys....................................................................................................................1-18
Menus ...........................................................................................................................1-19
Power Sources.............................................................................................................1-20
MultiMed/NeoMed Pod ................................................................................................1-21
etCO2 Pod and Multigas Module................................................................................1-22
Recorder.......................................................................................................................1-22
Remote Displays..........................................................................................................1-23
Complete Menu Structure...........................................................................................1-23

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 INSTRUCTIONS FOR USE

CHAPTER 2: Monitor Setup

Getting Started...............................................................................................................2-2
Using the AC Adapter .............................................................................................2-2
Using the Battery ....................................................................................................2-3
Assembling MultiMed and NeoMed Pods .............................................................2-8
Starting the Monitor ......................................................................................................2-9
Main Screen Configuration.........................................................................................2-10
Waveform Selection..............................................................................................2-10
Bottom Channel Display.......................................................................................2-11
OR Mode ................................................................................................................2-14
Show Respiration or etCO2 Parameters .............................................................2-14
Setting the Master Speaker Volume ..........................................................................2-16
Standby ........................................................................................................................2-17
Saving Setups..............................................................................................................2-18

CHAPTER 3: Network Applications

Overview.........................................................................................................................3-2
Network Configurations................................................................................................3-3
Basic Network Components ..................................................................................3-4
Basic Bedside Setups.............................................................................................3-5
Network Operation ........................................................................................................3-6
Docking Station.......................................................................................................3-7
Docking and Undocking .........................................................................................3-9
Wireless Network Configuration .........................................................................3-10
Wireless Network Operation ................................................................................3-11
Network Safety Considerations .................................................................................3-14
Alarm and Status Messages.......................................................................................3-15

CHAPTER 4: Admission/Discharge/Transfer
Overview.........................................................................................................................4-2
Patient Admission .........................................................................................................4-2
Admit Menu..............................................................................................................4-3
Patient Category......................................................................................................4-3
Name and ID ............................................................................................................4-5
Admit Date ...............................................................................................................4-6
Patient Discharge ..........................................................................................................4-6
Data Transfer .................................................................................................................4-8
Transfer Across the Network .................................................................................4-9
Transfer with a Data Memory PC Card................................................................4-10

VF6 Gamma/Gamma XL ix
 CHAPTER 5: Alarms and Messages
Alarm Grades .................................................................................................................5-2
Life-Threatening Alarms.........................................................................................5-2
Serious Alarms........................................................................................................5-3
Advisory Alarms .....................................................................................................5-3
Alarm Settings ...............................................................................................................5-4
Setting Alarm Limits ...............................................................................................5-5
Turning Parameter Alarms On/Off.........................................................................5-7
Turning Alarm Recordings On/Off.........................................................................5-8
External Alarm Lights .............................................................................................5-8
Alarm Validation ............................................................................................................5-9
Silencing Alarms .........................................................................................................5-10
Alarm Silence Key.................................................................................................5-10
All Alarms OFF Key ..............................................................................................5-11
Assigning Alarm Groups ............................................................................................5-11
Central Alarms .............................................................................................................5-13
Alarms in OR Mode .....................................................................................................5-14
Messages .....................................................................................................................5-15

CHAPTER 6: Trends
Overview.........................................................................................................................6-2
Trend Setup....................................................................................................................6-2
Trend Graphs .................................................................................................................6-3
Trend Table ....................................................................................................................6-5
Special Conditions and Codes.....................................................................................6-6

CHAPTER 7: Recordings
Overview.........................................................................................................................7-2
Recorder Preparation....................................................................................................7-3
Assigning Network Recorders .....................................................................................7-5
Recording Waveforms ..................................................................................................7-6
Timed Recordings...................................................................................................7-6
Continuous Recordings .........................................................................................7-7
Recording Formats .................................................................................................7-7
Recording Trends..........................................................................................................7-9
Recording Alarms........................................................................................................7-11
Stored Recordings ......................................................................................................7-12
Event Recall...........................................................................................................7-12
Saving, Printing, Deleting Stored Recordings ...................................................7-13
Recording Status Messages.......................................................................................7-14

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 INSTRUCTIONS FOR USE

CHAPTER 8: ECG and Heart Rate

Overview.........................................................................................................................8-2
Patient Preparation........................................................................................................8-2
Selecting and Preparing the Electrodes ...............................................................8-2
Preparing the Patient’s Skin ..................................................................................8-3
Positioning the Electrodes.....................................................................................8-4
ECG Monitoring Settings ..............................................................................................8-7
Cable Type ...............................................................................................................8-7
Lead Selection and Display Amplitude .................................................................8-8
Cascade Display......................................................................................................8-9
One- or Two-Channel Signal Processing............................................................8-10
Pulse Tone Source................................................................................................8-11
Pulse Tone Volume ...............................................................................................8-12
Pacer Detection .....................................................................................................8-13
Displaying Sync Marks .........................................................................................8-14
ECG and HR Safety Considerations ..........................................................................8-15
HR Alarm Settings.................................................................................................8-15
Neonatal ECG Monitoring.....................................................................................8-16
ECG 50/60 Hz Notch Filter Setting.......................................................................8-16
Muscle Stimulators ...............................................................................................8-16
Electrosurgery (ESU) ............................................................................................8-16
Infusion pumps .....................................................................................................8-18
Defibrillators and Cardioversion .........................................................................8-18
High P-Waves and T-Waves .................................................................................8-18
Pacemakers ...........................................................................................................8-19
AV Sequential or DDD Pacemakers.....................................................................8-20
Pacemakers with Impedance-Derived Rate Response......................................8-20
Large Amplitude Pacer Pulses ............................................................................8-20
Transcutaneous Electrical Nerve Stimulators (TENS).......................................8-21

CHAPTER 9: Arrhythmia
Overview.........................................................................................................................9-2
Turning Arrhythmia Monitoring ON .............................................................................9-4
Arrhythmia Setup ..........................................................................................................9-5
Rate and Count........................................................................................................9-6
Arrhythmia Alarms..................................................................................................9-6
Arrhythmia Alarm Recordings ...............................................................................9-6
Relearning a Patient’s ECG ..........................................................................................9-7

CHAPTER 10: ST Segment Analysis

Overview.......................................................................................................................10-2
ST Monitoring Display.................................................................................................10-3

VF6 Gamma/Gamma XL xi
 ST Setup .......................................................................................................................10-4
Isoelectric and ST Measuring Points ..................................................................10-4
ST Reference Complex .........................................................................................10-6
ST Alarms.....................................................................................................................10-7

CHAPTER 11: Respiration Monitoring

Overview.......................................................................................................................11-2
Patient Preparation......................................................................................................11-2
Selecting and Preparing the Electrodes .............................................................11-2
Preparing the Patient’s Skin ................................................................................11-2
Electrode Placement for Respiration Monitoring...............................................11-3
Rsp Safety Considerations.........................................................................................11-4
Respiration Monitoring Display .................................................................................11-5
Displaying Respiration Data ................................................................................11-5
Rsp Display Channel ............................................................................................11-6
Resp Display Amplitude .......................................................................................11-7
Respiration Monitoring Settings ................................................................................11-8
Rsp Mode ...............................................................................................................11-8
Resp Markers ........................................................................................................11-9
Apnea Time............................................................................................................11-9
Coincidence Alarm .............................................................................................11-10
Relearning a Patient’s Respiration Pattern ......................................................11-11
OxyCRG Monitoring (Neonatal Option) ...................................................................11-12
Displaying OCRG Waveforms............................................................................11-12
OCRG Recordings ..............................................................................................11-14

CHAPTER 12: Pulse Oximetry

Intended Use ................................................................................................................12-2
Overview.......................................................................................................................12-2
Connections.................................................................................................................12-3
Sensor Application......................................................................................................12-4
SpO2 Safety Considerations ......................................................................................12-5
SpO2 Monitoring Display............................................................................................12-6
SpO2 Display Channel..........................................................................................12-6
SpO2 Display Amplitude ......................................................................................12-7
Cascade Display ...................................................................................................12-7
SpO2 Monitoring Settings ..........................................................................................12-8
Pulse Tone Source................................................................................................12-8
Pulse Tone Volume ...............................................................................................12-9
Signal Strength Bar Graph .................................................................................12-10
Averaging Mode ..................................................................................................12-11

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 INSTRUCTIONS FOR USE

CHAPTER 13: End-Tidal CO2

Overview.......................................................................................................................13-2
etCO2 Source...............................................................................................................13-3
etCO2 Display ..............................................................................................................13-4
Monitoring Preparations .............................................................................................13-6
Connecting Sensor and etCO2 Pod ....................................................................13-6
Attaching the Capnostat and Airway Adapter....................................................13-6
Calibrating the Sensor and Adapter..................................................................13-10
etCO2 Monitoring Settings .......................................................................................13-12
Averaging Mode ..................................................................................................13-12
RRc Apnea Time..................................................................................................13-12
Balance ................................................................................................................13-13
Measuring Mode..................................................................................................13-14
Anesthetic Agent Compensation.......................................................................13-15
Atmospheric Pressure Compensation..............................................................13-15
etCO2 Alarms.............................................................................................................13-17

CHAPTER 14: Scio Multigas Module

Intended Use ................................................................................................................14-2
Overview.......................................................................................................................14-2
Connections.................................................................................................................14-2
The Scio Module ..........................................................................................................14-5
Types of Modules..................................................................................................14-6
Site of Operation ...................................................................................................14-9
Installing/Removing the Water Trap..................................................................14-10
Connecting Sampling Lines and Power Cord ..................................................14-11
Warm-Up ..............................................................................................................14-14
OR Mode.....................................................................................................................14-15
Parameter Display...............................................................................................14-17
CO2 Display and Setup.......................................................................................14-18
Multigas Display and Setup ...............................................................................14-19
End Case and Standby .......................................................................................14-22

CHAPTER 15: Non-Invasive Blood Pressure

Overview.......................................................................................................................15-2
NBP Safety Considerations..................................................................................15-3
Cuff Selection and Placement ....................................................................................15-4
NBP Measurements.....................................................................................................15-6
Single Measurements ...........................................................................................15-6
Interval Mode .........................................................................................................15-6
Inflation Mode........................................................................................................15-8
Measurement Tone ...............................................................................................15-9

VF6 Gamma/Gamma XL xiii

 NBP Measurements in OR Mode..............................................................................15-10
NPB Alarms................................................................................................................15-11

CHAPTER 16: Invasive Blood Pressure

Overview.......................................................................................................................16-2
Invasive Pressure Labels............................................................................................16-3
IBP Display...................................................................................................................16-3
Display Channel and Waveform Amplitude........................................................16-4
Selecting and Preparing the Transducer ..................................................................16-5
Zeroing and Calibration Check ............................................................................16-6
Zero and Calibration Check Troubleshooting ....................................................16-7
Calibrating Reusable Transducers......................................................................16-8

CHAPTER 17: Temperature

Overview.......................................................................................................................17-2
Temperature Probes....................................................................................................17-2
Placing the Probe..................................................................................................17-2

CHAPTER A: Options and Accessories

Options .......................................................................................................................... A-2
MultiMed/NeoMed Pods ............................................................................................... A-2
ECG................................................................................................................................ A-3
Pulse Oximetry (SpO2)................................................................................................. A-5
End Tidal CO2 (etCO2) ................................................................................................. A-8
Scio Multigas Module................................................................................................... A-9
Temperature................................................................................................................ A-10
Invasive Blood Pressure (IBP) .................................................................................. A-11
Non-invasive Blood Pressure (NBP)......................................................................... A-12
Power Sources............................................................................................................ A-12
Displays and Display Components........................................................................... A-14
Recorder...................................................................................................................... A-14
Miscellaneous ............................................................................................................. A-15

CHAPTER B: Cleaning and Disinfecting

Cleaning and Disinfecting ........................................................................................... B-2
Monitor .................................................................................................................... B-2
Patient Cables ........................................................................................................ B-2
Reusable ECG Electrodes ..................................................................................... B-2
Reusable SpO2 Sensor ......................................................................................... B-3
NBP Cuff ................................................................................................................. B-3
Temperature probes and cables........................................................................... B-3

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 INSTRUCTIONS FOR USE

Reusable Pressure Transducers and Cables ...................................................... B-4

Masimo SET SpO2 Pod ................................................................................................ B-4
etCO2 Pod and Accessories........................................................................................ B-5
Capnostat Sensor .................................................................................................. B-5
ReusableAirway Adapters..................................................................................... B-5
Nasal Sampling Cannulas and Tubing................................................................. B-5
Sidestream Sampling Pump.................................................................................. B-5
Scio Module and Accessories..................................................................................... B-8
Emptying the Water Trap....................................................................................... B-8
Cleaning/Replacing the Fan Filter ........................................................................ B-9

CHAPTER C: Default Settings and Biomedical Support

Default Settings ............................................................................................................ C-2
Biomedical Support.................................................................................................... C-11
Startup Tests ........................................................................................................ C-11
Checking the NBP Calibration ............................................................................ C-12
Biomed Menu........................................................................................................ C-13
Saving a Patient Setup ........................................................................................ C-14
Locked Options and Demo Mode ....................................................................... C-14
Diagnostic Logs ................................................................................................... C-15
Changing Units of Measure................................................................................. C-16
Turning External Alarm Lights ON/OFF ............................................................. C-17
Parameter Colors ................................................................................................. C-18
NBP/SpO2 Interlock ............................................................................................. C-19
ASY/VF Alarms ..................................................................................................... C-19
Pacer Mode ........................................................................................................... C-20

CHAPTER D: Technical Data

Overview........................................................................................................................ D-2
Regulatory Compliance ......................................................................................... D-2
Basic System Components................................................................................... D-3
Monitoring Accessories ........................................................................................ D-8
Monitoring Specifications ................................................................................... D-11
Electromagnetic Compatibility.................................................................................. D-22

Glossary

INDEX

VF6 Gamma/Gamma XL xv
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xvi Gamma/Gamma XL VF6

1 Overview

Important General Safety Considerations...................................................................1-2

Electromagnetic Compatibility ..............................................................................1-2
Reducing EMI ..........................................................................................................1-3
Site of Operation .....................................................................................................1-3
Electrical Safety ......................................................................................................1-4
Connections to Peripheral Devices .......................................................................1-4
Safety, Inspection, and Maintenance ....................................................................1-5
Electrosurgery and Defibrillation Safety...............................................................1-6
Pacemaker Safety ...................................................................................................1-6
Device Markings ......................................................................................................1-7
General Description.......................................................................................................1-8
Front Panel ...................................................................................................................1-10
Back Panel....................................................................................................................1-11
Left Side Panel .............................................................................................................1-12
Right Side Panel ..........................................................................................................1-13
Interface Plate (optional).............................................................................................1-14
Gamma/Gamma XL Display ........................................................................................1-15
Alarm Colors..........................................................................................................1-15
Parameter Colors ..................................................................................................1-16
Rotary Knob .................................................................................................................1-17
Fixed Keys....................................................................................................................1-18
Menus ...........................................................................................................................1-19
Power Sources.............................................................................................................1-20
MultiMed/NeoMed Pod ................................................................................................1-21
etCO2 Pod and Multigas Module................................................................................1-22
Recorder .......................................................................................................................1-22
Remote Displays..........................................................................................................1-23
Complete Menu Structure ...........................................................................................1-23
1 OVERVIEW

Important General Safety Considerations

CAUTION: Read all operating instructions carefully before using the monitor. Specific
warnings and cautions are found throughout the User’s Manual where they apply.

WA R N I N G : M o n i t o r o p e r a t i o n is c u r r e n t l y n o t s u p p o r t e d i n
t h e f o l l o w i n g e n v i r o n m e n ts : m a g n e t i c r e s o n a n c e i m a gi n g
( M R I ) , a i r c r a ft , a m b u l a n c e , h om e o r h y pe rba ri c c ha m b e r
e nvi r on me n ts .

CAUTION: Use only batteries that are approved by Dräger (contact your local
representative). The use of non-approved batteries may damage the device.

NOTE: Dräger recommends replacing any lead-acid battery after 12 months of

continued use and replacing a Lithium-ion battery after 24 months of continued use. For
safe disposal of lead-acid and lithium ion batteries, follow your local regulations. To
prevent risk of fire or explosion, never dispose of the battery in fire.

A full technical description is available upon request from your local Dräger
representative.

Electromagnetic Compatibility
The monitor has been designed and tested for compliance with current regulatory
standards as to its capacity to limit electromagnetic interference (EMI), and also as to
its ability to block the effects of EMI from external sources.
The monitor complies with the following standards pertaining to EMI emissions and
susceptibility: EN55011 and EN60601-1-2.

1-2 Gamma/Gamma XL VF6

 IMPORTANT GENERAL SAFETY CONSIDERATIONS

Reducing EMI
To reduce possible problems caused by EMI , we recommend the following:
z Use only Dräger-approved accessories.
z Ensure that other products used in areas where patient monitoring and/or life-
support is used comply to accepted emissions standards (EN55011).
z Try to maximize the distance between electromedical devices.
z Strictly limit exposure and access to portable radio-frequency sources (e.g.,
cellular phones and radio transmitters). Be aware that portable phones may
periodically transmit even when in standby mode.
z Maintain good cable management. Do not route cables over electrical
equipment. Do not intertwine cables.
z Ensure all electrical maintenance is performed by qualified personnel.

Site of Operation
CAUTION: The site of operation for the monitor must meet temperature, humidity, and
air pressure requirements. For details, see the product description in Appendix D.

WA R N I N G : D o n o t o p e r a t e t h e m o n i t o r i n p r e s e n c e o f
f l a mm a b l e a n e s t h e t i c m i x t u r e s w i t h a i r, o x y g e n , o r n i t r o u s
o x i d e . I f t h e d e v i c e s a re u s e d w h e r e f l a m m a b l e a ne s t h e t i c
s u b s ta n c e s a r e u s e d , t h e p o s s i b i l i t y o f a n e x p l o s i o n c a n n o t
be excluded.

WA R N I N G : D o n o t u s e t h e m o n i t o r n e a r d e v i c e s w i t h
m i c r o w a v e o r o t h e r h i g h f r e q u e n c y e mi s s i o n s t h a t m a y
i n t e r f e r e w i t h t h e m o n i t o r ’s o p e r a t i o n .

WA R N I N G : I f f lu i d s a r e a c c i d e n ta l l y s p i l l e d o n t h e m o n i t o r, i t
s h o u l d b e r e m o v e d f r o m s e r v i c e i m m e d i a t e l y a n d t h o ro ug hl y
i n s pe c t e d by y ou r B i o me d t o e ns ure t ha t t he re i s no
c o m p r o m i s e i n e l e c t r i c a l s a f e t y.

CAUTION: Place the monitor on a flat and stable surface to prevent it from falling. Do
not place the monitor into a cabinet, wall recess or similar enclosure during operation.
These units are convection cooled (no fan) and need adequate airflow to dissipate heat.

VF6 Gamma/Gamma XL 1-3

1 OVERVIEW

Electrical Safety

CAUTION: Operate the monitor and any connected devices only in a clinical
environment where the electrical installation is in accordance with local electric codes.
The universal AC adapter, CPS, or IDS should be connected to a fully tested, hospital-
grade outlet with proper grounding.

If the AC adapter, CPS, or IDS is disconnected, the monitor “Battery charger” light
turns off and the unit switches immediately to battery power.

Connections to Peripheral Devices

All peripheral devices and connections to the monitor (except the Infinity network)
must comply with IEC 60601-1 requirements.

CAUTION: In the interest of patient safety and equipment performance, Dräger does
not authorize the connection of other manufacturers’ equipment not approved by
Dräger. It is the user's responsibility to contact Dräger to determine compatibility and
warranty status if connections to other manufacturers' equipment are desired.

CAUTION: When connecting peripheral devices to the monitor, make sure that the
entire system complies with the following requirement: IEC 60601-1-1: Safety
requirements for medical electrical systems.

1-4 Gamma/Gamma XL VF6

 IMPORTANT GENERAL SAFETY CONSIDERATIONS

Safety, Inspection, and Maintenance

WA R N I N G : B e c a u s e o f t h e d a n g e r o f e l e c t r i c s h o c k , n e v e r
r e m o v e t h e c o v e r o f a n y d e v i c e w hi l e i n o p e r a t i o n o r
c o n n e c t e d t o a p ow e r o u t l e t v i a t h e A C a d a pt e r.

In the interest of safety, regular equipment inspection and maintenance is required.

Once a year, check all cables, devices, and accessories for damage, ground resistance,
chassis and patient leakage currents, and all alarm functions. Also, ensure that all
safety labels are legible. Maintain a record of these safety checks. For additional
information, refer to the Service manual.
Do not use cables that appear cracked, worn or damaged. Use of such cables may
contribute to poor monitoring performance or cause the display of erroneous values.
Leakage current increase when connecting multiple medical devices to a patient.
Ensure the electrical shock classification for each device is suitable for the intended
application.
Dräger recommends that safety and functional checks be performed on the monitor at
least once each year. The temperature and non-invasive blood pressure circuits of the
monitor should be calibrated at least every two years. These checks should be
performed by authorized personnel, as described in the appropriate Service manual.
When main or battery power is not available, the monitor stores patient data and
settings in an internal battery backed-up SRAM. This internal battery lasts
approximately 10 years if the monitor is operated from main power or from the lead
acid or lithium ion battery.

CAUTION: To preserve the life of the internal battery, always leave the monitor
connected to main power (using the AC adapter) when not in use. If the monitor is
stored unconnected from line or lead acid/lithium ion battery power, the capacity of the
internal battery is drained in approximately three years.

VF6 Gamma/Gamma XL 1-5

1 OVERVIEW

Electrosurgery and Defibrillation Safety

The monitor is protected against high-frequency interference from electrosurgery
units (ESU) and discharges from defibrillators, as well as against 50- and 60-Hertz
power line interference.

WA R N I N G : T h e m o n i t o r i s n o t p r o t e c t e d a g a i n s t h i g h -
frequency interference from diathermy equipment.

CAUTION: During Electrosurgery, observe the following guidelines to minimize ESU

interference and provide maximum user and patient safety:
z Use the ESU block to connect ECG cables.
z Keep all transducers and intermediate cables off of earth ground and away
from the ESU knife and return wires.
z Use the SpO2 pulse rate instead of the ECG to determine the heart rate.
z Use rectal temperature probe sheaths to cover any internally placed
temperature sensors.
z Always use the accessories designed for ESU environments.
z If pacer detection is on, the ESU interference may be detected as pacer spikes
displayed on the ECG.

Pacemaker Safety

WA R N I N G : R a t e m e t e r s m a y c o n t i n u e t o c o u n t t h e pa c e m a k e r
r a t e d ur i n g o c c ur r e n c e s o f c a r d i a c a r r e s t o r s o m e
a r r h y t h m ia s . D o n o t r e l y e n t i r e l y u p o n r a t e m e t e r a l a r m s .
K e e p pa c e m a k e r pa t i e n ts u n d e r c l o s e s u r v e i l l a n c e .

WA R N I N G : M a k e s u r e t h a t pa c e r d e t e c t i o n i s t u r n e d o f f f o r
pa t i e n ts w i t h o u t pa c e m a k e r s , a n d t u r n e d o n f o r pa t i e n ts w i t h
pa c e m a k e r s .

1-6 Gamma/Gamma XL VF6

 IMPORTANT GENERAL SAFETY CONSIDERATIONS

Device Markings

) Power On/Off

I Battery operated equipment.

 Attention, consult the accompanying documents.

 Type CF, defibrillator-proof equipment.

 Direct current.

∼ Alternating current.

 Danger: Risk of explosion if used in presence of flammable anesthetics.

This device bears the P label in accordance with the provisions of the
P 0123 Directive 93/42/EEC of 14June 1993 concerning medical devices.

IPX1 Protected against harmful effects of dripping water.

NBP Non-Invasive Blood Pressure.

IBP Invasive Blood Pressure.

Waste Electrical and Electronic Equipment (WEEE) disposal requirements.

VF6 Gamma/Gamma XL 1-7

1 OVERVIEW

General Description
The Gamma Series monitor is a durable, lightweight, and portable patient monitor that
can operate as a stand-alone device or as part of the Dräger Infinity network. The
Dräger PICK AND GO™ concept allows the monitor’s quick and easy disconnection
from the network, and the monitor can travel with the patient from one clinical station
to another — i.e. from the bedside to the OR to a step-down unit and back.
The monitor provides high-quality patient care for adult, pediatric, and neonatal
patients in clinical environments and offers the following monitoring functions:
z ECG and Heart Rate Monitoring (3-, 5-, and 6-lead).
z Arrhythmia Detection (Basic and Full).
z 2-lead ST Segment Analysis (adult and pediatric mode only).
z Respiration Monitoring (impedance pneumography).
z Pulse Oximetry.
z End-tidal CO2 Monitoring.
z Anesthetic Gas Monitoring (Gamma XL only).
z Temperature Monitoring.
z OxyCardiorespirogram (neonatal mode only).
z Non-Invasive Blood Pressure Monitoring.
z Invasive Blood Pressure Monitoring.
z Trend Storage.
z Event Storage.
z Recordings.
z Patient Data Transfer (via PC Card or Network).
z Wireless Network Operation.
The monitor Gamma has a 6.5”, the monitor Gamma XL an 8.4” color display. Both
monitors have a rechargeable battery. A universal AC adapter is available for
connection to a hospital- grade outlet.

1-8 Gamma/Gamma XL VF6

 GENERAL DESCRIPTION

When used as a stand-alone device, you can connect the following peripheral
equipment to the monitor via the monitor’s interface plate:
z An R50 Series recorder for printing alarm data, waveforms, trends, and
diagnostic logs.
z A nurse call system for broadcasting life-threatening, serious, and advisory
alarms.
z A VGA remote display for viewing monitoring data on a larger screen.
For exporting data to external devices, the monitor provides a fast synchronization
output (i.e. for defibrillators) and an RS232 connector (via an interface plate or an
Infinity Docking Station/CPS Communication Power Supply).
When operating within the Infinity network, the monitor communicates with other
network devices and with the central station, allowing central monitoring of bedside
data.
For more information on network operation, refer to the chapter Network Application.
You can transfer patient data between monitors with the help of a Data Memory PC
Card or via the network. For information on data transfer, see the chapter Admission,
Transfer, Discharge.

VF6 Gamma/Gamma XL 1-9

1 OVERVIEW

Front Panel

1 Alarm Light 3 Rotary Knob

(not available on SC 6002/6802XL)

2 Fixed Keys 4 Power ON/OFF Key

1-10 Gamma/Gamma XL VF6

 BACK PANEL

Back Panel

1 Power Supply Connection 2 Battery Compartment Cover

VF6 Gamma/Gamma XL 1-11

1 OVERVIEW

Left Side Panel

1 NBP Hose Connection 3 Invasive Blood Pressure Connection

2 MULTIMED/NEOMED Connection 4 PodPort (optional etCO2 Pod
Connection)

1-12 Gamma/Gamma XL VF6

 RIGHT SIDE PANEL

Right Side Panel

1 Carrying Handle 3 Memory Card Slot

2 USB Connector 4 QRS Sync. Output
(only GammaXL monitors)

VF6 Gamma/Gamma XL 1-13

1 OVERVIEW

Interface Plate (optional)

1 X5: External VGA/Scio Multigas 2 X7: Alarm Output/R50 Recorder/RS232

Module

1-14 Gamma/Gamma XL VF6

 GAMMA/GAMMA XL DISPLAY

Gamma/Gamma XL Display

1 Waveform Channel 1, 2, 3 3 Message Area

2 Waveform/Parameter Channel 4 4 Parameter Boxes

NOTE: The fourth display channel is available as an option for the Gamma monitor,
but standard on all monitors Gamma XL. For information on screen configuration, see
the chapter Monitor Setup. For information on the fourth channel option, please contact
your Dräger representative.

Alarm Colors
Colors are used to call your attention to important events:
z Black letters on a red background are used for life-threatening alarms and
their messages (e.g., Asystole).
z Black letters on a yellow background are used for serious alarms and their
messages (e.g., Rsp Too High).
z Black letters on a white background are used for advisory alarms and their
messages (e.g., Rsp Lead Off).
z Amber letters on a dark gray background are used for network messages (see
the Network Applications chapter for details).
z White letters on a blue background are used for messages and information
unrelated to the network (e.g., Battery Charging).

VF6 Gamma/Gamma XL 1-15

1 OVERVIEW

Parameter Colors
The parameter color extends to the following display elements:
z Parameter label.
z Parameter waveform.
z Parameter trend labels and graphs.
You can choose the parameter color for most parameters, except for the following:

Multigas Parameter Labels O2-white, N2O-blue, ISO-purple, ENF-orange, HAL-red,

DES-blue, SEV-yellow

Multigas Parameter Values White

ST Takes on the color chosen for ECG.

(The ST reference complex is always purple.)

Choosing parameter colors is a password-protected function (see the appendix Default

Settings and Biomedical Support).

1-16 Gamma/Gamma XL VF6

 ROTARY KNOB

Rotary Knob
Using the rotary knob, you can:
z Select a screen area (parameter box or waveform field).
z Call up a menu and change menu options.
z Scroll through trend tables and graphs.
z Scroll through stored events.
z Switch between trend tables and graphs.

STEPS: Calling up a menu

1. Turn the knob clockwise or counterclockwise to navigate the screen. Selected
areas appear framed.
2. Press (click) the knob to call up a screen area’s menu (a parameter menu or a
waveform channel menu).

STEPS: Changing menu options

1. Dial to highlight the desired menu option.
2. Press the knob to activate the option.
3. Dial in the desired setting.
4. Press the knob to confirm the change.
5. To exit the menu, press the Main Screen fixed key.

VF6 Gamma/Gamma XL 1-17

1 OVERVIEW

Fixed Keys
The monitor has a Power ON/OFF key and eight fixed keys on the front of the unit.
These keys give the user access to various monitoring functions:

Press this key to turn the monitor on or off.

Power

Alarm Silence Press this key to silence an active alarm for one minute.

Record Press this key to start a manual recording. If no recorder is connected

or assigned to this monitor, the recording is stored as an event and
can be viewed, printed or deleted at a later date.

Alarm Limits Press this key to access the alarm limits table.

NBP Start/Stop Press this key to start a manual NBP measurement, or to stop one in
progress.

All Alarms Off Press this key to silence all alarms for three minutes.

Fast Access Press this key to access trend and event data. In OR mode, this key
(Zoom) also allows discharging the patient or putting the monitor into standby.

Menu Press this key to access the monitor’s Main Menu.

Main Screen Press this key to return to the monitor’s main screen from any open
menu or display, or to return to monitoring after Standby or a patient
discharge.

1-18 Gamma/Gamma XL VF6

 MENUS

Menus
Menus provide easy access to monitoring functions, including:
z Initial monitor and system setup.
z The setting of alarm functions.
z The setting of monitoring options for each parameter.
Menus are displayed in the waveform area. Use the rotary knob or a fixed key to
access menus. A complete menu tree is shown at the end of this chapter.

NOTE:
z Some menu items are only available, if the corresponding monitoring function
has been enabled/selected (i.e. fourth waveform channel, second IBP parameter,
full arrhythmia monitoring, ST monitoring, etCO2 monitoring, OCRG, wireless
network monitoring).
z Parameter boxes for invasive blood pressure (IBP) show the labels ART, PA,
CVP, ICP or a generic pressure label (GP1 or GP2); see the chapter Invasive
Blood Pressure.

VF6 Gamma/Gamma XL 1-19

1 OVERVIEW

Power Sources
The monitor can be operated with battery power or connected to line power via an AC
adapter or Docking Station. See the chapter Monitor Setup for a description of battery
operation and the AC adapter. See the chapter Network Applications for a description
of the Docking Station and Pick-and-Go transport.

Monitor with Battery

Monitor with AC Adapter

Infinity Docking Station

1-20 Gamma/Gamma XL VF6

 MULTIMED/NEOMED POD

MULTIMED/NEOMED Pod
For easier cable management, ECG cable sets, the SpO2 sensor and temperature
probes are housed in a MULTIMED or NEOMED pod. See the chapter Monitor Setup for
information on assembling the patient cables.

MultiMed 5 Pod and Accessories

MultiMed 6 Pod and Accessories

NeoMed Pod and Accessories

VF6 Gamma/Gamma XL 1-21

1 OVERVIEW

etCO2 Pod and Multigas Module

An etCO2 pod for the measurement of end-tidal CO2, and a Multigas module for the
measurement of O2, CO2, N2O and five anesthetic agents are available as an option.
See the chapters End-Tidal CO2 and Multigas for more information.

etCO2 Pod

Scio Multigas Module

Recorder
You can connect a Dräger R50 Series strip-chart recorder to the monitor for the
documentation of your patient’s vital sign information, including trends and alarms.
For information on recordings, see the chapter Recordings.

R50 Recorder

1-22 Gamma/Gamma XL VF6

 REMOTE DISPLAYS

Remote Displays
The bedside monitor can send data to a larger VGA video display for an enhanced
view of the monitoring functions. The VGA display connects directly to the Infinity
Docking Station (IDS), interface plate, or the Communication Power Supply (CPS).
Use of a Dräger-approved video display is recommended. For ordering information,
see the Accessories appendix.

NOTE: The remote display output on the IDS/CPS is not galvanically isolated. If you
use a video monitor other than the one approved by Dräger, it must comply with IEC
60601-1. Upon installation, the installer must ensure that in normal and single fault
conditions, the entire system meets the requirements of IEC 60601-1 and IEC 60601-1-1
(Medical Electrical Systems Standards). Refer to the video monitor’s operating
instructions to ensure that the interconnection is within its intended use as specified by
the manufacturer. Additionally, radiated and conducted emissions classification,
suitability for flammable locations and water ingress protection must be considered
based on the intended use of the system.

Complete Menu Structure

(see below)

VF6 Gamma/Gamma XL 1-23

1 OVERVIEW

Main Menu
Review Trend Graphs

Trend Tables

Event Recall

Admit/Discharge Patient Admit Patient Category Adult

Pediatric

Neonate

Name (dial in)

ID (dial in)

Admit Date (current date)

Care Unit (select)

Bed Label (select)

Discharge Discharge Patient? No

Yes

Transfer Care Unit (select)

Transfer Bed (select)

Start Transfer Confirm

Cancel

Copy Data Copy to Card Name

ID

Start Transfer

Copy to Monitor Name

ID

Start Transfer

1-24 Gamma/Gamma XL VF6

 COMPLETE MENU STRUCTURE

Monitor Setup Main Screen Bottom Channel All

(not in OR mode) Waveform

Wave+NBP

NBP

OR Mode ON

OFF

(in OR mode only) Bottom Channel Parameter 1, 2, 3

(not in OR/OCRG mode) Show Rsp/etCO2 etCO2

Rsp

(with Lithium-Ion battery) Screen Brightness Dim

Bright

Monitor Options Speaker Volume 10, 20...100%

OFF

Trend Setup Channel 1 (select parameter)

Channel 2 (select parameter)

Channel 3 (select parameter)

Recordings Primary Recorder (select)

Secondary Recorder (select)

Review Event Recall

Biomed (password)

Alarm Groups 1 - 255

Standby

VF6 Gamma/Gamma XL 1-25

1 OVERVIEW

Fast Access Menu

End Case (in OR mode only) Discharge Patient? Yes

No

Standby (in OR mode only)

Bottom Channel (not in OR mode) All

Waveform

Wave+NBP

NBP

Trend Graphs

Trend Tables

Event Recall

Channel Display Menu

(1, 2, 3, 4 Channel) Waveform (select param.)

Size (param.specific)

Alarm Limits Table

(Parameter) Upper (dial in)

Autoset

Lower (dial in)

Alarm ON

OFF

Record Record

Store

Str/Rec

OFF

1-26 Gamma/Gamma XL VF6

 COMPLETE MENU STRUCTURE

HR Menu
(HR P-Box) Tone Source ECG

SpO2

Tone Volume 10, 20...100%

OFF

Pacer Detect ON

OFF

(if Pacer Mode = adv.) Fusion

QRS Mark ON

OFF

Arrhythmia Setup Rate (dial in)

Count (dial in)

Alarm ON

OFF

Record Record

Store

Str/Rec

OFF

ECG Processing ECG1

ECG1&2

ECG Leads 3, 5, 6

Arrhythmia Basic

Full

OFF

Relearn (last relearn)

VF6 Gamma/Gamma XL 1-27

1 OVERVIEW

Rsp Menu
(Resp P-Box) Resp Mode Manual

Auto

OFF

Resp. Marker ON

OFF

Relearn (last relearn)

Apnea Time 10 . . . 30

OFF

Coincidence ON

OFF

Multigas Menu
(Agent P-Box) Agent Detection Isoflurane

Enflurane

Halothane

Desflurane

Sevoflurane

Auto/Agent?

Multigas Alarms (alarm table)

Autozero Delay (1 minute before zero)

1-28 Gamma/Gamma XL VF6

 COMPLETE MENU STRUCTURE

etCO2 Menu (with POD)

NOTE: If Scio rather than the pod is the etCO2 source, the etCO2 menu shows only the
selections etCO2 Source and RRc Apnea.

(etCO2 P-Box) etCO2 Source POD

SCIO

Averaging Breath

10s, 20s

Instant.

RRc Apnea 10 . . . 30

OFF

Sensor Cal.

Adapter Cal.

Balance Air

N2O/O2

>60% O2

Heliox

Meas. Mode Main

Side

Insp. Agent 0 . . . 20

Exp. Agent 0 . . . 20

Atm. Press. Mode Auto

Manual

Atm. Pressure 400 . . . 800

VF6 Gamma/Gamma XL 1-29

1 OVERVIEW

SpO2 Menu
(SpO2 P-Box) Tone Source ECG

SpO2

Tone Volume 10, 20...100%

OFF

Bar Graph ON

OFF

Averaging Normal

Fast

Sensor Type (informational only)

ST Menu
(ST P-Box) ISO (place point)

ST (place point)

Ref ON

OFF

Save (last save)

1-30 Gamma/Gamma XL VF6

 COMPLETE MENU STRUCTURE

NBP Menu
(NBP P-Box) Interval Mode 2 . . . 240

OFF

Calibration Mode ON

OFF

Inflation Mode Adult: 270

Ped: 180

Neo: 140

Measurement Tone ON

OFF

IBP Menu
(IBP P-Box) Label (select pressure)

Zero

Cal. Factor 80 . . . 120

Mano. Cal. (mmHg) 1 . . . 300

VF6 Gamma/Gamma XL 1-31

1 OVERVIEW

Biomed Menu
NOTE: These are password-protected functions.

Biomed Save Setups Confirm

Cancel

Locked Options Enable Option Demo

Lock 1, 2, 3, 4 (software key)

Diagnostic Logs

Units T °C or °F

etCO2 mmHg, kPa or Vol%

Pressures mmHg or kPa

ST mm or mV

Service (password) (service functions)

Monitor Setup Alarm Light ON

OFF

Parameter Colors (select color)

NBP/SpO2 Interlock ON

OFF

ASY/VF Alarms Always On

Follow HR

Pacer Mode Basic

Advanced

1-32 Gamma/Gamma XL VF6

2 Monitor Setup

Getting Started...............................................................................................................2-2
Using the AC Adapter .............................................................................................2-2
Using the Battery ....................................................................................................2-3
Assembling MultiMed and NeoMed Pods .............................................................2-8
Starting the Monitor.......................................................................................................2-9
Main Screen Configuration .........................................................................................2-10
Waveform Selection ..............................................................................................2-10
Bottom Channel Display.......................................................................................2-11
OR Mode ................................................................................................................2-14
Show Respiration or etCO2 Parameters .............................................................2-14
Setting the Master Speaker Volume...........................................................................2-16
Standby.........................................................................................................................2-17
Saving Setups ..............................................................................................................2-18
2 MONITOR SETUP

Getting Started

CAUTION:
z Before monitoring your patient, the battery that is delivered with a new monitor
has to be fully charged (see below).
z Before monitoring your patient, be sure you have read the Important General
Safety Considerations in the Overview chapter.

Using the AC Adapter

The AC adapter connects the monitor to a hospital-grade power outlet. It charges the
battery during normal operation. In case of a power failure, the monitor switches to
battery power without loss of monitoring data or settings.

CAUTION: Use only the AC adapter approved by Dräger. Using a non-approved power
supply could damage the monitor.

2-2 Gamma/Gamma XL VF6

 GETTING STARTED

STEPS: Connecting the AC Adapter

1. Connect the AC adapter's cable to the DC input on the monitor’s back panel.
2. Connect the power cord to the AC adapter.
3. Plug the other end of the power cord into a hospital-grade outlet. The battery
charge indicator on the front panel lights up.
4. Press the Power fixed key and wait until the display lights up and the monitor
completes its self-test.

If the monitor does not power on, verify the connections and retry. If it fails again,
take the unit out of operation and contact DrägerService.

Using the Battery

The battery powers the monitor when the monitor is not connected to line power via
the AC adapter, an IDS Docking Station, or a CPS Communication Power Supply
(IDS and CPS are described in the chapter Network Applications). The battery fits into
the battery compartment at the back of the monitor.
There are two types of batteries: lead acid, or lithium ion (shown below). Lead acid
batteries provide 75 minutes of continuous monitoring; lithium ion batteries provide
210 minutes in Bright Screen Mode and 240 minutes in Dim Screen Mode of
continuous monitoring.

Lithium Ion Battery Lead Acid Battery

Lead acid and Lithium-ion batteries can be installed or removed by the user. The green
battery gauge displayed at the bottom left of the screen indicates the battery run time
remaining for uninterrupted monitoring.

NOTE: The battery gauge appears only when you operate the monitor on battery
power.

VF6 Gamma/Gamma XL 2-3

2 MONITOR SETUP

When the battery charge is less than approximately 25%, the following happens:
z The battery gauge displays in yellow.
z The monitor emits an alert tone.
z The monitor displays the message Replace Battery Pack at frequent intervals.
If the battery charge drops below 10 V, monitoring stops, but monitoring settings,
trended data, and stored recordings are saved in memory.

Screen Brightness
To save power, the monitor’s display may automatically dim when you change to
battery operation.
With a lead acid battery, the display always dims on battery power. With a lithium ion
battery, you can choose whether or not the displays dims.
The Brightness setting remains in effect through a power cycle. Regardless of the
setting, lithium ion batteries can power the monitor for at least three hours, even if the
display remains bright during battery operation.

NOTE:
z The menu option Screen Brightness only appears when the monitor is equipped
with a lithium ion battery.
z This function is only supported with recent releases of the micro-controller
code. If the Screen Brightness option is not available in the menu, although a
lithium ion battery is installed, an update of the micro-controller code is
necessary (contact your Dräger representative).

2-4 Gamma/Gamma XL VF6

 GETTING STARTED

STEPS: Selecting the Screen Brightness

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Main Screen.
4. Click on Screen Brightness.
5. Select Dim or Bright and click the knob.

STEPS: Inserting a Lead Acid Battery into the Monitor

NOTE: Before installing the battery, read the cautions and warnings in the Important
General Safety Considerations section at the beginning of this manual.

NOTE: A lithium-ion battery can replace the lead-acid battery in Gamma/GammaXL

patient monitors. If a lithium-ion battery has been selected as an option, see the
Installation Instructions provided with the lithium-ion battery for inserting and removing
the battery.

1. Turn the monitor so that its rear panel is facing towards you.
2. Press in on the tab in the right side of the battery compartment door and swing
the door open until it lifts off the hinges on the left side.

3. Insert the rechargeable battery in the compartment, electrical terminals side

first. The terminals of the battery must be pushed into the clip in the left side
of the battery compartment.

VF6 Gamma/Gamma XL 2-5

2 MONITOR SETUP

4. With the battery pushed into the left side of the battery compartment, press the
right side of the battery into the clip at the right side.
5. Insert the left side of the battery door into the hinges, and swivel the door
closed until the locking tab snaps into place.
6. Press the Power fixed key to turn the monitor on. The green light indicator in
the key should light up.
7. Wait until the end of the self-tests and verify that the battery gauge appears at
the bottom of the display.

NOTE: The battery gauge appears only when you operate the monitor on battery
power.

To prolong battery life, we recommend the following:

z Use the AC adapter whenever possible.
z Keep the battery charged.

STEPS: Charging the Battery with the Monitor

The battery that is delivered with a new monitor needs to be fully charged before
monitoring. When connected to line power via the AC Adapter, IDS, or CPS, the
monitor automatically charges the battery and the green Battery Charger LED lights
up (the monitor can be turned on or off).

2-6 Gamma/Gamma XL VF6

 GETTING STARTED

To charge the battery:

1. Connect the monitor to line power and let the lead acid battery charge for 5½
hours, the lithium ion battery for 8 hours. (The Battery Charging message
appears intermittently.)
2. Wait until the battery is fully charged before monitoring a patient. (The
Battery Charging message no longer appears.)

NOTE: If the battery does not charge properly, the message Battery Charger Error
appears. Contact your Biomedical technician to replace the battery.

STEPS: Charging Lead Acid Batteries with a Battery Charger

You can charge up to four additional lead acid batteries with the battery charger
available from Dräger. To do so:

1. Place the lead acid batteries on the battery charger.

2. Keep the lead acid batteries in the charger for at
least four hours to ensure a full charge.

CAUTION: U s e t h e b a t t e ry c h a rg e r t o c h a rg e l e a d a c i d
b a t t e r i e s o n l y. L i t h i u m i o n b a t t e r i e s a r e n o t c o m pa t i b l e w i t h
t h e D r ä g e r l e a d a c i d b a t t e r y c h a r g e r.

STEPS: Removing a Lead Acid Battery from the Monitor

1. Connect the monitor to AC power or turn the monitor off.
NOTE: If the monitor is connected to AC power, monitoring can continue while you
replace the battery. If the monitor is not connected to AC power, turn the monitor off
before removing the battery in order to assure a proper monitor shut-down.

2. Place the monitor on a flat surface.

3. Open the battery compartment door (back of the monitor).
4. Lift the battery from under the locking tab and pull the battery out.

VF6 Gamma/Gamma XL 2-7

2 MONITOR SETUP

WA R N I N G : To a v o i d e x p l o s i o n , d o n o t d i s a s s e m b l e , o r
d i s p o s e o f t h e b a t t e r y i n f i r e . D o n ot c h a n g e t h e b a t t e r y i n t h e
p re s e n c e o f e x p l o s i v e h a z a r d s b e c a u s e o f t h e p o s s i b i l i t y o f
s pa r k s . I f t h e m o n i t o r i s n o t t o b e u s e d f o r a p ro l o n g e d t i m e ,
r e m o v e t h e b a t t e r y f r o m t h e b a t t e r y c o m pa r t m e n t .

Assembling MULTIMED and NEOMED Pods

Choose a 5-lead or 6-lead MULTIMED Pod (adult/pediatric applications) or a NEOMED
Pod (neonatal applications) for your monitoring session. Assemble the pods as
illustrated prior to connecting them to the monitor. (Parameter-specific patient
preparation is described in the individual parameter chapters.)

1) SpO2 sensor 2) ECG lead sets 3) Temperature sensor

NOTE: The FiO2 and TEMP B connectors of the NEOMED™ pod are not supported
with the Gamma Series monitors.

WA R N I N G : D o n o t u s e t h e N E O M E D P o d d u r i n g e l e c t r o s u r g e r y.
U s e d u r i n g c a u t e r y m a y r e s u l t i n b u r n s t o t h e pa t i e n t o r
c li n i c a l s ta f f .

2-8 Gamma/Gamma XL VF6

 STARTING THE MONITOR

Monitor with connected MultiMed

Starting the Monitor

1. Press the Power fixed key. The green light indicator in the key lights up and
the monitor emits 2 short tones.
2. Wait until the main screen appears at the end of the self-tests.

NOTE:
z If an internal failure or error should occur, the monitor’s screen turns blank. If
this should happen, turn the monitor off, then on again. In case of persistent
failure, remove the monitor from service and call your Biomed technician.
z Do not use the monitor if you do not have an AC Adapter, CPS, IDS, or a fully
charged battery. Call your Biomed if you are not familiar with the use of the
battery or the power adapter.

VF6 Gamma/Gamma XL 2-9

2 MONITOR SETUP

Main Screen Configuration

The monitor has four display channels. The top three channels show waveforms and
their corresponding parameter boxes. The bottom channel can be configured to show
either parameter boxes, enlarged NBP values, a waveform, or a combination of a
waveform and parameter boxes (see illustrations on pages 2-12 and 2-13).
NOTE:
z A fourth display channel is standard for monitors Gamma XL and available as
an option for monitors Gamma. For information, contact your Dräger
representative.
z Settings for screen brightness are explained under Using the Battery, above.

Waveform Selection

STEPS: Selecting Parameters for Waveform Channel Display

1. On the main screen, select a waveform channel with the rotary knob and click
the knob.

2. In the Channel Setup menu, click on Waveform and select the desired
parameter or ECG lead for display. (For more information, including the ECG
cascaded display, see the chapter ECG and Heart Rate.)

NOTE: If you change the monitor’s parameter display and the MULTIVIEW
WORKSTATION is storing waveforms selected manually (Auto Track OFF), you must
also change the parameters at the MULTIVIEW WORKSTATION. For more information,
see the MULTIVIEW WORKSTATION’s Instructions for Use.

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 MAIN SCREEN CONFIGURATION

Bottom Channel Display

STEPS: Selecting the Bottom Channel Display

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Main Screen.

4. Click on Bottom Channel.

NOTE: You can also call up the Bottom Channel menu by pressing the Fast Access
fixed key.

5. Click on All, NBP, Waveform, or Wave+NBP to select one of the following

bottom channel displays:

VF6 Gamma/Gamma XL 2-11

2 MONITOR SETUP

Bottom Channel showing parameter boxes

Bottom Channel showing enlarged NBP values

2-12 Gamma/Gamma XL VF6

 MAIN SCREEN CONFIGURATION

Bottom Channel showing a fourth waveform

Bottom Channel showing a waveform and parameter boxes

VF6 Gamma/Gamma XL 2-13

2 MONITOR SETUP

OR Mode
The OR mode allows access to multigas monitoring functions and is available for
monitors Gamma XL operating in the adult or pediatric mode.

STEPS: Selecting the OR Mode

1. Verify that the adult or pediatric patient category is selected.
2. Press the Menu fixed key.
3. Click on Monitor Setup.
4. Click on Main Screen.

5. Click on OR Mode.
6. Select ON and click the knob.

NOTE: For more information on the OR mode and the OR mode parameter display,
see the chapter Multigas.

Show Respiration or etCO2 Parameters

STEPS: Selecting Rsp/etCO2

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Main Screen.

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 MAIN SCREEN CONFIGURATION

4. Click on Show Rsp/etCO2.

5. Select Rsp or etCO2 and click the knob.

NOTE:
z For more information on Respiration or etCO2 monitoring, see the respective
parameter chapters.
z The menu option Show Rsp/etCO2 appears only if the ST, IBP2, and either the
etCO2 or Multigas locked options are enabled.

VF6 Gamma/Gamma XL 2-15

2 MONITOR SETUP

Setting the Master Speaker Volume

The setting for the master speaker volume defines the volume for alarm tones, pulse
tones, attention and error tones. The available settings are 10, 20...100% and OFF.
NOTE:
z For safety reasons, you cannot turn the speaker volume off when the monitor
operates as a stand-alone device or if the French-NFC mode has been selected
(a Service setting).
z If your monitor is operating in the Infinity network and you turn the speaker
volume off, a crossed speaker symbol appears above the first waveform
channel.

STEPS: Setting the Speaker Volume

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Monitor Options.
4. Click on Speaker Volume.

5. Click the knob, select a setting, and click the knob again.

NOTE: The setting for the master speaker volume defines the maximum volume for
all tones, including the user-adjustable QRS and SpO2 pulse tones. Therefore, if you set
the master speaker volume to Low, but set the QRS and SpO2 pulse tones to High in the
ECG or SpO2 menu (see ECG and SpO2 chapters), the master volume setting prevails
and pulse tones sound at a low volume.

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 STANDBY

Standby
The standby function lets you interrupt and then resume monitoring. When you put the
monitor into standby, all patient data and monitoring setups are saved in memory until
you resume monitoring. During standby, the monitor displays a Standby banner. If the
monitor is part of the Infinity network and its monitoring data is displayed on the
central station, the Standby banner appears also on the central display.

STEPS: Placing the Monitor into Standby

1. Press the Menu fixed key.
2. Click on Standby.

In the OR mode, you can also:

1. Press the Fast Access fixed key.

2. Click on Standby.

STEPS: Exiting Standby

1. To resume monitoring, press the Main Screen fixed key. The New Patient?
prompt appears.
2. Select New Patient No, if you want to resume
monitoring the same patient. Select New Patient Yes,
if you want to start monitoring a new patient. If
admitting a new patient, the monitor erases all
previously stored patient data (see the chapter
Admission, Transfer, Discharge).

NOTE:
z Upon startup, coming out of standby, or admitting a new patient, alarms are
disabled for 3 minutes or until you press the All Alarms OFF fixed key.
z During standby, you can modify patient demographic data at the central station
at any time. The new data is transferred to the monitor and available when
monitoring resumes.

VF6 Gamma/Gamma XL 2-17

2 MONITOR SETUP

Saving Setups
The current monitoring configuration can be saved and used again. A saved
configuration is specific to the selected patient category and is automatically restored
when a you admit a new patient of the same category (e.g., pediatric).
The following monitoring settings are saved: waveform channel assignments and
scales, alarm limits and on/off status, NBP interval mode, IBP pressure labels,
arrhythmia monitoring (adult or pediatric mode only), respiration mode and markers,
apnea time, coincidence alarm, etCO2 measurement mode, pacemaker setting and
detection, bottom channel display selection, recording selections (on/off/store), and
trend setup.
NOTE:
z Saving setups is a password-protected function and can only be performed by
your Biomed.
z You cannot save a setup when an OCRG is displayed on the screen. Exit the
OCRG display before saving.

STEPS: Saving a Setup (password required)

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Biomed.

4. Dial in the Biomed password and click the knob.

5. Click on Save Setups.
6. Click on Save Setup, select Confirm (or Cancel) and click the knob.

The monitor saves the current monitoring setup for future use. The setup is available
even after the current patient has been discharged from this monitor.

2-18 Gamma/Gamma XL VF6

3 Network Applications

Overview.........................................................................................................................3-2
Network Configurations ................................................................................................3-3
Basic Network Components ..................................................................................3-4
Basic Bedside Setups.............................................................................................3-5
Network Operation.........................................................................................................3-6
Docking Station .......................................................................................................3-7
Docking and Undocking .........................................................................................3-9
Wireless Network Configuration .........................................................................3-10
Wireless Network Operation ................................................................................3-11
Network Safety Considerations..................................................................................3-14
Alarm and Status Messages .......................................................................................3-15

NOTE:
z The current software operates on the Dräger Infinity network, but does not
support the Dräger Sirenet network.
z To assure optimal network performance of your monitoring system, make sure
all network components operate at the appropriate software level as disclosed in
the Dräger compatibility chart. For more information, contact your technical
personnel or your Dräger representative.
3 NETWORK APPLICATIONS

Overview
The Infinity network provides communication links between the bedside monitor and
other network devices such as a central station, other monitors, recorders, and laser
printers. The network allows you to monitor your patient at a central location away
from the bedside, and to monitor many patients at once. In detail, within the Infinity
network you can:
z View patient data of up to 16 patients at a dedicated central station
(MULTIVIEW WORKSTATION™).
z Admit patients at the central station.
z Receive bedside alarm messages at the central station and at other devices
within the network.
z Receive alarm messages from other devices within the network at the local
bedside monitor.
z Control alarms from the central station.
z Initiate a Relearn of a patient’s ECG and respiration pattern from the central
station.
z Set arrhythmia parameters from the central station.
z Print recordings on network recorders and laser printers.
z Transfer patients between monitors in the network.
z Collect diagnostic logs at the central station.
z View monitoring data on a larger video display.
If the monitor becomes disconnected from the network, it operates in standalone mode
and the MULTIVIEW WORKSTATION displays an offline message.

NOTE: In order to limit the number of alarm messages from remote bedside monitors
within the network, you can group bedside monitors into separate alarm groups so that
only messages from monitors within the same group are shared. For details see the
chapter Alarms and Messages.

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 NETWORK CONFIGURATIONS

Network Configurations
A basic Infinity network includes:
z Bedside monitors.
z A central station (MULTIVIEW WORKSTATION - optional).
z Docking stations at the bedside.
z R50 Series recorders.
z Infinity network cabling and repeater hubs.
A basic Infinity wireless network includes:
z Bedside monitors.
z A central station (MULTIVIEW WORKSTATION - optional).
z Wireless LAN PC Cards.
z Access points with antennae.
z R50 Series recorders.
z Infinity network cabling and repeater hubs.
Dräger offers a large variety of network components and supplies that allow you to
customize your hospital’s network configuration. Network setup and configuration are
Service functions performed during installation. Please see your local Dräger
representative for details.

NOTE: A Care Unit is a group of bedside monitors with the same hospital-assigned
identification (i.e. CCU, ICU). The name of a Care Unit must be unique within the
Infinity network configuration. A Monitoring Unit is a logical group of bedside
monitors that share certain monitoring functions, such as alarm annunciations,
recordings, and remote views. A Monitoring Unit can have more than one central station
and span more than one Care Unit.

VF6 Gamma/Gamma XL 3-3

3 NETWORK APPLICATIONS

Basic Network Components

Bedside Monitor Central Station

Simple Docking Station Infinity Docking Station

(mount only) (IDS)

IDS Power Supply

Communication Power Supply Interface Plate R50 Recorder

(CPS)

Laser Printer Access Points Wireless LAN PC Card

3-4 Gamma/Gamma XL VF6

 NETWORK CONFIGURATIONS

Basic Bedside Setups

Access Point

Bedside Setup with IDS

Monitor with
Wireless LAN PC Card

Bedside Setup with CPS Monitor with Interface Plate

VF6 Gamma/Gamma XL 3-5

3 NETWORK APPLICATIONS

Network Operation
The bedside monitor operates in network mode when it is:
z Docked at a docking station,
z Equipped with a wireless PC card in a wireless network
Docking stations must be configured for network mode (versus standalone mode) by
Dräger personnel during installation. Only Dräger personnel can modify these
configurations, which define numerous network functions, including bedside labels,
recorder labels, and the availability of remote control functions of the bedside monitor
from other network devices.
Wireless monitors must be admitted to the network during installation. Once admitted,
the user can then select care unit and bed label assignments according to where the
wireless monitor is stationed (see the section Wireless Network Configuration, below).
While a wireless monitor is docked at a docking station, it automatically accepts the
docking station’s care unit and bed label assignments.
If central monitoring is enabled at the bedside monitor, you can assign the bedside
monitor to a display channel on the central station’s screen. The monitor continuously
sends the following information to the central station:
z Parameter values (including values reported as ***).
z Waveforms and their scales.
z Current bedside alarm limits and settings.
z Alarms and status messages.
At the central station, you can also call up the bedside monitor’s trend data and
diagnostic log and you can store monitoring events (see the MULTIVIEW
WORKSTATION Instructions for Use).

3-6 Gamma/Gamma XL VF6

 NETWORK OPERATION

NOTE:
z The only configurations of the IDS/CPS that you can perform via the monitor’s
menus are the assignment of alarm groups and the selection of primary and
secondary network recorders (see the chapters Alarms and Messages and
Recordings).
z If central monitoring is disabled at the IDS/CPS,
-- you cannot turn the monitor’s master speaker volume off,
-- no network offline messages appear at the bedside monitor.
z If central monitoring is disabled at the IDS/CPS, you can continue to access the
network recorder assigned to the IDS/CPS and alarm messages continue to be
broadcast between devices in an alarm group.
z Configuration of the monitor’s network behavior is a password-protected
Service function. For more information, consult with your biomedical
personnel.
z If a network connection cannot be established upon power-up, the monitor
displays the message Incompatible CPS or Network Error.

Docking Station
The Infinity Docking Station (IDS) with companion DC power supply powers the
monitor and provides connections for optional peripheral devices such as recorders,
remote displays, or a nurse call system. The docking station serves as a secure mount
for the monitor and allows quick mounting and dismounting in PICK AND GO transport
situations.
While the monitor is docked at a docking station, its batteries are being charged. In
case of a power failure, the monitor switches immediately to battery power without
loss of data or monitoring settings.

NOTE: The Infinity Docking Station (IDS), which offers full network connectivity
and power, has replaced the simple Docking Station (mount only), which is used in
conjunction with a Communication Power Supply (CPS). References to the simple
Docking Station and CPS are included here for sites that still use them.

VF6 Gamma/Gamma XL 3-7

3 NETWORK APPLICATIONS

Infinity Docking Station (back panel)

1 Power Supply 5 External VGA/RS232

2 Alarm Output 6 Multigas Module
3 Infinity Network 7 Independent Surgical Display (ISD)
4 R50 Recorder

Mount-only Docking Station and CPS (back panel)

1 Infinity Network 5 External VGA/RS232

2 R50 Recorder 6 Power Cord
3 Alarm Output 7 ON/OFF switch
4 Docking Station

3-8 Gamma/Gamma XL VF6

 NETWORK OPERATION

Docking and Undocking

STEPS: Docking the Monitor

1. Hold the monitor firmly by its handle and set it
onto the Docking Station. Make sure the monitor
is securely positioned and clicks into place. The
Docking Station’s locking lever does not move
unless the monitor is seated properly.
2. Slide the locking lever to the right in order to
engage the electrical connections and lock the
monitor in place. The battery charging indicator
on the front of the monitor lights up.

CAUTION: To avoid dropping the monitor, do not let go of the monitor’s handle until
you have moved the locking lever as far to the right as possible, thereby locking the
monitor in place.

STEPS: Undocking the Monitor

1. Hold the monitor firmly by its handle. Slide the lever to the left to disengage
the power supply. (The monitor automatically switches to battery power.)
2. Continue to move the lever to the left until it clicks. Tilt the monitor forward
and lift it off the Docking Station.

When you remove the monitor from the Docking Station, patient data and settings
remain stored in the monitor's memory. The central station blanks the monitor’s data
and displays the message Bed Disconnected (unless a wireless card is inserted -- see
the section Wireless Network Configuration, below). Once the monitor returns to its
Docking Station, it resumes sending patient data to the central station.

PICK AND GO versus Network Error

The network can distinguish between a network error and the intentional removal of a
bedside monitor from its Docking Station.
If the monitor loses its connection with the network due to a technical problem, the
network generates a network error message. When the monitor is removed from its
Docking Station for transport, the central station displays a network status message
(Bed Disconnected).

VF6 Gamma/Gamma XL 3-9

3 NETWORK APPLICATIONS

If the bedside monitor’s speaker volume had been set to OFF during network
operation, upon loss of communication with the network, it is automatically reset to
50% (default stand-alone level), or to 100% in case of an active alarm (network error
message).

Wireless Network Configuration

CAUTION: To No wireless network can guarantee complete and uninterrupted network
connection of all devices. Before operating the monitor in a wireless network
configuration, please read the Network Safety Considerations at the end of this chapter.
The Infinity Gamma Series monitor can operate in a wireless network which allows
the monitor to establish and maintain contact with the Infinity network and the central
station without being docked at a Docking Station.
A wireless monitor transmits and receives data with the help of a wireless LAN PC
card installed in the Memory Card slot on the monitor’s side panel. The wireless card
communicates with access points which are strategically placed within a monitoring
unit in order to cover the desired transmission area.
If a wireless monitor loses contact with all access points and wireless transmission is
interrupted (i.e. you remove the wireless card or the monitor is out of range), the
network generates an offline message and the monitor operates as a standalone device.
NOTE:
z When the battery charge of an undocked wireless Infinity monitor becomes low,
the central station, to which the monitor is assigned, issues an adivsory alarm.
z For detailed information about installation and configuration of wireless
components, refer to the Dräger publication “Infinity Network Planning,
Design, and Installation Handbook-- Wireless Extensions Supplement.”

A wireless network offers the following:

z Seamless Patient Transport — A wireless monitor continues to
communicate with the Infinity network during Pick-and-Go transport
situations and its data remains on the central display after leaving the bedside
Docking Station.
z Seamless Patient Relocation — Patient and monitor can be moved to a
different room or care unit without losing contact with the Infinity network.
z Simplified Network Setup — Wireless monitors can be networked without
the need of docking stations or hard-wired hub connectors, which reduces the
need for network cables within the hospital. (Note: Central station, access
points, and recorders/printers are connected to the network by cable.)

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 NETWORK OPERATION

STEPS: Installing the Wireless Card

1. Turn the monitor off.
2. Facing the monitor, turn the card so that the flat side (back label) faces you.
3. Press the card firmly into the card slot until the slot’s release button protrudes.

Card Slot

Release Button

To remove the card, turn the monitor off and press the release button.

Wireless Network Operation

Care Unit and Bed Label Assignments

A wireless monitor receives care unit and bed label assignments in one of the
following ways:
z Automatically when docking at a Docking Station.
z By manual entry via the Patient Admit menu.
When docking at a Docking Station, a wireless monitor automatically accepts the
Docking Station’s Care Unit and Bed Label assignments and communicates with the
Infinity network via the Docking Station. When the monitor undocks, the wireless
card and access points take over communication between the monitor and the
network.
When operating in a network without docking stations, you enter the Care Unit and
Bed Label assignments in the Patient Admit menu (see the following steps).

VF6 Gamma/Gamma XL 3-11

3 NETWORK APPLICATIONS

NOTE: Upon undocking, the monitor can either keep or give up the bed label
assignment it received from the Docking Station, depending on the network setup
performed by Service personnel during installation.
z If the monitor has been configured to keep the Docking Station’s bed label upon
undocking, the monitor retains the bed label as well as its display position at the
central station.
z If the monitor has been configured to give up the Docking Station’s bed label
upon undocking, it either reverts back to a previously entered bed label, or the
user must manually enter a new care unit and bed label via the Patient Admit
menu. If the bed label entered is already in use, the monitor displays an error
message.

NOTE: After turning a wireless monitor on, it receives a list of available care units
and bed labels from the MULTIVIEW WORKSTATION. If this list is not immediately
available in the monitor’s Patient Admit menu, wait until the list has been fully
transmitted.

STEPS: Selecting Care Unit and Bed Label

1. Undock the monitor, if docked.
2. Press the Menu fixed key.
3. Click on Admit/Discharge.
4. Click on Patient Admit.

5. Click on Care Unit.

6. Dial in the desired care unit from the list of available choices and click the
knob.
7. Click on Bed Label.

3-12 Gamma/Gamma XL VF6

 NETWORK OPERATION

8. Dial in the desired bed label from the list of available choices and click the
knob.

NOTE:
z You can enter a care unit and bed label only after undocking the monitor. While
the monitor is docked or operating as a stand-alone device, these menu
selections are not available.
z Upon undocking, wait a few moments until the monitor has received a list of
available care units from the network.
z Always select the care unit before selecting the bed label, because the Bed
Label menu only lists bedside monitors located in the selected care unit.
z The overall list of available care units and bed labels is established during
network installation. If you cannot find the desired care unit or bed label as a
menu choice, contact your Biomed or DrägerService.

Central Display
The central station identifies wireless monitors by a transmission icon on the
central display. Upon undocking, the bedside monitor’s central display channel
(viewport) remains assigned to the wireless monitor. If another monitor docks on the
same Docking Station which is still associated with the wireless monitor, the new
monitor receives the same bed label from the Docking Station, but does not replace
the wireless monitor in the viewport of the central station. In order to view the new
monitor on the central display, the user has to assign a different display channel to the
new monitor via the central station’s Assign Bed menu.
NOTE:
z Patient name and ID continuously identify the patient on central displays,
recordings, and data bases, whether the monitor is in transport or docked.
z If a wireless monitor is transmitting to a central station but has not been
assigned a viewport at that station, the message Not monitored by central
appears in the monitor’s message area.

Patient Relocation
You can move monitor and patient to a different room and care unit by simply docking
the monitor at the new location. Alternatively you can select care unit and bed label of
the intended new location via the Patient Admit menu (see the section Selecting Care
Unit and Bed Label).
During transport, the wireless monitor continues to communicate with its assigned
central station via the access points. Upon docking at the new location, the monitor
accepts the new Docking Station’s care unit and bed label assignments as well as its
display position on the central station’s cluster screen.

VF6 Gamma/Gamma XL 3-13

3 NETWORK APPLICATIONS

If you change central stations, that is, move the monitor to a room that is monitored by
a different central station, the original central station blanks the monitor’s data and
displays the message Bed Disconnected.
NOTE: During the transition between wireless and wired network operation, the
network may generate an error tone, if the transition takes more than a few seconds.
There is no loss of data and normal network operation continues, as soon as the
MULTIVIEW WORKSTATION has recognized the monitor’s new connection status.

Network Safety Considerations

When operating the monitor in a wireless network, please observe the following:
z Before using the wireless monitoring equipment, read the instructions and
safety warnings supplied by the wireless equipment manufacturer.
z While the unit is transmitting or receiving signals, do not hold the
transmitting/receiving unit close to exposed body parts, especially the face or
eyes. The antenna/wireless card should be at least 2" (5 cm) away from the
body.
z Operation of the wireless network relies on uninterrupted signal transmission
between the transmitting and receiving components of the network. When
using the wireless network, be aware that
-- certain structural limitations within the hospital building may interfere
with signal transmission,
-- other devices emitting radio frequencies, such as microwave ovens or
warmers, may interfere with signal transmission,
-- the frequencies emitted by the device may interfere with the operation of
other wireless operated medical equipment.
z The installation of wireless equipment must be performed by qualified
Service technicians. Any changes or modifications to the equipment not
expressly approved by the equipment manufacturer may result in equipment
malfunction or damage.
z Access points are not considered medical equipment and should be kept out of
the patient’s vicinity.
z The maximum number of wireless bedside monitors per dedicated access
point on the Infinity Network is eight.
z The maximum number of wireless bedside monitors per dedicated access
point on the OneNet Network™ is six.

3-14 Gamma/Gamma XL VF6

 ALARM AND STATUS MESSAGES

Alarm and Status Messages

When the monitor is connected to the network, network messages alert you of network
operating conditions. Some messages display only once (i.e., Remote Limit Change),
while others appear alternately until the condition has been resolved (i.e. alarm messages
such as BED 200:ECG Leads Off). A network alarm error creates an error tone, while
status messages do not.

Screen Message Condition

Selected Bed Label A wireless monitor undocks, but its assigned bed label is already
Currently in Use in use.
The user selects a care unit and bed label for a wireless monitor,
but the bed label is already in use.

Duplicate Address Another network device has been programmed with a conflicting
identification. The bedside monitor is treated as being offline.

Incompatible CPS The monitor is connected to a SIRENET CPS, not an Infinity IDS/
CPS.
The monitor is connected to an Infinity IDS/CPS, but the software
is incompatible. Call your service support.

Network Alarm Error An interruption in the network communication has been detected
while an alarm is active; the speaker volume at the bedside
monitor has been increased to its maximum level.

Not Monitored by Central A wireless monitor is transmitting to a central station, but is not
assigned a viewport on the central station’s cluster screen.

Offline The monitor is not connected to the network or the network is not
configured correctly.
A wireless monitor has traveled out of range.
The wireless card is not installed properly.

Remote Limit Change Alarm settings (on/off, alarm limits, alarm recording, including
ARR and ST) have been changed at the MULTIVIEW
WORKSTATION.

Remote Relearn Relearning of the patient’s ECG or respiration pattern has been
initiated at the MULTIVIEW WORKSTATION.

Silence by Remote Alarm has been silenced at the MULTIVIEW WORKSTATION.

VF6 Gamma/Gamma XL 3-15

3 NETWORK APPLICATIONS

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3-16 Gamma/Gamma XL VF6

4 Admission/Discharge/Transfer

Overview.........................................................................................................................4-2
Patient Admission .........................................................................................................4-2
Admit Menu..............................................................................................................4-3
Patient Category......................................................................................................4-3
Name and ID ............................................................................................................4-5
Admit Date ...............................................................................................................4-6
Patient Discharge ..........................................................................................................4-6
Data Transfer..................................................................................................................4-8
Transfer Across the Network .................................................................................4-9
Transfer with a Data Memory PC Card ................................................................4-10
4 ADMISSION/DISCHARGE/TRANSFER

Overview
The Patient Admit menu allows you to enter and edit a patient’s personal data (name,
ID, admit date) and select the patient category. If your monitor is operating in a
monitoring network, you can also review or change the monitor’s care unit and bed
label assignments.
In network mode, you can admit patients at the bedside monitor or at the central
station. The central station offers more data entry fields (such as birth date, height,
weight) which the Infinity Gamma Series monitor does not display but which can be
reviewed or edited at the central station (see MULTIVIEW WORKSTATION Instructions
for Use).
You can transfer patient data between monitors over the Infinity network or with the
help of a data card. If you discharge a patient, the monitor deletes the patient’s
monitoring data.

Patient Admission
When you turn on the monitor or exit the standby mode, the monitor displays a New
Patient? prompt to assure that previously stored patient data is deleted before you
monitor a new patient.
To start monitoring a new patient, press the rotary knob and click on New Patient?
YES. The monitor deletes all previously stored monitoring data, including trends,
events, and recordings.
To continue monitoring a previous patient, press the rotary knob and click on New
Patient? NO. The monitor retains previously stored monitoring data.

NOTE: After a power-cycle or upon leaving standby, all alarms are turned off for
three minutes or until you press the All Alarms Off fixed key.

4-2 Gamma/Gamma XL VF6

 PATIENT ADMISSION

Admit Menu

STEPS: Calling up the Patient Admit Menu

1. Press the Menu fixed key.
2. Click on Admit/Discharge.
3. Click on Patient Admit.

NOTE: You cannot enter selections for Care Unit and Bed Label when the monitor is
docked at a Docking Station or operating as a stand-alone device. For information on
selecting the care unit and bed label, see the chapter Network Applications.

Patient Category
NOTE: The currently selected patient category is indicated between the first and
second waveform channels next to the parameter boxes.

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4 ADMISSION/DISCHARGE/TRANSFER

STEPS: Selecting the Patient Category

1. Call up the Patient Admit menu (Menu > Admit/Discharge > Patient Admit,
see above).
2. Click on Patient Category.

3. Dial in the desired patient category (Adult, Pediatric, Neonate) and click the
knob.

When you change the patient category, the monitor:

z Clears all current alarms, including their messages.
z Stops any NBP measurement in progress.
z Deletes stored trend data, events, and recordings.
z Returns alarm limits to their category-specific default settings (see appendix
Default Settings and Biomedical Support).
z Returns waveform display scales (sizes) to their category-specific default
settings (see appendix Default Settings and Biomedical Support).
z Sets the display range for trend values according to the selected patient
category (see Trends chapter).
When switching to the neonatal mode, the monitor also:
z Disables arrhythmia detection and clears all arrhythmia labels from the
screen.
z Disables pacemaker detection.
z Disables ST Segment analysis (if option is available).
z Allows viewing of an Oxy-Cardiorespirogram (if option is available).

4-4 Gamma/Gamma XL VF6

 PATIENT ADMISSION

Name and ID

STEPS: Entering Name and ID

1. Call up the Patient Admit menu (Menu > Admit/Discharge > Patient Admit,
see above).
2. Click on Name. A white entry field appears for the first character of the name.
3. Click the knob, dial in the first character (A-Z, a-z,
0-9) and click the knob again.
4. Turn the knob clockwise to scroll to the next entry field and click. Dial in the
second character and click. If you need to separate words (i.e. first name from
last name), click on a blank space.
5. Enter the remaining characters accordingly.
— The Admit Menu can display up to 9 characters
at a time, but you can enter additional characters
(up to 25 for the name and up to 12 for the ID)
by scrolling past the up arrow ( ↑ ) at the end of the line, thereby shifting the
entry to the left. Once entered, the full name does appear in the name field
above the top waveform channel, on central station displays, and on record-
ings.
— To make changes to your entry, you can dial in
and click on the left or right arrow ( ← and → ).
Clicking on the left arrow deletes the character
and moves the entry one space to the left; clicking on the right arrow moves
the character and the entry one space to the right.
6. To exit the name entry line, click on the up arrow
( ↑ ).

7. Enter the patient ID accordingly.

VF6 Gamma/Gamma XL 4-5

4 ADMISSION/DISCHARGE/TRANSFER

Admit Date

STEPS: Entering the Admit Date

1. Call up the Patient Admit menu (Menu > Admit/Discharge > Patient Admit,
see above).
2. Click on Admit Date. The monitor automatically enters the current date.

3. If necessary, edit the date by clicking on the day, month, or year entry fields
and dialing in the desired date.
4. To exit the date entry line, simply scroll off to the left or right.

Patient Discharge
You can discharge a patient only at the bedside monitor, not at the central station.
Upon discharge, the monitor deletes all previously stored monitoring data (such as
QRS reference complexes, trends, events, and recordings), and returns to default or
previously stored monitoring settings (see the chapter Default Settings and
Biomedical Support).

4-6 Gamma/Gamma XL VF6

 PATIENT DISCHARGE

STEPS: Discharging a Patient

1. Press the Menu fixed key.
2. Click on Admit/Discharge.
3. Click on Discharge.

4. Click on Discharge Patient? YES.

When you discharge a patient at the bedside monitor, the central station deletes the
bedside monitor’s data from the bed view and displays a Discharge banner for this
bed.
NOTE:
z In OR mode, you can discharge the patient via the Fast Access key.
z You can also discharge a patient from the New Patient? prompt upon leaving
the Standby mode. In this case, however, the patient’s name remains displayed
at the central station until you admit a new patient.

VF6 Gamma/Gamma XL 4-7

4 ADMISSION/DISCHARGE/TRANSFER

Data Transfer
You can transfer patient data between monitors in the following ways:
z By sending data to a different monitor over the Infinity network.
z By copying data onto a memory card and then loading it into a different
monitor (stand-alone option).
The transfer of patient data involves a source monitor and a destination monitor. The
source monitor is the unit from which the data is transferred. The destination monitor
is the unit receiving the data. Transferred patient data includes the patient’s name, ID,
admit date, patient category, as well as stored trends.
NOTE:
z When a data transfer takes place between two monitors whose selected units of
measure do not match (i.e.°C/°F, mmHg/kPa, mm/mV), the destination monitor
adopts the units of measure that were selected at the source monitor.
z When a data transfer takes place between two monitors with different enabled
software options, the destination monitor accepts data only for those options
which are enabled at the destination monitor (i.e. ST, etCO2), and ignores the
rest.
z If the Respiration or the etCO2 waveform was displayed at the source monitor,
but the same waveform is not selected for display at the destination monitor
(see selection Show Rsp/Show etCO2 in the Respiration chapter), then the data
for this parameter cannot be accepted by the destination monitor. To transfer
this data, first select the desired waveform display (Rsp or etCO2) at the
destination monitor.
z For data transfer between Gamma Series monitors, lead V+ is transferred only
if both the source and the destination monitors are using a 6-lead ECG cable.
Use of a smaller lead set cable only transfers data corresponding to the smaller
lead set. The remaining data is lost.
z Stored events cannot be transferred.

4-8 Gamma/Gamma XL VF6

 DATA TRANSFER

Transfer Across the Network

NOTE: Before data transfer can take place over the network, the source monitor must
be placed into Standby mode.

STEPS: Transfer Across the Network

At the source monitor:

1. Place the source monitor into Standby.

At the destination monitor:

1. Press the Menu fixed key.

2. Click on Admit/Discharge.
3. Click on Transfer. The Transfer menu opens.

4. Click on Care Unit. Selection *** is the default and automatically selects all
care units. If you want to narrow your search for the transfer bedside monitor
and select the specific care unit in which the source monitor is located, dial in
the appropriate care unit from the available choices in the menu and click the
knob.
NOTE: The menu shows only those care units which have at least one bedside
monitor in Standby mode.

5. Click on Transfer Bed.

6. Select the bed label of the source monitor and click the knob.

VF6 Gamma/Gamma XL 4-9

4 ADMISSION/DISCHARGE/TRANSFER

NOTE:
z The Transfer Bed menu displays all networked bedside monitors in the selected
care unit that are currently in Standby mode.
z You must click on a bed label, even if there is only one available bedside
monitor listed in the transfer menu; if you do not select a bedside monitor, the
transfer cannot take place.
z If a previous patient had not been discharged at the destination monitor before
data transfer, the discharge takes place automatically during transfer and all
previous patient data is deleted.

7. Click on Start Transfer.

8. Click on Confirm to start the transfer.

During transfer, the Transfer menu displays the status message Transferring data.
Once the transfer is complete, the patient is automatically discharged from the source
monitor and admitted to the destination monitor.
If the transfer is interrupted or unsuccessful, the destination monitor displays a
transfer error message. In this case, the source monitor retains its data and you can
attempt the transfer again.

Transfer with a Data Memory PC Card

The transfer of patient data with a memory card involves copying data from the source
monitor onto a card and then from the card into the destination monitor.

CAUTION: Your monitor may not be equipped with ESD protection for the memory
card slot. Refer to the Service manual or contact you Biomed for further details.

NOTE:
z Previous monitor hardware versions may not support data transfer with the
memory card. If the Copy to Card menu does not appear on the Main Menu
when you select Admit/Discharge > Copy Data, refer to the Service manual or
contact your Biomed.
z You can copy patient data only to the Data Memory PC Card.

4-10 Gamma/Gamma XL VF6

 DATA TRANSFER

The source monitor copies patient admit data as well as

stored trends onto the card. To assure that the copied data
is correctly identified with the patient, you must have
entered a patient name or ID for the source monitor
before the data transfer can take place. If necessary, enter
the patient’s name or ID before proceeding with the data
transfer (see the section Name and ID, above).
When copying data to a memory card, the source monitor
erases all information previously stored on the card.
Similarly, copying data from a card to a monitor
overwrites (not appends) all data currently stored in the destination monitor. At the
end of a successful data transfer from the card, the destination monitor erases all
contents from the card.
NOTE: While the monitor is operating in the wireless network, no data transfer via
the memory card can take place, because the wireless card occupies the memory card
slot.

STEPS: Copy to Card

CAUTION: Before a copy, the monitor erases all contents of the card.

1. Insert a memory card into the memory card slot on

the right side of the source monitor.
2. Press the Menu fixed key.
3. Click on Admit/Discharge.
4. Click on Copy Data.

5. Click on Copy to Card. The monitor displays the Copy to Card menu.

VF6 Gamma/Gamma XL 4-11

4 ADMISSION/DISCHARGE/TRANSFER

6. When the message ‘Ready’ appears in the Status field, click on Start
Transfer: Confirm (or Cancel to cancel the transfer).
During data transfer, the monitor displays the message ‘Wait’ in the Status field or an
error message, if copying cannot be initiated (i.e. card is not fully inserted). If the copy
was successful, the monitor time stamps the card and displays the message ’Card data
copy complete’; otherwise, the monitor displays the error message ’Card data copy
unsuccessful’. Using an invalid memory card (i.e., a software card) produces the
message ’Card Contents Invalid’ together with an error tone, and copy to card is not
possible.

STEPS: Copy to Monitor

CAUTION:
z Copying data from a card to a monitor overwrites (not appends) all data
currently stored in the monitor.
z After it has copied all the data from a card, the monitor erases data stored on
the card.

1. Insert the memory card into the memory card slot on the right side of the
destination monitor.
2. Press the Menu fixed key.
3. Click on Admit/Discharge.

4-12 Gamma/Gamma XL VF6

 DATA TRANSFER

4. Click on Copy Data.

5. Click on Copy to Monitor. The Copy to Monitor menu appears with the
patient Name, ID and Status in the corresponding fields.

NOTE: The Offset, minutes field shows how many minutes have passed since the
patient data was written on the card. The field shows a negative value if the card was
written earlier than the current time on the destination monitor. The field shows a
positive value if the time stored on the card is ahead of the time displayed on the
destination monitor.

6. When the message ’Ready’ appears in the Status field, click on Start
Transfer: Confirm (or Cancel to cancel the transfer).

At the end of a successful copy, the monitor displays the message ’Card data copy
complete.’ If it was unable to copy data from the card, the monitor displays the error
message ’Card data copy unsuccessful.’ If the data on the card is older than 24 hours,
the error message ‘No data to copy for last 24 hours’ alerts the user of the invalid
procedure.

VF6 Gamma/Gamma XL 4-13

4 ADMISSION/DISCHARGE/TRANSFER

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4-14 Gamma/Gamma XL VF6

5 Alarms and Messages

Alarm Grades .................................................................................................................5-2

Life-Threatening Alarms .........................................................................................5-2
Serious Alarms ........................................................................................................5-3
Advisory Alarms......................................................................................................5-3
Alarm Settings ...............................................................................................................5-4
Setting Alarm Limits ...............................................................................................5-5
Turning Parameter Alarms On/Off .........................................................................5-7
Turning Alarm Recordings On/Off.........................................................................5-8
External Alarm Lights .............................................................................................5-8
Alarm Validation ............................................................................................................5-9
Silencing Alarms..........................................................................................................5-10
Alarm Silence Key .................................................................................................5-10
All Alarms OFF Key...............................................................................................5-11
Assigning Alarm Groups ............................................................................................5-11
Central Alarms .............................................................................................................5-13
Alarms in OR Mode......................................................................................................5-14
Messages......................................................................................................................5-15
5 ALARMS AND MESSAGES

Alarm Grades
The monitor annunciates both audible and visual alarms to alert you to significant
changes in the patient’s condition and to malfunctions of the equipment that may
affect the accuracy of measurements.
All alarms fall under one of three alarm grades:
z Life-threatening.
z Serious.
z Advisory.
If the monitor detects more than one alarm at a time, it annunciates the alarm with the
highest priority.

Life-Threatening Alarms
A life-threatening alarm has the highest priority. The monitor triggers life-threatening
alarms for asystole, ventricular fibrillation, ventricular tachycardia, and
bradycardia (bradycardia in neonatal mode only).
A life-threatening alarm has the following characteristics:
z The HR parameter box blinks and appears red.
z The monitor emits a continuous warble tone.
z The monitor displays the alarm cause in both the parameter box and the
message area.
z The alarm continues until you press the Alarm Silence fixed key, the All
Alarms OFF fixed key, or turn that parameter’s alarm off (see the section
Alarm Settings, below).

WA R N I N G : I f t h e m o n i t o r d i s p l a y s t h e b a n n e r H R , A S Y, V F
O ff , t h e re i s n o a l a r m a n n u n c i a t i o n f o r a s y s t o l e a n d
ventricular fibrillation.

5-2 Gamma/Gamma XL VF6

 ALARM GRADES

Serious Alarms
A serious alarm has the second highest priority. It alerts you to significant changes in
the patient’s condition other than life-threatening events as defined in the preceding
section. For example, if a monitored parameter falls below the selected alarm limits,
the monitor triggers a serious alarm. An unrecognized physiological condition, as
when a detected parameter is outside the monitor’s measuring range, triggers a serious
alarm also.
A serious alarm has the following characteristics:
z The parameter box blinks and appears yellow.
z The monitor produces two short tones continuously.
z The monitor displays the alarm cause in both the parameter box and the
message area.
z The monitor stops the alarm automatically when the condition ceases to exist.
z The monitor stops the alarm when a new alarm of equal or higher grade is
triggered.

Advisory Alarms
An advisory alarms has the lowest priority. It can result from one of three conditions:
z When the monitor cannot produce a parameter value due to a technical
problem (e.g. a lead-off condition).
z A patient cable or accessory failure (e.g. a blocked line in the pressure cuff).
z The presence of persistent artifact.
An advisory alarm has the following characteristics:
z The parameter box blinks and appears white.
z The monitor produces a single tone followed by a 1½ second pause,
continuously.
z The monitor displays the alarm cause in both the parameter box and the
message area.
z The monitor stops the alarm automatically when the condition ceases to exist.
z The monitor stops the alarm when a new alarm of equal or higher grade is
triggered.

VF6 Gamma/Gamma XL 5-3

5 ALARMS AND MESSAGES

Alarm Settings
On the Alarm Limits table you can:
z Set alarm limits.
z Turn parameter alarms on or off.
z Turn alarm recordings on or off.
To call up the Alarm Limits table, press the Alarm Limits fixed key.

The Alarm Limits table has several pages with additional parameters. To call up
additional pages and parameters:
z Press the Alarm Limits fixed key again, or
z Click on the up or down arrow in the upper left-hand corner of the table.

NOTE:
z Set the alarm volume (10 to 100%) in the Monitor Setup menu (see the chapter
Monitor Setup).
z Set arrhythmia alarms and alarm recordings on the Arrhythmia Setup table (see
the chapter Arrhythmia).

5-4 Gamma/Gamma XL VF6

 ALARM SETTINGS

Setting Alarm Limits

You can set alarm limits for each parameter individually, or you can use the AutoSet
function to set alarm limits for all parameters at once based on the current parameter
values.

STEPS: Setting alarm limits individually

1. Press the Alarm Limits fixed key.
2. Scroll to the Upper column for the desired
parameter and click the knob.
3. Dial in the desired upper limit and click the knob.
4. Scroll to the Lower column and click the knob.
5. Dial in the desired lower limit and click the knob.

STEPS: Using the AutoSet function

1. Press the Alarm Limits fixed key.
2. Scroll to AutoSet. The column AutoSet shows
the upper and lower limits that are automatically
calculated for each parameter based on current
parameter values.

VF6 Gamma/Gamma XL 5-5

5 ALARMS AND MESSAGES

3. To accept these limits for all parameters, click on AutoSet. The automatically
calculated limits are written into the Upper and Lower columns.

NOTE:
z The AutoSet function sets alarm limits for all parameters at once, even for those
not displayed on the current page of the Alarm Limits table. Exception: There is
no AutoSet function for PVC.
z If a parameter value is not currently available (e.g. during a lead-off condition),
the monitor does not adjust the alarm limit for that parameter when you click on
AutoSet.
z After using the AutoSet function, you can change individual alarm limits at any
time.
z Due to slight rounding differences in values, the alarm limits display for kPa
values at the central station does not match the alarm limits display for kPa
values at the Infinity Gamma Series monitor.

For the AutoSet function, the monitor calculates alarm limits as a percentage of the
current parameter values as follows:

Parameter Upper Limit Lower Limit

SpO2 fixed at 100%* -5%

HR, PLS, Rsp, etCO2, iCO2, RRc, +20% -15%

GP1, GP2, and NBP

Scio Multigas +10% -15%

Temperature +7% -7%

ST +2.0 -2.0

*For neonatal monitoring mode, the Upper Limit Adjustment is fixed at 95%.
Higher adjustments must be made manually.

5-6 Gamma/Gamma XL VF6

 ALARM SETTINGS

Turning Parameter Alarms On/Off

The monitor annunciates alarms only for parameters whose alarm is turned on. You
can turn alarms on or off for each parameter individually.
When you turn a parameter alarm off, the monitor displays a crossed
bell icon in the corresponding parameter box.

STEPS: Turning Parameter Alarms On or Off

1. Press the Alarm Limits fixed key.
2. Scroll to the Alarm column of the desired parameter and click the knob.

3. Dial in the desired setting and click the knob.

WA R N I N G : I f t h e m o n i t o r d i s p l a y s t h e b a n n e r H R , A S Y, V F
O ff , t h e re i s n o a l a r m a n n u n c i a t i o n f o r a s y s t o l e a n d
ventricular fibrillation. If Respiration alarms are off, the
m o n i t o r d o e s n ot a l a r m f o r a p n e a e v e n ts .

NOTE:
z In French-NFC mode (a Service setting), either the HR or the SpO2 alarm must
be on. If you turn one of these alarms off, the monitor automatically turns the
other alarm on.
z If the monitor is networked to a MULTIVIEW WORKSTATION and the patient has
been admitted to the Event Disclosure application, the MULTIVIEW
WORKSTATION documents any alarm that is turned on. For more information,
refer to the MULTIVIEW WORKSTATION Instructions for Use.

VF6 Gamma/Gamma XL 5-7

5 ALARMS AND MESSAGES

Turning Alarm Recordings On/Off

The monitor prints and/or stores alarm recordings automatically, if the Record and/or
Store function is enabled on the Alarm Limits table.

STEPS: Turning Alarm Recordings/Storage On or Off

1. Press the Alarm Limits fixed key.
2. Scroll to the Record column of the desired parameter and click the knob.

3. Dial in the desired recording/storage setting and click the knob.

See the Recordings chapter for a description of alarm recordings, stored recordings,
and the Event Recall screen.

External Alarm Lights

A set of alarm lights on top of the monitor blink red for life-threatening alarms and
yellow for serious alarms if the external alarm light function is enabled (default setting
is ON). If more than one alarm occurs at the same time, the lights blink for the alarm
with the highest alarm grade. If the user silences the alarm, the alarm lights remain lit
without flashing. If the user turns all alarms off, the alarm lights are turned off as well.
Turning the external alarm lights on/off is a password-protected function (see the
appendix Default Settings and Biomedical Support).
WA R N I N G : T h e e x t e r n a l a l a r m l i g h t s e t t i n g ( O N / O F F ) i s n o t
i n d i c a t e d o n t h e s c r e e n . B e f or e m o n i t or i n g y o u r pa t i e n t ,
c o n s u l t w i t h y o u r B i o m e d a b o u t t h e a l a rm l i g h t s e t t i n g .

NOTE:
z The external alarm lights do not flash for advisory alarms.
z During startup, the alarm lights blink briefly as part of the monitor’s functional
check.

5-8 Gamma/Gamma XL VF6

 ALARM VALIDATION

Alarm Validation
The alarm validation feature minimizes nuisance alarms for transient conditions.
When a parameter value falls below or rises above its current alarm limits, the monitor
waits a predetermined time before triggering the alarm. If the parameter value returns
to within the upper or lower alarm limit before the end of the alarm validation period,
the monitor does not trigger the alarm.
The alarm validation period is part of the software (see table below) and cannot be
modified. The monitor triggers the alarm at the end of the validation period.
Parameters have the following alarm validation periods:

Parameter-Specific Alarm Validation Periods

Upper Limit Lower Limit

Parameter
(in seconds) (in seconds)

ECG/Heart rate (HR) 2 0

Pulse rate (PLS) 4 10
ST Segment Analysis* 60 60
Respiration rate (Rsp) 8 10
Arterial Oxygen Saturation (SpO2) 4 10
etCO2*, iCO2*, T, PVC, Arrhythmia Events 0 0
Scio Multigas* 0 0
RRc* 8 10
Invasive blood pressure (ART, PA, CVP, ICP, 4 4
GP1, GP2*)
Non-invasive blood pressure (NBP) 0 0
*Available only if option is enabled

VF6 Gamma/Gamma XL 5-9

5 ALARMS AND MESSAGES

Silencing Alarms
The monitor offers two fixed keys to silence alarms:
z Alarm Silence.
z All Alarms OFF.

WA R N I N G : D u r i n g a l a r m s u s p e n s i o n s , n e v e r l e a v e a pa t i e n t
u na t t e n d e d , a n d a l w a y s r e - e n a b l e t h e a l a r m s a s s o o n a s
possible.

Alarm Silence Key

Press the Alarm Silence fixed key to silence active alarms. The silence period lasts 1
minute unless a new alarm occurs.
During the silence period while an alarm condition persists:
z The parameter box stops blinking but remains highlighted.
z The message remains displayed on the bottom of the screen.
If the patient’s condition has not changed after one minute:
z The monitor sounds the same alarm again.
z You can press the Alarm Silence fixed key again to silence the alarm for an
additional minute.
If the monitor detects a new alarm condition during the silence period:
z The monitor annunciates the new alarm immediately, delivering both audible
and visual alarm indicators.
z The new parameter box blinks while the parameter box of the previously
silenced alarm remains highlighted.
The new message appears at the bottom of the screen and then alternates with the
message for the previously silenced alarm.
If the monitor detects two or more new alarm conditions during the silence period:
z The monitor delivers the audible signal for the newest alarm with the highest
priority.
z Both alarming parameter boxes blink.
z The message for both alarms is displayed alternately in the message area of
the screen.

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 ASSIGNING ALARM GROUPS

All Alarms OFF Key

Press the All Alarms OFF fixed key to suspend all alarm indications for 3 minutes.
During an alarm suspension, the message banner All Alarms OFF appears on top of
the waveform area.
NOTE: When starting the monitor, coming out of Standby, or answering “Yes” to the
New Patient prompt, alarms are suspended for 3 minutes or until you press the All
Alarms OFF key to deactivate the alarm suspension.

During the 3-minute alarm suspension:

z All currently annunciated alarm tones cease.
z All parameter boxes return to normal colors.
z All alarm messages are removed from the message area.
z All new alarms are blocked.
z Currently activated alarms, including latched alarms, are acknowledged.
z When on the network, the message banner All Alarms OFF appears in the
bedside monitor’s remote display on the MULTIVIEW WORKSTATION and in
the ClusterView.

Assigning Alarm Groups

If a monitor is part of the Infinity network, alarm messages from other networked
monitors appear in the message area (i.e. BED 20: ECG Leads Off). In order to limit
the number of messages from remote bedside monitors, you can group bedside
monitors into separate alarm groups so that only messages from monitors within the
same alarm group are shared. If you do not want to display any remote alarm message
at a particular bedside monitor, place that monitor in its own alarm group.

CAUTION: The user must confirm at each individual bedside monitor that the monitor
is assigned to the desired alarm group.

VF6 Gamma/Gamma XL 5-11

5 ALARMS AND MESSAGES

STEPS: Assigning Alarm Groups

1. Press the Menu fixed key.
2. Click on Monitor Setup.

3. Click on Alarm Groups.

4. Click the knob, dial in the number of the desired alarm group, and click the
knob again.

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 CENTRAL ALARMS

Central Alarms
If the bedside monitor appears on the central station’s display, the central station
announces all bedside alarms. The alarm grade (life-threatening, serious, advisory) is
determined by the bedside monitor’s setting. If the central station fails to indicate a
bedside alarm within 10 seconds, the bedside monitor reports a network alarm error
and alarms sound at their highest volume at the bedside. Once the network error is
corrected, the bedside monitor’s master volume returns to the last user setting.
NOTE:
z When the monitor is connected to the Infinity network, you can turn the master
speaker volume off at the bedside monitor. If the monitor is operating as a
stand-alone device, you cannot turn the speaker volume off at the bedside
monitor (also see the Monitor Setup chapter).
z During a network alarm error, the master speaker volume at the bedside monitor
can be lowered via the Monitor Setup menu. The network error message
remains on the screen until the error condition is resolved.

From the central station, you can remotely:

z Set alarm limits.
z Turn parameter alarms On or Off.
z Silence active alarms.
z Turn alarm recordings On or Off.
Changes made to the alarm limits at the central station take effect immediately at the
bedside monitor. For more information, see the MULTIVIEW WORKSTATION’s
Instructions for Use.

VF6 Gamma/Gamma XL 5-13

5 ALARMS AND MESSAGES

Alarms in OR Mode
When you select the OR mode (see the chapter Multigas), the monitor’s alarm
behavior for some alarms changes in order to avoid nuisance alarms during surgical
procedures. In OR mode, the following applies:
z All ECG Lead Off conditions as well as the sensor application errors SpO2
Transparent and SpO2 Light Blocked cause one-time advisory alarm
indications only.
z Alarm indicators for life-threatening and serious alarms become non-latching,
that is, they cease when the alarm situation ends.
z A prolonged RRc apnea condition causes an escalation of alarm indications.
When the first apnea interval expires, the monitor issues a one-time advisory
alarm. If the RRc apnea condition persists through 3 apnea intervals, the
monitor issues a one-time serious alarm. If the RRc apnea condition persists
through 6 apnea intervals, the monitor issues a one-time life-threatening
alarm. (The length of the apnea interval depends on the selected RRc Apnea
Time, 10 to 30 seconds; see the chapter End-Tidal CO2.)

5-14 Gamma/Gamma XL VF6

 MESSAGES

Messages
The monitor displays the following types of messages:
z Alarm messages to alert you to a physiological condition (e.g., Asystole).
z Status messages to alert you to faults and their causes (e.g., RA Lead Off) or to
follow the work-in-progress of your monitor (e.g., Alarm Recording Started).
z Diagnostic messages to alert you to hardware and software conditions (e.g.,
Low Battery Reset).
z Network messages (including Alarm Group messages) to alert you to network
operating conditions (also see the chapter Network Applications).
The monitor displays alarm messages according to their alarm grade on a red, yellow
or white background in the message area (e.g., Asystole) and in the parameter box
(e.g., ASY).
The monitor displays status and network messages in the message area at the bottom
of the screen.
Diagnostic messages appear during the self-test routines that occur immediately after
you turn the monitor on.
Alarm and most status and network messages appear alternately until the condition
has been resolved. Diagnostic messages and some status and network messages
appear only once.
Whenever possible, Dräger recommends that you check the equipment and the
accessories carefully before monitoring your patient to eliminate faulty conditions.
Careful patient preparation also eliminates most common error conditions.

WA R N I N G : D o n o t o p e r a t e t h e m o n i t o r i f y o u d e t e c t a n y
e q u i p m e n t m a l f u n c t i o n . I n t h i s c a s e , ta k e t he u ni t o ut o f
o p e r a t i o n a n d c a l l y o u r B i o m e d o r D r ä g e rS e r v i c e .

VF6 Gamma/Gamma XL 5-15

5 ALARMS AND MESSAGES

Heart Rate, Arrhythmia, ST Segment Analysis

Message Possible Cause Suggested Action

Message: Arrhythmia The monitor is learning the • Wait until the message
Relearning patient’s normal QRS complex to disappears from the screen.
Parameter value: LRN use as reference.

Message: Asystole No QRS detection for the last 4 • Observe the patient and treat if
Parameter value: ASY seconds. clinically indicated.
Heart rate is below 15 beats/ • Select a lead with at least an
minute. amplitude of 0.5 mV.
• Select another lead to meet the
above criterion.
• Reposition or change the
electrodes if the amplitude is still
low.
• Use good skin preparation.
Message: RL Lead Off The monitor has detected a lead-off • Check the patient cable and lead
* condition for the currently wires carefully.
HR parameter value: processed lead. The cause could • Check the MULTIMED/NEOMED
<value> be one of the following: pod. Replace pod if defective.
ST<lead1>/ST<lead2> Unplugged cable • Replace any cable or lead wire
parameter value: Broken cable that is suspect.
<blank> Loose lead wire • Reapply gel on the electrode or
Message: V Lead Off * Faulty lead wire change the electrode (if
Message: V+ Lead Off Dried out gel on the electrode disposable).
Message: RA Lead Off Wrong cable type selection. • Select another ECG lead for
Message: LL Lead Off The MULTIMED/NEOMED pod may processing if the electrode or lead
Message: LA Lead Off be defective. wire cannot be replaced.
Message: ECG Leads
Off
HR parameter value:
***
ST<lead1>/ST<lead2>
parameter value:
<blank>
* For all the electrode disconnected messages (V, V+ RA, LL, LA, RL) the parameter box shows
*** if this is the lead currently being monitored. If another valid lead is being monitored (i.e. ECG
1&2) then the parameter value for HR, ST<lead1> and ST<lead2> is <value>
Message: ARR Lead wires not connected. • Check lead wires.
Cannot Learn Lead
<lead>
Parameter value:
<value>

5-16 Gamma/Gamma XL VF6

 MESSAGES

Heart Rate, Arrhythmia, ST Segment Analysis (continued)

Message Possible Cause Suggested Action

Message: ECG Artifact Patient’s movement. • Calm the patient.

HR parameter value: Shivering, tremors. • Check the electrodes.
*** Excessive signal noise. • Apply the electrodes carefully.
ST<lead1>/ST<lead2> Bad contact of electrodes.
parameter value: • Secure the electrodes.
Interference from auxiliary • Observe good skin preparation
<blank> equipment. techniques.
• Isolate the patient from auxiliary
equipment, if possible.
• If the artifact message is frequent,
contact your Biomed to check the
setting of the notch 50/60 Hz filter.
Message: HR Too The patient’s heart rate falls • Observe the patient carefully.
High outside the upper range (300 beats • Apply treatment if clinically
Parameter value: +++ per minute). indicated.
Message: HR>UL The patient’s heart rate falls • Observe the patient carefully.
<value> outside the current upper or lower • Apply treatment if clinically
Message: HR <LL alarm limits. indicated.
<value> The current alarm limits are • Change the alarm limits as
Parameter value: inappropriate for this patient described in the “HR Alarms”
<value> section.
Message: MultiMed The MULTIMED/NEOMED pod is • Verify the pod connections.
Disconnected disconnected from the monitor.
PVC parameter value:
<blank>
HR parameter value:
***
ST<lead1>/ST<lead2>
parameter value:
<blank>
Message: Pacer Off Pacer detection is not selected. • If you are monitoring a paced
patient, select the pacer detection
function.
Message: V Fib Detection of a ventricular • Observe the patient and treat if
Parameter value: VF fibrillation. The ventricular rhythm is clinically indicated.
chaotic. • View each lead on the monitor
and check the amplitude. To
detect the QRS, the amplitude
should be at least 0.5 mV on the
mV scale.
• Reposition or change the
electrodes if the amplitude is still
low.
• Use good skin preparation.

VF6 Gamma/Gamma XL 5-17

5 ALARMS AND MESSAGES

Heart Rate, Arrhythmia, ST Segment Analysis (continued)

Message Possible Cause Suggested Action

Message: V Tach n or more consecutive PVCs have • Observe the patient and treat if
Parameter value: VT been detected with a beat-to-beat clinically indicated.
rate greater than or equal to the VT
rate set in the Alarm Tables. (n =
VT count parameter)
Message: Bradycardia 8 or more consecutive QRS • Observe the patient and treat if
Parameter value: complexes have been detected clinically indicated.
BRDY with a beat-to-beat rate less than
80% of the patient’s normal rate.
Message: RUN 3 to N-1* consecutive PVCs with a • Observe the patient and treat if
Parameter value: RUN beat-to-beat rate >= the VT rate clinically indicated.

Message: AIVR 3 or more PVCs with a rate < the • Observe the patient and treat if
Parameter value: VT rate clinically indicated.
AIVR
Message: SVT N* or more consecutive normal • Observe the patient and treat if
Parameter value: SVT beats with a beat-to-beat rate >= clinically indicated.
the SVT rate
Message: CPT A sequence of beats with the • Observe the patient and treat if
Parameter value: CPT pattern: normal, PVC, PVC, normal clinically indicated.

Message: BGM A sequence of beats with the • Observe the patient and treat if
Parameter value: BGM pattern: normal, PVC, normal, clinically indicated.
PVC, normal
Message: TACH N* or more consecutive normal • Observe the patient and treat if
Parameter value: beats with a beat-to-beat rate >= clinically indicated.
TACH the TACH rate

Message: PAUS A sequence of two normal beats • Observe the patient and treat if
Parameter value: with an N-N* interval > the Pause clinically indicated.
PAUS rate times the average N-N interval
(±100ms)
Message: ST <lead> The monitor has detected a lead-off • Check the patient cable and lead
Off condition for the currently wires carefully.
ST<lead1> and processed lead. The cause could • Check the MULTIMED pod.
ST<lead2> parameter be one of the following: Replace pod if defective.
value: *** Unplugged cable • Replace any cable or lead wire
Broken cable that is suspect.
Loose lead wire • Reapply gel on the electrode or
Faulty lead wire change the electrode (if
Dried out gel on the electrode disposable).
Wrong cable type selection. • Select another ECG lead for
The MULTIMED/NEOMED pod may processing if the electrode or lead
be defective. cannot be replaced.

5-18 Gamma/Gamma XL VF6

 MESSAGES

Heart Rate, Arrhythmia, ST Segment Analysis (continued)

Message Possible Cause Suggested Action

Message: Cannot ST cannot analyze with a paced • ST segment analysis cannot be

Analyze beat performed on pacemaker patients
ST<lead1> and
ST<lead2> parameter
value: <blanK>
Message: ST Too High The detected ST value is outside • Check the patient and apply
ST<lead1> and the measurement range. treatment if necessary.
ST<lead2> parameter • Check the electrode placement
value: +++ and change their position if
Message: ST Too Low necessary.
ST<lead1> and
ST<lead2> parameter
value: ---
Message: ST > UL The ST rate falls outside the • Observe the patient carefully.
ST<lead1> and current upper or lower alarm limits. • Apply treatment if clinically
ST<lead2> parameter The current alarm limits are indicated.
value: <value> inappropriate for this patient. • Change the alarm limits as
Message: ST < LL described in the “Cardiac
ST<lead1> and Monitoring” chapter.
ST<lead2> parameter
value: <value>
Message: ST Lead Invalid ST<leadname>. • Select correct ST lead(s).
<1> and/or ST Lead ST<lead1> or ST<lead2> • Verify ST lead(s) connection.
<2> Invalid connection restored from a fault.
ST<lead1> and/or Excessive signal noise.
ST<lead2> parameter Bad contact of electrodes.
value: <blank>
Interference from auxiliary
equipment.

VF6 Gamma/Gamma XL 5-19

5 ALARMS AND MESSAGES

Respiration

Message Possible Cause Suggested Action

Message: Apnea The monitor is detecting an apnea • Check the patient. Treat the
Parameter value: Apn event that exceeds the apnea time patient, if clinically indicated.
set in the menu. • If the absence of impedance
Incorrect placement of the changes is due to the placement
electrodes. of the electrodes, reposition them
Improper threshold. until the message clears.
Missed shallow breaths. • If apnea is due to an improper
threshold, set the threshold until
the message clears.
• If breaths are missing, use the
manual respiration mode to
ensure the detection of shallow
breaths.
Message: MultiMed The MULTIMED/NEOMED pod is • Verify the pod connections.
Disconnected disconnected from the monitor.
Parameter value: ***
Message: Coincidence The impedance changes due to • Check the patient.
Parameter value: cardiac activity are being counted • Check the electrode placement.
<value> as breaths.
(Neonatal mode only)
Message: Rsp Fault Technical problem. • Turn the monitor off, then on.
Parameter value: *** • If the problem persists, take the
unit out of operation and call
DrägerService.
Message: Rsp High Impedance out-of-range. • Check the cables for damage.
Impedance Broken cables. • Check the electrodes.
Parameter value: *** Dried out gel on the electrodes. • Move the electrodes, if
Poor skin preparation. necessary.
Message: Rsp Testing Self-tests in progress. • Wait until the end of the self-tests.
Parameter No displayed value.
value:<blank>
Message: Rsp > <UL The respiration rate falls outside • Observe the patient carefully.
value> the current upper or lower alarm • Apply treatment if clinically
Message: Rsp < <LL limits. indicated.
value> The current alarm limits are • Change the alarm limits as
Parameter value: inappropriate for this patient. described in the “Respiration
<value> Alarms” section.

5-20 Gamma/Gamma XL VF6

 MESSAGES

Respiration (continued)

Message Possible Cause Suggested Action

Message: Rsp Artifact High frequency artifact in the • Check the electrodes and
Parameter value: *** signal. reposition them.
Large baseline shifts. • Find the source of interference
Patient movement. and remove it.
TENS interference. • Replace the electrodes if
IV infusion pump interference. necessary.
• Change the cable or lead wires.
Message: Rsp Lead The cause could be one of the • Check patient cable and lead
Off following: wires carefully.
Parameter value: *** Unplugged cable. • Replace any cable or lead wire
Broken cable. that is suspect.
Loose lead wire. • Reapply gel or change the
Faulty lead wire. electrode.
Dried out gel on electrodes. • Check the MULTIMED/NEOMED pod
The MULTIMED/NEOMED pod may and replace, if necessary.
be defective.
Message: Rsp The monitor is learning the • Wait for the respiration rate to
Learning patient’s normal respiration pattern appear on the display.
Parameter value: LRN to establish detection threshold.

Message: Rsp Too The respiration rate is higher than • Check the patient and apply
High 155 breaths per minute. treatment if necessary.
Parameter value: +++ The monitor may be counting • Check the electrode placement
artifacts. and change their position if
Interference due to auxiliary necessary.
equipment. • Move the electrodes away from
the source of interference.
Message: Use ECG II An ECG lead other than lead II is • Select Lead II to ensure accurate
for Rsp displayed while 3 ECG lead cable respiration monitoring.
Parameter value: *** is selected.

etCO2, iCO2, RRc

Message Possible Cause Suggested Action

Message: etCO2 Capnostat sensor is unplugged. • Disconnect the etCO2 sensor,

Sensor Unplugged then reconnect it. If the message
Parameter value: *** persists, try a new sensor.

Message: etCO2 etCO2 pod is unplugged. • Check etCO2 pod connection.

Unplugged • Disconnect the etCO2 pod, then
Parameter value: *** reconnect it. If the message
persists, contact your Biomed.

VF6 Gamma/Gamma XL 5-21

5 ALARMS AND MESSAGES

etCO2, iCO2, RRc (continued)

Message Possible Cause Suggested Action

Message: etCO2 > UL etCO2 is outside alarm limits • Check the patient and treat if
Message: etCO2 < LL because of: necessary.
Parameter value: • A physiological condition. • Change the alarm limits
<value> • Inappropriate alarm limits. • Check equipment and replace if
• A defective sensor or etCO2 pod. necessary.

Message: iCO2 > UL iCO2 is above alarm limits because • Check the patient.
Parameter value: of: • Check ventilator for:
<value> • A physiological condition. • --inspiratory flow
• Rebreathing. --expiratory time
• Inappropriate alarm limits. --faulty expiratory valve
• A defective sensor or etCO2 pod • Change the alarm limits
• Check equipment and replace if
necessary.
Message: RRc > UL RRc is outside alarm limits • Check the patient and treat if
Message: RRc < LL because of: necessary.
Parameter value: • A physiological condition. • Change the alarm limits
<value> • Inappropriate alarm limits. • Check equipment and replace if
• A defective sensor or etCO2 pod. necessary.

Message: etCO2 Too CO2 value is out of range (high). • Check the patient and treat if
High necessary.
Parameter value: *** • Recalibrate the sensor.
Message: RRc Too RRc value exceeds the upper • Check the patient and treat if
High range. necessary.
Parameter value: *** • Recalibrate the sensor.
Message: etCO2 Atm. etCO2 pod barometric pressure • Try the sensor again. If the
Press. Sensor Failure sensor failure message persists, try a new
Parameter value: *** sensor.

Message: etCO2 etCO2 pod barometric pressure • Shift to Manual mode and dial in
Calibrate Atm. Press. sensor calibration needed an atmospheric pressure value.
Parameter value: *** • If automatic pressure sensing
required, contact the Biomedical
department..
Message: etCO2 CAPNOSTAT has not yet reached a • Wait for the sensor to warm up
Sensor Warming Up stable temperature. (up to three minutes at room
Parameter value: temperature). If the message fails
<value> to clear, contact the Biomedical
department.
Message: etCO2 CAPNOSTAT source current is out of • Try the sensor again. If the
Sensor Failure range or sensor did not warm up message persists, try a new
Parameter value: *** within 3 minutes. sensor.

5-22 Gamma/Gamma XL VF6

 MESSAGES

etCO2, iCO2, RRc (continued)

Message Possible Cause Suggested Action

Message: etCO2 External heat source is warming • Remove heat source.

Sensor too warm the sensor. • If the problem persists,
Parameter value: *** disconnect and reconnect the
sensor.
• Replace the sensor.
Message: etCO2 Place Last sensor calibration failed or is • Place the sensor on the zero cell
Sensor on Zero Cell not the last sensor calibrated on and wait for zeroing to complete.
Parameter value: *** this pod.

Message: etCO2 The sensor temperature is unstable • Wait at least three minutes for the
Sensor Temp Not following warm-up. message to disappear. If the
Stable message persists, replace the
Parameter value: *** reusable sensor.

Message: Check Airway adapter is dirty, not fully • Make sure the adapter is properly
etCO2 Check Airway seated, or out or calibration. seated.
Adapter/Cal. • Clean and calibrate the airway
Parameter value: *** adapter.
Message: etCO2 Calibrating on zero cell. • Informational message; no action
Calibrating Sensor required.
Parameter value:
<blank>
Message: etCO2 Calibration on zero cell could not • Check for any heat sources
Cannot Cal. Sensor be completed because of warming the sensor and remove
Parameter value: *** CAPNOSTAT temperature instability. them.
• Wait at least three minutes for the
temperature to stabilize.
Message: etCO2 Airway adapter is dirty, not fully • Make sure the adapter is properly
Adapter Failure seated, or out of calibration. seated.
Parameter value: *** • Clean and calibrate the reusable
airway adapter.
Message: etCO2 Place Calibration on zero cell completed • Place sensor on the reference
Sensor On Ref Cell successfully. cell and wait for calibration to
Parameter value: complete.
<value>
Message: etCO2 Calibration on zero cell failed. • Recalibrate. If the message
Sensor Cal. Failed persists, try a new sensor.
Parameter value: ***
Message: etCO2 Calibrating on reference cell. • Informational message; no action
Verifying Sensor Cal required.
Parameter value: ***
Message: etCO2 Verification completed successfully. • Informational message; no action
Sensor Cal. Verified required.
Parameter value:
<value>

VF6 Gamma/Gamma XL 5-23

5 ALARMS AND MESSAGES

etCO2, iCO2, RRc (continued)

Message Possible Cause Suggested Action

Message: etCO2 Airway adapter calibration (zeroing • Informational message; no action

Calibrating Adapter in room air) in progress. required.
Parameter value:
<blank>
Message: etCO2 Cal. Breaths detected during the 20 • Make sure that the sensor is not
Failed, Breaths? second period following activation connected to the patient’s
Parameter value: of the Adapter Cal. key. ventilator breathing circuit and is
<value> not close to a CO2 source.
Recalibrate.
Message: etCO2 Airway adapter cal. (zeroing in • Recalibrate holding sensor in
Cannot Cal. Adapter room air) could not be completed room air (not on zero cell).
Parameter value: because of CAPNOSTAT • Wait at least three minutes for
<value> temperature instability, or because temperature to stabilize and
the CAPNOSTAT was on the zero recalibrate.
cell.
• Remove any heat source
warming the sensor and
recalibrate.
• Remove sensor from Zero cell,
place on the adapter, and
recalibrate.
Message: etCO2 Airway adapter calibration (zeroing • Informational message.
Adapter Cal. Accepted in room air) completed
Parameter value: successfully.
<value>
Message: etCO2 Airway adapter calibration (zeroing • Make sure the adapter is properly
Adapter Cal. Failed in room air) failed. attached to the sensor and that its
Parameter value: windows are clean.
<value> • If the problem persists, try
another adapter.
Message: etCO2 Corrupt software. • Try a new pod.
Incompatible Pod Wrong version of software or • Consult your hospital’s Biomed.
Parameter value: *** hardware.
Message: etCO2 Sidestream measurement mode • Calibrate the new adapter.
Adapter Cal. Required was initiated, requiring airway
Parameter value: *** adapter cal. (zeroing in room air) to
calibrate pump/flow.
Message: etCO2 Sidestream tubing obstructed, or • Clear the blockage in the tubing.
Tubing Blocked filter is clogged. • Replace the pod.
Parameter value: ***
Message: etCO2 Sidestream tubing has a leak. • Change the tubing.
Tubing Leak
Parameter value: ***

5-24 Gamma/Gamma XL VF6

 MESSAGES

etCO2, iCO2, RRc (continued)

Message Possible Cause Suggested Action

Message: etCO2 etCO2 communication or hardware • Check etCO2 pod connection.

Hardware Failure failure. • Check all tubing
Parameter value: *** • Disconnect the etCO2 pod, then
reconnect it. If the message
persists, contact your Biomed.

Multigas

Message Possible Cause Suggested Action

Message: CO2 Out of The inspired/expired • Observe the patient; treat, if

Range concentrations fall outside the necessary.
Parameter value: +++ monitor’s display range. • Check connections.
Message: O2 Out of • Disconnect and reconnect the
Range Scio module.
Parameter value: +++ • Power-cycle the monitor or
undock/redock the monitor from
Message: <agent> Out the Docking Station.
of Range • Contact DrägerService.
Parameter value: +++
Message: iO2 > UL The inspired/expired • Observe the patient; treat, if
Message: iO2 < LL concentrations fall outside the necessary.
Parameter value: current upper or lower alarm limits. • Adjust alarm limits.
<value>
Message: etO2 > UL
Message: etO2 < LL
Parameter value:
<value>
Message: The inspired/expired • Observe the patient; treat, if
i <agent> > UL concentrations fall outside the necessary.
Message: current upper or lower alarm limits. • Adjust alarm limits.
i <agent> < LL
Parameter Value:
<value>
Message: et <agent>
> UL
Message: et <agent>
< LL
Parameter value:
<value>

VF6 Gamma/Gamma XL 5-25

5 ALARMS AND MESSAGES

Multigas (continued)

Message Possible Cause Suggested Action

Message: Gas sensor failure (for CO2, O2, • Power cycle the Scio module. If
<parameter> invalid N2O or agent). message still persists, call
Parameter value: *** DrägerService.

Message: <agent> The user has specified an agent, • Switch to automatic agent
detected (only for Scio but Scio is detecting a different detection.
modules with automatic agent. • Specify the correct agent.
agent detection) A second agent is present in a two-
Parameter value: gas mixture.
<blank or value>
Message: Multigas Scio reports reduced or unknown • Observe the patient; treat, if
reduced accuracy accuracy (even after completion of necessary.
Parameter value: warm-up period). • Check connections.
<value> • Disconnect and reconnect the
Scio module.
• Power-cycle the monitor or
undock/redock the monitor from
the Docking Station.
• Contact DrägerService.
Message: Multigas No connection or faulty connection • Check connections and cables.
Unplugged between monitor and Scio module. • If message persists, contact
Parameter value: *** DrägerService.
Message: Multigas Loss of communication or • Check connections.
H/W failure hardware problem detected. • Disconnect and reconnect the
Parameter value: Scio module.
*** or <value> • Power-cycle the monitor or
undock/redock the monitor from
the Docking Station.
• Contact DrägerService.
Message: Multigas Scio start-up mode. • Informational message.
initialization
Parameter value:
<blank>
Message: Multigas Scio warm-up period: Reduced • Wait to end of warmup period.
warming up accuracy. Scio reaches full accuracy after a
Parameter value: warm-up period of about 7.1
<values> minutes or after the first zeroing.

Message: Multigas Scio starts the automatic zeroing • To delay zeroing for 5 minutes,
zero in 1 minute process in one minute. click on Autozero Delay in the
Parameter value: Multigas Setup menu (see the
<values> chapter Multigas).

5-26 Gamma/Gamma XL VF6

 MESSAGES

Multigas (continued)

Message Possible Cause Suggested Action

Message: Multigas Scio is undergoing automatic • Wait until zeroing is completed.

zero in progress zeroing process. During zeroing, During zeroing, displayed gas
Parameter value: the monitor does not update the values might not be accurate.
<blank> displayed gas values.

Message: Multigas Scio zeroing was successful. • Informational message.

zero OK
Parameter value:
<values>
Message: Multigas Scio zeroing was not successful. • Verify that the environment does
zero failed not contain contaminants.
Parameter value: *** • Check for leaks or occlusions.
• Contact DrägerService.
Message: Multigas Scio reports an occlusion or • Check all catheters for occlusion.
Tubing Blocked pneumatic problem. • If necessary, replace catheters.
Parameter value: ***
Message: Check Scio reports a full watertrap. • Empty/replace watertrap (see the
Watertrap/Sample There is no sampling line. chapter Multigas).
Line • Connect sampling line.
Parameter value:
<values>

Pulse Oximetry (SpO2)

Message Possible Cause Suggested Action

Message: PLS Too Motion artifact. • Calm the patient.

High
Parameter value: +++
Message: PLS Too Pulse rate is below the measuring • Observe patient; treat, if
Low range. necessary.
Parameter value: ---
Message: SpO2 Fault The monitor has detected a • Turn the monitor off, then on.
- Power Cycle Monitor hardware failure. • If the message does not clear,
Parameter value: *** take the unit out of operation and
call your Biomed.
Message: PLS Fault
Parameter value: ***
Message: MultiMed The MULTIMED/NEOMED pod is • Verify the pod connections.
Disconnected disconnected from the monitor.
SpO2 and PLS
parameter value:
<blank>

VF6 Gamma/Gamma XL 5-27

5 ALARMS AND MESSAGES

Pulse Oximetry (SpO2) (continued)

Message Possible Cause Suggested Action

Message: SpO2 Light The sensor does not detect the • Check the sensor.
blocked light. • Make sure the light indicator is
Message: PLS Light The sensor cannot detect a signal not blocked.
blocked that can be measured. • Remove any trace of nail polish.
Parameter value: ***
• Move sensor location.
• Use different sensor.
Message: SpO2 The sensor may be faulty. • Remove bandages or rings that
Weak Signal The sensor cannot detect a signal may obstruct the signal.
Message: PLS Weak that can be measured. • Reapply the sensor.
Signal • Observe the waveform on the
Parameter value: *** screen. If you suspect a faulty
sensor, replace it.
Message: SpO2 The monitor has detected motion • Move sensor to another location.
Motion artifacts in the signal. The cause • Observe the resulting waveform
Parameter value: *** can be one of the following: on the screen.
The patient is moving
Message: PLS Motion The patient is coughing
Parameter value: *** Hemodynamic interference
Hypothermia
Vascular compromises to the
extremity
Message: SpO2 No The monitor has been unable to • Calm the patient.
measurement measure the parameter for the last • Check the sensor placement.
Message: PLS No 30 seconds.
• Move the sensor to a location with
measurement less movement.
Parameter value: ***
• If message persists, call
DrägerService.
Message: SpO2 The monitor detects an excessive • Cover the sensor with an opaque
Regulate Error amount of ambient light giving low material such as a towel.
Message: PLS amplitude and inaccurate readings
Regulate Error as a result. The possible sources of
Parameter value: *** excessive light are:
Surgical or bilirubin lamp
Fluorescent lights
Infrared heating lamps
Sunlight
Message: SpO2 The monitor is analyzing the signal. • Wait until the message
Searching This occurs during the first 5 to 10 s disappears from the screen.
Parameter value: of operation or as a result of motion
<blank> artifact.

5-28 Gamma/Gamma XL VF6

 MESSAGES

Pulse Oximetry (SpO2) (continued)

Message Possible Cause Suggested Action

Message: SpO2 The sensor may be disconnected • Check sensor and connections.
Transparent from the patient. • If problem persists, change
Message: PLS Sensor may be defective. sensor.
Transparent
Parameter value: ***
Message: SpO2 The sensor’s extension cable • Verify sensor to extension cable
Unplugged disconnected from the pod. connection.
Message: PLS The sensor is disconnected from • Verify extension cable to pod
Unplugged the extension cable. connection.
Parameter value: *** The MULTIMED/NEOMED cable is • Verify pod connection to monitor.
defective.
• Verify correct sensor.
The sensor is defective.
The sensor is not recommended
for use with your monitor.
Message: Replace The SpO2 sensor is not functioning • Replace the sensor.
SpO2 Sensor properly.
Message: SpO2 <LL The patient’s oximetry level or • Observe the patient.
<value> pulse rate falls outside the current • Apply treatment if clinically
Message: SpO2 >UL alarm limits. indicated.
<value> The alarm limits are inappropriate • Change the alarm limits.
Parameter value: for this patient.
<value> The SpO2 level has changed since • If you suspect a sensor failure,
you last selected the alarm limits. check and replace the sensor, if
necessary.
Message: PLS<LL Elevated carboxyhemoglobin or
<value> methemoglobin levels.
Message: PLS>UL Significant levels of intravascular
<value> dyes.
Parameter value: Placement of sensor on an
<value> extremity that has a blood pressure
cuff, arterial catheter or
intravascular line.
Faulty equipment.
Message: Sensor not compatible with monitor • Use compatible sensor (Masimo/
SpO2: non-Masimo configuration. Nellcor).
sensor • Contact your hospital’s
SpO2: non-Nellcor Biomedical department to change
sensor the monitor configuration.
Parameter Value: ***
Message: A MultiMed with an SpO2 sensor • Remove the sensor intermediate
SpO2: Duplicate intermediate cable and an SpO2 cable from the MultiMed; or
Device Connected pod are connected to the monitor at • Remove the SpO2 pod.
the same time.

VF6 Gamma/Gamma XL 5-29

5 ALARMS AND MESSAGES

Temperature (T)

Message Possible Cause Suggested Action

Message: T >UL The patient's temperature falls • Observe the patient.

<value> outside the current temperature • Change the alarm limits for this
Message: T <LL alarm limits. patient.
<value> • If you suspect a temperature
probe failure, check and replace
it.
Message: MultiMed The MULTIMED/NEOMED pod is • Verify the pod connections.
Disconnected disconnected from the monitor.
Parameter value:
<blank>
Message: T Fault The monitor has detected a • Turn the monitor off, then on.
Parameter value: *** hardware failure. • If the message does not clear,
take the unit out of operation and
call your Biomed.
Message: T The temperature probe is • Verify the probe connection to the
Unplugged disconnected from the MULTIMED/ pod.
Parameter value: *** NEOMED pod. • Verify the probe. If defective,
The MULTIMED/NEOMED cable is change the probe.
defective.
The probe is defective.
The probe is not recommended for
use with your monitor.
Message: T Test Fail The monitor has detected a • If the test fails, turn the monitor
problem in the temperature sensor off, then on.
during startup. • If the message does not clear,
take the unit out of operation and
call your Biomed.
Message: T Too Low The detected temperature is • Check your patient.
Message: T Too High outside the measurement range. • Check the probe for defects.
Parameter value: • Check the patient cable
<blank> connections.
• Change the probe, if necessary.

5-30 Gamma/Gamma XL VF6

 MESSAGES

Invasive Blood Pressure (IBP)

Message Possible Cause Suggested Action

IBP Low Pulse Systolic and diastolic values are • Check the patient.
less than 60% of the baseline. • Zero and check the transducer
Elevated heart rate. calibration factor.
Hemodynamic interference (e.g., • Remove the clot by opening the
decreased stroke volume). stopcock to the patient and
Clot has formed on the catheter tip. drawing back with a sterile
Catheter is lodged against the syringe.
vessel wall. • If you cannot draw back, follow
Transducer is not properly aligned your hospital procedure for
to the patient’s heart level. removing clots.
• Straighten all tubing. If air is
Air in tubing. present in the tubing, follow your
Kinked tubing. hospital procedures for removing,
flushing and repositioning the
catheter.
Message: IBP Static This message appears when the • Turn combined systolic and
Parameter value: invasive pressure alarms are on diastolic alarm off.
<value> while zeroing. • Check the patient.
No pulse. • Repeat zeroing.
Message: IBP Sys <LL The patient’s invasive pressure • Observe the patient.
<value> falls outside the current alarm • Change the current alarm limits.
Message: IBP Sys limits.
>UL <value> The current alarm limits are
Message: IBP Mean inappropriate for this patient.
<LL <value>
Message: IBP Mean
>UL <value>
Message: IBP Dia <LL
<value>
Message: IBP Dia >UL
<value>
Parameter value:
<value>
Message: IBP Too The value is outside the • Check the connections and
High measurement range. cables.
Parameter value: +++ The transducer may be picking up • Zero and calibrate the transducer,
Message: IBP Too pressure from the IV infusion if necessary.
Low system.
Parameter value: - - -
Note that the label “IBP” is replaced on screen with the user-defined label (e.g., “ART Too Low”).

VF6 Gamma/Gamma XL 5-31

5 ALARMS AND MESSAGES

Non-Invasive Blood Pressure (NBP)

Message Possible Cause Suggested Action

Message: NBP Cannot Faulty equipment. • Check the patient.

Measure Improper cuff placement. • Check the hose and cuff.
Parameter value: *** Patient’s pulse too low. • Move the cuff to a limb with less
Excessive patient movement. movement.
• Check proper placement of the
cuff.
• Restart measurement.
Message: NBP Artifact The patient is moving or shivering. • Check the patient.
Parameter value: *** • Move the cuff to a different limb
with less movement.
Message: NBP No Weak signal. Monitor is unable to • Check the patient and treat if
Pulsation detect a sufficient number of necessary.
Parameter value: *** pulsations of adequate amplitude • Check the hose and cuff.
within two minutes.
• Check for proper size, placement
of cuff.
Message: NBP Cuff The monitor has detected a • Check for leaks in the cuff or
Leak significant drop in the cuff pressure hose.
Parameter value: *** during inflation. • Change the cuff and hose, if
necessary.
Message: NBP Fault - Faulty equipment. • Check the hose and cuff.
Power Cycle Monitor Improper cuff placement. • Check proper placement of cuff.
Parameter value: *** Transducer needs calibration. • Turn the monitor off, then on if
NBP hardware needs repair or you detect a hardware failure.
calibration. • If the message does not clear,
Hardware safety timer has expired. take the unit out of operation and
call your Biomed or
DrägerService.
Message: NBP Mean The patient's pulse is too low for • Check the patient.
Only the monitor to derive the systolic • Check proper placement of the
Parameter Value: and diastolic pressure values but cuff.
NBP M <value> large enough to report the mean
pressure value.
NBP S <***>
Improper cuff placement
NBP D <***>
Message: NBP Meas. Measurement time has exceeded 2 • Repeat the measurement.
Timeout minutes.
Parameter value: ***
Message: NBP Open There is no significant increase in • Verify the cuff connection.
Line cuff pressure during the inflation
Parameter value: *** cycle.

5-32 Gamma/Gamma XL VF6

 MESSAGES

Non-Invasive Blood Pressure (NBP) (continued)

Message Possible Cause Suggested Action

Message: NBP There is a significant increase in • Substitute cuff or tubing if

blocked Line cuff pressure during the inflation necessary.
Parameter value: *** cycle.
Blocked output condition detected.
Cuff or tubing may be obstructed.
Message: NBP The cuff pressure exceeds the • Call your Biomed.
Overpressure overpressure threshold.
Parameter value: ***
Message: NBP Sys The patient’s pressure falls outside • Observe the patient.
<LL <value> the current alarm limits or these • Change the current alarm limits
Message: NBP Sys limits are inappropriate for this for this patient.
>UL <value> patient.
Message: NBP Dia
<LL <value>
Message: NBP Dia
>UL <value>
Message: NBP Mean
>UL <value>
Message: NBP Mean
<LL <value>
Parameter value:
<value>
Message: NBP Out of NBP values are above/below the • Check patient and treat, if
Range NBP measuring range. necessary.
Parameter value: *** • Verify that the inflation mode is
appropriate for the patient.
Change if necessary.
Message: NBP Low The patient’s systolic pressure is • Change to a higher inflation limit.
Inflation Limit above the current inflation limit.
Parameter value: ***
Message: NBP Check The wrong size NBP cuff is being • Verify the cuff size and placement
Cuff Size used on the patient. are proper for the patient.
Parameter value: *** • Verify all connections.
• Change the cuff if necessary.
Message: NBP Check There is no significant increase in • Verify all connections.
Hose Connection cuff pressure during the inflation • Change the hose if necessary.
Parameter value: *** cycle.

VF6 Gamma/Gamma XL 5-33

5 ALARMS AND MESSAGES

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5-34 Gamma/Gamma XL VF6

6 Trends

Overview.........................................................................................................................6-2
Trend Setup....................................................................................................................6-2
Trend Graphs .................................................................................................................6-3
Trend Table ....................................................................................................................6-5
Special Conditions and Codes .....................................................................................6-6
6 TRENDS

Overview
The monitor can store the last 24 hours of trended data. If there is no alarm, the
monitor averages the monitored vital signs every minute and stores the results in its
trend memory.
You can view the trends in the following formats:
z As a graph (graphical trends).
z As a table (tabular trends).
Graphical and tabular trended values are displayed from left to right in increasing
time. If you discharge or admit a patient, the monitor erases trend data, patient data,
and stored recordings/events. Network time changes are reflected in both the graphical
and tabular trends.
By default, HR, SpO2 and NBP are the first three parameters displayed on the
graphical and tabular trend screens. However, you can select any three parameters for
the top positions on these screens (see below). The order of these parameters is saved
as part of the setup, when you save the current monitoring configuration (see the
chapter Monitor Setup).
For non-invasive blood pressure, the monitor stores a trend value at the end of a
successful measurement, or an error code at the end of an unsuccessful measurement,
but never more frequently than once every sixty seconds (i.e., if you take two NBP
measurements within one minute, the monitor stores only the last measurement as a
trend value).

Trend Setup
Select trend parameters for the three top positions on the trend display as follows:

STEPS: Selecting Parameters for Trend Channel Display

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Trend Setup.
4. Click on the desired trend display Channel.
5. Select the desired parameter and click the knob.

6-2 Gamma/Gamma XL VF6

 TREND GRAPHS

Trend Graphs
Trend Graphs display up to 12 hours of trended data at a time, sampled and updated
every minute. When you first access the graphical trend screen, the monitor shows the
most recent trend values plotted against a time grid along the horizontal axis of the
graph.

The monitor identifies parameters by their color on the graph (labels and waveforms).
When you click on the trend cursor (see below) trend values appear to the right of the
graph in white or in the color of the alarm grade, if the parameter was in alarm during
the one-minute trend sampling interval.
Each trended parameter has a scaled vertical axis to the left of the trend display
channel. Values that fall outside the trend scale are plotted at the maximum or
minimum of that scale. To see these values, move the cursor to the plotted line and
read the values on the graph.
Pressure trend graphs (NBP, GP1, GP2) show small vertical segments: a top segment
for the systolic pressure, a bottom segment for the diastolic pressure, and a blank
segment in between, representing the mean pressure. Mean only values are plotted as
single curves.

VF6 Gamma/Gamma XL 6-3

6 TRENDS

STEPS: Calling up Trend Graphs

1. Press the Menu fixed key.
2. Click on Review.
3. Click on Trend Graphs.

NOTE: You can also call up the Trend Graphs by pressing the Fast Access fixed key.

STEPS: Navigating the Trend Graphs Screen

z Up and down arrows — scroll through the available parameters one page at
a time.
z Left and right single arrows — move the trend window to the oldest or the
most recent trend data.
z Left and right double arrows — scroll through older or more recent trend
data.
z Hour button — select a trend window of 1, 2, 4, 8 or 12 hours. A smaller
time scale (i.e. 1 hour) displays more detail than a larger time scale (i.e. 12
hours). The time-stamps on the horizontal time axis reflect the scale selected.
z Cursor — display or hide a vertical cursor. Turn the rotary knob to move the
cursor to a specific location (time) on the trend graphs screen. The stored
trend values corresponding to that location appear to the right of the trend
display channels.
z Tabular — call up the Trend Table.

NOTE: If you try to scroll past the end of the trend graphs screen, the monitor emits
an error tone.

6-4 Gamma/Gamma XL VF6

 TREND TABLE

Trend Table
The trend table shows up to 5 hours of trended data at a time. When you first access
the trend table, the monitor shows the most recent trend values in the right column for
the parameters being monitored.

The monitor identifies parameter labels by their color. Trend values appear in white or
in the color of the alarm grade, if the parameter was in alarm during the one-minute
trend sampling interval.

STEPS: Calling up the Trend Table

1. Press the Menu fixed key.
2. Click on Review.
3. Click on Trend Tables.

NOTE: You can also call up the Trend Table by pressing the Fast Access fixed key.

VF6 Gamma/Gamma XL 6-5

6 TRENDS

STEPS: Navigating the Trend Table

z Up and down arrows — scroll through the available parameters one page at
a time.
z Left and right single arrows — move the trend window to the oldest or the
most recent trend data.
z Left and right double arrows — scroll through older or more recent trend
data.
z Minutes (Min) — select a trend window of 1, 5, 15, 30 or 60 minutes. Data
columns are spaced according to the selected window.
NOTE: Completed NBP measurement add an extra column to the table.

z Graphical — call up the Trend Graphs screen.

NOTE: If you try to scroll past the end of the trend table, the monitor emits an error
tone.

Special Conditions and Codes

When a parameter is not monitored during a trend sampling interval, the value is blank
on the trend display.
When alarms are enabled, the monitor stores and displays the first occurrence of the
alarm with the highest priority detected during the one-minute trend sampling interval.
Trend storage and display priorities are as follows:

1. Power-up, testing, and standby.

2. Life-threatening alarms (i.e. ASY, VT, VF).
3. Out-of-range conditions (+++ or ---).
4. Serious alarms: Alarm limit violations and apnea.
5. Advisory alarms: Artifact and lead-off conditions.

For conditions that fall under the same priority, the monitor stores and displays the
first condition detected during the trend sampling interval.
Life-threatening alarms are marked by a small dot on the bottom of the HR trend
channel on the Trend Graphs screen.
Technical conditions show a gap on the trend displays and the trend value is replaced
by one of the technical codes listed below.

6-6 Gamma/Gamma XL VF6

 SPECIAL CONDITIONS AND CODES

Technical Code Condition

––– Lower measuring range exceeded

(IBP, ST)

+++ Upper measuring range exceeded

(HR, ST, IBP, PLS, etCO2, RRc, Rsp, Multigas)

*A* Artifact (ECG, Rsp); Multigas Data Invalid

*C* Blocked Line, Cuff Leak, Open Line, Overpressure (NBP)

*F* Fault (SpO2, PLS, NBP, Multigas)

*L* Lead Off (ECG, Rsp, ST)

*M* Failure to measure (NBP)

ISO and ST measuring points changed

*O* No pulsations (NBP)

*U* Unplugged cable; loss of communication

*X* Measurement time-out (NBP)

LRN Learning (Rsp, ARR)

ON Power up, patient admit, exit from Standby

STB Standby

TST System test

blank No value (Respiration monitoring off, NBP between measurements, ST

monitoring off, T over or under measurement range)

VF6 Gamma/Gamma XL 6-7

6 TRENDS

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6-8 Gamma/Gamma XL VF6

7 Recordings

Overview.........................................................................................................................7-2
Recorder Preparation ....................................................................................................7-3
Assigning Network Recorders .....................................................................................7-5
Recording Waveforms...................................................................................................7-6
Timed Recordings ...................................................................................................7-6
Continuous Recordings .........................................................................................7-7
Recording Formats .................................................................................................7-7
Recording Trends ..........................................................................................................7-9
Recording Alarms........................................................................................................7-11
Stored Recordings.......................................................................................................7-12
Event Recall ...........................................................................................................7-12
Saving, Printing, Deleting Stored Recordings ...................................................7-13
Recording Status Messages.......................................................................................7-14
7 RECORDINGS

Overview
You can connect a Dräger R50 Series 2-channel strip-chart recorder to the monitor in
order to print out monitoring data, including trends and alarm data. If your monitor is
part of the Infinity network, recordings can also be printed on a centrally located
recorder or laser printer assigned to the bedside monitor (see the section Assigning
Recorders). In the Infinity network, you can request recordings remotely via the
central station (see the Instructions for Use of the central station).
Recordings of waveforms are either timed or continuous and print at a recording speed
of 25 mm/s. All recordings are identified by the patient’s name, ID, and bed label as
well as the date and time of the recording request.
If no recorder is available, the monitor automatically stores up to 10 recordings which
you can later view, print, save, or delete via the Event Recall screen (see the section on
Event Recall).
NOTE: Trend recordings, OCRG recordings, and recordings of the Diagnostic Log
cannot be stored.

You can request a recording manually by pressing the Record fixed key, or the
monitor can trigger alarm recordings automatically for life-threatening alarms and
limit violations, if the Record function is enabled on the Alarm Limits table (see the
chapter Alarms and Messages).
The monitor displays recorder status and error messages to help you follow the
progress of a recording or alert you to operational errors. For a list of these messages,
see the message table at the end of this chapter.

7-2 Gamma/Gamma XL VF6

 RECORDER PREPARATION

Recorder Preparation
Connect the R50 Series recorder to the interface plate at the back of the monitor or to
the Infinity Docking Station, if available.

CAUTION: Always place recorders and laser printers on a flat and stable surface to
prevent them from falling.

NOTE:
z The configuration/installation of a network laser printer is a Service function.
z The function of the R50 recorder key Alternate Speed or mm/s is not
supported by the Gamma Series monitor.

R50 Recorder Connection

R50 Recorder Connection

VF6 Gamma/Gamma XL 7-3

7 RECORDINGS

STEPS: Loading Paper

1. Press and release the top right button to open the paper door of the recorder.

2. Pull out the paper roll from the spool holder and any paper remaining in the
printing mechanism.
3. Place a new paper roll into the spool holder. Unroll a few inches of paper from
the bottom. The printed side should be facing up.

4. Align the paper roll with the paper guides. If not aligned, the paper could jam.
5. Close the paper door.
6. To verify proper connection and paper loading, generate a timed recording.

7-4 Gamma/Gamma XL VF6

 ASSIGNING NETWORK RECORDERS

CAUTION:
z Use only the recording paper specified by Dräger. Use of other paper will result
in unclear printing and damage to the printing head.
z Store all paper in an environment that meets the recorder storage specifications
listed in the “Technical Data” appendix. Failure to store paper properly can
result in damage to the recorder.

Assigning Network Recorders

For monitors connected to the Infinity network, you can choose a primary and
secondary recorder/laser printer within the network. The monitor sends a recording
request first to the primary recording device. If that device is busy or unavailable (i.e.
out of paper), the monitor sends the request to the secondary recording device. If no
recording device is available, the monitor stores the recording (see the section Stored
Recordings in this chapter).

STEPS: Assigning Network Recording Devices

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Recordings.

4. Click on Primary Recorder, select the desired recorder/printer and click the
knob again.
5. Click on Secondary Recorder, select a secondary recorder/printer, if
available, and click the knob again.

VF6 Gamma/Gamma XL 7-5

7 RECORDINGS

NOTE:
z R50 Series recorders and laser printers in a wireless network are identified in
the menu by the device label assigned to them during network configuration.
Laser printers in a conventional network (monitor is docked at a Docking
Station) are identified by the label LP.
z The Infinity network supports only one laser printer.

Recording Waveforms
To print real-time monitoring data, two types of recordings are available:
z Timed Recordings.
z Continuous Recordings.
For both recording types, the recording speed is 25 mm/s.
Timed and continuous recordings include up to two waveforms. If one of the
waveforms is hidden by a menu, you can still request a recording. If a cascaded
waveform is displayed, only the waveform from the first channel prints out.
NOTE: Timed and continuous recordings cannot be started while the Alarm Limits
table, trends or diagnostic logs are displayed. To start recording, exit those displays
before requesting a recording.

Timed Recordings
Timed Recordings print a total of 20 seconds of patient data, of which about 10
seconds occurred prior to the recording request (Delay), and about 10 seconds after
the recording request.
If no recorder/printer is available, the monitor stores the recording (see Stored
Recordings, below). You can cancel the storage within 5 seconds of the initial
recording request.
The monitor cancels a timed recording if you modify the display, size or scale of a
waveform while the recording is ongoing.

STEPS: Starting a Timed Recording

1. Press the monitor’s Record fixed key.
2. To cancel the recording, press the Record key again or the Stop key on the
recorder while printing is in progress.

7-6 Gamma/Gamma XL VF6

 RECORDING WAVEFORMS

Continuous Recordings
Continuous recordings provide an up-to-the-second printout of patient data. This
mode is useful when more than 20 seconds of data must be printed during critical,
short-term applications.
NOTE:
z You can request a continuous recording during an alarm, timed, trend, and
diagnostic log recording. To do so, first stop the recording in progress with the
Record fixed key on the monitor, then press and hold the same key to start the
continuous recording.
z Continuous OCRG recordings are not supported.

STEPS: Starting a Continuous Recording

1. Press the Record fixed key for at least two seconds. Two beeps indicate when
the recording starts.
2. To cancel the recording, press the Record fixed key again or the Stop key of
the recorder while printing is in progress.

Continuous recordings cannot be stored. If you attempt to store a continuous

recording, the monitor will store it as a timed recording with 20 seconds of patient
data.
NOTE:
z If the user requests a continuous recording at the central station while a timed
recording is in progress, the timed recording is cancelled. A continuous
recording can only be printed out if two recorders are available. If only one
recorder is available, the continuous recording request is converted to a timed
recording, then stored and printed when the recorder becomes available.
z An uninterrupted continuous recording on a laser printer consists of up to 120
pages.

Recording Formats
A timed or continuous recording consists of a header and two waveforms with proper
scales, units of measure and parameter labels.

VF6 Gamma/Gamma XL 7-7

7 RECORDINGS

R50 Recording Strip

Printout of Laser Printer

The printout is identified by the following:

z Patient name and ID.
z Bed label and Care Unit.
z Date and time of the recording request.
z Recording delay and speed.
z Monitored parameters and values.
z Crossed bell symbol for parameters whose alarm is disabled.
z Recording mode (timed or continuous).
z *** or blanks if numeric values and waveforms are unavailable.

7-8 Gamma/Gamma XL VF6

 RECORDING TRENDS

The printout shows the top two waveforms that were displayed on the monitor’s
screen at the time of the print request. A small black marker along the bottom of the
printout indicates the time of the print request.
NOTE:
z If the second waveform channel is set to Cascade, only the waveform in the first
waveform channel prints out.
z OCRG recordings cannot be printed on a laser printer.

Recording Trends
Trend printouts are long-term records of heart rate and other patient vital signs. The
printouts are snapshots of the table or graphs as displayed when you press the Record
fixed key on the monitor.
Trend parameters are printed in the order selected by the user. In addition, parameter
trend data is printed only if valid trend data is available for that parameter in the
tabular trend columns or in the graphical trend window.
You must view the graphical and tabular trends in order to record them. An alarm
recording request preempts a trend recording.
In monitors that display Neonatal OCRG, the recorder prints 144 seconds of patient
OCRG data that occurred prior to pressing the Record fixed key. The illustration
below shows an OCRG recording strip.

STEPS: Recording the Trend Table

1. Display the Trend Table.
2. Press the Record fixed key on the monitor. The illustration below shows a
typical trend table recording strip.

VF6 Gamma/Gamma XL 7-9

7 RECORDINGS

STEPS: Recording Trend Graphs

1. Display the Trend Graph.
2. Press the Record fixed key on the monitor. The illustration below shows a
typical trend graph recording strip.

NOTE: Because of the larger paper size, laser printers are best suited to print out trend
data.

7-10 Gamma/Gamma XL VF6

 RECORDING ALARMS

Recording Alarms
The monitor initiates a timed recording for life-threatening alarms and limit violations
provided that:
z The parameter is being monitored.
z The parameter alarm is enabled.
z The parameter alarm recording is enabled.
z A recorder/printer is available.
Turn parameter alarms and alarm recordings on or off on the Alarm Limits or the
Arrhythmia Setup tables (see the chapters Alarms and Messages and Arrhythmia).
Alarm recordings have priority over timed, trend, and diagnostic log recordings (e.g.,
if a trend recording is in progress, the monitor immediately cancels it to print the
alarm recording instead).

NOTE:
z The monitor prints a recording for life-threatening alarms even if the alarm
recording function is turned off.
z Continuous recordings have priority over alarm recordings. Alarm recordings
cannot be printed while continuous recordings are already in progress.
z Neonatal OCRG apnea alarm recordings print 144 seconds of patient data,
consisting of 108 seconds of pre-event data and 36 seconds of post-event data.

The monitor cancels an alarm recording if you modify the display, size, or scale of a
waveform during recording. You can also cancel an alarm recording by pressing the
monitor’s Record fixed key or the Stop key on the recorder. The monitor alerts you to
a cancelled recording request by briefly displaying the message “Recording
Cancelled.”
If a cascaded waveform is displayed, the recording prints out only the top waveform.
If a new alarm occurs while an earlier alarm is ready to print or the printing is in
progress, the monitor finishes printing out the first alarm recording and ignores the
second alarm recording.

VF6 Gamma/Gamma XL 7-11

7 RECORDINGS

Stored Recordings
The monitor can store up to 10 alarm or timed recordings consisting of 20 seconds of
data each (about 10 seconds of pre-event/request data and about 10 seconds of post-
event/request data.) Recordings are stored when:
z No recorder/laser printer is available or if the recorder/laser printer is
temporarily out of order (i.e. no recording paper).
z You turned on the automatic storage of alarm recordings on the Alarm Limits
table (see the chapter Alarms and Messages).
When the recording storage is full, the monitor deletes the oldest unsaved recordings
as new recordings come in. You can view, print, save, and delete stored recordings via
the Event Recall screen (see below).
Upon successfully storing a recording, the monitor emits 2 beeps. To cancel a
recording storage in progress, press the Record fixed key on the monitor within 5
seconds of the start of the recording storage.
NOTE: The monitor does not store continuous, trend, OCRG or diagnostic log
recordings. Continuous recordings are converted to timed recordings and then stored.

Event Recall
You can view 4 seconds of waveform data for each stored recording on the Event
Recall screen (4 seconds of pre-event/request data). The screen also shows the
parameter values at the time of the recording storage.
To call up the Event Recall screen:

1. Press the Menu fixed key.

2. Click on Review.
3. Click on Event Recall.

NOTE:
z You can also access the Event Recall screen via the Fast Access fixed key or by
clicking on Monitor Setup > Recordings > Review in the Main Menu.
z The Event Recall screen shows only 4 seconds of data for each stored
recording, although the monitor has actually stored 20 seconds of data for each
stored recording. If you print the stored recording, the recording strip contains
all 20 seconds of stored data.

7-12 Gamma/Gamma XL VF6

 STORED RECORDINGS

The Event Recall heading shows the amount of pre-event/request data (Delay, about
10 s), the recording speed, date and time of the recording, and the type of the
recording (bedside timed or the parameter in alarm).

STEPS: Navigating the Event Recall Screen

1. Click on Prev to call up older stored recordings.
2. Click on Next to call up more recently stored recordings.
3. Click on More... next to the list of parameters to view additional parameters
and their values at the time of the recording storage.

Saving, Printing, Deleting Stored Recordings

You can save, print or delete stored recordings via the Event Recall screen. The
monitor allows you to permanently save up to 9 stored recordings. A saved recording
cannot be deleted and it is marked by a padlock icon.

STEPS: Saving a Stored Recording

1. Call up the Event Recall screen.
2. Click on Prev or Next to select a stored recording.
3. Click on Save (click on Save again, to unlock the saved recording).

VF6 Gamma/Gamma XL 7-13

7 RECORDINGS

STEPS: Printing or Deleting a Stored Recording

1. Call up the Event Recall screen.
2. Click on Prev or Next to select a stored recording.
3. Click on Print or Delete.

NOTE: You can only delete a saved recording, if you first unlock it by clicking on
Save again.

Recording Status Messages

The monitor displays messages during a recording to help you follow the progress of a
recording and to alert you to any operational errors.
Message Possible Cause
Recorder Door Open Close door to obtain recordings.
Recorder Failure Recorder error; call your Biomed.
Excessive artifact in the waveforms; the recorder does not have
sufficient power to print the recording.
Check Printer Printer error: Laser printer connection lost, printer out of paper or
tray open.
Recorder Out of Paper Load paper to obtain recordings.
Recording Cancelled The recording has been cancelled following a user’s request. Wait
for the message to clear to request another recording.
Recording Finished The recording is printed. Another recording can be initiated.
Recording Started Recording in progress. Wait for the recording message to clear
before requesting another recording.
Recording Stored The recording has been stored.
<#> Stored Recording(s) Indicates number of stored recordings.

7-14 Gamma/Gamma XL VF6

8 ECG and Heart Rate

Overview.........................................................................................................................8-2
Patient Preparation........................................................................................................8-2
Selecting and Preparing the Electrodes ...............................................................8-2
Preparing the Patient’s Skin ..................................................................................8-3
Positioning the Electrodes .....................................................................................8-4
ECG Monitoring Settings ..............................................................................................8-7
Cable Type ...............................................................................................................8-7
Lead Selection and Display Amplitude .................................................................8-8
Cascade Display......................................................................................................8-9
One- or Two-Channel Signal Processing............................................................8-10
Pulse Tone Source ................................................................................................8-11
Pulse Tone Volume ...............................................................................................8-12
Pacer Detection .....................................................................................................8-13
Displaying Sync Marks .........................................................................................8-14
ECG and HR Safety Considerations ..........................................................................8-15
HR Alarm Settings.................................................................................................8-15
Neonatal ECG Monitoring.....................................................................................8-16
ECG 50/60 Hz Notch Filter Setting .......................................................................8-16
Muscle Stimulators ...............................................................................................8-16
Electrosurgery (ESU) ............................................................................................8-16
Infusion pumps .....................................................................................................8-18
Defibrillators and Cardioversion .........................................................................8-18
High P-Waves and T-Waves .................................................................................8-18
Pacemakers ...........................................................................................................8-19
AV Sequential or DDD Pacemakers.....................................................................8-20
Pacemakers with Impedance-Derived Rate Response ......................................8-20
Large Amplitude Pacer Pulses ............................................................................8-20
Transcutaneous Electrical Nerve Stimulators (TENS).......................................8-21
8 ECG AND HEART RATE

Overview
The monitor can:
z Display one or two ECG leads.
z Calculate the average heart rate per minute.
z Identify a number of arrhythmia events, including asystole, ventricular
fibrillation, bradycardia, and ventricular tachycardia (see the chapter
Arrhythmia).
z Analyze ST segment deviations for the displayed ECG leads (option -- see the
chapter ST-Segment Analysis).
Electrodes applied to the patient’s chest pick up the electrical impulses initiated by the
heart. The monitor amplifies these electrical signals and displays them on the screen.
The monitor accepts 3, 5, and 6-lead ECG cable sets. With a 3-lead set you can
monitor the leads I, II, and III. With a 5-lead set you can monitor the leads I, II, III,
aVR, aVL, aVF and V (chest). With a 6-lead set you can monitor the leads I, II, III,
aVR, aVL, aVF, V (chest) and V+ (additional chest).
When you first turn on the monitor, it calculates heart rate within 15 seconds or 3
beats, whichever is longer, and displays the value in the HR parameter box.
Thereafter, the heart rate is updated after every detected beat. The heart symbol ♥
pulsates with every detected QRS complex. When the HR alarm is turned off, a
crossed bell appears beside the HR value. When monitoring a paced patient, the letter
“P” is added to the heart symbol.
NOTE: If voltage to the monitored ECG lead(s) is too high, the waveform goes blank
until the input voltage returns to a range that can be monitored.

Patient Preparation

Selecting and Preparing the Electrodes

There is a wide selection of reusable and prepackaged, pre-gelled, and disposable
electrodes to choose from.
Always select the best electrode for your particular monitoring situation. Because of
their stability, the use of Ag/AgCl reusable or disposable electrodes is recommended.
If using reusable electrodes, place a ¼ to ½ inch (½ to 1 cm) of conductive gel in the
spacer before application and attach the electrodes to the skin with an adhesive ring.

8-2 Gamma/Gamma XL VF6

 PATIENT PREPARATION

If using pre-gelled electrodes, verify that there is enough gel in the gel-filled area. .
NOTE: Never use disposable electrodes after their expiration dates or when
the gel has dried out.

Preparing the Patient’s Skin

WA R N I N G : C o n d u c t i v e pa r ts o f e l e c t r o d e s a n d c o n n e c t o r s
( i n c l u di ng t he ne u t ra l e l e c t ro de ) s ho ul d n ot c on ta c t ot h e r
conductive material, including earth.
The quality of ECG monitoring depends largely on the strength and quality of the
signals received by the electrodes. Careful skin preparation and application techniques
assure strong signals with minimal artifact and interference.
Select flat, non-muscular sites to position the electrodes and follow the clinical
techniques of your hospital. We suggest the following standard technique:

1. Prepare the skin by clipping or shaving excess hair.

2. Remove any skin residue or oils with an alcohol pad.
3. Remove the outer epidermal layer as required to reduce skin impedance.
Mildly abrade only the electrode contact site with ultrafine sandpaper (220-
400 grit). Apply the electrodes one at a time and make sure the electrode gel is
in contact with the abraded skin area.
4. For severely diaphoretic patients, use a benzoin prep for tighter adherence of
the electrodes.
5. Inspect the electrode gel to make sure it is moist. Apply the pad with a circular
motion on the adhesive area first, then press gently on the gel area to prevent
the gel from being squeezed out.
6. Change electrodes every 24-48 hours to ensure a good quality signal.
However, if the electrocardiographic pattern becomes less distinct, if the
patient is diaphoretic, or if skin irritation develops, the electrodes must be
changed and reapplied sooner.

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8 ECG AND HEART RATE

Positioning the Electrodes

Position the electrodes on the chest at locations that provide the clearest and most
informative electrocardiogram for each patient. The following table identifies each
lead wire and its associated color for the IEC 2 (AHA/US) and IEC 1 color schemes.

Lead Wire IEC 2 (AHA/US) IEC 1

LA Black Yellow

LL Red Green

RA White Red

V Brown White

RL Green Black

V+ Gray and Brown Gray and White

The following pictures show possible configurations of 3-, 5-, and 6-lead electrode
sets. Note that these configurations are examples only; final configuration must be
determined by trained clinical personnel.

3-Lead Standard Configuration

8-4 Gamma/Gamma XL VF6

 PATIENT PREPARATION

3-Lead MCL1 Configuration

NOTE: Select ECG I in the waveform channel for monitoring the MCL1
configuration.

5-Lead Standard Configuration

VF6 Gamma/Gamma XL 8-5

8 ECG AND HEART RATE

6-Lead Standard Configuration

3-Lead Configuration for Neonates

When monitoring neonates, the use of a 3-lead configuration is recommended. Dräger
also recommends use of the NEOMED™ Pod for neonates. Position the right arm
(RA), left arm (LA) and left leg (LL) electrodes as illustrated below.

8-6 Gamma/Gamma XL VF6

 ECG MONITORING SETTINGS

ECG Monitoring Settings

Cable Type
This option lets you select the number of lead wires connected to your patient. This is
particularly important when monitoring with a 5- or 6-lead cable set to ensure the
proper detection and display of augmented leads.
NOTE: If an augmented lead was displayed when switching from a 5-lead or 6-lead
cable to a 3-lead cable set, the monitor defaults to the display of lead II. This ensures the
display of an ECG when switching cable types.

STEPS: Selecting the Cable Type

1. Click on the HR parameter box.
2. Click on More....
3. Click on ECG Leads.

4. Dial in the desired cable type and click the knob.

VF6 Gamma/Gamma XL 8-7

8 ECG AND HEART RATE

Lead Selection and Display Amplitude

Select the lead(s) that provides the clearest and most informative electrocardiogram
for your patient. The Size selection lets you modify the amplitude of the displayed
ECG for optimum viewing. The available ECG sizes are:
z 0.25, 0.5, 1, 2, 4, and 8 mV/cm.

STEPS: Selecting the Lead and Size

1. Click on the waveform channel where the ECG waveform is currently
displayed.
2. Click on Waveform.

3. Select the desired ECG lead and click the knob.

4. Click on Size.
5. Select the desired display amplitude and click the knob.

NOTE:
z The lead assigned to the first waveform channel cannot be assigned to the
second waveform channel, except in Cascade mode.
z If you change the monitor’s leads and the MULTIVIEW WORKSTATION is storing
waveforms selected manually (Auto Track OFF), you must also change the
leads at the MULTIVIEW WORKSTATION. For more information, see the
MULTIVIEW WORKSTATION’s Instructions for Use.

8-8 Gamma/Gamma XL VF6

 ECG MONITORING SETTINGS

Cascade Display
The electrocardiogram displayed in the first channel is about four seconds long. To
display eight seconds of the same waveform, select the cascade mode. Cascade mode
continues the display of the first waveform channel into the second channel.

NOTE:
z The Cascade is only available in the second waveform channel. If etCO2, IBP2
and ST are enabled, the ECG cascade is not available.
z The second channel of a cascaded waveform cannot be printed on recordings.

STEPS: Selecting the Cascade Display

1. Click on the second waveform channel.
2. Click on Waveform.

3. Select Cascade and click the knob.

NOTE: You cannot adjust the display amplitude (Size) for the second waveform
channel when Cascade is selected; the amplitude is the same as the one in the first
channel.

VF6 Gamma/Gamma XL 8-9

8 ECG AND HEART RATE

One- or Two-Channel Signal Processing

The monitor can process one or two ECG leads. If you select two-channel signal
processing, ECG and arrhythmia monitoring is less vulnerable to artifact, because the
monitor can assign a greater weight to the “cleaner” channel or even exclude a
channel from signal processing altogether, if it exceeds a certain level of artifact. In
this case, ECG monitoring continues without interruption, unless both channels start
showing excessive artifact.
The monitor processes the two leads displayed in the top two waveform channels. If
no lead or only one lead is currently displayed in these channels, the monitor uses the
last leads previously displayed there.
NOTE: When you call up the second page of the HR Setup menu by clicking on
More... (see below), the two ECG leads available for signal processing appear to the
right of the menu. To change these leads, exit the HR Setup menu, click on waveform
channel 1 or 2, and select a different ECG lead for display.

STEPS: Selecting One- or Two-Channel Signal Processing

1. Click on the HR parameter box.
2. Click on More....
3. Click on ECG Processing.

4. Select the desired setting (ECG1 or ECG1&2) and click the knob.

8-10 Gamma/Gamma XL VF6

 ECG MONITORING SETTINGS

Pulse Tone Source

You can select either ECG or SpO2 as the pulse tone source. With ECG as the pulse
tone source, the tone’s pitch is constant (rather than modulated -- see the chapter Pulse
Oximetry) and a pulsating ♥ symbol appears in the HR parameter box with each
detected heart beat.

STEPS: Selecting the Pulse Tone Source

1. Click on the HR parameter box.
2. Click on Tone Source.

3. Select ECG and click the knob.

VF6 Gamma/Gamma XL 8-11

8 ECG AND HEART RATE

Pulse Tone Volume

When ECG is selected as the pulse tone source, the monitor emits a tone every time it
detects a QRS complex. You can adjust this tone volume between 10% and 100% (or
turn the pulse tone off).
NOTE:
z Tone volume settings are common to both ECG and SpO2 source signals.
Whatever setting you select for ECG is valid for SpO2 and vice-versa.
z The monitor’s Master Speaker Volume (see the chapter Monitor Setup)
determines the volume of all tones. If you select a pulse tone volume higher
than that of the speaker volume, the pulse tone volume sounds only at the level
of the speaker volume. If you select a lower setting for the pulse tone, the pulse
tone sounds at the volume selected.

STEPS: Setting the Pulse Tone Volume

1. Click on the HR parameter box.
2. Click on Tone Volume.

3. Select the desired setting and click the knob.

8-12 Gamma/Gamma XL VF6

 ECG MONITORING SETTINGS

Pacer Detection
Pacer detection is used for paced patients in the adult and pediatric monitoring modes.
The monitor detects paced pulses in the amplitude range of ±5 to ±700 mV. When
pacer detection is enabled, the letter “P” is added to the flashing ♥ symbol in the HR
parameter box for each paced beat. In addition, green positive spikes on the ECG
waveform indicate pacemaker pulses.
The monitor has an advanced pacer detection mode called Fusion, which offers
increased detection sensitivity to fused paced beats. To select the Pacer Fusion mode
in the HR menu, advanced pacer functions have to be enabled in the Biomed menu
(see the appendix Default Settings and Biomedical Support).
When monitoring paced patients, Dräger suggests the following:
z Use the electrode positions that are best suited for paced patients (see the
electrode placement section).
z Select the lead with the highest R-wave.
z Follow the pacemaker precautions given at the end of this section (see ECG
and HR Safety Considerations).

STEPS: Selecting the Pacer Detection Mode

1. Select the HR parameter box and click the knob.
2. Click on Pacer Detect.

3. Dial in the desired setting (ON, OFF or Fusion) and click the knob.

NOTE: The monitor indicates Pacer Off or Pacer Fusion Mode between the first two
waveform channels.

VF6 Gamma/Gamma XL 8-13

8 ECG AND HEART RATE

Displaying Sync Marks

The timing of the sync pulse triggered by the QRS complex can vary slightly. You can
display sync marks on the R-wave of the electrocardiogram to verify the timing of the
pulse.
The monitor displays sync marks as a white line during synchronization. For heart
rates between 30 and 250 beats per minute with QRS amplitudes greater than or equal
to 0.5 mV, the sync pulse occurs within 35 ms of the R-wave peak. See the section
ECG and HR Safety Considerations for details.
NOTE: If SpO2 is displayed in the first channel and ECG in the second channel, no
QRS markers appear on the ECG.

STEPS: Displaying QRS Sync Marks

1. Click on the HR parameter box.
2. Click on QRS Marks.

3. Dial in the desired setting (ON/OFF) and click the knob.

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 ECG AND HR SAFETY CONSIDERATIONS

ECG and HR Safety Considerations

HR Alarm Settings
Set HR alarm limits on the Alarm Limits table (see the chapter Alarms and Messages).
If you turn the HR alarm off, the monitor displays a crossed bell icon in the HR
parameter box and the banner HR Limits Off above the first waveform channel. If
arrhythmia monitoring and alarms for asystole and ventricular fibrillation are also
disabled, the monitor displays the banner HR, ASY, VF Off.
NOTE:
z By default, alarms for asystole and ventricular fibrillation are always on;
however, these alarms can be disabled in the password-protected Biomed menu
(see the appendix Default Settings and Biomedical Support).
z If arrhythmia detection is on, alarms for asystole (ASY) and ventricular
fibrillation (VF) are automatically on and cannot be turned off.

WA R N I N G : I f t h e m o n i t o r d i s p l a y s t h e b a n n e r H R , A S Y, V F
O ff , t h e re i s n o a l a r m a n n u n c i a t i o n f o r a s y s t o l e a n d
ventricular fibrillation.

VF6 Gamma/Gamma XL 8-15

8 ECG AND HEART RATE

Neonatal ECG Monitoring

To obtain the most accurate heart rate count and waveform display, select the ECG
lead(s) with the smallest T wave and the largest monophasic QRS.

WA R N I N G : N e o n a ta l Q R S c o m p l e x e s t h a t a r e b i p h a s i c a n d
less than 40 ms wide, or monophasic and less than 20 ms
wide, are displayed smaller than their actual amplitude.

ECG 50/60 Hz Notch Filter Setting

When the line frequency is set incorrectly, the resulting 50 or 60 Hz noise on the ECG
signal can make the ECG waveform unreadable along with masking QRS complexes.
As a result, detection of the QRS complexes becomes unreliable. When these cannot
be sensed reliably, incorrect HR calculations may result, leading to both false positive
and false negative HR alarms.

Muscle Stimulators

WA R N I N G : T h e u s e o f e l e c t r i c a l m u s c l e s t i m u l a t o r s m a y
i n t e r f e r e w i t h E C G a n d r e s p i r a t i on m o n i t or i n g . I f t hi s o c c u r s ,
discontinue their use.

Electrosurgery (ESU)
The monitor’s ECG function is protected against high-frequency interference from
defibrillators and electrosurgical units. The ESU BLOCK (optional) enhances the
performance of the monitor during electrosurgery and allows you to use standard ECG
lead sets. It reduces noise on ECG tracings and helps protect the patient from burns.

8-16 Gamma/Gamma XL VF6

 ECG AND HR SAFETY CONSIDERATIONS

STEPS: Using the ESU Block

1. Turn off pacemaker detection.
2. Plug the ESU block into the MULTIMED 5 pod as shown above. If you are
using a MULTIMED 6 pod, ignore the extra V lead connection.
3. Plug a standard white ECG lead set into the ESU block as shown. Do not use
shielded blue lead wires with the ESU block.
4. Remove the ESU block to continuously monitor the patient.

WA R N I N G :
z Dräger recommends using the ESU block during
e l e c t r o s u r g e r y. I f y o u d o n o t h a v e a n E S U b l o c k , u s e
o n l y D r ä g e r b l u e E C G l e a d w i r e s . T h e y h e l p p ro t e c t t h e
pa t i e nt f r o m b ur n s c a u s e d b y E S U - i n d u c e d c u r r e n t
flowing through the lead wires.
z I m p e d a n c e r e s p i r a t i o n m o n i t o r i n g a n d pa c e m a k e r s p i k e
d e t e c t i on a re i no pe r a t i v e w h e n u s i n g t h e E S U b l o c k .
z The NEOMED pod is not intended for use during
e l e c t r o s u r g e r y. To p r o t e c t pa t i e nts f r o m b u r n s , d o n o t
use the NEOMED pod in an ESU environment.

To minimize interference from ESUs, we recommend the following:

z Place the electrodes as far from the surgical incision as possible while
maintaining a clinically useful configuration.
z Place the cable and lead wires as far from the ESU as possible and
perpendicular to the ESU cables.
z Use an ESU neutral electrode with the largest possible contact area.
z When possible, place the ESU neutral electrode close to and directly under the
surgical site, avoiding bony protuberances.
z Replace the electrodes at regular intervals.
z Read the instructions provided with the ESU for additional information.
z For patients without a pacemaker, turn the pacer detection off. If pacer
detection is on, the ESU interference may be detected as pacer spikes that
display on the ECG.
The ECG waveform(s) and the HR value may be affected during electrosurgery.
However, after discontinuing the use of electrosurgery equipment, the waveform(s)
and value is displayed as normal.

VF6 Gamma/Gamma XL 8-17

8 ECG AND HEART RATE

Infusion pumps
Use of an infusion pump may cause artifact in ECG signals. To determine if the pump
is the source of electrical interference in the signal, turn it off, if possible. If the
artifact disappears, it was probably caused by the pump.
To minimize artifact and improve the signal, try the following:
z Choose ECG lead(s) with the best signal for monitoring or replace the
electrodes.
z Keep ECG cables away from the infusion pump and its wiring.

Defibrillators and Cardioversion

WA R N I N G :
z B e f or e a t t e m p t i n g a c a r d i o v e r s i o n , v e r i f y t h e t i m i n g o f
t h e s y n c p ul s e o n y o u r m o n i t o r.
z N e v e r p l a c e t h e d e f i b r i l l a t o r pa d d l e s o v e r t h e E C G
e l e c t r o d e s o r c a b l e s . T h e d i s c h a r g e c a n b u r n t he
pat i e n t o r t h e c l i n i c i a n , o r f i b r i ll a t e t h e c l i n i c i a n a n d
n o t d e f i b r i l l a t e t h e pa t i e n t .

High P-Waves and T-Waves

WA R N I N G : T h e m o n i t o r m a y c o u n t h i g h a m p l i t u d e P o r T-
w a v e s ( > 0 . 2 m V ) o f l o n g d ur a t i o n a s Q R S c o m p l e x e s . T h i s c a n
r e s u l t i n m i s s e d l o w - r a t e a l a rm s . I f t h e d i s p l a y e d h e a r t r a t e
(HR) is higher than that indicated by the waveform, the
m o n i t o r m a y b e c o u n t i n g u n u s u a l l y h i g h T- w a v e s o r P - w a v e s
as QRS complexes.

To obtain the most accurate heart rate count, do the following:

z Follow the steps outlined for pacemaker patients, selecting the lead with the
highest R-wave relative to the T-wave and the P-waves or both.
z If inaccurate counting continues, reposition the electrodes until you obtain an
acceptable waveform. In addition, Dräger recommends monitoring the heart
rate for these patients with an SpO2 sensor.

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 ECG AND HR SAFETY CONSIDERATIONS

Pacemakers
Take special care in the evaluation of ECG waveforms.The monitor successfully
passed the pacer pulse rejection test. However, it is not possible to anticipate every
waveform characteristic.

WA R N I N G : I n c a s e o f u n c e r ta i n t y r e g a r d i n g t h e i n t e r p r e ta t i o n
of QRS complexes, the monitor is designed to err in the
d i r e c t i o n o f f a l s e p os i t i v e r a t h e r t h a n f a l s e n e g a t i v e a l a r m s .
I n pa c e d pa t i e n ts , Q R S c o m p l e x e s m a y n o t b e c o u n t e d ,
r e s u l t i n g i n f a ls e l o w - r a t e a l a rm s u n d e r t h e f o l lo w i n g
c i rc u ms ta nc e s :
z F us e d b e a ts a n d a s y n c hr o n o u s pa c e r s w h e n c ou pl i n g
i n t e r v a l s a re + 1 0 t o – 9 0 m s .
z 7 0 0 m V pa c e r p u l s e s f o l l o w e d b y Q R S c o m p l e x e s
s ma l l e r t h a n 0 . 5 m V.
z A s y n c hr o n o u s pa c e r p u l s e s w i t h o v e r s h o ot .

WA R N I N G : F u s i o n m o d e pac e r d e t e c t i o n i s n o t i n t e n d e d f o r
u s e w it h l a r g e - v o l ta g e , u n i p o l a r pa c e m a k e r s . I t i s i n t e n d e d
f o r u s e o nl y w i t h b i p h a s i c pa c e m a k e r s . P l e a s e o bs e r v e t h e
f o l l o w in g :
z B e f o r e s e l e c t i n g P a c e r F u s i o n M o d e , b e c e r ta i n t h a t t h e
pa t i e nt h a s a b i p h a s i c pa c e m a k e r ( e x t e rn a l o r
i m p l a n t e d ) a n d t h a t i t i s a c c u r a t e l y p ro g r a m m e d a s
a p p r o p r i a t e f o r t h a t pa t i e n t .
z D o n o t s e l e c t F u s i o n M o d e i f y o u a r e u n c e r ta i n w h a t
t y p e o f pa c e m a k e r i s i n u s e o r h o w i t i s p r o g r a m m e d .
z Select Fusion Mode only to suppress repeated false
asystole and/or false low heart rate alarms.
z S e l e c t i n g P a c e r F u s i o n M o d e m a y i n c re a s e t h e r i s k o f
t h e m o n i t o r f a l s e l y c o u n t i n g pa c e r s p i k e s a s Q R S
c o m p l e x e s a n d m a y c a u s e c a r d i a c a rr e s t t o g o
undetected. Therefore, special surveillance of any
pa c e m a k e r pa t i e n t m o n i t o r e d w i t h t h i s m o d e i s s t r o n g l y
recommended.

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8 ECG AND HEART RATE

WA R N I N G : T h e m o n i t o r m a y n o t c o u n t h e a r t r a t e s a c c u r a t e l y
a n d m a y m i s i n t e rp r e t r a t e - d e p e n d e n t a r r h y t h m i a i n s o m e
pa c e d pa t i e n ts . D o n o t r e l y e n t i r e l y o n t h e d i s p l a y e d h e a r t
r a t e t o a s s e s s a pa c e d pa t i e n t ’s c o n d i t i o n . A l w a y s o b s e r v e
t h e s e pa t i e n ts c l o s e l y a n d m o n i t o r a l l o f t h e i r v i ta l s i g n s
c a r e f u l l y.

AV Sequential or DDD Pacemakers

For pacemaker patients, follow these steps:
z Always attach at least four electrodes to allow for a choice of leads.
z Turn pacer detection on.
z Select the lead with the highest R-wave and the least interference.
z Verify that the HR calculation is accurate by comparing it to the ECG
waveform.
z Monitor the pulse or the respiration or both using a method other than ECG.
For patients without pacemakers, turn the pacer detection off.

Pacemakers with Impedance-Derived Rate Response

These pacemakers emit pulses for the purpose of adjusting the pacer rate to the
patient’s respiration rate. The monitor may classify such impedance spikes as pacer
spikes and display them in very short, regular intervals superimposed on the patient’s
ECG. For patients with pacemakers, change the electrode placement until the
impedance spikes shrink in size or disappear.

Large Amplitude Pacer Pulses

WA R N I N G : S o m e pa c e m a k e r s , e s p e c i a l l y e x t e r n a l
pa c e m a k e r s , e m i t p ul s e s w i t h a m p l i t u de s f a r e x c e e d i n g t h o s e
s h o w n i n t h e pa c e r p u l s e r e j e c t i o n ta b l e . T h e m o n i t o r m a y
m i s i n t e r p r e t s u c h p ul s e s a s v a l i d Q R S c om p l e x e s a nd m a y
fail to detect cardiac arrest.

8-20 Gamma/Gamma XL VF6

 ECG AND HR SAFETY CONSIDERATIONS

Transcutaneous Electrical Nerve Stimulators (TENS)

TENS signals are similar to pacemaker spike signals and may be accidentally labeled
as such by the monitor.

WA R N I N G : Va l i d Q R S c o m p l e x e s f o l l o w i n g m i s l a b e l e d T E N S
s i g n a l s c o u l d b e r e j e c t e d . T h e r e s ul t m a y b e f a l s e a s y s t o l e o r
low heart rate alarms. If TENS signals continue to be
i n t e r p r e t e d a s pa c e r s pi k e s , t u r n t h e pa c e r d e t e c t i o n o f f .

VF6 Gamma/Gamma XL 8-21

8 ECG AND HEART RATE

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8-22 Gamma/Gamma XL VF6

9 Arrhythmia

Overview.........................................................................................................................9-2
Turning Arrhythmia Monitoring ON .............................................................................9-4
Arrhythmia Setup...........................................................................................................9-5
Rate and Count........................................................................................................9-6
Arrhythmia Alarms ..................................................................................................9-6
Arrhythmia Alarm Recordings ...............................................................................9-6
Relearning a Patient’s ECG ..........................................................................................9-7

Arrhythmia Classification Expert (ACE)

The Infinity Gamma Series monitor uses Dräger’s ACE TM (Arrhythmia Classification
Expert) technology to screen out misleading or erroneous arrhythmia information.
ACE is not rule-based; it uses trained logic to draw informed conclusions about the
patient. This provides more accurate detection of legitimate cardiac events while
reducing the likelihood of false alarms.
9 ARRHYTHMIA

Overview
Arrhythmia monitoring is available for adult and pediatric patients. The arrhythmia
monitoring mode you select (Basic, Full, or OFF) determines which kinds of
arrhythmia events the monitor detects (see table below).
NOTE:
z Full arrhythmia monitoring is available as an option and must be enabled by
your Biomed.
z Arrhythmia monitoring is not available for neonates.

When you turn arrhythmia monitoring on, the monitor passes through a learning phase
(30 to 40 seconds) in which it learns the patient’s dominant QRS pattern and stores it
for reference. Subsequent beats and QRS rhythms are then compared to the stored
reference and classified as either normal or irregular (arrhythmia).
During the learning phase, LRN appears in the HR parameter box and the message
Arrhythmia Relearning in the message area at the bottom of the screen. You can also
initiate a learning phase manually at any time (see the section Relearning a Patient’s
ECG, below). Date and time of the last learning phase are indicated in the HR Setup
menu.

NOTE: For arrhythmia monitoring, the monitor processes the leads selected for ECG
monitoring (see the chapter ECG and Heart Rate).

9-2 Gamma/Gamma XL VF6

 OVERVIEW

Arrhythmia Monitoring Modes

Label Event Description

OFF: The monitor detects these events when Arrhythmia = OFF (via ECG)
ASY Asystole 4 seconds pass without the detection of a valid QRS
complex
VF Ventricular The monitor identifies a sinusoidal waveform with
Fibrillation fibrillation characteristics
Basic: The monitor detects these additional events when Arrhythmia = Basic
VT Ventricular N* or more consecutive PVCs with a beat-to-beat rate >=
Tachycardia the VT rate
BRDY** Sinus 8 or more consecutive normal beats with an average rate
Bradycardia <= the BRDY rate
Full: The monitor detects these additional events when Arrhythmia = Full
RUN Ventricular 3 to N-1* consecutive PVCs with a beat-to-beat rate >= the
Run VT rate
AIVR Accelerated 3 or more PVCs with a rate < the VT rate
Idioventricular Rhythm
SVT Supraventricular N* or more consecutive normal beats with a beat-to-beat
Tachycardia rate >= the SVT rate
CPT Ventricular A sequence of beats with the pattern: normal, PVC, PVC,
Couplet normal
BGM Ventricular A sequence of beats with the pattern: normal, PVC,
Bigeminy normal, PVC, normal
TACH Sinus N* or more consecutive normal beats with a beat-to-beat
Tachycardia rate >= the TACH rate
PAUS Pause A sequence of two normal beats with an N-N* interval >
the Pause rate times the average N-N interval (±100ms)
ARTF Artifact A sinusoidal signal with a frequency of 10 to 20 Hz and an
amplitude > 0.4 mV p-p, or with a frequency of 0.25 to
10 Hz and an amplitude > 10 mV p-p
* N is the event count set on the Arrhythmia Setup Table.
** In neonatal mode, you can set alarm limits for BRDY in the Alarm Limits table and the
monitor alarms upon a limit violation for this event.

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9 ARRHYTHMIA

Turning Arrhythmia Monitoring ON

STEPS: Turning Arrhythmia Monitoring On/Off

1. Click on the HR parameter box.
2. Click on More....

3. Click on Arrhythmia.
4. Select the desired setting (Basic, Full, OFF) and click the knob.

NOTE:
z If arrhythmia detection is on, alarms for asystole (ASY) and ventricular
fibrillation (VF) are automatically on and cannot be turned off.
z If a continuous recording is in progress when you turn arrhythmia monitoring
on, printing stops and the recording is canceled.
z When the monitor detects a baseline shift, arrhythmia monitoring is suspended
temporarily and resumes 35 seconds after the last detection of the baseline shift.

When you turn arrhythmia monitoring on, the monitor displays the
PVC rate in the HR parameter box. If the monitor detects an
arrhythmia event, it displays the label of the event and an alarm
message in the message area at the bottom of the screen.

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 ARRHYTHMIA SETUP

Arrhythmia Setup
The Arrhythmia Setup table lets you set Rate and Count limits for certain arrhythmia
parameters and turn alarms and alarm recordings on or off. Call up the Arrhythmia
Setup table as follows:

1. Click on the HR parameter box.

2. Click on Arrhythmia Setup.

When you turn full arrhythmia monitoring on, the Arrhythmia Setup table spans 2
pages. Click on one of the arrow keys in the upper left-hand corner to view additional
parameters.
NOTE:
z Alarm settings for PVC can be selected in the Alarm Limits table (see the
chapter Alarms and Messages).
z By default, alarms for asystole and ventricular fibrillation are always on;
however, these alarms can be disabled in the password-protected Biomed menu
(see the appendix Default Settings and Biomedical Support).

WA R N I N G : I f t h e m o n i t o r d i s p l a y s t h e b a n n e r H R , A S Y, V F
O ff , t h e re i s n o a l a r m a n n u n c i a t i o n f o r a s y s t o l e a n d
ventricular fibrillation.

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9 ARRHYTHMIA

Rate and Count

STEPS: Selecting Rate and Count Limits

1. Call up the Arrhythmia Setup table (see above).
2. Click on the limit in the Rate or Count column for the desired arrhythmia
parameter.
3. Dial in the desired limit and click the knob.
NOTE: You can change limits only for VT, BRDY (rate only), SVT, TACH, and
PAUS (rate only). The displayed limits for RUN and AIVR are informational.

Arrhythmia Alarms

STEPS: Turning Arrhythmia Alarms On/Off

1. Call up the Arrhythmia Setup table (see above).
2. Click on the alarm setting in the Alarm column of the desired arrhythmia
parameter.
3. Dial in the desired setting ( ON/OFF ) and click the knob.

NOTE: You cannot turn the alarms for asystole (ASY) and ventricular fibrillation
(VF) off in the Arrhythmia Setup table. Disabling alarms for these life-threatening
events is a password-protected function (see Default Settings and Biomedical Support)..

WA R N I N G : C e r ta i n v e n t r i c u l a r ta c h y c a r d i a ( V T ) h a v e
s in us oi d a l w a v e f o rm s c l o s e l y r e s e m b l i n g t h o s e o f v e n t r i c u l a r
f i b r i l l a t i o n ( VF ) . B e c a u s e o f t h e s i m i l a r i t y o f t h e s e
w a v e f o rm s , t h e m o n i t o r m a y c l a s s i f y s u c h t y p e s o f
v e n t r i c u l a r ta c h y c a r d ia a s v e n t r i c u l a r f i b r i l l a t i o n , t h e m o r e
s e ri o us o f t h e t w o c on di t i o ns .

Arrhythmia Alarm Recordings

STEPS: Turning Alarm Recordings On/Off

1. Call up the Arrhythmia Setup table (see above).

9-6 Gamma/Gamma XL VF6

 RELEARNING A PATIENT’S ECG

2. Click on the recording setting in the Record column of the desired arrhythmia
parameter.
3. Dial in the desired setting (Record, Store, Str/Rec, or OFF).

NOTE:
z You cannot turn alarm recordings for asystole (ASY) and ventricular fibrillation
(VF) off. For these events, only the settings Record and Str/Rec are available.
z See the chapter Recordings for a description of alarm and stored recordings and
how to view, save, print, or delete stored recordings via the Event Recall screen.

Relearning a Patient’s ECG

It is advisable to initiate a relearning under one or more of the following conditions:
z Eight hours have passed since the last learning of a reference complex.
z You repositioned the electrodes.
z You observe clinically questionable arrhythmia calls.
z There have been significant changes in the patient’s ECG.
z The message ARR Relearn appears in the message area.
The monitor automatically relearns in the following cases:
z When you turn arrhythmia monitoring on or change between basic and full
arrhythmia monitoring.
z When you change the displayed ECG leads while arrhythmia monitoring is
on.

STEPS: Relearning the Patient’s ECG

1. Make sure that the ECG lead wires are properly connected and that the ECG
displayed seems normal for this patient.
2. Click on the HR parameter box.
3. Click on More....
4. Click on Relearn.

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9 ARRHYTHMIA

NOTE: You cannot initiate a relearning, if arrhythmia monitoring is turned off.

During the learning phase, LRN appears in the HR parameter box and the message
Arrhythmia Relearning in the message area at the bottom of the screen. Once learning
is complete, date and time of the learning phase are displayed in the HR Setup menu
next to the Relearn selection.

9-8 Gamma/Gamma XL VF6

10 ST Segment Analysis

Overview.......................................................................................................................10-2
ST Monitoring Display.................................................................................................10-3
ST Setup .......................................................................................................................10-4
Isoelectric and ST Measuring Points ..................................................................10-4
ST Reference Complex .........................................................................................10-6
ST Alarms .....................................................................................................................10-7
10 ST SEGMENT ANALYSIS

Overview
The monitor provides an option for ST segment analysis, available for the adult and
pediatric monitoring modes. When activated, this option analyzes the patient’s normal
QRS pattern and determines values for ST segment deviation (i.e., how far the ST
segment of the QRS complex is above or below the isoelectric line). ST segment
analysis is performed on the two leads selected for ECG monitoring. The default leads
for ST analysis are lead II and V (with a 5- or 6-lead cable), the same default leads
assigned for Arrhythmia monitoring. Upper and lower limits are user-selectable and
the monitor triggers an alarm in case of limit violation.
When you connect the monitor to a patient, the monitor begins the process of learning
the patient’s dominant ECG beat pattern: this pattern serves as a baseline for
determining subsequent normal beats. The monitor stores an average ST complex that
is derived from those beats classified as normal. In order to obtain an ST segment
deviation value, the monitor then compares the isoelectric and the ST segment level of
the average complex. The ST segment deviation represents the difference in voltage
between the isoelectric and the ST segment level of the average complex. The monitor
displays the ST segment deviation in the ST parameter box. The value is updated
every 15 seconds.

NOTE:
z You can initiate a Relearn of the ECG reference pattern manually at any time
(see the chapter Arrhythmia).
z ST deviation values are displayed in mm (default) or mV. Changing the units of
measurement is a password-protected function. For information, contact your
Biomedical personnel.
z In OR mode (see the chapter Multigas), the ST parameter box is not displayed
and deviations in the ST segment are neither monitored nor trended.

WA R N I N G : T h e S T a l g o r i t h m h a s b e e n t e s t e d f or t h e a c c u r a c y
o f d e t e c t i n g S T s e g m e n t d e v i a t i o n s . T h e s i g n i f i c a nc e o f t h e
ST segment deviations must be determined by a clinician.

10-2 Gamma/Gamma XL VF6

 ST MONITORING DISPLAY

ST Monitoring Display
The monitor performs the ST segment analysis on the two leads
selected for ECG monitoring. If the ECG leads monitored are not
currently displayed, the monitor processes the signal on the last
ECG lead(s) selected. When the ST option is enabled, and the
monitor is set for adult or pediatric monitoring mode, the ST1 and
ST2 values are continuously displayed in the ST parameter box.
However, the number of ST leads displayed changes according to the ECG lead
configuration selected. With a 3-lead monitoring configuration, for example, the ST
parameter box shows only one ST value. Configurations with more than 3 leads
produce ST1 and ST2 values, even if only one ECG waveform is displayed on screen.
If the first and second waveform channels display ECG leads, the ST parameter box
appears next to the second waveform channel. If only the first waveform channel
displays an ECG lead, the ST parameter box appears at the bottom of the screen.
If ST1 or ST2 alarm limits are disabled, a crossed bell appears next to the
corresponding ST value. When ST alarms are on and an ST value goes above or below
the user-defined limits, the ST parameter box flashes and the alarm message appears
at the bottom of the display. If the monitor detects another alarm simultaneously (for
example, an ST and an SpO2 alarm), it reports both events (see the chapter Alarms and
Messages for details).
When you change an ST lead and it is no longer displayed on screen, the trended
values for the old lead stay in the trend memory.

NOTE: When the monitor uses the Export Protocol to communicate with an external
device, ST values are rounded to the nearest millimeter (or millivolt) and transmitted as
whole numbers. For example, a value of 1.7 mm is transmitted as 2 mm.

VF6 Gamma/Gamma XL 10-3

10 ST SEGMENT ANALYSIS

ST Setup
Call up the ST Setup menu by clicking on the ST parameter box.

For each ST lead selected, the ST Setup menu displays the following:
z ST Segment Waveform — Includes the last averaged QRS complex. The
label and scale of the ST waveform appear on the left side of the waveform.
The waveform scale is the same scale used for the ECG lead displayed on the
main screen.
z Position of Isoelectric and ST Measurement Points — Allow the clinician
to display and set the isoelectric and ST measurement points in relation to the
beginning and end of the QRS complex, respectively. When you click on ISO
or ST, the location of the isoelectric and measuring points is indicated by
vertical lines on the ST1 and ST2 waveforms. Numerical values at the bottom
and on the right side of the waveforms further define the location of these two
points (in milliseconds or millimeters/millivolts).
z Ref(erence) — Displays or hides the ST reference complex, a purple
waveform obtained by saving the currently displayed ST waveform.
z Save — Saves and time-stamps the currently displayed ST waveform as a
reference waveform. As new values are captured, the real-time ST segment
waveform overlaps the reference waveform to show changes in the ST
segment.

Isoelectric and ST Measuring Points

ST segment deviations are specified in terms of a displacement above or below the
isoelectric level. To calculate this displacement, the monitor compares the amplitudes
of the signal at two user-selectable measurement points in the patient’s QRS
waveform. One point is typically set at the isoelectric level on the waveform. The
other point is typically set within the ST segment of the waveform. The difference (in
millimeters or millivolts) between the amplitude of the isoelectric point and the

10-4 Gamma/Gamma XL VF6

 ST SETUP

amplitude of the ST measurement point represents the ST deviation. The available

settings for each point are:
z Isoelectric Point: from the start of the averaged ST complex to the Fiducial
point, in increments of 4 ms
z ST Measurement Point: from the Fiducial point to the end of the averaged ST
complex, in increments of 4 ms
The default position for the isoelectric point is -28 milliseconds before the start of the
QRS complex, as measured along the horizontal (time) axis. The default position for
the ST measurement point is +80 milliseconds after the end of the QRS complex. The
starting and ending points for the QRS complex are determined by the QRS detection
algorithm.
In practice, however, the determination of the isoelectric and ST measurement points
must be made on the basis of a careful clinical evaluation. The ST display provides the
means for changing the isoelectric and ST measurement points in order to ensure an
accurate ST deviation measurement.

NOTE: You should always check the position of the isoelectric and ST measurement
points before starting ST monitoring.

STEPS: Setting the Isoelectric and ST Measuring Points

1. Click on the ST parameter box.
2. Click on ISO. Two vertical lines, indicating the location of the ISO and the ST
measurement points, appear in the ST waveform channels.
.

3. With the rotary knob, move the position of the ISO point to the desired
location and click the knob. The corresponding value (in milliseconds) is
shown next to the ISO label.
4. Click on ST.
5. With the rotary knob, move the position of the ST measuring point to the
desired location and click the knob. As you dial, the ST deviation values to
the right of the ST waveforms change according to the new measuring point
location.

VF6 Gamma/Gamma XL 10-5

10 ST SEGMENT ANALYSIS

ST Reference Complex
The averaged ST segment waveform(s) displayed in the ST menu can be saved as
reference complexes. The reference waveforms can then be superimposed on the
current ST segment waveform to highlight changes in the ST segment since the last
save. Upon saving, the reference complex is time-stamped and available for display.

NOTE: If you change an ECG lead and access the ST Setup menu, you lose the saved
ST reference complex. The saved ST reference complex is retained if you change a lead
and later reselect it without entering the ST Setup menu.

STEPS: Displaying the ST Reference Complex

1. Click on the ST parameter box.
2. Click on Ref to turn the display of the reference complex ON or OFF.

STEPS: Saving the ST Reference Complex

1. Click on the ST parameter box.
2. Click on Save. Date and time of saving appear next to the Save option.

10-6 Gamma/Gamma XL VF6

 ST ALARMS

ST Alarms
Set ST alarm limits on the Alarm Limits table (see the chapter Alarms and Messages).
The default ST segment deviation alarm limits are +1.0 mm (or +0.10 mV) for the
upper limit and -1.0 mm (or -0.10 mV) for the lower limit. However, adjustments to
the upper and lower alarm limit settings must be made based on careful clinical
evaluation. You can set the upper and lower limits within the following range:
z -15.0 mm to +15.0 mm, in 0.1 mm increments (-1.5 mV to +1.5 mV, in 0.01
mV increments, when using millivolts.)
NOTE: Always check the upper and lower ST alarm limits before starting ST
monitoring.

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10 ST SEGMENT ANALYSIS

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10-8 Gamma/Gamma XL VF6

11 Respiration Monitoring

Overview.......................................................................................................................11-2
Patient Preparation......................................................................................................11-2
Selecting and Preparing the Electrodes .............................................................11-2
Preparing the Patient’s Skin ................................................................................11-2
Electrode Placement for Respiration Monitoring...............................................11-3
Rsp Safety Considerations .........................................................................................11-4
Respiration Monitoring Display..................................................................................11-5
Displaying Respiration Data ................................................................................11-5
Rsp Display Channel ............................................................................................11-6
Resp Display Amplitude .......................................................................................11-7
Respiration Monitoring Settings ................................................................................11-8
Rsp Mode ...............................................................................................................11-8
Resp Markers.........................................................................................................11-9
Apnea Time ............................................................................................................11-9
Coincidence Alarm..............................................................................................11-10
Relearning a Patient’s Respiration Pattern ......................................................11-11
OxyCRG Monitoring (Neonatal Option) ...................................................................11-12
Displaying OCRG Waveforms ............................................................................11-12
OCRG Recordings...............................................................................................11-14
11 RESPIRATION MONITORING

Overview
NOTE: The Rsp parameter box is not displayed when you first enable the ST, IBP2,
or the etCO2 or Multigas locked options. Rsp monitoring can be restored, however,
when you select Show Rsp in the Main Screen menu (see below).
The monitor measures impedance respiration by passing a high-frequency current
between two ECG electrodes on the patient's chest. Electrical resistance (impedance)
between the electrodes varies with the chest’s expansion and contraction during
inspiration and expiration. The monitor can derive a respiration waveform and rate
from these impedance changes.
You can set the monitor’s breath detection sensitivity to Auto or Manual. If set to
Auto, the monitor automatically adjusts the breath detection sensitivity according to
the average size of the detected breaths. If set to Manual, the detection sensitivity is
based on the waveform amplitude you select (see the section Respiration Monitoring
Display, below).
The monitor is designed to:
z Display the respiration waveform continuously.
z Calculate the average respiration rate per minute.
z Detect apnea in adult, pediatric, and neonatal patients.
NOTE: When using a 3-Lead ECG cable, you must display ECG lead II. If Lead I or
III is displayed instead, the monitor does not calculate a respiration rate and requests that
you select Lead II.

Patient Preparation

Selecting and Preparing the Electrodes

Proper selection and preparation of the ECG electrodes is important for effective
respiration monitoring. See the chapter ECG and Heart Rate for information on
preparing and placing electrodes.

Preparing the Patient’s Skin

Follow the recommended instructions given in the chapter ECG and Heart Rate.

11-2 Gamma/Gamma XL VF6

 PATIENT PREPARATION

Electrode Placement for Respiration Monitoring

For respiration monitoring, the signal is passed by the same electrodes used for
cardiac monitoring, as illustrated below. The monitor uses the right arm (RA)
electrode and the left leg (LL) electrode as the path for the high-frequency signal.
For deep abdominal breathers, you may want to move the right arm (RA) electrode, in
order to span the maximum expansion and contraction of the lungs.

NOTE: If you are using this electrode placement for monitoring respiration, lead I and
II are compromised for monitoring ECG.

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11 RESPIRATION MONITORING

Rsp Safety Considerations

WA R N I N G :
z D o n o t r e l y u p o n i m p e d a n c e r e s pi r a t i o n m o n i t or i n g a s
the sole method for detecting the cessation of
b re a t h i n g . P a t i e nts a t r i s k f o r r e s p i r a t o r y d i s t r e s s
s h o u l d b e o b s e r v e d c l o s e l y a n d h e a rt r a t e a l a r m s
s h o u l d b e e n a b l e d a n d s e t a p p r o p r i a t e l y. T h e u s e o f
additional methods for respiratory monitoring, such as
e t C O 2 a n d Sp O 2 a r e r e c om m e n d e d w he n e v e r p os s i b l e .
z L a r g e a m p l i t u d e pa c e r s p i k e s ( 1 0 0 m V o r g r e a t e r ) m a y
i n t e r f e r e w i t h t h e m o n i t o r ’s a b i l i t y t o m o n i t o r
respiration.
z I m p e d a n c e r e s p i r a t i o n m o n i t o r i n g a n d pa c e m a k e r s p i k e
d e t e c t i on a re i no pe r a t i v e w h e n u s i n g e i t h e r t h e
s hi e l d e d b l u e l e a d w i r e s o r t h e E S U b l o c k .

11-4 Gamma/Gamma XL VF6

 RESPIRATION MONITORING DISPLAY

Respiration Monitoring Display

You can display the respiration waveform in one of the bottom display channels.
NOTE:
z The monitor has a total of three or, as an option, four waveform display
channels. For more information, contact your Dräger representative.
z When using a 3-Lead ECG cable, you must display ECG lead II. If Lead I or III
is displayed instead, the monitor does not calculate a respiration rate and
requests that you select Lead II.
z The respiration waveform moves at 25% (~ 6.25mm/sec) of the rate of other
waveforms on the screen.

The respiration rate appears in the Rsp parameter box next to the Rsp waveform.
When you start monitoring, the rate value does not appear until the detection of six
valid breaths.

Displaying Respiration Data

If the ST, IBP2, and either the etCO2 or Multigas locked options are enabled, you can
call up the Rsp display from the Main Screen menu as follows:

STEPS: Displaying Respiration Data

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Main Screen.
4. Click on Show Rsp/etCO2.

5. Select Rsp and click the knob.

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11 RESPIRATION MONITORING

NOTE: The menu option Show Rsp/etCO2 appears only if the ST, IBP2, and either
the etCO2 or Multigas locked options are enabled. The menu option does not appear in
OR mode.

When you first turn the respiration display on, the monitor relearns the patient’s
respiration pattern and displays Rsp Relearning in the message field at the bottom of
the screen and the LRN label in the Rsp parameter box.

Rsp Display Channel

Display the Rsp Waveform in one of the bottom display channels as follows:

STEPS: Selecting the Rsp Display Channel

1. Click on the desired waveform channel.
2. Click on Waveform.

3. Select Rsp and click the knob.

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 RESPIRATION MONITORING DISPLAY

Resp Display Amplitude

The Size option lets you increase or decrease the amplitude of the respiration
waveform. In manual breath detection sensitivity mode (see the section Selecting the
Rsp Mode, below), the detection sensitivity is based on the selected waveform
amplitude. Available amplitude settings are:
z 10% to 100%, in increments of 10% (default 50%)
WA R N I N G : I n M a n u a l M o d e , i f y o u s e t t h e s i z e o f t h e
r e s p i r a t i o n w a v e f o r m t o o l o w, s h a l l o w b re a t h s m a y n ot b e
counted. If set too high, cardiac artifact might be counted as
b r e a t h s . T h e r e f or e , a l w a y s t u r n r e s p i r a t i o n m a r k e r s o n i n
manual mode to help you select an appropriate waveform
a mp l i t u d e / d e t e c t i o n s e n s i t i v i t y ( s e e t he s e c t i o n D i s p l a y i n g
R s p M a r k e r s) .

STEPS: Selecting the Rsp Display Amplitude

1. Click on the Rsp waveform channel.
2. Click on Size.

3. Select the desired display amplitude and click the knob.

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11 RESPIRATION MONITORING

Respiration Monitoring Settings

Rsp Mode
To enable respiration monitoring, select the Auto or Manual Respiration Monitoring
Mode.
In Auto mode, the monitor adjusts the breath detection sensitivity to the strength of the
respiration signal, adjusting it over several minutes. It also adjusts the sensitivity for
large baseline drifts and lead-off conditions.
In Manual mode, you adjust the sensitivity by increasing or decreasing the waveform
display amplitude (see the section Selecting the Rsp Display Amplitude).

STEPS: Selecting the Respiration Mode

1. Click on the Rsp parameter box.
2. Click on Resp. Mode.

3. Select the desired monitoring mode (Auto or Manual) or turn respiration

monitoring off (OFF).

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 RESPIRATION MONITORING SETTINGS

Resp Markers
When you turn respiration markers on, the monitor displays a spike on the respiration
waveform every time it detects a valid breath. (Respiration markers are not printed.) If
breath detection occurs on a clipped portion of the waveform (as when the waveform
exceeds the waveform channel’s selected size), respiration is still detected and
marked.
In manual mode, always use the displayed markers to set the waveform size at a point
where shallow breaths are counted and cardiac artifacts rejected.

STEPS: Displaying Resp Markers

1. Click on the Rsp parameter box.
2. Click on Rsp. Marker.

3. Select ON or OFF and click the knob.

Apnea Time
The monitor detects apnea in all monitoring modes provided an apnea time is selected
in the menu. Apnea times are:
z 10 to 30 seconds, in increments of 5.
Upon detection of an apnea event and after the selected apnea time has elapsed, the
monitor triggers a serious alarm.
NOTE:
z Regardless of the apnea time setting, the monitor continues to alarm for
respiration rate, artifact, and lead-off conditions if the respiration alarm is On.
z The detection of central apnea is accomplished through impedance
plethysmography.

VF6 Gamma/Gamma XL 11-9

11 RESPIRATION MONITORING

STEPS: Selecting the Apnea Time

1. Click on the Rsp parameter box.

2. Click on Apnea Time.

3. Select the desired setting and click the knob.

NOTE: The value selected for Apnea Time also updates the RRc Apnea option in the
etCO2 parameter menu.

Coincidence Alarm
The coincidence alarm alerts you when the respiration rate is within 20% of the heart
rate over three consecutive breaths. This alarm indicates that the monitor may be
counting heart beat artifacts as respiration signals. The monitor alarms and displays
the message Coincidence if the coincidence alarm is turned on. If the coincidence
alarm is off, the monitor does not alarm but still displays the message. This alarm
grade is serious for neonatal monitoring and advisory for adult and pediatric
monitoring. Check and change the electrode placement if you receive a coincidence
message until you obtain a clear respiration signal.

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 RESPIRATION MONITORING SETTINGS

STEPS: Turning the Coincidence Alarm On/Off

1. Click on the Rsp parameter box.

2. Click on Coincidence.
3. Select the desired setting (On/OFF) and click the knob.

Relearning a Patient’s Respiration Pattern

When respiration monitoring is enabled and set to Auto, the monitor takes about one
minute to automatically learn the patient's respiration pattern. You can initiate a new
learning phase at any time. When respiration monitoring is enabled and set to Manual,
you must initiate the learning of the respiration pattern manually. Whenever you
change or reposition electrodes or if you notice significant changes in the patient's
breathing pattern, repeat the learning process.

STEPS: Relearning a Patient’s Respiration Pattern

1. Click on the Rsp parameter box.

2. Click on Relearn.

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11 RESPIRATION MONITORING

During the learning phase, the monitor displays the message Rsp Relearning at the
bottom of the screen and the LRN label in the Rsp parameter box. During the learning
phase, the patient should rest as quietly as possible and breathe normally.

OxyCRG Monitoring (Neonatal Option)

The monitor offers a neonatal Oxycardiorespirogram (OCRG or OxyCRG) provided
the option is enabled on your monitor (for more information, see your Dräger
representative). Neonatal OxyCRG is a non-invasive procedure to display a beat-to-
beat heart rate (bbHR) trend, an SpO2 trend, and a respiration or etCO2 waveform
simultaneously on a dynamically updated display. (OCRG monitoring requires that
sensors and electrodes for SpO2, HR, and respiration are attached to the patient.)

Displaying OCRG Waveforms

The OxyCRG waveforms are displayed in the second and third waveform channels.
The second waveform channel shows the beat-to-beat Heart Rate (bbHR) trend and
the SpO2 trend waveforms. The bbHR trend has a range of 65 to 290. The SpO2 trend
has a range from 70% to 100%. The third waveform channel shows a time-
compressed respiration or etCO2 waveform.

STEPS: Displaying the OCRG Waveforms

1. Make sure the Neonatal monitoring mode is selected.
2. Click on the second or third waveform channel.
3. Click on Waveform.

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 OXYCRG MONITORING (NEONATAL OPTION)

4. Select OCRG and click the knob.

STEPS: Selecting Rsp or etCO2 as the OCRG Waveform

1. Call up the Main Screen menu while the OCRG is displayed
(Menu>Monitor Setup>Main Screen).
2. Click on OCRG Parameter 3.

3. Select Rsp or etCO2 and click the knob.

STEPS: Adjusting the OCRG Waveform Size

1. Click on the third waveform channel.
2. Click on Size.

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11 RESPIRATION MONITORING

3. Select the desired size and click the knob.

OCRG Recordings
The monitor can print OCRG alarm and manual recordings, if OCRG waveforms are
displayed. OCRG recordings show the second and the third waveform channels (not
the first channel).
An apnea event triggers an OCRG alarm recording, which includes 108 seconds of
pre-apnea OCRG data and 36 seconds of post-apnea OCRG data.
If no recorder is available, the monitor stores the OCRG apnea alarm recording (see
the chapter Recordings for a description of stored recordings).

NOTE: OCRG recordings cannot be printed on a laser printer.

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12 Pulse Oximetry

Intended Use ................................................................................................................12-2

Overview.......................................................................................................................12-2
Connections .................................................................................................................12-3
Sensor Application ......................................................................................................12-4
SpO2 Safety Considerations ......................................................................................12-5
SpO2 Monitoring Display ............................................................................................12-6
SpO2 Display Channel ..........................................................................................12-6
SpO2 Display Amplitude ......................................................................................12-7
Cascade Display....................................................................................................12-7
SpO2 Monitoring Settings...........................................................................................12-8
Pulse Tone Source ................................................................................................12-8
Pulse Tone Volume ...............................................................................................12-9
Signal Strength Bar Graph .................................................................................12-10
Averaging Mode ..................................................................................................12-11
12 PULSE OXIMETRY

Intended Use
The Infinity Masimo SET® SpO2 SmartPod® is indicated for the continuous
noninvasive monitoring of functional oxygen saturation or arterial hemoglobin (SpO2)
and pulse rate (measured by an SpO2 sensor). It is intended for use under the direct
supervision of a licensed healthcare practitioner (i.e. Physicians, Nurses, and
Technicians).
The Infinity Masimo SET® pod is indicated for use with adult, pediatric, and neonatal
patients.
The Infinity Masimo SET® pod and accessories are indicated for use during both
motion and non-motion conditions, and for patients who are well or poorly perfused in
hospitals and hospital type facilities.

WA R N I N G : T h e I n f i n i t y M a s i m o S E T ® SpO 2 p o d h a s n ot b e e n
t e s t e d a n d i s n ot a p p r o v e d f o r u s e w i t h i n t h e M R I
e n v i r o n me n t s i n c e t h e i r f u n c t i o n c o u l d b e c o m p r o m i s e d ,
p o s s i b l y l e a d i n g t o pa t i e n t i n j u r y.

Overview
Pulse Oximetry monitoring is a non-invasive method to determine the functional
oxygen saturation of the patient’s arterial blood (SpO2) and the pulse rate.
A sensor is attached to the patient (usually the finger) and measures the absorption of
light by the oxyhemoglobin. The light sent through the tissue is transformed into a
signal that is processed by the monitor. The monitor is designed to:
z Display the oximetry waveform.
z Calculate the SpO2 pulse rate.
z Identify critical levels of arterial oxygen saturation.

NOTE: Possession or purchase of the Masimo SET™ SpO2 pod does not convey any
express or implied license to use the device with unauthorized sensors or cables which
would alone, or in combination with this device, fall within the scope of one or more of
the patents relating to this device.

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 CONNECTIONS

Connections
You can connect an SpO2 sensor to a MultiMed/NeoMed pod or to an SpO2 pod
communicating via USB interface with the monitor (Infinity® Masimo SET™).
Connect the MultiMed/NeoMed pod to the MultiMed connector on the monitor’s left
side plate.
Connect the SpO2 pod to the USB connector X8 on the monitor’s right side plate.
NOTE:
z You can use either the MultiMed/NeoMed or an SpO2 pod for SpO2
monitoring, but not both at the same time. If you connect an SpO2 pod while a
MultiMed/NeoMed pod with SpO2 sensor is connected to the monitor, the
monitor displays an error message.
z The SpO2 pod interface is a locked option and must be enabled in the password-
protected Biomed menu.
z Compatibility for the Masimo SET SpO2 pod is a locked option and must be
enabled in the password-protected Biomed menu.
z The USB connector must be configured for the SpO2 pod interface in the
password-protected Service menu.
z When a Masimo pod is connected, the SpO2 menu displays Masimo* in the
sensor type field.

To Monitor
(USB Connector X8)

To Monitor
(MultiMed Connector)

MultiMed Pod Masimo SET™ Pod

Connector for SpO2

Intermediate Cable

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12 PULSE OXIMETRY

Sensor Application
The quality of SpO2 measurements depends largely on the strength and quality of the
signal received by the sensor.
Infinity Gamma Series monitors support Dräger, Nellcor and Masimo SpO2 sensors.
The SpO2 menu shows which sensor type is currently selected. If you connect a sensor
different from the type shown in the SpO2 menu, the monitor displays an error
message.
Selecting the sensor type is a password-protected function. To change the sensor type,
contact your Biomed department.

CAUTION: Read the instructions provided with the sensor to select the best application
technique and to review all safety related information.

STEPS: Applying the Sensor

1. Select a sensor that is best suited for your patient (type and size, see the list of
available sensors in the appendix Options and Accessories).
2. Clean reusable sensors before and after each use.
3. Position the sensor correctly and attach it to your patient (see sensor
manufacturer’s recommendations).
4. Connect the sensor to the intermediate cable and the intermediate cable to the
MULTIMED/NEOMED pod.
5. Inspect the sensor application site frequently. If the sensor is too tight, it may
damage the tissue and impede blood flow. If the sensor is damaged, do not use
it.

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 SPO2 SAFETY CONSIDERATIONS

SpO2 Safety Considerations

WA R N I N G :
z Use only sensors approved by Dräger Medical (see the
a p p en d i x O p t i o n s a n d A c c e s s o r i e s) . O th e r s e n s o r s m a y
n o t p r o v i d e a d e q u a t e p r o t e c t io n d u r i n g d e f ib ri l l a ti o n .
z U s e o n l y M a s i m o - c o m pa t i b l e s e n s o r s a n d c a b l e s w it h
the Masimo SET pod.
z D u r i n g e l e c t r o s u r g e r y, u s e o n l y D r ä g e r Sp O 2 s h i e l d e d
e x t e n s i o n c a b l e s w it h a b l u e l o c k i n g m e c h a n i s m t o
protect from ESU interference.
z Check sensors periodically (recommended is at least
e v e ry f o u r h o u r s ) . M o v e t h e s e n s o r i f t h e r e i s a n y s i g n o f
s k i n i r ri tat i o n o r i m pa i r e d c i rc u l a ti o n .
z Bright light can interfere with pulse oximetry
m e a s u r e m e n ts , c a u s i n g e r r a t i c o r m i s s i n g v a l u e s . W h e n
the sensor is likely to become exposed to direct bright
l i g h t , i t s h o u l d b e c o v e re d w i t h a n o pa q u e m a t e r i a l .
z E le v a t e d l e v e l s o f c a r b o x y h e m o g l o b i n o r m e t h e m o g l o b i n
i n m o n i t o r e d pat i e n ts o r t h e p r e s e n c e o f s u b s tan c e s
c o n ta i n i n g d y e s c a n r e s u l t i n i n a c c u r a t e p u l s e o x i m e t r y
readings.
z I f t h e m o n i t o r d e t e c ts a n Sp O 2 a n d / o r P L S We a k S ig n a l
c o n d i t i o n d u r i n g a n N B P m e a s u re me n t , t h e a u d i b l e a n d
v i s u a l a l a r m s f o r t h e We a k S i g n a l c o n d i t i o n a r e
s u p p r e s s e d . H o w e v e r, t h e m o n i t o r a n n o u n c e s a l l o t h e r
Sp O 2 / P L S c o n d i t i o n s a s t h e y o c c u r.
z A p u l s e o x i m e te r s h o u l d n o t b e u s e d a s a n a p n e a
m o n i t o r.
z D i f f i c u l t i e s i n h e r e n t i n Sp O 2 m o n i t o r i n g re q u i r e t h a t
pa t i e n ts r e c e i v e s p e c i a l a t t e n t i o n d u r i n g e l e c t r o s u r g e r y
( E S U ) . To m i n i m i z e i n t e r f e r e n c e f r o m t h e E S U , d o t h e
following:
- Pl a c e t h e Sp O 2 s e n s o r a s f a r f r o m t h e s u r g i c a l s i t e a s
po ssib le.
- Pl a c e t h e Sp O 2 c a b l e s a s f a r f r o m t h e E S U a s p o s s i b l e ,
an d pe rp endicula r to the E SU cables.
- Us e a n E S U n e u t r a l e l e c t r o d e w i t h t h e l a r g e s t p o s s i b l e
c o n ta c t a re a .
- Wh e n p o s s i b le , p l a c e t h e E S U n e u t r a l e l e c t r o d e c l o s e
to and directly under the surgical site avoiding bony
protuberances. If this is not possible, interference
from the ESU may result.
- Co n s u l t t h e o p e ra t i n g i n s t r u c ti o n s o f y o u r
e l e c t r o s u r g i c a l e q u i p m e n t f o r a d d it i o n a l i n f o r m a t i o n .

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12 PULSE OXIMETRY

SpO2 Monitoring Display

The quality of the pulse waveform and the SpO2 values are an indication that the
sensor is attached to the patient correctly. In most clinical situations, the waveform is
displayed in the second or third channel in order to view the electrocardiogram in the
first channel during SpO2 monitoring. The message SpO2 Searching appears
following the connection of the sensor to the patient.
Within seconds, the first pulse oximetry value appears in the SpO2
parameter box. When the SpO2 and PLS alarms are turned off, a
crossed bell appears next to the parameter values.

NOTE: In order to avoid nuisance SpO2 alarms caused by impeded circulation

in the limb during an NBP measurement, set NBP/SpO2 Interlock to ON (a
password-protected function, see Default Settings and Biomedical Support).

SpO2 Display Channel

When monitoring with a 5- or 6-lead ECG cable, you can display the SpO2 waveform
in any waveform channel. If monitoring with a 3-lead ECG cable, you cannot display
the SpO2 waveform in the top channel.

STEPS: Selecting the SpO2 Display Channel

1. Click on the desired waveform channel.
2. Click on Waveform.

3. Select SpO2 and click the knob.

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 SPO2 MONITORING DISPLAY

SpO2 Display Amplitude

The Size option lets you modify the amplitude of the displayed SpO2 waveform for
optimum viewing. The available sizes are
z 10% to 100%, in increments of 10% (default 50%).

STEPS: Selecting the SpO2 Display Amplitude

1. Click on the SpO2 waveform channel.
2. Click on Size.

3. Dial in the desired setting and click the knob.

Cascade Display
The pulse waveform is about four seconds long. To display eight seconds of the same
waveform, select the Cascade display mode.
NOTE:
z The second channel of a cascaded pulse waveform cannot be printed on
recordings.
z The Cascade display is only available in the second waveform channel.
Cascade is not available on monitors with the ST, etCO2 and the second
invasive blood pressure options enabled.

STEPS: Selecting the Cascade Display

1. Assign SpO2 to the first display channel.
2. Select the second waveform channel and click the knob.
3. Click on Waveform.

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12 PULSE OXIMETRY

4. Select Cascade and click the knob.

NOTE: The cascade SpO2 waveform disappears from the screen whenever you
choose to display the electrocardiogram again in the first channel. If you then want to
display the standard SpO2 waveform, select the second or third channel.

SpO2 Monitoring Settings

Pulse Tone Source

You can select either ECG or SpO2 as the source for the pulse tone. When SpO2 is the
pulse tone source, the pitch of the tone is modulated according to O2 blood saturation
levels. A tone occurs with each pulse detected via the SpO2 signal. You can add a bar
graph to the SpO2 parameter box to show signal strength (see later in this chapter).
Select SpO2 as the pulse tone source when pulse oximetry is the primary vital sign to
monitor or preferred over ECG (e.g., with paced patients or in the presence of HR
artifacts).

STEPS: Selecting the Pulse Tone Source

1. Click on the SpO2 parameter box.
2. Click on Tone Source.

3. Select SpO2 and click the knob.

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 SPO2 MONITORING SETTINGS

Pulse Tone Volume

When SpO2 is selected as the tone source, the pulse tone changes with the level of
arterial oxygen saturation. Low saturation levels result in low pitched tones; high
saturation levels result in high pitched tones. If SpO2 is selected as the tone source but
is not currently being measured, no pulse tones are heard. You can adjust the pulse
tone volume between 10% and 100% (or turn the pulse tone off).

STEPS: Selecting the Pulse Tone Volume

1. Click on the SpO2 parameter box.
2. Click on Tone Volume.

3. Select the desired setting and click the knob.

NOTE: If you select a Tone Volume higher than the speaker volume of the monitor,
the Tone Volume is that of the speaker volume. If you select a lower setting, the pulse
tone sounds at the selected volume.

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12 PULSE OXIMETRY

Signal Strength Bar Graph

The monitor can display a pulsing bar graph. The number of
illuminated segments is proportional to the pulse amplitude. Proper
sensor placement and environmental conditions ensure a strong
signal. Refer to the section Sensor Application for details.

NOTE: The SpO2 waveform and bar graph are auto-scaled by the Masimo SpO2 pod.

STEPS: Displaying the Signal Strength Bar Graph

1. Click on the SpO2 parameter box.
2. Click on Bar Graph.

3. Select ON or OFF and click the knob.

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 SPO2 MONITORING SETTINGS

Averaging Mode
The monitor calculates the oxygen saturation of the arterial blood and the derived
pulse rate based on the averaging mode you select in the SpO2 menu. The two modes
are Normal and Fast and determine the speed of calculation for the SpO2 average.
z Normal - reflects 90% of an SpO2 change within 30 seconds (less sensitive to
motion artifact, but slower to alarm).
z Fast - reflects 90% of an SpO2 change within 20 seconds (quicker to alarm,
but more sensitive to motion artifact).
Response time may improve as pulse rate increases.
NOTE:
z When monitoring most patients, Dräger recommends using the Normal
averaging mode. The Fast mode is designed for neonatal patients when fast
reporting of oxygen desaturation is important.
z Averaging times with the Masimo SET pod are as follows:
- Normal Mode: Averaging in 8 seconds.
- Fast Mode: Averaging in 2 to 4 seconds.

STEPS: Selecting the Averaging Mode

1. Click on the SpO2 parameter box.
2. Click on Averaging.

3. Select the desired setting (Normal or Fast) and click the knob.

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12 PULSE OXIMETRY

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13 End-Tidal CO2

Overview.......................................................................................................................13-2
etCO2 Source ...............................................................................................................13-3
etCO2 Display ..............................................................................................................13-4
Monitoring Preparations .............................................................................................13-6
Connecting Sensor and etCO2 Pod ....................................................................13-6
Attaching the Capnostat and Airway Adapter ....................................................13-6
Calibrating the Sensor and Adapter ..................................................................13-10
etCO2 Monitoring Settings .......................................................................................13-12
Averaging Mode ..................................................................................................13-12
RRc Apnea Time..................................................................................................13-12
Balance ................................................................................................................13-13
Measuring Mode ..................................................................................................13-14
Anesthetic Agent Compensation.......................................................................13-15
Atmospheric Pressure Compensation ..............................................................13-15
etCO2 Alarms .............................................................................................................13-17
13 END-TIDAL CO2

Overview
The Infinity Gamma Series monitor measures concentrations of end-tidal CO2
(etCO2) when this option is enabled and the etCO2 pod or a Scio multigas module is
connected to your monitor. (Ordering information about these options is available
from your Dräger representative.) The etCO2 pod can perform mainstream
measurements in all monitoring modes and sidestream measurements in the adult and
pediatric monitoring modes. The Scio multigas module can perform sidestream
measurements in the adult and pediatric monitoring modes.
NOTE: This chapter describes etCO2 monitoring with the etCO2 pod. For information
about monitoring with the Scio multigas module, see the chapter Multigas.

The etCO2 pod acquires signals from a CAPNOSTAT® sensor. For mainstream
measurements, the Capnostat fits over an adapter inserted into the patient’s airway.
For sidestream measurements, the Capnostat fits on the nasal sampling cannula
tubing.
The Capnostat analyzes the patient’s expired and inspired air by sending a beam of
infrared light through transparent ports in the adapter and detecting changes in the
CO2 absorption levels. The etCO2 pod processes this data and derives values for the
following parameters:
z Instantaneous CO2 — The instantaneous value of the CO2 level; displayed
on the monitor as a waveform (or capnogram) depicting the variation in
airway CO2 levels during a patient’s respiration cycle.
z End-tidal CO2 (etCO2) — The level of CO2 in the airway at the end of
expiration. If you specify one breath as the averaging interval, the monitor
reports the CO2 level at the end-expiration point of each breath. If you specify
a particular averaging interval (10 or 20 seconds), the monitor reports the
maximum value measured during this interval. The current value for etCO2 is
displayed in the etCO2 parameter box.
z Inspired CO2 (iCO2) — The level of CO2 in the airway during inspiration;
taken as the minimum value during the previous measurement interval. The
current value for iCO2 is displayed in the etCO2 parameter box.
z Respiration Rate (RRc) — The patient’s respiration rate; derived from the
etCO2 signal by calculating an average rate over the eight most recent breaths.
The current value of RRc is displayed in the etCO2 parameter box.

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 ETCO2 SOURCE

etCO2 Source
The monitor can receive CO2 signals from a connected etCO2 pod or Scio multigas
module.

STEPS: Selecting the etCO2 Signal Source

1. Click on the etCO2 parameter box.
2. Click on etCO2 Source.
3. Select POD or SCIO and click the knob.

NOTE:
z The monitor displays the etCO2 parameter box, when etCO2 (rather than
Respiration) has been selected for display in the Main Screen menu. For
information about the Main Screen configuration and the menu selection Show
Rsp/etCO2, see the chapter Monitor Setup.
z The menu selection etCO2 Source only appears when etCO2 and/or Scio
multigas monitoring is enabled.
z If the monitor receives CO2 signals from the Scio module, you can set the RRc
Apnea time in the etCO2 menu, but no other etCO2 setup functions are available
in the menu.

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13 END-TIDAL CO2

etCO2 Display
The etCO2 parameter box displays the current values for etCO2,
iCO2 and RRc. If the Scio module is the signal source, the parameter
labels are marked with an asterisk (*). If alarms are set to Off, a
crossed-bell icon appears next to each parameter label.

NOTE: The etCO2 waveform moves at 25% (~ 6.25mm/sec) of the rate of other
waveforms on the screen.

The illustration below depicts a normal etCO2 waveform:

The letters A - E indicate the phases of the respiration cycle:

A-B Baseline (the level of minimum CO2 concentration) observed immediately
after inspiration.
B-C Expiration phase.
C-D Expiratory plateau. The level of CO2 in the lungs ceases to increase
significantly.
D End-tidal concentration point at the end of the expiration phase, at which etCO2 is
measured.
D-E Onset of the inspiration phase.

Display Channel and Waveform Amplitude

You can display the etCO2 waveform in one of the lower waveform channels. The
Size option lets you modify the display amplitude of the etCO2 waveform for
optimum viewing. The available sizes are:
z 40, 60, 80, 100 mmHg (5, 8, 10, 12, kPa or %)

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 ETCO2 DISPLAY

STEPS: Selecting the etCO2 Display Channel and Waveform

Amplitude
1. Click on the desired waveform channel.
2. Click on Waveform.

3. Select etCO2 and click the knob.

4. Click on Size.
5. Select the desired setting and click the knob.

VF6 Gamma/Gamma XL 13-5

13 END-TIDAL CO2

Monitoring Preparations

Connecting Sensor and etCO2 Pod

1. Connect the Capnostat sensor to the etCO2 pod as shown.
2. Connect the etCO2 pod to the monitor as shown.

NOTE: For mainstream measurements, the Capnostat snaps over an adapter inserted
into the patient’s airway. For sidestream measurements, the Capnostat snaps on the nasal
sampling cannula tubing (see page 13-7).

etCO2 Connections

1 Monitor 3 Nafion® Tubing (sidestream)

2 Capnostat

Attaching the Capnostat and Airway Adapter

The configuration of the airway adapter and Capnostat sensor varies, depending on
whether you are setting up mainstream or sidestream monitoring. The following
pictures show each configuration. Refer to Instructions for Use of the Capnostat for
further information.

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 MONITORING PREPARATIONS

Mainstream Monitoring
In mainstream monitoring mode, the patient is intubated with an endotracheal tube
that is connected to a ventilator (see below).

1 Capnostat Sensor 4 Mainstream Airway Adapter

2 To etCO2 Pod 5 To Patient
3 To Ventilator

STEPS: Mainstream Monitoring Setup

1. Select a mainstream airway adapter. Make sure the windows are clean and
dry. Clean or replace the adapter if necessary.
2. Snap the airway adapter into the Capnostat. Align the mark on the bottom of
the adapter with the mark on the bottom of the sensor. You hear a click when
the connection is made.
3. If you are switching adapter types (e.g., mainstream to sidestream, or adult to
neonatal, etc.), you must perform an adapter calibration. Refer to the section
Calibrating the adapter and sensor section in this chapter.

VF6 Gamma/Gamma XL 13-7

13 END-TIDAL CO2

4. Insert the airway adapter in a vertical position between the elbow and the
ventilator circuit “Y”. Make sure that the sensor cable is positioned away
from the patient.
NOTE: It is important to position the adapter vertically. This prevents patient
secretions from obscuring the adapter windows.

Sidestream Monitoring
(Adult and Pediatric Modes Only)
Sidestream monitoring is appropriate for non-intubated patients or for intubated
patients who are breathing spontaneously. A pump in the etCO2 pod draws air through
the Capnostat, which samples the patient’s inspired and expired air as it passes a nasal
sampling cannula. The figure below illustrates a sidestream monitoring setup.
NOTE: Sidestream monitoring is disabled in neonatal monitoring mode.

1 Nasal Sampling Cannula 4 To etCO2 Pod Sidestream Input

2 Capnostat Sensor 5 Sidestream Airway Adapter
3 To etCO2 Pod 6 Nafion® Dehumidification Tubing

13-8 Gamma/Gamma XL VF6

 MONITORING PREPARATIONS

STEPS: Sidestream Monitoring Setup

1. Select a sidestream airway adapter. Make sure the windows are clean and dry.
Clean or replace the adapter if necessary.
2. Use the sidestream sampling tubing to connect the airway adapter to the
bacteria filter. The filter can be locked in place with the luer lock connector of
the sidestream sampling tubing. The sampling tubing connects to the input
connector on the face of the etCO2 pod.
3. Dräger recommends you connect a Nafion® dehumidification tubing set.
4. Connect a nasal sampling cannula to the dehumidification tubing set, if one is
used; otherwise, connect the cannula directly to the sidestream airway
adapter.
NOTE: Dehumidification and cannula tubing can affect the calibration of the airway
adapter. If you change to different combinations or lengths of cannula and
dehumidification tubing, perform an adapter calibration.

5. Snap the sensor into the airway adapter. Align the mark on the bottom of the
adapter with the mark on the bottom of the sensor.
6. If you are switching adapter types (e.g., mainstream to sidestream, or adult to
neonatal), you must perform an adapter calibration. Refer to the section
Calibrating the Adapter and Sensor in this chapter.
7. Insert the cannula tips into the patient’s nostrils, pass the cannula tubing
behind the ears, and slide the retaining sleeve up so that the tubing is snug
under the chin.
8. Secure the Capnostat sensor to the bedding or to the patient’s bed clothing.
9. Make sure the sensor cabling and nasal cannula tubing are secured and out of
the patient’s way.
NOTE: It is important to always position the airway adapter vertically. This prevents
patient secretions from obscuring the adapter windows.

VF6 Gamma/Gamma XL 13-9

13 END-TIDAL CO2

Calibrating the Sensor and Adapter

Before etCO2 monitoring, you need to calibrate the Capnostat sensor and airway
adapter so that the etCO2 pod can compensate for the specific characteristics of sensor
and adapter.

Sensor Calibration
In most cases, you need to calibrate the Capnostat sensor only when you connect it to
a particular etCO2 pod for the first time. After this initial calibration, the pod stores the
characteristics of the current sensor in its memory. Even when you later disconnect the
sensor and then reconnected it to the same etCO2 pod, the pod can recall and use the
calibration results.
Perform a calibration whenever you connect a different sensor to the pod. Date and
time of the last sensor calibration are displayed in the etCO2 menu’s Sensor Cal. field.

STEPS: Calibrating the Sensor

1. Make sure the monitor is turned on and that the etCO2 pod is properly
connected.
2. Allow the sensor to warm up (~2 minutes at room temperature). When the
sensor reaches a stable temperature, the monitor displays the message etCO2
Place Sensor on Zero Cell.
3. Locate the combined Zero/Reference cell.
4. Place the sensor onto the Zero cell. The calibration process begins
automatically, and takes about 20 seconds. During calibration, the monitor
displays the message etCO2 Calibrating Sensor. When calibration is
complete, the monitor displays the message etCO2 Place Sensor on Ref Cell.
5. Place the sensor on the Reference cell. During verification, the monitor
displays the message etCO2 Verifying Sensor Cal. When the verification
process is complete, the monitor displays the message etCO2 Sensor Cal.
Verified.
6. Remove the sensor from the Reference cell. When the monitor displays the
message etCO2 Check Airway Adapter/Cal., you can connect the Capnostat
sensor to the patient’s airway adapter.

You can now use the sensor. If the verification fails, the monitor again displays the
message etCO2 Place Sensor on Zero Cell.

13-10 Gamma/Gamma XL VF6

 MONITORING PREPARATIONS

Adapter Calibration
Perform an adapter calibration every time you switch adapter types (e.g., mainstream
to sidestream or adult to neonatal). You do not normally have to calibrate an adapter if
you are replacing it with another of the same type.

STEPS: Calibrating the Airway Adapter

1. Click on the etCO2 parameter box.
2. Hold the sensor and the adapter away from any source of CO2 (including the
patient’s mouth or your own).
3. Click on Adapter Cal.

The calibration takes approximately 15 seconds. The monitor displays the message
etCO2 Calibrating Adapter. When calibration is successfully completed, the monitor
displays the message etCO2 Adapter Cal. Accepted. A status message appears if
calibration fails.

VF6 Gamma/Gamma XL 13-11

13 END-TIDAL CO2

etCO2 Monitoring Settings

Averaging Mode
The monitor displays the highest etCO2 measurement calculated during a specified
interval. Averaging enables you to set this interval to Instantaneous, Breath, 10
seconds, or 20 seconds. The default is 10 seconds. Choose Breath (i.e., one etCO2
measurement for each breath) for patients whose breathing patterns are consistently
regular. Choose 20 s for patients with erratic breathing patterns. Choose Instant. for
immediate display of values (no value averaging).
NOTE: The instantaneous averaging mode is primarily used by biomedical or service
personnel for calibration purposes.

STEPS: Setting the Averaging Interval

1. Click on the etCO2 parameter box.
2. Click on More...
3. Click on Averaging.

4. Select the desired averaging mode and click the knob.

RRc Apnea Time

The monitor can detect apnea in all monitoring modes based on changes in exhaled
CO2 values. Apnea times are:
z 10 to 30 seconds in increments of 5 or OFF
NOTE:
z In neonatal monitoring mode, the Apnea alarm is on by default.
z Apnea detection is accomplished through capnography.

13-12 Gamma/Gamma XL VF6

 ETCO2 MONITORING SETTINGS

Upon detection of an apnea event and after the selected apnea time has elapsed, the
monitor triggers a serious alarm.

STEPS: Setting the RRc Apnea Time

1. Click on the etCO2 parameter box.
2. Click on More...
3. Click on RRc Apnea.

4. Select the desired apnea time and click the knob.

NOTE: Changing the value for the RRc Apnea time also changes the Apnea Time
setting for Rsp monitoring.

Balance
The monitor assumes a default oxygen concentration of 21% (the percentage of
oxygen in ambient air) for all etCO2 measurements. If the patient is receiving
supplemental oxygen or an anesthetic agent, you must select the gas being
administered (available settings are N2O/O2, >60% O2, and Heliox). Failure to
compensate for supplemental gases results in inaccurate etCO2 measurement values.
Depending on the selection, gas composition values are as follows:

Selection Expired Composition Values (%)

CO2 O2 N2 N2O He
Air 5 17 78 0 0
N2O/O2 5 35 0 60 0
>60% O2 5 75 20 0 0
Heliox 5 35 0 0 60

VF6 Gamma/Gamma XL 13-13

13 END-TIDAL CO2

STEPS: Setting a Balance for Airway Gases

1. Click on the etCO2 parameter box.
2. Click on More...
3. Click on Balance.

4. Select a desired gas balance (Air, N2O/O2, >60% O2 or Heliox) and click the
knob.

Measuring Mode
Configure the etCO2 pod for mainstream or sidestream monitoring as follows.

STEPS: Selecting the Measuring Mode

1. Click on the etCO2 parameter box.
2. Click on More...
3. Click on Meas. Mode.

4. Select the desired measurement mode (Main or Side) and click the knob.

13-14 Gamma/Gamma XL VF6

 ETCO2 MONITORING SETTINGS

Anesthetic Agent Compensation

The monitor allows the user to adjust the etCO2 detection to compensate for expired
and inspired anesthetic agents in the patient’s air supply. Failure to compensate for
anesthetic agents results in inaccurate measurement values. Available compensation
settings are:
z 0% to 20%, in increments of 1% (default 0%).
NOTE: If you set the Expired field, the Inspired field automatically adjusts to an
appropriate value. However, if you set the Inspired field, the Expired field does not
change.

STEPS: Setting Anesthetic Agent Compensation

1. Click on the etCO2 parameter box.
2. Click on MORE.
3. Click on Exp. Agent (or Insp. Agent).

4. Select the desired compensation and click the knob.

Atmospheric Pressure Compensation

The monitor can automatically detect the ambient barometric pressure and
compensate for it during etCO2 measurements. Alternatively, you can enter
atmospheric pressure values manually. Current barometric pressure values appear next
to the Atm. Pressure selection in the etCO2 parameter box.
NOTE:
z The type of atmospheric pressure compensation is usually selected by your
hospital’s service personnel. Consult your Biomed before changing the pressure
compensation mode.
z In automatic pressure mode, you cannot change the atmospheric pressure value
manually.

VF6 Gamma/Gamma XL 13-15

13 END-TIDAL CO2

STEPS: Selecting the Atmospheric Pressure Mode

1. Click on the etCO2 parameter box.
2. Click on More...
3. Click on Atm. Press. Mode.

4. Select the automatic or manual mode and click the knob.

STEPS: Entering Atmospheric Pressure Values Manually

1. Click on the etCO2 parameter box.
2. Click on More...
3. Click on Atm. Pressure.

4. Dial in the current barometric pressure value.

NOTE: Atmospheric pressure values can be read from a barometer or obtained by

calling the closest weather station.

13-16 Gamma/Gamma XL VF6

 ETCO2 ALARMS

etCO2 Alarms
The monitor alarms for the following etCO2 parameters:
z etCO2 alarm (critical levels of CO2 saturation in the exhaled breath).
z iCO2 alarm (critical levels of CO2 saturation in the inhaled breath, or
rebreathing).
z RRc alarm (significant changes in the respiratory rate, derived from the
capnogram waveform).
z RRc Apnea alarm (apnea conditions based on the respiratory rate derived
from the capnogram waveform).
In addition, the monitor alarms for unplugged cables, weak signals, and in the absence
of periodic measurement updates.
You can set etCO2 upper and lower limits for all monitoring modes within the
following range:
z 5 to 95 mmHg for the etCO2 alarm (0.7 to 12.7 kPa or %).
z 4 to 10 mmHg for the iCO2 alarm (0.5 to 1.3 kPa or %).
z 5 to 145 breaths per minute for the RRc alarm (mainstream).
z 5 to 65 breaths per minute for the RRc alarm (sidestream).
Turn etCO2 alarms on or off and set the alarm limits in the Alarm Limits table (see the
chapter Alarms and Messages).

VF6 Gamma/Gamma XL 13-17

13 END-TIDAL CO2

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13-18 Gamma/Gamma XL VF6

14 Scio Multigas Module

Intended Use ................................................................................................................14-2

Overview.......................................................................................................................14-2
Connections .................................................................................................................14-2
The Scio Module ..........................................................................................................14-5
Types of Modules ..................................................................................................14-6
Site of Operation ...................................................................................................14-9
Installing/Removing the Water Trap ..................................................................14-10
Connecting Sampling Lines and Power Cord ..................................................14-11
Warm-Up ..............................................................................................................14-14
OR Mode .....................................................................................................................14-15
Parameter Display ...............................................................................................14-17
CO2 Display and Setup.......................................................................................14-18
Multigas Display and Setup ...............................................................................14-19
End Case and Standby .......................................................................................14-22
14 SCIO MULTIGAS MODULE

Intended Use
The Scio Four modules sample breathing gases from adults and pediatrics. The gas
modules continuously measure the content of CO2, N2O, O2 and one of the anesthetic
agents, Halothane, Isoflurane, Enflurane, Sevoflurane, and Desflurane in any mixture
and communicates real time and derived gas information to the Infinity monitors.

Overview
NOTE:
z Multigas monitoring is only available for the monitor Gamma XL (not for the
monitor Gamma). Multigas monitoring is a locked option and restricted to those
clinical sites that have the corresponding gas monitoring capabilities and
delivery systems in place.
z Multigas monitoring is only available in the Adult and Pediatric monitoring
modes.

The Gamma XL supports multigas monitoring functions when operating in the OR

mode. The monitor receives multigas data from a Dräger Scio multigas module and
can display concentrations of O2, CO2, N2O, and of the anesthetic agents Halothane,
Isoflurane, Enflurane, Sevoflurane, and Desflurane.

Connections

Standalone Monitor
Connect the Scio module via connector X2 or RS232C to connector X5 on the
monitor’s interface plate, using an adapter and/or intermediate cable (see illustration
below).

NOTE:
z When the Scio module is connected to the monitor’s interface plate, data
collection via the export protocol (connector X5) is not available. If data export
is necessary, connect the Scio module to the USB connector X8 on the
monitor’s side panel.
z Connecting cables are listed in the appendix Options and Accessories.

14-2 Gamma/Gamma XL VF6

 CONNECTIONS

Connections: Standalone Monitor

Scio Module 6871255

Other Scio Modules Gamma XL Interface Plate

Scio Module 6871255

Other Scio Modules Gamma XL USB Connector

1 Scio Connector X2 5 USB Adapter Cable

2 Scio Adapter Cable (9-15 pin) 6 Gamma XL USB Connector
3 Scio Connecting Cable 7 Scio Serial Extension Cable
4 Gamma XL Connector X5 8 Scio Connector RS232C (X2, 9 pin)

VF6 Gamma/Gamma XL 14-3

14 SCIO MULTIGAS MODULE

Networked Monitor
Connect the Scio module via connector X2 (RS232C) to connector X5 on the Infinity
Docking Station (IDS), using the supplied intermediate cables.

Connections: Networked Monitor

Scio Module 6871255

Other Scio Modules Infinity Docking Station

1 Scio Connector X2 4 IDS Connector X5

2 Scio Adapter Cable (9-15 pin) 5 Scio Connector RS232C (X2, 9 pin)
3 Scio Connecting Cable

14-4 Gamma/Gamma XL VF6

 THE SCIO MODULE

The Scio Module

The Scio module is a free-standing unit that samples breathing gases from adult and
pediatric patients in non-, partial- and total rebreathing systems. The module measures
inspiratory and expiratory gases and communicates both real-time and derived gas
information to the monitor.
For the measurement of CO2 and volatile anesthetics, the Scio module draws a small
amount of the patient’s respiratory gas through a measuring chamber. It then shines an
infrared light through the chamber which the sample gas components absorb in
different amounts, depending on the gas concentrations. For the measurement of O2
(when available), the Scio module uses a paramagnetic cell that produces a physical
reaction proportional to the O2 concentration.
The Scio module is available in different models (see below), offering different levels
of functionality. The type of Scio module connected is displayed in the Multigas Setup
menu.
WA R N I N G : T h e S c io m o d u l e s am p l e s b r e a t h i n g g a s e s a t a
s a m p l e f l o w r a t e o f 2 0 0 ± 2 0 o r 1 5 0 ± 2 0 m l / m i n . M o d ul e s w i t h a
sample flow rate of 200 ±20 ml/min. specify this flow rate on
t h e b a c k pa n e l . I f t h e f l o w r a t e i s n ot s pe c i f i e d o n t h e b a c k
pa n e l , t h e m o d u l e h a s a f l o w r a t e o f 1 5 0 ± 2 0 m l / m i n .

VF6 Gamma/Gamma XL 14-5

14 SCIO MULTIGAS MODULE

Types of Modules
Scio Four Oxi plus / Scio
Measures content of
• CO2, N2O, O2 and anesthetic agents
(automatic agent identification)

Note: The name for the model with this functionality

is either Scio Four Oxi plus or simply Scio.

Scio Four plus

Measures content of
• CO2, N2O and anesthetic agents
(automatic agent identification)

Scio Four Oxi

Measures content of
• CO2, N2O, O2 and one anesthetic agent
specified by user

Scio Four
Measures content of
• CO2, N2O and one anesthetic agent
specified by user

14-6 Gamma/Gamma XL VF6

 THE SCIO MODULE

Scio Module: Sample Front and Back Panels

Scio Front Panel

Scio Back Panel For Model 6871255

Scio Back Panel For Other Models

1 Water Trap 6 ON/OFF Switch

2 External Power Indicator 7 Flow Rate Label
3 Fan Filter 8 RS232C Connector (X2, 9 pin)
4 Exhaust Port 9 Medibus Connector
5 External Power Supply

VF6 Gamma/Gamma XL 14-7

14 SCIO MULTIGAS MODULE

WA R N I N G :
z S a m p l i n g o f t h e r e s p i r a t o ry g a s f r o m t h e pa t i e n t
b re a t h i n g c i r c u i t m a y r e d uc e t h e d e l i v e r e d pa t i e n t t i d a l
v o l u m e . C l i n i c i a n s s h o u l d a d j u s t t h e f re s h g a s s u p p l y
a s n e c e s s a r y.
z T he p re s e n c e o f o r g a n i c c l e a n i n g s o l u t i o ns o r g a s e s
c o n ta i n i n g f re o n m a y a d v e r s e l y i m pa c t t h e a c c u r a c y o f
t h e S c i o m o d ul e . I f o rg a n i c c l e a n i n g s o l u t i o n s e n t e r t h e
w a t e r t ra p , t h e y d a m a g e t h e w a t e r t ra p ’s m e m b ra n e a n d
t h e w a t e r t r a p ’s f u n c t i o n a l i t y c a n n o l o n g e r b e a s s u r e d .
z T he p re s e n c e o f a e r o s o l s i n t h e b re a t h i n g c i r c u i t
should be avoided as these might adversely affect
measured agent concentration values and/or damage
t h e w a t e r t ra p m e m b r a n e .

CAUTION:
z The displayed gas information is intended to be used by trained and authorized
health care professionals only.
z The Scio module purges and zeroes itself approximately once every 2 hours.
The purging/zeroing cycle typically lasts no longer than 25 seconds (an
extended zeroing cycle may be performed after the initial power-up of the Scio
unit). During zeroing, the monitor blanks the gas parameter values and the
etCO2 waveform on the screen. The message Multigas Zero in Progress appears
in the message area.
z Due to the response time of the sensors and the gas sample flow rate, the stated
accuracy of O2, CO2, N20 and anesthetic agents is limited by the respiratory
rate and by the inspiratory to expiratory ratio (I:E). For details, see the
Technical Data appendix.

NOTE:
z The Scio module is self-zeroing and does not need routine calibration by the
clinical staff. However, a yearly check of the Scio calibration components
should be performed by authorized technical personnel.
z To ensure safety, the Scio module requires routine cleaning. For instructions see
the appendix Cleaning and Disinfecting.

14-8 Gamma/Gamma XL VF6

 THE SCIO MODULE

Site of Operation
The site of operation must meet the temperature, humidity, and atmospheric pressure
requirements listed in the appendix Technical Data. In addition, observe the following
guidelines:
z Make sure that the platform which supports the module is large enough, level,
and stable.
z Make sure that the fan exhaust screen at the rear of the module and the
ventilation holes on the underside are not obstructed.
z Place the module at least 25 cm (10 inches) away from any possible source of
ignition, such as sparking.
z Place the module close enough to the patient so that the sampling lines can
reach the airway T-connector and the exhaust tubing of the hospital’s exhaust
gas scavenging system without stretching.

WA R N I N G :
z To a v o i d i n j u r y f r o m a f a l l i n g d e v i c e , p l a c e t h e m o d u l e
o n a s e c u r e p l a tf o r m .
z A s s u r e a d e q u a t e v e n t i l a t io n/ h e a t d i s s i pa t i o n a n d a v o i d
d i r e c t c o n ta c t w i t h t h e m o d u l e , a s i t m a y b e h o t .
z Do not use mobile phones within 33 feet (10 m) of the
Scio module. Such phones may cause equipment
malfunction.
z Do not expose the Scio module to mechanical
v i b r a t i o n s o r s h o c k d u r i n g m e a s u r e m e n ts . M e c h a ni c a l
v i b r a t i o n s o r s h o c k c a n h a v e a d v e r s e e f f e c ts o n
measured gas values.
z D o n o t o p e r a t e t h e S c i o m o d ul e i n m a g n e t i c r e s o n a n c e
i m a g i n g e n v i r o n m e n ts ( M R I ) .
z D o n o t u s e a S c i o m o d ul e n e a r d e v i c e s w i t h m i c ro w a v e
o r o t h e r h i g h - f r e q u e n c y e mi s s i o n s . T h e s e e m i s s i o n s
m a y i n t e r f e r e w i t h t h e m o d u l e ’s o p e r a t i o n .
z The Gamma XL and the Scio module must both be
c o n n e c t e d t o a h os p i ta l o ut l e t ( U S A : h o s p i ta l - g r a d e
outlet) within the same room.
z When the Gamma XL is used with the Scio module, it
m e e ts t h e C l a s s A l i m i ts o f C I S P R 11 . T h e s y s t e m i s n o t
i n t e n d e d f o r c o n n e c t io n t o p u b l i c m a i n s .

VF6 Gamma/Gamma XL 14-9

14 SCIO MULTIGAS MODULE

Installing/Removing the Water Trap

Push the water trap into its receptacle on Scio’s front panel until the
trap clicks into place. Make sure the trap is empty.
To remove the trap, hold it firmly on the ridged surfaces and pull it
out of the receptacle.

CAUTION: Replace the water trap every 4 weeks. Failure to do so can damage the
system.

CAUTION: To prevent damage to the water trap and measuring system:

z Do not use Scio without a water trap.
z Do not spray O-rings of the water trap connector with silicone.
z Do not clean water trap, as alcohol or other cleaning agents/disinfectants can
damage the water trap membrane.
z Do not use the water trap with nebulizers.
z Avoid the presence of aerosols in the breathing circuit.

(For information on emptying the water trap and related maintenance functions, see
the appendix Cleaning, Disinfecting, Sterilizing.)

14-10 Gamma/Gamma XL VF6

 THE SCIO MODULE

Connecting Sampling Lines and Power Cord

WA R N I N G :
z S a m p l i n g l i n e s s ho ul d b e k e p t a s s h o r t a s p o s s i b l e ( b u t
n ot s t r e t c h e d ) t o m i n i m i z e d e a d s pa c e a n d o pt i m i z e
r e s p o n s e t i m e . L on g s a m p l i n g l i n e s d e g ra de t h e
p e rf o r ma n c e o f s i d e s t re a m m e a s u r e m e n ts , m a y a f f e c t
a c c u r a c y, a n d r e s ul t i n s l o w e r r e s p o n s e t i m e s .
z A l w a y s c he c k t h e i n t e g r i t y o f s a m p l i n g l i n e s . L e a k a g e
of respiration gases from the measuring system can
lead to erroneous readings.
z Always use Dräger-approved S c i o s a m pl i n g l i ne s
( p o l y p r o p y l e n e ) . N e v e r u s e s ta n d a r d p re s s u r e - s e ns o r
t u b i n g ( PV C ) . PVC t u b i n g a b s o r b s a n e s t h e t i c a g e n ts ,
w h i c h i t l a t e r r e l e a s e s ( d e g a s s i n g ) . T h e u s e o f s ta n d a r d
PV C t u b i n g c a n r e s ul t i n e r r o n e o us a g e n t c o n c e n t ra t i o n
readings.
z S a m p l i n g l i n e s a n d T- c o n n e c t o rs a re n ot r e u s a b l e a n d
m u s t b e r e p l a c e d a ft e r e a c h pa t i e n t . Wa t e r t r a ps a n d f a n
filters must be replaced at regular intervals (see the
a p p e n d i x C l e a n i n g , D i s i n f e c t i n g , St e r i l i zi n g) .
z To a v o i d t h e r i s k o f e x p l o s i o n , d o n o t u s e f l a m m a b l e
a n e s t h e t i c a g e n ts s u c h a s e t h e r a n d c y c l o p r o pa n e i n
t h e p re s e n c e o f t h e S c i o m o d u l e .

1. Connect one end of the sampling line to the water trap, and the other end to
the airway T-connector.
2. If the return of sample gas is not possible, connect one end of the exhaust
tubing to the exhaust port at the rear of the module, and the other end to the
hospital’s gas-scavenging system.
NOTE: If possible, use sample gas recirculation
z to prevent increased anesthetic agent concentration in the operation room,
z to conserve anesthetic agents,
z to prevent undesired losses of volume during low-flow application.

WA R N I N G : A c c u m u l a t i o n o f e x h a l e d m e ta b o l i c p r o d u c ts m a y
o c c u r d u r i n g l o w f l o w a n e s t h e s i a , t h e r e f o re m o n i t o r i n g o f
o x y g e n c on c e n t ra t i on i s ma nd a t o ry. Fl u s h in g t he c i r c u i t w i t h
f r e s h g a s a t r e g u l a r i n t e r v a l s m a y b e n e c e s s a r y pa r t i c u la rl y i f
decreasing oxygen concentrations are measured.

VF6 Gamma/Gamma XL 14-11

14 SCIO MULTIGAS MODULE

3. Connect recirculating sample gas tubing as follows:

„ For Dräger COSY breathing system (Fabius GS):
- Use Sample Gas Return kit M 32 692.
- Push the rubber sleeve on to the exhaust port on the back of Scio and
plug the connector into the socket on the front of the COSY
(Fabius GS) until it clicks into place.
„ For other breathing systems:
-Use Sample Gas Return kit M 32 692 with an integrated bacterial fil-
ter and adapt it to the breathing system used adjacent to the expired
gas valve so that the returned sample gas is routed through the CO2
absorber.

CAUTION:
z Replace Sample Gas tubing Bacterial filter every 6 months.
z Strictly follow the Instructions for Use of the breathing system.

NOTE:
z Use only Dräger-approved sidestream sampling lines. Dräger does not assume
responsibility for the reliability and safety of Scio measurements, if non-
approved tubing is used.
z The exhaust port is a hose barb type connector.

14-12 Gamma/Gamma XL VF6

 THE SCIO MODULE

1 Bacterial Filter 5 External Power Supply Connector

2 To Sample Gas Recirculation System 6 X2 Connector
3 Sample Gas Return Tubing 7 RS232C Connector (X2 9 pin)
4 Exhaust Port

4. Connect the power supply to the power connector at the rear of the module.
5. Connect the power supply to an outlet specified for the use of medical
equipment in a hospital.

VF6 Gamma/Gamma XL 14-13

14 SCIO MULTIGAS MODULE

Warm-Up
NOTE: Most Scio modules have a power switch on the back panel. To turn the
module on/off, flip the power switch. Scio module 6871255 comes without a power and
turns on as you connect it to power.

Upon start-up, the Scio module passes through an initialization and warm-up period.
During this time, concentrations for certain gases may not be available and the
anesthetic agent may not be identified. Scio achieves full accuracy after a warm-up
period of about 7.1 minutes.

WA R N I N G : D u r i n g w a r m - u p , r e p o r t e d v a l u e s m a y n o t b e
a c c u r a t e . R e f e r t o t h e Te c h n i c a l D a t a a p p e n d i x f o r a d e ta i l e d
d e s c r i p t i o n o f S c i o a c c u r a c y.

14-14 Gamma/Gamma XL VF6

 OR MODE

OR Mode

NOTE: Multigas monitoring is available only for monitors Gamma XL in the OR

mode. The OR mode is available only for the adult and pediatric patient categories.

STEPS: Selecting the OR Mode

1. Verify that the adult or pediatric patient category is selected.
2. Press the Menu fixed key.
3. Click on Monitor Setup.
4. Click on Main Screen.

5. Click on OR Mode.
6. Select ON and click the knob.

NOTE: The alarm behavior for some parameters changes in the OR mode. For details,
see the chapter Alarms and Messages.

VF6 Gamma/Gamma XL 14-15

14 SCIO MULTIGAS MODULE

14-16 Gamma/Gamma XL VF6

 OR MODE

Parameter Display
In the OR mode, etCO2 occupies the third waveform channel. The Multigas parameter
box occupies the right-most position in the bottom waveform channel. For the
remaining bottom-channel display positions, you can select parameters as follows:

1. Call up the Main Screen menu (Menu>Monitor Setup>Main Screen).

2. Click on Bottom Channel.
3. Click on Parameter 1 (= left-most bottom channel display position) and
select the desired parameter for display (or select Blank to leave the position
empty).

4. Repeat this step for bottom-channel display positions 2 and 3.

NOTE: If you leave a bottom-channel parameter box blank, NBP takes over the
empty position(s), stretching over two (or three) bottom-channel parameter boxes. If
NBP is not displayed, the parameter boxes remain empty and you cannot take NBP
measurements.

VF6 Gamma/Gamma XL 14-17

14 SCIO MULTIGAS MODULE

CO2 Display and Setup

The CO2 parameter box displays the inspired and expired values
for CO2 in Vol% (or mmHg, kPa). If CO2 alarms are disabled,
crossed-bell icons appear next to the corresponding parameter
values.
In OR mode, Scio is automatically the etCO2 source, regardless
of previous source selections. (The source selection item on the etCO2 Setup menu is
for display only in the OR mode.)
NOTE: When you exit the OR mode, the Scio module remains the etCO2 source and
the parameter labels etCO2, iCO2 and RRc are displayed with an asterisk (*). In order to
change the etCO2 source, click on the etCO2 parameter box and change the source
selection (SCIO or POD) in the etCO2 setup menu.

Available CO2 Setup Functions in OR Mode

Adjust the etCO2 waveform amplitude by clicking on the waveform and selecting a
Size.
Set the RRc apnea time between 10 and 30 seconds (or OFF) by clicking on the CO2
parameter box and on RRc Apnea.
For more information on etCO2 setup functions, see the chapter End-Tidal CO2.

14-18 Gamma/Gamma XL VF6

 OR MODE

Multigas Display and Setup

The multigas parameter box displays the inspired and expired
values in Vol% for O2, CO2, N2O, and for one of the anesthetic
agents Halothane (HAL), Isoflurane (ISO), Enflurane (ENF),
Sevoflurane (SEV), or Desflurane (DES), if present. The multigas
parameter box does not show alarm limits, but shows an alert icon
next to the O2 label when the lower alarm limit for iO2 is set
below 21%.
If there are two anesthetic agents in the breathing system, the monitor displays the
concentration values of the primary agent in the parameter box and indicates the name
of the secondary agent briefly in the message area, accompanied by an attention tone.
If there are more than two agents in the breathing system, the monitor indicates a gas
mixture (Mix) and displays (***) for the agent values in the parameter box.
NOTE:
z The Multigas parameter box display varies according to the type of Scio
module connected and gas parameters monitored (see description of the
different Scio modules and their functions, above).
z The primary agent is the agent with the higher MAC value (minimum alveolar
concentration). 1 MAC is equal to the alveolar anesthetic concentration at one
atmosphere (760 mmHg) at which 50% of all patients no longer respond to
noxious stimuli.
z With Scio Four Oxi plus and Scio Four Plus, the anesthetic agent identification
threshold is max. 0.3 Vol%. The agent identification threshold of a second agent
is 0.4 Vol% or, if Desflurane is the primary agent, one tenth (10%) of the
Desflurane concentration. If a second agent is identified, the monitor displays
the name of the second agent briefly in the message area, accompanied by an
attention tone.
z If the Scio module has a software version older than 1.19.00 and there is more
than one agent in the breathing system, the monitor indicates a gas mixture and
displays (***) in the agent parameter box.
z With the exception of inspired and end-tidal CO2, Scio parameters do not
appear on remote views called up on monitors within the network.

VF6 Gamma/Gamma XL 14-19

14 SCIO MULTIGAS MODULE

Agent Detection
Scio Modules With Automatic Agent Identificaton
(Scio/Scio Four Oxi plus, Scio Four plus)
For Scio modules with automatic agent identification, you can select automatic agent
detection (Auto) or you can select a specific agent for monitoring and display.
If agent detection is set to Auto, the monitor displays the label and gas concentration
values of the primary agent in the parameter box. If there are two anesthetic agents in
the breathing system, the monitor indicates the name of the secondary agent briefly in
the message area, accompanied by an attention tone. If there are more than two agents
in the breathing system, the monitor indicates a gas mixture (Mix) and displays (***)
for the agent values in the parameter box.
If agent detection is set to a specific agent, but the selected agent is not reported as
either the primary or the secondary agent by Scio, the monitor blanks the agent values
in the parameter box.
Scio Modules Without Automatic Agent Identification
(Scio Four Oxi, Scio Four)
For Scio modules without automatic agent identification, you must select a specific
agent manually.
Before you select an agent, the monitor displays the label AA? in the multigas
parameter box and no agent monitoring occurs. When you select a specific agent, the
monitor displays the selected agent parameter label as well as gas concentrations
values for the specified agent.
WA R N I N G :
z S c i o m o d u l e s w i t h o ut a u t o m a t i c a g e n t i d e n t i f i c a t i o n
cannot detect which type of agent is present in the
b re a t h i n g s y s t e m . T he re f o re , t h e a c c u r a c y o f d i s pl a y e d
g a s c o n c e n t ra t i o n v a l u e s r e l i e s s o l e l y o n t h e c o r r e c t
agent selection in the Agent Detection menu.
z S c i o m o d u l e s w i t h o ut a u t o m a t i c a g e n t i d e n t i f i c a t i o n
c a n n o t r e c o g n i z e a n e s t h e t i c g a s m i x t u re s . I f a ne s t h e t i c
gases are mixed, the monitor displays incorrect gas
c o n c e n t ra t i o n v a l u e s .

NOTE:
z When an agent has been specified in the Agent Detection menu, the monitor
does not alarm for any other agent nor does it store any other agent’s values in
the trend storage.
z For monitors without automatic agent identification, the agent selection returns
to ‘Agent?’ after a patient discharge.

14-20 Gamma/Gamma XL VF6

 OR MODE

STEPS: Choosing the Agent Detection Mode

1. In OR mode, click on the O2/N2O/Agent parameter box.
2. Click on Agent Detection.
3. Select Auto or select the desired agent.
4. Click the knob.

Multigas Alarms
Set upper and lower multigas alarm limits on the Alarm Limits table. Access the table
with the Alarm Limits fixed key and scroll to the multigas parameters, or call up the
table as follows:

1. Click on the O2/N2O/Agent parameter box.

2. Click on Multigas Alarms.

NOTE: The chapter Alarms and Messages lists multigas alarm and status messages as
well as suggested remedies.

Autozero Delay
The Scio module is self-zeroing. It automatically initiates zeroing of its gas sensors
against room air about every 2 hours. During zeroing, the monitor blanks the
displayed Scio parameter values on the screen. If zeroing cannot be completed within
75 seconds, the monitor displays an error message (see the chapter Alarms and
Messages).
One minute before the start of zeroing, the monitor sounds an attention tone (2 beeps)
and displays the message Multigas zero in 1 minute. You can delay zeroing once for a
5-minute period as follows:

STEPS: Requesting an Autozero Delay

1. In OR mode, click on the O2/N2O/Agent parameter box.
2. Click on Autozero Delay.

WA R N I N G : D e la y i n g z e r o i n g m a y c o m p r o m i s e t h e a c c u r a c y o f
gas values.

NOTE: The menu selection Autozero Delay is only displayed and available for one
minute, just before zeroing starts.

VF6 Gamma/Gamma XL 14-21

14 SCIO MULTIGAS MODULE

End Case and Standby

In OR mode, you can quickly discharge the patient or put the monitor into Standby via
the Fast Access key as follows:

1. Press the Fast Access fixed key.

2. Click on End Case.
3. Click on Discharge Patient? Yes/No.
or
2. Click on Standby to put the monitor into Standby.

14-22 Gamma/Gamma XL VF6

15 Non-Invasive Blood Pressure

Overview.......................................................................................................................15-2
NBP Safety Considerations..................................................................................15-3
Cuff Selection and Placement ....................................................................................15-4
NBP Measurements .....................................................................................................15-6
Single Measurements ...........................................................................................15-6
Interval Mode .........................................................................................................15-6
Inflation Mode ........................................................................................................15-8
Measurement Tone ...............................................................................................15-9
NBP Measurements in OR Mode ..............................................................................15-10
NPB Alarms ................................................................................................................15-11
15 NON-INVASIVE BLOOD PRESSURE

Overview
WA R N I N G : B e f o r e n o n - i n v a s i v e b l o o d p r e s s u r e m o n i t o r i n g ,
p l e a s e r e a d t h e s a f e t y i n f o r m a t i o n i n t he s e c t i o n N B P S a f e t y
C o n s i d e r a t i o n s , b e l o w.

WA R N I N G : B e f o r e m o n i t o r i n g n e o n a t e s a n d i n f a n ts :
z S e l e c t t h e a p p r o p r i a t e c u f f s i z e f o r y o u r pa t i e n t .
z S e l e c t t h e n e o n a ta l o r p e d ia t r i c pa t i e n t c a t e go ry i n t h e
P a t i e n t A d m i t m e n u . T h i s p ro t e c ts n e o n a t e s , i n f a n ts ,
a n d p e d i a t r i c pa t i e n ts f r o m h i g h c uf f p re s s u r e s u s e d
f o r a d u l ts .
z S e l e c t t h e p ro pe r I n f l a t i o n M o d e ( N e o 1 4 0 a n d P e d i a t r i c
180).

NOTE: Dräger recommends NBP calibration checks as part of regular monitor

maintenance and whenever the accuracy of measurement values is in doubt. NBP
calibration checks should be performed by qualified technical personnel. See the
appendix Default Settings and Biomedical Support for a description of the NBP
calibration check. For detailed calibration instructions, refer to the Service manual.

The monitor can acquire and process non-invasive blood pressure (NBP) signals and
display the results. Blood pressure measurements are determined by the oscillometric
method and are equivalent to those obtained by intra-arterial methods, within the
limits prescribed by the Association for Advancement of Medical Instrumentation,
Electronic Automated Sphygmomanometers (AAMI/ANSI SP-10).
If the pulse signal is poor due to patient movements, improper cuff placement or noise
in the signal, the cuff deflates and the monitor attempts a second measurement. For
causes and possible remedies for a poor pulse signal see the alarm message tables in
the chapter Alarms and Messages.
The monitor displays the systolic, diastolic, and mean pressure values in the NBP
parameter box (mmHg or kPa). You can select an enlarged NBP display in the bottom
channel of the main screen display. For more information, see the section Main Screen
Configuration in the Monitor Setup chapter.
At the end of each NBP measurement, the NBP cuff deflates to a pressure of 10
mmHg or less (adult and pediatric modes), or to a pressure of 5 mmHg (neonatal
mode). A time stamp in the NBP parameter box indicates the time of the last NBP
measurement.

15-2 Gamma/Gamma XL VF6

 OVERVIEW

NBP Safety Considerations

WA R N I N G :
z Changes in the cuff position relative to the heart level
a f f e c t m e a s u r e m e n ts . I f t h e c uf f i s n o t p l a c e d a t h e a r t
l e v e l , a d d + 1 . 4 m m H g f o r e a c h 2 c m a b o v e t he h e a r t a n d
subtract -1.4 mmHg for each 2 cm below the heart. Make
s u re t h a t t h e h o s e i s n o t k i n k e d o r o b s t r u c t e d . D o n o t
place the cuff on a limb with an infusion line.
z I n s o m e c a s e s , r a p i d a n d p r o l o n g e d m e a s u r e me n ts c a n
r e s u l t i n p e t e c h i a , i s c h e mi a , p u r p u r a o r n e u ro pa t h y.
Dräger recommends that you apply the cuff
a p p r o p r i a t e l y a n d t h a t y o u c he c k t h e c u f f s i t e r e g ul a r l y
w he n m o n i t o r i n g a t f r e q u e n t i n t e r v a l s o r o v e r e x t e n de d
p e r i o ds o f t i m e . I n a d d i t i o n, c he c k t h e pa t i e nt f o r s i g n s
o f i m p e d e d b l o o d f l o w i n t he l i m b .
z N B P m e a s u r e me n ts m a y n o t b e a c c u r a t e w i t h
c o n v u l s i v e pa t i e n ts o r pa t i e n ts w i t h t r e m o r s .

CAUTION: Do not allow the hose or cuff to get in contact with fluids. Check the hose
and cuff frequently for signs of damage and debris. An obstruction in the hose may
cause the cuff to inflate and deflate improperly and may result in inaccurate readings.

NOTE: To obtain accurate blood pressure readings, keep the limb and cuff
motionless. To protect patients from extremely high cuff pressures and extended cuff
inflation, the cuff deflates automatically in the following conditions:
z The cuff pressure exceeds 273 mmHg in Adult 270 inflation mode, or 180
mmHg in Pediatric 180 inflation mode.
z The cuff pressure exceeds 150 mmHg in Neo 140 inflation mode.
z The measurement takes longer than 2 minutes for Adult 270 or Pediatric 180
inflation modes.
z The measurement takes longer than 90 seconds (or longer than 60 seconds in
French NFC mode) for Neo 140 inflation mode.
z A technical alarm has occurred.

VF6 Gamma/Gamma XL 15-3

15 NON-INVASIVE BLOOD PRESSURE

Cuff Selection and Placement

The quality of NBP monitoring depends largely on the quality of the signals received
by the monitor. For this reason, it is important to select the appropriate cuff size for
your patient. Cuff sizes are clearly marked on the cuff. Measure the circumference of
your patient’s limb. Use only Dräger-approved cuffs with your monitor (see the
appendix Options and Accessories).

STEPS: Applying the NBP Cuff

1. Ask the patient to sit or lie down. The limb should be relaxed, extended and
placed on a smooth surface for support.
2. Place the cuff at 2 to 5 cm above the elbow crease (or in the middle of the
back of the thigh). The cuff label “this side to patient” must be placed against
the skin.
3. Place the “Artery Ø” marker over the artery, pointing to hand or foot. Once
the cuff is applied, the cuff label “index line” must fall within the area marked
as “range.”
4. Wrap the deflated cuff snugly around the limb without impeding blood flow.
5. Caution the patient not to talk or move upon inflation of the cuff.

15-4 Gamma/Gamma XL VF6

 CUFF SELECTION AND PLACEMENT

1 Cuff Size Indicators 4 Range Labels

2 Artery Label 5 Label: This side to patient
3 Index Line

To avoid kinks in the hose, center the cuff bladder on the

artery so that the hose is to the left or to the right of the
artery.
Connect the NBP cuff and hose to the monitor’s hose
connector on the left side of the device.

NBP Connector

VF6 Gamma/Gamma XL 15-5

15 NON-INVASIVE BLOOD PRESSURE

NBP Measurements

Single Measurements
The monitor gives you two options for taking NBP measurements:
z Taking single NBP measurements.
z Selecting the Interval Mode to take NBP measurements automatically at
specific time intervals.
NOTE: After an NBP measurement, the valves are opened to ensure that all residual
pressure is released from the cuff. During this process, it is normal for the NBP valves to
“chatter” for a few moments following the NBP measurement.

STEPS: Taking a Single NBP Measurement

1. Press the fixed key NBP Start/Stop. The cuff inflates.
2. Wait until the cuff deflates.

At the end of the measurement, the monitor emits an end-of-measurement tone (2

beeps), if the measurement tone is enabled in the NBP menu (see below). A time
stamp indicating the time of the measurement appears in the NBP parameter box.
To cancel an NBP measurement in progress, press NBP Start/Stop again.

Interval Mode
The interval mode lets you program the monitor to initiate NBP measurements
automatically at specific intervals. The following time intervals are available:
z 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 30, 45, 60, 120, 180, 240
minutes (or OFF default).
NOTE: The minimum time between the end of an automatic interval measurement
and the next automatic measurement is 30 seconds.

STEPS: Taking NBP Interval Measurements

1. Press and hold the NBP Start/Stop key,
or

1. Click on the NBP parameter box.

2. Click on Interval Mode.

15-6 Gamma/Gamma XL VF6

 NBP MEASUREMENTS

3. Select the desired interval and click the knob.

NOTE:
z When you press and hold the NBP Start/Stop key to turn the Interval Mode on,
the interval time is the one that was previously selected.
z If the Interval Mode is active before you power cycle the monitor, the Interval
Mode setting is retained through a power cycle. If the Interval Mode is turned
off before you power cycle the monitor, you have to reselect an interval time in
the NBP menu, before interval measurements can be started with the NBP Start/
Stop key.
z After exiting Standby, you have to restart NBP measurement cycles by pressing
the NBP Start/Stop key.
z During an active single NBP measurement, you cannot turn the Interval Mode
on or off.

To end interval measurements, press and hold the NBP Start/Stop key or turn the
Interval Mode OFF in the NBP menu.
As soon as you turn the interval mode on, the monitor starts an
NBP measurement. A bar graph appears in the NBP parameter box
to indicate the time left until the start of the next measurement.
In addition to measurements in the automatic cycle, you can take a
single measurement at any time. However, if the bar graph empties
before the end of your single NBP measurement, the next
automatic NBP measurement occurs only when the bar graph empties again. As a
result, the monitor skips one interval measurement.
If the monitor detects an error (while the NBP alarm is on), any attempts to take NBP
measurements (single or at intervals) generate an error tone. For more information,
see the chapter Alarms and Messages.

VF6 Gamma/Gamma XL 15-7

15 NON-INVASIVE BLOOD PRESSURE

Inflation Mode
You must select the appropriate inflation limits for your patient. The following table
shows the monitor’s inflation values for each inflation mode:

Initial Inflation After a Valid Maximum Minimum

Inflation Inflation Measurement (mmHg) Inflation Inflation
Mode (mmHg) (mmHg) (mmHg)
Adult 270 160 ± 10 Last Sys + 25 ±10 265 ±5 110 ±10
Pediatric 180 120 ± 10 Last Sys + 25 ±10 180 ±10 90 ±10
Neo 140 110 ± 10 Last Sys + 30 ±10 142 ±10 70 ±10
Note:
For patient category Adult, you can choose inflation modes Adult 270, Pediatric 180 and
Neonatal 140.
For patient category Pediatric, you can choose inflation modes Pediatric 180 and Neonatal 140.
For patient category Neonatal, you can choose inflation mode Neonatal 140.

STEPS: Selecting the Inflation Mode

1. Click on the NBP parameter box.
2. Click on Inflation Mode.

15-8 Gamma/Gamma XL VF6

 NBP MEASUREMENTS

3. Select the desired inflation mode and click the knob.

WA R N I N G : I f t h e n e o n a ta l i n f l a t i o n m o d e i s s e l e c t e d , a b l o o d
p re s s u r e h i g h e r t h a n t h e i n f l a t i o n r a n g e m a y a c t i v a t e t h e
“NBP Cannot Measure”, “NBP No Pulsation”, or “NBP Mean
O nl y ” a l a r m s . I f t h i s h a p p e n s , m a n u a l l y c h e c k t h e pa t i e n t ’s
p re s s u r e a n d , i f a pp ro pr i a t e , s w i t c h t o a p e d i a t r i c i n f l a t i o n
mode.

Measurement Tone
The end of an NBP measurement can be indicated by an end-of-measurement tone (2
beeps). The loudness of the tone depends on the setting for the monitor’s speaker
volume. If the volume is turned off, the tone does not sound.

STEPS: Turning the Measurement Tone ON/OFF

1. Click on the NBP parameter box.
2. Click on Measurement Tone.

3. Select ON or OFF and click the knob.

VF6 Gamma/Gamma XL 15-9

15 NON-INVASIVE BLOOD PRESSURE

NBP Measurements in OR Mode

In the OR mode (see the chapter Multigas), you can display the NBP parameter in the
bottom channel, spanning one, two or three parameter boxes.

STEPS: Displaying NBP in OR mode

1. Turn on the OR mode (Menu>Monitor Setup>Main Screen>OR Mode ON).
2. In the Main Screen menu, click on Bottom Channel.
3. Click on Parameter 1 (left-most parameter box in bottom channel),
Parameter 2 or Parameter 3.
4. Select NBP and click the knob.

NOTE: If you want NBP to span two or three parameter boxes, select NBP for one of
the bottom channel parameters, and Blank for the remaining bottom-channel
parameters.

5. To save this screen configuration, save the setup (a password-protected

function, see the appendix Default Settings and Biomedical Support.)

15-10 Gamma/Gamma XL VF6

 NPB ALARMS

NPB Alarms
Turn NBP alarms on or off and set alarm limits on the Alarm Limits table (see the
chapter Alarms and Messages). If alarms are on, the monitor alarms for limit
violations as well as patient movements, improper placement of the cuff and
overpressure conditions.
NOTE: When an NBP alarm occurs, the monitor alerts you once and, when the alarm
is acknowledged by pressing the Alarm Silence or the All Alarms Off key, does not alert
you again of the same alarm even though displayed values may remain out of limits.

You can set the systolic, mean, and diastolic alarm limits within the following range:
z 10 to 250 mmHg, in increments of 1 mmHg.

VF6 Gamma/Gamma XL 15-11

15 NON-INVASIVE BLOOD PRESSURE

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15-12 Gamma/Gamma XL VF6

16 Invasive Blood Pressure

Overview.......................................................................................................................16-2
Invasive Pressure Labels............................................................................................16-3
IBP Display ...................................................................................................................16-3
Display Channel and Waveform Amplitude ........................................................16-4
Selecting and Preparing the Transducer...................................................................16-5
Zeroing and Calibration Check ............................................................................16-6
Zero and Calibration Check Troubleshooting ....................................................16-7
Calibrating Reusable Transducers ......................................................................16-8
16 INVASIVE BLOOD PRESSURE

Overview

NOTE: Invasive Blood Pressure Monitoring is a locked option for the monitors
Gamma/GammaXL.

During invasive blood pressure monitoring (IBP), the monitor measures arterial and
venous blood pressures and
z Displays one or two pressure waveforms continuously (the monitoring of two
invasive pressure parameters is available as an option).
z Calculates systolic, mean, and diastolic invasive blood pressures values.
In the IBP setup menu (see the section Invasive Pressure Labels), you can select one
of the following pressure labels to identify the type of invasive blood pressure being
monitored.

ART Arterial Pressure

PA Pulmonary Arterial Pressure

CVP Central Venous Pressure

ICP Intracranial Pressure

GP1/GP2 Generic Pressure Label 1 and 2

(GP2 is available as an option)

NOTE: This manual refers to the invasive blood pressure parameter generally as IBP1
or IBP2. The actual displayed pressure labels are those you choose in the IBP setup
menu. Always select an appropriate label for your invasive pressure monitoring session.

Set IBP alarms on the Alarm Limits table (see the chapter Alarms and Messages). If
you are monitoring two invasive pressure parameters, each has its own alarm settings.
For invasive pressure parameters that generate only a mean pressure value, you cannot
set systolic or diastolic alarm limits.

16-2 Gamma/Gamma XL VF6

 INVASIVE PRESSURE LABELS

Invasive Pressure Labels

STEPS: Selecting the Invasive Pressure Label

1. Click on the IBP1 parameter box.
2. Click on Label.

3. Select the appropriate pressure label for your monitoring session and click the
knob.

IBP Display
The monitor measures pressure in millimeters of mercury (mmHg) or kilo pascals
(kPa), and can display up to two pressure waveforms in the lower display channels.
The pressure parameter boxes show the following information:
z Parameter label (e.g., ART).
z Systolic pressure value (e.g., 125).
z Diastolic pressure value (e.g., 85).
z Mean pressure value (e.g., 102).
z A crossed bell if invasive pressure alarms are turned off.
If the second invasive pressure option is enabled, the second invasive blood pressure
has its own parameter box.

VF6 Gamma/Gamma XL 16-3

16 INVASIVE BLOOD PRESSURE

Display Channel and Waveform Amplitude

The monitor displays pressure waveforms in the lower display channels. Depending
on the pressure label, you can select waveform amplitudes within the following
ranges:

Pressure Possible Size Settings Adult/Pediatric Neonatal Default

Label Default Setting Setting
ART, GP1, GP2 50, 75, 100,...300 mmHg 200 mmHg 100 mmHg
(8, 12, 16,...40 kPa) (24 kPa) (16 kPa)
PA 20, 40, 50, 75, 100, 150 mmHg 50 mmHg 50 mmHg
(4, 6, 8, 12, 16, 20 kPa) (8 kPa) (8 kPa)
CVP -5, 10, 20, 30, 40, 50 mmHg 20 mmHg 20 mmHg
(-1.0, 2, 4, 5, 6, 8 kPa) (4 kPa) (4 kPa)
ICP 0, 5, 10, 15, 20, 50, 100 mmHg 20 mmHg 10 mmHg
(1, 2, 3, 4, 8, 16 kPa) (4 kPa) (2 kPa)

STEPS: Selecting the IBP Display Channel and Waveform

Amplitude
1. Click on the desired waveform channel.
2. Click on Waveform.

3. Select the desired pressure parameter and click the knob.

4. Click on Size.
5. Select the desired display amplitude and click the knob.

NOTE: The Channel setup menu makes only those pressure labels available which
have been selected for the monitoring session in the IBP setup menu (or the default GP1/
GP2).

16-4 Gamma/Gamma XL VF6

 SELECTING AND PREPARING THE TRANSDUCER

Selecting and Preparing the Transducer

WA R N I N G :
z N e v e r r e - u s e a s i n g l e - u s e ( d i s p o s a b l e ) t r a n s d u c e r.
z D r ä g e r a p p r o v e d t r a n s du c e r s r e d u c e t h e r i s k o f pa t i e n t
burns during electrosurgery or defibrillation. Use of
n o n - a p p ro v e d t r a n s d u c e r s m a y c o m p r o m i s e t h i s
function.

The quality of pressure monitoring depends on the quality of the signals received by
the monitor. To maximize the strength of the pressure signal when it reaches the
transducer, assemble the tubing system carefully following the application techniques
of your hospital. Noise and motion artifact as well as air bubbles in the tubing system
distort the signal and give inaccurate measurements. Consider the following:

1. Select a high pressure tubing system (compliant tubing dampens and distorts
the signal).
2. Select the shortest possible length of tubing to preserve signal strength and
minimize motion artifact.
3. Follow your hospital procedures in assembling the tubing system.

WA R N I N G : To a v o i d e l e c t r i c s h o c k , d o n o t u s e a n y
c o n d u c t i v e pa r ts i n t h e h y d r a ul i c s y s t e m c on ne c t i o n t o t h e
t r a n s d u c e r.

Connect the IBP transducer to the IBP-connector on the

monitor’s left side panel.

IBP Connector

VF6 Gamma/Gamma XL 16-5

16 INVASIVE BLOOD PRESSURE

Zeroing and Calibration Check

The Zero field in the IBP setup menu:
z Displays the date and time of the last zeroing procedure.
z Allows you to zero the pressure transducer before entering a calibration
factor.
NOTE: Before zeroing, make sure the transducer is at heart level. It is necessary to
zero the transducer immediately after the introduction of the catheter in the patient’s
vascular system and before monitoring. You should also zero the transducer once a day
or after changing the tubing or the dome of the transducer.
Pressure transducers are sensitive and their calibration may change significantly
following a mechanical shock or an overpressure in the system (e.g., after drawing
blood or injecting drugs).
If you are using reusable transducers, it is necessary to calibrate them with a mercury
manometer to determine the calibration factor. This calibration procedure is typically
the responsibility of your Biomed.
The calibration check procedure described in this section consists of adjusting the
monitor by entering the calibration factor given by your Biomed, if you are using
reusable transducers.
If you are using disposable transducers, use 100 as the calibration factor. Disposable
transducers are all pre-calibrated.
See the table on Zero and Calibration Check Troubleshooting (below) to help you
during the procedure.

STEPS: Zeroing and Entering a Cal. Factor

1. Click on the IBP1 parameter box.

2. Re-align the transducer to the patient’s heart level.

3. Close the transducer stopcock to the patient.

16-6 Gamma/Gamma XL VF6

 SELECTING AND PREPARING THE TRANSDUCER

4. Open the venting stopcock to air (atmosphere). The monitor displays a flat
waveform and a static IBP condition for the systolic (S) value.
5. Click on Zero.
6. Verify that the zero has been established. If zeroing failed, repeat steps 2 to 6.
If zeroing is successful, continue.
7. If applicable, select Cal. Factor and click the knob.
8. Dial in the calibration factor and click the knob.
9. If you are monitoring two invasive blood pressures, repeat these steps for the
second pressure parameter.

NOTE: The monitor displays an error message (IBP1 Cannot Zero or IBP2 Cannot
Zero) when zeroing fails. Call your Biomed or replace the transducer if zeroing fails
after two attempts. If the monitor rejects the calibration factor that you selected, change
the transducer or call your Biomed. The transducer needs to be calibrated.

Zero and Calibration Check Troubleshooting

Screen Message Possible Cause Suggested Action
IBP Cannot Zero, • The transducer offset is outside • Verify the pressure cable connection
IBP Zero Time-out the zero balance range of +/- to the monitor.
190 mmHg • Keep all tubing motionless.
• The signal is too noisy. • Check the stopcock and verify that the
• The waveform is non static system is open to air completely.
(more than 3 mmHg variation in • Repeat the zeroing procedure.
3 seconds).
• Replace the transducer if faulty.
• The monitor was unable to zero
the transducer within 10
seconds.
IBP Invalid Cal • The calibration factor is outside • Replace the transducer if calibration
the range of 80 to 120 fails after two attempts.
(inclusive). • Call your Biomed to calibrate the
transducer with a mercury manometer
if calibration fails repeatedly.
• Check the pressure cable for damage.
Note that instead of “IBP” the messages show the selected pressure label
(e.g., “ART Cannot Zero”).

VF6 Gamma/Gamma XL 16-7

16 INVASIVE BLOOD PRESSURE

Calibrating Reusable Transducers

You must calibrate reusable invasive blood pressure transducers with the mercury
manometer within five minutes after zeroing. Note: This procedure is for reusable
transducers only.

STEPS: Calibrating the IBP Transducer

1. Zero the pressure transducer via the IBP setup menu.
2. Click on the IBP1 parameter box.
3. Click on Mano. Cal.

4. Connect the pressure transducer to the mercury manometer.

5. Pump the manometer to a value recommended by your hospital protocol.
6. Dial in the calibration value to match the mean pressure value and click the
knob.
7. If you are monitoring two invasive blood pressures, repeat these steps for the
second pressure parameter.

NOTE: If invasive blood pressure alarms are on, the message IBP static appears.

16-8 Gamma/Gamma XL VF6

17 Temperature

Overview.......................................................................................................................17-2
Temperature Probes....................................................................................................17-2
Placing the Probe ..................................................................................................17-2
17 TEMPERATURE

Overview
The monitor supports the use of temperature probes for oral, rectal and axillary
applications. The monitor accepts one probe at a time and displays absolute
temperature values in degrees Celsius (oC) or in degrees Fahrenheit (oF).
NOTE:
z Selecting the unit of measure is a password-protected function. See your
Biomed for details.
z When the monitor uses the export protocol to communicate with an external
device, the temperature values in degrees Celsius (oC) are transmitted as whole
numbers without a decimal point on the external device. For example, a
temperature value of 37.6 degrees is transmitted as 376.

To calculate a temperature value, the monitor averages the temperature signal over
several seconds. The temperature label and measurement value appear above the first
waveform channel. There is no waveform display for temperature.
Set T alarms on the Alarm Limits table (see the chapter Alarms and Messages). If you
turn T alarms off, a crossed bell symbol appears next to the temperature value above
the first waveform channel.

Temperature Probes
A wide selection of reusable and disposable thermistor probes is available. Use only
Dräger-approved probes (see the appendix Options and Accessories); other probes are
not recommended and may produce inaccurate measurement results.

Placing the Probe

Rectal Probes
To place the probe, follow the clinical techniques of your hospital. We also suggest the
following:

1. Mark the insertion depth (2 to 4 inches) with a rubber ring or tape.

2. Insert the probe through the rectum into the colon and tape the cable in place.

NOTE: Cover reusable probes with a protective rubber cover.

17-2 Gamma/Gamma XL VF6

 TEMPERATURE PROBES

Axillary Probes
When esophageal or rectal probes cannot be used, a skin probe can give a good
estimate of body temperature. For placement of the axillary probe, proceed as follows:

1. Place the probe under the axilla.

2. Tape it in place.

WA R N I N G : To p r e v e n t b u r n s d u r in g e l e c t r o s u r g e r y, ta k e t h e
f o l l o w in g p re c a u t i o n s :
z Do not use surface probes.
z U s e o n l y s h e a t h e d r e c ta l p ro b e s .

WA R N I N G : Te m p e r a t u r e p r o b e p r o t e c t i v e c o v e r s c o n ta i n
l a t e x . D o n o t u s e o n p e r s o n s w i t h l a t e x h y p e r s e n s i t i v i t y.

VF6 Gamma/Gamma XL 17-3

17 TEMPERATURE

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17-4 Gamma/Gamma XL VF6

A Options and Accessories

This appendix lists Dräger-approved options and accessories for use with the Infinity
Gamma Series monitors. To place an order, please contact your local Dräger
representative.
Monitoring in the wireless network requires series access points and wireless LAN PC
cards. To order components for wireless network operation, contact your local Dräger
representative for information on approved manufacturers.
Options .......................................................................................................................... A-2
MultiMed/NeoMed Pods ............................................................................................... A-2
ECG ................................................................................................................................ A-3
Pulse Oximetry (SpO2)................................................................................................. A-5
End Tidal CO2 (etCO2) ................................................................................................. A-8
Scio Multigas Module ................................................................................................... A-9
Temperature ................................................................................................................ A-10
Invasive Blood Pressure (IBP)................................................................................... A-11
Non-invasive Blood Pressure (NBP)......................................................................... A-12
Power Sources............................................................................................................ A-12
Displays and Display Components........................................................................... A-14
Recorder ...................................................................................................................... A-14
Miscellaneous ............................................................................................................. A-15
A OPTIONS AND ACCESSORIES

Options

ST Segment Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 58 937

Invasive Blood Pressure Monitoring (IBP1/IBP2 for Gamma XL) . . . . . . . . . . MS 15 484

Second Invasive Blood Pressure Channel (IBP2 for Gamma) . . . . . . . . . . . 59 54 503

Neonatal OxyCardiorespirogram (OCRG) . . . . . . . . . . . . . . . . . . . . . . . . . 59 57 480

Full Arrhythmia Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 87 189

Fourth Display Channel (standard for Gamma XL) . . . . . . . . . . . . . . . . . . . . . 74 87 171

etCO2 Monitoring (standard for Gamma XL) . . . . . . . . . . . . . . . . . . . . . . . . . . 59 57 472

Scio Multigas Monitoring (only for Gamma XL) . . . . . . . . . . . . . . . . . . . . . . . MS 13 205

Wireless Network Capability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 87 197

Nellcor Sensor Compatibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 98 392

Masimo Sensor Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 98 400

MULTIMED/NEOMED Pods

MULTIMED 5® pod, long cable (2.5m) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 68 391

with large cable clip
for ECG 3- and 5-lead patient cable,
temperature and SpO2 measurements

MULTIMED 5® pod, short cable (1.5 m). . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 50 196

MULTIMED 6® pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 91 221

for ECG 3- 5-, and 6-lead patient cables
temperature and SpO2 measurements

NEOMED® pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 90 539

with mount for attachment to incubator
for ECG 3-lead Adapter Cable,
temperature and SpO2 measurements

3-Lead ECG Adapter Cable for NeoMed pod (1.5 m) . . . . . . . . . . . . . . . . 55 92 162

A-2 Gamma/Gamma XL VF6

 ECG

ECG

ESU Block

ECG ESU Block, 5-lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 47 226

Must be used for patients monitored in OR

ECG ESU Block, 6-lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 86 140

Must be used for patients monitored in OR

ECG Lead Sets

IEC Color Code 1 is the European color scheme
3-lead set = RA red, LL green, LA yellow.
5-lead set = RA red, LL green, LA yellow, RL black, V white.
6-lead set = RA red, LL green, LA yellow, RL black, V white, V+ gray & white.
IEC Color Code 2 is the AHA/US color scheme:
3-lead set = RA white, LL red, LA black.
5-lead set = RA white, LL red, LA black, RL green, V brown.
6-lead set = RA white, LL red, LA black, RL green, V brown, V+ gray and brown.

ECG 3-lead grabber-set, IEC1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 56 433

ECG 3-lead grabber-set, IEC2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 56 441

ECG 5-lead grabber-set, IEC1, 1m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 56 466

ECG 5-lead grabber-set, IEC2, 1m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 56 458

ECG 6-lead grabber-set, IEC1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 56 482

ECG 6-lead grabber-set, IEC2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 56 474

VF6 Gamma/Gamma XL A-3

A OPTIONS AND ACCESSORIES

Single-Wire ECG Lead Sets (MonoLead)

ECG MonoLead 3, IEC1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 555

ECG MonoLead 3, IEC2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 556

ECG MonoLead 5, IEC1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 559

ECG MonoLead 5, IEC2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 560

ECG MonoLead 6, IEC1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 682

ECG MonoLead 6, IEC2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 683

Adapters
The following adapters are required to use MonoLeads with MulitMed 5/6 pods:

Adapter MonoLead to MultiMed 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 679

Adapter MonoLead to MultiMed 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 680

MonoLead, Dual Pin Version

ECG MonoLead 3, Dual Pin, IEC1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 16 160

ECG MonoLead 3, Dual Pin, IEC2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 16 233

ECG MonoLead 5, Limb Lead Dual Pin IEC1. . . . . . . . . . . . . . . . . . . . . . . MS 16 161

ECG MonoLead 5, Limb Lead Dual Pin, IEC2 . . . . . . . . . . . . . . . . . . . . . . MS 16 229

ECG MonoLead 5, Chest Lead Dual Pin IEC1 MS 16 232

ECG MonoLead 5, Chest Lead Dual Pin, IEC2 MS 16 230

Miscellaneous ECG

ECG electrodes, Neonatal, disposable, 300 pcs. . . . . . . . . . . . . . . . . . . . . 51 95 024

ECG electrodes, disp., 50 pcs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 27 750

Adapter pin for neonatal electrodes, package of 5 . . . . . . . . . . . . . . . . . . . 51 94 779

for use with MultiMed 5

A-4 Gamma/Gamma XL VF6

 PULSE OXIMETRY (SPO2)

Pulse Oximetry (SpO2)

NOTE: Configuring the monitor for the use of Masimo or Nellcor sensors is a
password-protected locked option. For more information, contact your Biomedical
department.

Dräger

Reusable Sensors

Dräger Reusable SpO2 Sensor, adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 13 235

SpO2 adult sensor for finger application
Patient weight > 40 kg (88 lb.).
Note: Not for use with Micro2+.

Disposable Sensors

Dräger Disposable SpO2 Sensor, vinyl, adult MS 16 449

Dräger Disposable SpO2 Sensor, foam, adult MS 16 445

Dräger Disposable SpO2 Sensor, vinyl, pediatric MS 16 448

Dräger Disposable SpO2 Sensor, foam, pediatric MS 16 444

Masimo
Pod and Kit
Masimo SET SpO2 Pod Kit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 16 900
Includes pod, connection to monitor and mounting hardware.
Masimo SET SpO2 Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 16 356

Reusable Sensors
MASIMO LNOP-DCI, adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 70 312
SpO2 adult sensor for finger or toe application
Patient weight > 30 kg (66 lb.)
MASIMO LNOP-DCIP, pediatric . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 70 304
SpO2 pediatric sensor for finger or toe application
Patient weight 10-50 kg (22-110 lb.)
MASIMO LNOP-YI, adult/pediatric/neonatal . . . . . . . . . . . . . . . . . . . . . . . 74 97 014
SpO2 multisite sensor
finger or toe application - Patient weight > 10 kg (22 lb.)
great toe application - Patient weight 3-10 kg (6.6-22 lb.)
across foot or palm and back of hand - Patient wt < 3 kg (6.6 lb.)

VF6 Gamma/Gamma XL A-5

A OPTIONS AND ACCESSORIES

Disposable Sensors (Adhesive Single-Patient Use)

MASIMO LNOPADT, adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 96 990
SpO2 adult sensor for finger or toe application
Patient weight > 30 kg (66 lb.)
MASIMO LNOPPED, pediatric. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 96 982
SpO2 pediatric sensor for finger or toe application
Patient weight 10-50 kg (22-110 lb.)
MASIMO LNOPNEO, neonatal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 96 974
SpO2 neonatal sensor for finger or toe application
Patient weight < 10 kg (22 lb.)
MASIMO LNOPNEO SS, neonatal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 96 966
SpO2 neonatal sensor for sensitive skin application
Patient weight < 10 kg (22 lb.)

Cables and Accessories

Masimo Pod-LNCS Sensor Cable, 3m . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 17 522
Connects Masimo LNCS Sensor to Masimo SET SpO2 Pod.
Masimo Pod-LNOP Sensor Cable, 3m . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 17 041
Connects Masimo LNOP Sensor to Masimo SET SpO2 Pod.
SpO2 Masimo ProCal+ Cable, 2m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 92 601
SpO2 Masimo ProCal+ Cable, 1.5m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 13 926
Masimo SET SpO2 Pod Mount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 17 085
Monitor Sideplate with USB Connector (standard for Gamma XL) . . . . . . MS 17 428

A-6 Gamma/Gamma XL VF6

 PULSE OXIMETRY (SPO2)

Nellcor

Reusable Sensors

Nellcor Durasensor DS-100A, SpO2 Sensor, adult . . . . . . . . . . . . . . . . . . 72 62 764

SpO2 adult sensor for finger application
Patient weight > 40 kg (88 lb.)
Note: Not for use with Micro2+.

Disposable Sensors (Adhesive Single-Patient Use)

Nellcor OxiMAX MAX-A, adult, 24 pcs . . . . . . . . . . . . . . . . . . . . . . . . . . . . MX50065

SpO2 adult sensor for finger or toe application
Patient weight > 30 kg (66 lb.)

Nellcor OxiMAX MAX-AL, adult, 24 pcs . . . . . . . . . . . . . . . . . . . . . . . . . . . MX50071

SpO2 adult sensor for finger or toe application
Patient weight > 30 kg (66 lb.)

Nellcor OxiMAX MAX-I, infant, 24 pcs . . . . . . . . . . . . . . . . . . . . . . . . . . . . MX50067

SpO2 infant sensor for finger or toe application
Patient weight 3-20 kg (6.7-44 lb.)

Nellcor OxiMAX MAX-N, neonatal/adult, 24 pcs . . . . . . . . . . . . . . . . . . . . MX50068

SpO2 neonatal sensor for foot application
Patient weight < 3 kg or >40 kg (<6.7 lb. or >88 lb.)

Nellcor OxiMAX MAX-P, pediatric, 24 pcs . . . . . . . . . . . . . . . . . . . . . . . . . MX50066

SpO2 pediatric sensor for finger or toe application
Patient weight 10-50 kg (22-110 lb.)

Cables

SpO2 blue latched Nellcor extension cable, shielded, 1 m. . . . . . . . . . . . . 33 68 433

SpO2 blue latched Nellcor extension cable, shielded, 2 m. . . . . . . . . . . . . 33 75 834

VF6 Gamma/Gamma XL A-7

A OPTIONS AND ACCESSORIES

End Tidal CO2 (etCO2)

etCO2 pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 40 738

Pod connection cable, 3 m; universal pole mount

Mainstream Accessories

etCO2 Capnostat III sensor, 2.4 m cable . . . . . . . . . . . . . . . . . . . . . . . . . . 43 22 975

etCO2 airway adapter, adult
Calibration and Reference Cell
Cable clip, 5 each

etCO2 Airway Adapter, adult. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 21 796

etCO2 Airway Adapter, neonatal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 21 788

Sidestream Accessories

etCO2 S-Cannula, adult, 10 pcs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 14 395

etCO2 S-Cannula, pediatric, 10 pcs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 14 387

etCO2 Airway Adapter, sidestream, 10pcs . . . . . . . . . . . . . . . . . . . . . . . . . 47 14 437

etCO2 Nafion Tubing, 10pcs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 14 429

A-8 Gamma/Gamma XL VF6

 SCIO MULTIGAS MODULE

Scio Multigas Module

Scio Four Oxi plus Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 71 801

Scio Four plus Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 71 802

Scio Four Oxi Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 71 803

Scio Four Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 71 804

Scio Water Trap (set of 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 70 567

Scio Sampling Line (set of 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 90 286

Sample Gas Return Kit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M 32 692

Cables and Accessories

Scio Connecting Cable, 0,3 m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 13 503

Cable to connect the Scio Four module to the monitor’s interface plate
or the Infinity Docking Station

Scio Connecting Cable, 1,5 m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 13 864

Cable to connect the Scio Four module to the monitor’s interface plate
or the Infinity Docking Station

Scio Adapter Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 13 506

9 to 15 pin adapter cable to connect the Scio module 6871255 via
cable MS13503 or MS13864 to the X5 connector on the monitor or the
Infinity Docking Station, or via USB adapter MS15849 to the USB con-
nector on the monitor

USB Adapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 15 849

USB serial adapter to connect the Scio module to the Gamma XL USB
connector

Scio Serial Extension Cable, 1.8m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 23 211

Serial extension cable to connect the Scio Four module to the USB
adapter

VF6 Gamma/Gamma XL A-9

A OPTIONS AND ACCESSORIES

Temperature
Adapter Cable

Temp adapter cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 98 333

WA R N I N G : Te m p e r a t u r e p r o b e p r o t e c t iv e c o v e r s c o n ta i n
l a t e x . D o n o t u s e o n p e r s o n s w i t h l a t e x h y p e r s e n s i t i v i t y.

Core Probes

Temp probe, adult, 1.5m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 29 889

Temp probe, adult, 3m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 04 644

Temp probe, pediatric, 1.5m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 29 848

Temp probe, pediatric, 3m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 04 651

Temp protective covers, 10 pcs (latex) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 14 616

Skin Probes

Temp skin probe, adult 1.5m. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 29 822

Temp skin probe, adult 3m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 04 669

A-10 Gamma/Gamma XL VF6

 INVASIVE BLOOD PRESSURE (IBP)

Invasive Blood Pressure (IBP)

IBP Transducer SensoNor 844, reusable . . . . . . . . . . . . . . . . . . . . . . . . . 74 89 417

IBP Dome for SensoNor 844, 50 pcs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 64 908

IBP Transducer, OHMEDA, disposable, 5 pcs. . . . . . . . . . . . . . . . . . . . . . 45 28 741

IBP Intermediate Cable, OHMEDA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 75 933

3.7m pressure intermediate cable to connect reusable/disposable
OHMEDA transducers to monitor

IBP Intermediate Cable, SensoNor, 3.7m . . . . . . . . . . . . . . . . . . . . . . . . . 43 21 563

IBP Intermediate Y-Cable, Edwards, 3.7m . . . . . . . . . . . . . . . . . . . . . . . . 52 06 607

IBP Intermediate Y-Cable, OHMEDA, 3.7m . . . . . . . . . . . . . . . . . . . . . . . . 52 06 581

IBP Intermediate Y-Cable, Abbott/Medex, 3.7m. . . . . . . . . . . . . . . . . . . . . 52 06 573

IBP Intermediate Y-Cable, SensoNor, 3.7m . . . . . . . . . . . . . . . . . . . . . . . . 51 95 180

IBP Disposable Set for SensoNor 844, 10 pcs. . . . . . . . . . . . . . . . . . . . . . 74 89 433

IBP-Adapter 10-pin to 7-pin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 68 383

connects pressure transducer cables with 10-pin orange connectors to
monitor’s 7-pin shielded input connector

IBP Y-Adapter, 10 pin to 7 pin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 88 095

VF6 Gamma/Gamma XL A-11

A OPTIONS AND ACCESSORIES

Non-invasive Blood Pressure (NBP)

NBP Connecting Hoses

NBP connection hose, Adult/Pediatric, 3.7m . . . . . . . . . . . . . . . . . . . . . . . 12 75 275

NBP connection hose, neonatal, 2.4m . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 70 298

Reusable Cuffs (Adult and Child - Latex-free)

NBP cuff, child 12-19 cm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 430

NBP cuff, small adult, 17-25 cm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 427

NBP cuff, adult, 23-33 cm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 428

NBP cuff, large adult, 31-40 cm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 425

NBP cuff, adult thigh, 38-50 cm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 426

Disposable Cuffs (Single-Patient Use) Packages of 10 pcs.

NBP cuff, neonatal #1,3.1-5.7 cm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 70 181

NBP cuff, neonatal #2, 4.3-8.0 cm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 70 199

NBP cuff, neonatal #3, 5.8-10.9 cm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 70 207

NBP cuff, neonatal #4, 7.1-13.1 cm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 70 215

NBP cuff, neonatal #5, 8.3-15.0 cm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 70 173

Power Sources
AC Power Adapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 18 508

Gamma Series Battery Charger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 10 211

Gamma Series Replacement Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 47 697

Gamma Series Lithium Ion Battery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 32 354

A-12 Gamma/Gamma XL VF6

 POWER SOURCES

Power Cords

Power Cord Cont. Europe, CEE7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 21 712

Power Cord North America, 5-15R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 21 720

Power Cord Australia, New Zealand, AS 3112. . . . . . . . . . . . . . . . . . . . . . 18 51 705

Power Cord Great Britain, BS 1363 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 51 713

Power Cord, China, GB 1002) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 59 714

Power Cord Switzerland, SEV 1011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 21 613

Power Cord Denmark 18 51 721

Options
Interface Plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 76 493

Infinity DOCKING STATION (IDS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 06 110

Infinity DOCKING STATION (IDS), INTERFACE AND POWER . . . . . . . . . . . . . . . 57 32 388

Infinity DOCKING STATION (IDS), POWER . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 65 130

Infinity DOCKING STATION Power Supply with Auto-Selectable 120V/220V MS 18 284

Includes 2.5 m DC cable. Can be used as a direct replacement for the
Dräger IDS Power Supplies 55 84 912 and 59 49 271.
Note: Refer to the Installation instructions for proper use of the switch feature.

DC Cable 6m for IDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 91 313

6.0 m DC power cable for remote installation or repair/replacement with
59 55 393.

Mounting DOCKING STATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 15 319

mount only, no connections for standalone applications

VF6 Gamma/Gamma XL A-13

A OPTIONS AND ACCESSORIES

Displays and Display Components

Displays
Infinity Remote Display, 15”. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 16 472
Includes VGA cable, desk stand, US and European power cable
Infinity Remote Display, 17”. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 16 471
Includes VGA cable, desk stand, US and European power cable
Infinity Remote Display, 19”. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 16 470
Includes VGA cable, desk stand, US and European power cable
Mount Kit TFT-LCD Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MS 14 583
Compatible with GCX or Wesbrook wall mounting system.

Display Cables
Adapter Cable, 3 m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 26 084
Cable to connect the remote display to a Communication Power Supply
(CPS), Infinity Docking Station (IDS) or interface plate
Adapter Cable, 25 m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 94 910
Cable to connect the remote display to a Communication Power Supply
(CPS), Infinity Docking Station (IDS) or interface plate
Adapter cable, 23 m (required) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 36 173
Cable to connect the remote display to a Communication Power Supply
(CPS), Infinity Docking Station (IDS) or interface plate
Wall Mount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 20 152
Mount for remote display; with 33 cm (13-inch) extension arm. Adjust-
able height on a 48 cm (19-inch) vertical track.

Recorder

R50 Universal Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 52 630

R50 Network Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 40 068

R50 Monitor Cable, 0.6 m. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 12 993

Recorder/Alarm Output Y-cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 13 578

R50 Monitor Mount Bracket . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 20 145

R50 Recorder Paper, box of 10 rolls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 11 201

A-14 Gamma/Gamma XL VF6

 MISCELLANEOUS

Miscellaneous

Data Memory PC Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 18 248

Alarm Output Cable, IDS/CPS, 5 m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 94 928

Alarm Output Cable with Relay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 14 626

Infinity QRS Synchronization Output Cable, 3 m . . . . . . . . . . . . . . . . . . . . 43 14 667

RS232 Diagnostic UART cable, 3 m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 14 346

Export Protocol Cable, CPS/IDS, 3 m . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 06 441

VF6 Gamma/Gamma XL A-15

A OPTIONS AND ACCESSORIES

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A-16 Gamma/Gamma XL VF6

B Cleaning and Disinfecting

Cleaning and Disinfecting............................................................................................ B-2

Monitor .................................................................................................................... B-2
Patient Cables ........................................................................................................ B-2
Reusable ECG Electrodes ..................................................................................... B-2
Reusable SpO2 Sensor.......................................................................................... B-3
NBP Cuff ................................................................................................................. B-3
Temperature probes and cables ........................................................................... B-3
Reusable Pressure Transducers and Cables ...................................................... B-4
Masimo SET SpO2 Pod ................................................................................................ B-4
etCO2 Pod and Accessories........................................................................................ B-5
Capnostat Sensor .................................................................................................. B-5
ReusableAirway Adapters ..................................................................................... B-5
Nasal Sampling Cannulas and Tubing ................................................................. B-5
Sidestream Sampling Pump.................................................................................. B-5
Scio Module and Accessories ..................................................................................... B-8
Emptying the Water Trap....................................................................................... B-8
Cleaning/Replacing the Fan Filter ........................................................................ B-9
B CLEANING AND DISINFECTING

Cleaning and Disinfecting

Clean the monitor and all accessories after each patient or daily according to your
hospital’s standard procedures. We recommend the following cleaning solutions and
procedures.
CAUTION: Do not use disinfectants that contain phenol as they can spot plastics. Do
not autoclave or clean accessories with strong aromatic, chlorinated, ketone, ether, or
ester solvents. Never immerse electrical connectors.

Monitor
z Clean the monitor with a gauze moistened in a soap solution.
z Dry thoroughly with a lint-free cloth.
CAUTION: The material used for the monitor’s enclosure is a highly resistant
thermoplastic. Do not use plastic solvents, sharp tools or abrasives to clean it.

z Disinfect the monitor with a gauze moistened with diluted alcohol.

CAUTION: Do not steam autoclave, gas sterilize, or immerse the monitor in water or
cleaning solutions. Do not subject the monitor to intense vacuum.

z Dry thoroughly with a lint-free cloth.

Patient Cables
z Clean the patient cables with a gauze pad moistened with a soap solution.
z Dry thoroughly with a lint-free cloth.
z To disinfect patient cables, wipe the cables with a gauze moistened with
diluted alcohol.
z Dry thoroughly with a lint-free cloth.

Reusable ECG Electrodes

z Clean grabber-wire clips regularly with a toothbrush.
z Remove any gel residue from the electrode by brushing it off under running
water.
z Clean the electrodes with a gauze moistened with a soap solution.
z Dry thoroughly with a lint-free cloth.
z Disinfect the electrodes with a gauze moistened with diluted alcohol.
z Dry thoroughly with a lint-free cloth.

B-2 Gamma/Gamma XL VF6

 CLEANING AND DISINFECTING

Reusable SpO2 Sensor

See the cleaning instructions and recommendations provided with the sensor.

NBP Cuff
Wipe the NBP cuff with a cloth moistened with soap and water or a solution based on
household bleach (1:10), alcohol, or phenol.
CAUTION: The NBP cuff can be immersed in cleaning solution, but do not allow the
solution to enter the NBP hose. Warranty claims can be forfeited if cleaning solution is
allowed to enter the hose or the cuff.

Temperature probes and cables

z Do not use excessive pressure or flex the cables as this can stretch the
covering and break the internal wires.
z Clean the probes with a 3% hydrogen peroxide or 70% alcohol.
z Quickly immerse the cables in a detergent solution.
z Make sure the probe’s tip is firmly connected.
CAUTION:
z Do not use phenol disinfectants because vinyl absorbs them. Do not use strong
aromatic, chlorinated, ketone, ether or ester solvents. Do not immerse the
cables for any prolonged period in alcohol, mild organic solvents, or highly
alkaline solutions.
z Never boil or autoclave the cable. Vinyl withstands temperatures up to 100 °C
but begins to soften at around 90 °C. Handle gently when hot and wipe away
from the tip toward the cable.

VF6 Gamma/Gamma XL B-3

B CLEANING AND DISINFECTING

Reusable Pressure Transducers and Cables

CAUTION: Observe the following precautions when cleaning all pressure accessories.
z Avoid applying excessive pressure to a transducer diaphragm.
z Use disposable pressure accessories only once and then discard them.
z Do not subject transducers to water, steam, hot air sterilization, ether,
chloroform, or similar chemicals.
z Always protect the connector from moisture.
z Inspect the cable. Replace it if cracked.
z Store transducer cables loosely coiled at temperatures below 50°C.

STEPS: Cleaning Transducer and Diaphragm

1. Remove and clean the plastic dome with soap or a detergent solution using a
pipe cleaner or brush. Rinse it thoroughly.
2. Clean blood and foreign material from external surface of the transducer and
cable.
3. Dip the diaphragm in a blood solvent such as hydrogen peroxide. If you soak
the transducer, cover the diaphragm with the dome.
4. See also the instructions and recommendations provided with the transducer.

Masimo SET SpO2 Pod

1. Disconnect the pod from the monitor.
2. Clean the pod with a gauze moistened in enzymatic detergent or a solution of
green tinctured soap and water.
3. Dry thoroughly with a lint-free cloth.

CAUTION:
z Do not use organic solvents.
z Do not sterilize with steam, heat, radiation or ethylene oxide (ETO).
z Do not use sharp objects.
z Make sure that no liquid enters the pod.

B-4 Gamma/Gamma XL VF6

 ETCO2 POD AND ACCESSORIES

etCO2 Pod and Accessories

There are several accessories used with the etCO2 pod, each with its own cleaning
requirements.

Capnostat Sensor
Clean the sensor surfaces, including the sensor windows, with a damp cloth. Dry with
a clean, lint-free cloth, making sure the sensor windows are clean and dry. Never
immerse the sensor or attempt to sterilize it.

ReusableAirway Adapters
Rinse airway adapters in a warm soapy solution, then soak them in a liquid
disinfectant.
Dry with lint-free cloth. Make sure adapter windows are dry and free of any residue.

Nasal Sampling Cannulas and Tubing

Cannulas and tubing are for single-patient use only. Dispose of used cannulas and
tubing following your institution’s policy.

Sidestream Sampling Pump

The etCO2 pod contains a small pump that draws air from the nasal cannula, through
the sidestream airway adapter, and out the exhaust port on the etCO2 pod. The internal
parts of this pump are subject to contamination by exhaled secretions and must be
regularly cleaned by flushing a cleaning solution through the pump in the etCO2 pod.

Preparatory Steps
The following fluids are acceptable for cleaning:
z Isopropyl alcohol.
z A 5.25% water solution (by weight) of sodium hypochlorite (bleach).
z A locally approved sterilant.
In addition, you need the following items:
z A 60 cc catheter-tip syringe.
z A 2-foot section of 1/8- or 3/16-inch tubing to drain off fluid after it passes
through the etCO2 pump.
z A receptacle to receive the fluid after it drains from the etCO2 pod.

VF6 Gamma/Gamma XL B-5

B CLEANING AND DISINFECTING

CAUTION: Always use a syringe to flush cleaning solutions through the pump as
described in the instructions below. Do not attempt to use the sidestream sampling pump
itself to move cleaning solutions through the system. This may cause accelerated wear
on the pump bearings.

Setting up the Monitor and etCO2 Pod

To set up the monitor and the etCO2 pod:

1. Set etCO2 measurement mode to Side (for Sidestream monitoring).

2. Remove the etCO2 cartridge from the monitor.
3. Remove all sidestream sampling tubing from the pod connectors.
4. Attach the section of 1/8- or 3/16-inch tubing to the pod’s exhaust port, and
run it to a drainage receptacle placed below the pod.

Cleaning Procedure
To clean the sidestream pump:

1. Fill the 60cc catheter-tip syringe with cleaning fluid and fix it to the
sidestream input connector on the etCO2 pod.
2. Flush the fluid slowly through the pumping system and out through the tubing
connected to the exhaust port. Repeat two more times for a total of 180cc of
fluid.
3. Remove the syringe. Leave remaining fluid in the pumping system for 30
minutes. This disinfects the system.
4. After 30 minutes, fill the syringe with distilled water and flush through the
system. Repeat two more times.
5. Empty the syringe and use it to push several volumes of air slowly through the
system. This clears most of the solution from the pump.
6. Remove the syringe from the pod, but keep the drain tubing in place.

B-6 Gamma/Gamma XL VF6

 ETCO2 POD AND ACCESSORIES

Drying the Sidestream Pump Subsystem

After you have removed most of the fluid, it is important to dry the pump subsystem
completely.
To dry the sidestream pump subsystem:

1. Re-attach the etCO2 pod to the monitor. The sidestream sampling pump starts
running, and there is suction at the input port on the face of the pod.
NOTE: If the sidestream pump fails to start, make sure the capnostat sensor is
disconnected. The pump is designed to shut down while a connected sensor is warming
up.

2. With the input sidestream port still open and the drain tubing still connected,
let the pump run for several minutes to remove any water still trapped in the
system.
3. Block the sidestream input port with your finger for several seconds and then
unblock it. Repeat at least ten times.
4. Move your finger to the sidestream output port and block the port with your
finger for several seconds and then unblock it. Repeat at least ten times.
5. Remove the drain tubing, and allow the sidestream pump to continue running
for at least 30 minutes.

VF6 Gamma/Gamma XL B-7

B CLEANING AND DISINFECTING

Scio Module and Accessories

WA R N I N G :
z O c c u pa t i o n a l s a f e t y h a z a r d : U s e d s a m p l i n g t u b i n g , T-
c o n n e c t o r s , a n d w a t e r t r a ps c o u l d b e c o n ta m i n a t e d a n d
m u s t b e h a n dl e d a n d d i s po s e d o f w i t h c a r e . I n f e c t i o n
h a z a r d m a y b e p re s e n t . D i s p o s e o f t h e s e i t e m s i n
accordance with local regulations.
z Because of the danger of electric shock, never remove
the cover of any device while it is in operation or
c o n n e c t e d t o a p ow e r o u t l e t .

Emptying the Water Trap

The water trap should be emptied if the contents has reached the ‘full’ mark. To empty
the water trap:

1. Disconnect the sampling tubing.

2. Remove the trap from its receptacle by holding it firmly on
the ridged surfaces and pulling it out from the Scio module.
3. Connect an empty syringe (size > 20 ml without a needle) to
the port on the back of the water trap.

4. Pull water trap contents into the syringe.

5. Remove syringe and discard.
NOTE: Do not clean the water trap. If the water trap seems dirty or if it has been in
use for 4 weeks, replace it.

B-8 Gamma/Gamma XL VF6

 SCIO MODULE AND ACCESSORIES

Cleaning/Replacing the Fan Filter

The fan filter should be cleaned once per month and replaced at least once a year.

STEPS: Cleaning/Replacing the Fan Filter

1. Grasp the fan filter and remove it from its holding slots on the back of the
module.

Fan Filter

2. Vacuum up any accumulation of dust at the fan port and inside the filter (if
reusing the filter).
3. Reinsert the cleaned fan filter or a new filter.

VF6 Gamma/Gamma XL B-9

B CLEANING AND DISINFECTING

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B-10 Gamma/Gamma XL VF6

C Default Settings and Biomedical Support

Default Settings ............................................................................................................ C-2

Biomedical Support.................................................................................................... C-11
Startup Tests ........................................................................................................ C-11
Checking the NBP Calibration ............................................................................ C-12
Biomed Menu........................................................................................................ C-13
Saving a Patient Setup ........................................................................................ C-14
Locked Options and Demo Mode ....................................................................... C-14
Diagnostic Logs ................................................................................................... C-15
Changing Units of Measure................................................................................. C-16
Turning External Alarm Lights ON/OFF ............................................................. C-17
Parameter Colors ................................................................................................. C-18
NBP/SpO2 Interlock ............................................................................................. C-19
ASY/VF Alarms ..................................................................................................... C-19
Pacer Mode ........................................................................................................... C-20
C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Default Settings
The first section of this appendix list the default settings for the monitor. These
settings are programmed into the monitor as you receive it from the factory, and are
used by the monitor until the user changes them. The first three columns in the
following table show these settings for adult, pediatric, and neonatal monitoring
modes.
After discharging a patient to admit a new patient, most settings, called patient
settings, are remembered by the monitor while others return to their factory defaults.
If the user chooses to save the current patient setup, many factory settings are changed
to patient settings, and will be active for the next patient of that category. Whether or
not a setting returns to its factory default between patients or can be saved as a
monitoring configuration is noted in the following table.
NOTE:
z Alarm Limits, Alarm On/Off, and Record On/Off settings are considered
Patient Settings for all parameters except where noted.
z Some settings are for optional features and are only available on units with
these options installed or enabled.

C-2 Gamma/Gamma XL VF6

 DEFAULT SETTINGS

Adult Pediatric Neonatal After patient discharge,

Settings Settings Settings settings return to...?

ECG

Alarm On On On Saved Setup

Alarm Limits 120/45 150/50 180/80 Saved Setup

(upper/lower)

Alarm Recording Off Off Off Saved Setup

Tone Source ECG ECG ECG Previous Patient

Tone Volume Off Off Off Previous Patient

Pacer Detect Off Off N/A Saved Setup

QRS Marks Off Off Off Factory

ECG Processing ECG 1&2 ECG 1&2 ECG 1 Previous Patient

ECG Leads 5-Lead 5-Lead 3-Lead Previous Patient

Arrhythmia*

ASY, VF Alarms Always On Always On n/a Previous Patient

VT, RUN, AIVR, On On n/a Saved Setup

SVT, CPT, BGM
Alarm

BRDY, TACH, Off Off n/a

PAUS, ARTF Alarm

ASY and VF Alarm Record Record n/a Saved Setup

Recording

Other Events Off Off n/a

Arrhythmia Basic Basic n/a Saved Setup

Monitoring

*Not applicable for neonatal monitoring.

VF6 Gamma/Gamma XL C-3

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Adult Pediatric Neonatal After patient discharge,

Settings Settings Settings settings return to...?

ST Segment Analysis*

ST Measurement Beat offset Beat offset n/a Factory

Point +80ms +80ms

ST Isoelectric Point Beat onset Beat onset n/a Factory

-28ms -28ms

ST Alarm Off Off n/a Saved Setup

Alarm Limits +1.0mm/ +1.0mm/ n/a Saved Setup

(upper/lower) -1.0mm -1.0mm

Alarm Recording Off Off n/a Saved Setup

*For Adult and Pediatric monitoring only. All values shown apply to both ST<lead1> and
ST<lead2>.

Respiration

Alarm Off Off On Saved Setup

Alarm Limits 30/5 80/20 80/20 Saved Setup

(upper/lower)

Alarm Recording Off Off Off Saved Setup

Rsp Mode Auto Auto Auto Saved Setup

Rsp Marker Off Off On Saved Setup

Apnea Time Off Off 15 seconds Saved Setup

Coincidence Alarm Off Off On Saved Setup

etCO2

Alarm Off Off Off Saved Setup

Alarm Limits 50/30 50/30 50/30 Saved Setup

(upper/lower)

Alarm Recording Off Off Off Saved Setup

Insp. Agent 0 0 0 Previous Patient

Exp. Agent 0 0 0 Previous Patient

Balance Air Air Air Previous Patient

Averaging 20s 20s 20s Previous Patient

C-4 Gamma/Gamma XL VF6

 DEFAULT SETTINGS

Adult Pediatric Neonatal After patient discharge,

Settings Settings Settings settings return to...?

Meas. Mode Main Main Main Saved Setup

RRc Apnea Off 15 seconds 15 seconds Saved Setup

Atm. Press. Mode Auto Auto Auto Saved Setup

iCO2 Alarm Off Off Off Saved Setup

iCO2 Alarm Limits 4/0 4/0 4/0 Saved Setup

(upper/lower)

RRc Alarm Off Off On Saved Setup

RRc Alarm Limits 30/5 60/20 60/20 Saved Setup

(upper/lower)

* Displayed only if etCO2, ST and IBP2 locked options are enabled.

VF6 Gamma/Gamma XL C-5

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Adult Pediatric Neonatal After patient discharge,

Settings Settings Settings settings return to...?

Multigas

Alarm Off Off n/a Saved Setup

Alarm Recording Off Off n/a Saved Setup

Alarm Limits iO2: iO2: n/a Saved Setup

in vol% 18/100 18/100
(upper/lower) etO2: etO2:
10/100 10/100
i/etHal, i/etHal,
i/etISO, i/etISO,
i/etENF: i/etENF:
0/6 0/6
i/etSEV: i/etSEV:
0/9 0/9
i/etDES: i/etDES:
0/20 0/20

Agent Detection* Auto Auto n/a Factory Default

(or Agent?) (or Agent?)

Autozero Delay 5 min 5 min n/a n/a

*For Scio modules without automatic agent detection, the selection is None until the user selects
an agent.

SpO2

Alarm Off Off Off Saved Setup

Alarm Limits 100/90% 100/90% 95/85% Saved Setup

(upper/lower)

Alarm Recording Off Off Off Saved Setup

Tone Source ECG ECG ECG Previous Patient

Tone Volume Off Off Off Previous Patient

Bar Graph Off Off Off Previous Patient

Averaging Normal Normal Normal Previous Patient

PLS Alarm Limits 120/45 150/50 170/80 Saved Setup

(upper/lower)

Temperature

Alarm Off Off Off Saved Setup

C-6 Gamma/Gamma XL VF6

 DEFAULT SETTINGS

Adult Pediatric Neonatal After patient discharge,

Settings Settings Settings settings return to...?

Alarm Limits 39/34 °C 39/34 °C 39/34 °C Saved Setup

(upper/lower) 102.0/93.2 102.0/93.2 102.0/93.2
°F °F °F

Alarm Recording Off Off Off Saved Setup

Units °C °C °C Previous Patient

NBP

Alarm Off Off Off Saved Setup

Alarm Limits Saved Setup

(upper/lower) • 160/90 • 160/90 • 80/50
• Systolic • 125/60 • 125/60 • 70/40
• Mean • 110/50 • 110/50 • 60/25
• Diastolic

Alarm Recording Off Off Off Saved Setup

Interval Mode Off Off Off Saved Setup

Calibration Mode Off Off Off Previous Patient

Inflation Mode Adult:270 Ped.: 180 Neo.: 140 Previous Patient

Measurement Tone Off Off Off Saved Setup

IBP1, IBP2

Alarm Off Off Off Saved Setup

Alarm Limits Saved Setup

(upper/lower)
• Systolic • 160/90 • 160/90 • 120/50
• Mean • 125/60 • 125/60 • 85/40
• Diastolic • 110/50 • 110/50 • 80/35

Alarm Recording Off Off Off Saved Setup

Cal. Factor 100 100 100 Previous Patient

Manometer Cal. 100 100 100 Previous Patient

VF6 Gamma/Gamma XL C-7

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Adult Pediatric Neonatal After patient discharge,

Settings Settings Settings settings return to...?

Channel 1

Waveform ECG II ECG II ECG II Saved Setup

Size ECG: 1mV/ ECG: 1mV/ ECG: 1mV/ Saved Setup

cm cm cm
SpO2: 50% SpO2: 50% SpO2: 50%

Channel 2

Waveform Rsp Rsp Rsp Saved Setup

Size ECG: 1mV ECG: 1mV ECG: 1mV Saved Setup

SpO2: 50% SpO2: 50% SpO2: 50%
Rsp: 50% Rsp: 50% Rsp: 50%
IBP1, IBP2: IBP1, IBP2: IBP1, IBP2:
0-200 0-200 0-100
mmHg mmHg mmHg
etCO2*: 40 etCO2: 40 etCO2: 40

* If all the options are enabled, the etCO2 waveform replaces the Rsp waveform (if etCO2 is
connected).

Channel 3

Waveform SpO2 SpO2 SpO2 Saved Setup

Size SpO2: 50% SpO2: 50% SpO2: 50% Saved Setup

Rsp: 50% Rsp: 50% Rsp: 50%
IBP1, IBP2: IBP1, IBP2: IBP1, IBP2:
0-200 0-200 0-100
mmHg mmHg mmHg

C-8 Gamma/Gamma XL VF6

 DEFAULT SETTINGS

Adult Pediatric Neonatal After patient discharge,

Settings Settings Settings settings return to...?

Channel 4*

Display Parameter Parameter Parameter Saved Setup

Boxes Boxes Boxes

OR Mode Display* Parameter Parameter n/a n/a

Boxes Boxes

etCO2 waveform 5 5 5 Saved Setup

size

* A 4th display channel is standard for monitors Gamma XL, optional for monitors Gamma.
The OR mode is not available for monitors Gamma.

Main Menu

Patient Category Adult Pediatric Neonate Previous Patient

Bottom Channel All All All Saved Setup

OR Mode Off Off n/a Previous Patient

(option)

Show Rsp/etCO2 etCO2 etCO2 etCO2 Previous Patient

Date & Time current current current Previous Patient

Speaker Volume 100% 100% 100% Previous Patient

Trend Setup HR, SpO2, HR, SpO2, HR, SpO2, Saved Setup
NBP NBP NBP

Biomed (password-protected settings)

Units Previous Patient

•T • °C • °C • °C
• etCO2 • mmHg • mmHg • mmHg
• etCO2 in OR • vol % • vol % • n/a
mode*
• Pressures • mmHg • mmHg • mmHg
• ST* • mm • mm • mm

Alarm Light ON ON ON Previous

Patient

VF6 Gamma/Gamma XL C-9

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Adult Pediatric Neonatal After patient discharge,

Settings Settings Settings settings return to...?

Parameter Colors Parameterspecific for all patient categories: Previous

ECG, ST, ARR: green Patient
Resp: blue
ART, GP1, GP2: red
PA, etCO2: yellow
CVP, ICP: light blue
T, SpO2, NBP: white

NBP/SpO2 ON ON ON Previous
Interlock Patient

ASY/VF Alarms Follow HR Follow HR Follow HR Previous Patient

Pacer Mode Basic Basic Basic Previous Patient

*The OR mode is available as an option for monitors Gamma XL in adult and pediatric monitoring
modes.
*ST segment analysis is available as an option for monitors Gamma and Gamma XL in the adult
and pediatric monitoring modes.

Service: Monitor Setup (password-protected settings)

Language English English English Previous Patient

X5 Export Export Export Previous Patient

USB None None None Previous Patient

Data Collection Off Off Off Previous Patient

Line Frequency 60 Hz 60 Hz 60 Hz Previous Patient

C-10 Gamma/Gamma XL VF6

 BIOMEDICAL SUPPORT

Biomedical Support
This section of the appendix is designed for the Biomedical personnel of your
hospital. It includes an overview of the Biomed menu, basic setup, saving setups,
diagnostic functions, and calibration check procedures for NBP. This appendix is not a
substitute for the Infinity Gamma Series Service Manual that is available from Dräger.
CAUTION: Verify that the monitor’s line frequency under the “Service” menu is set to
match the 50 or 60 Hz mains power line frequency of your hospital. The line frequency
determines the center frequency of the ECG notch filter. The filter greatly reduces line
frequency noise on the ECG waveform. Refer to the Service manual for details how to
change frequency.

Startup Tests
The monitor runs internal tests continuously and upon power up to check various
functions, as well as the integrity of both ROM and RAM memories. If any of the tests
fail, the monitor resets and displays a message (see the following table). The test
results are recorded in the Diagnostic Log.
If the same error is detected three times in succession within 10 minutes without any
other intervening errors, the monitor stops resetting and generates a loud, continuous
error tone. If this happens, take the unit out of operation and call DrägerService.
NOTE: The monitor stores patient data and settings in an internal battery backed-up
memory. If any of the following messages appear frequently, the internal battery needs
to be changed.

Message Test

Default Patient Settings Restored Integrity of patient data settings.

Software Reset, See Diagnostic The software has previously detected and logged a fault
Log condition. See the Diagnostic log for the exact cause of the
reset.
Replace Battery Pack Battery <25%.
Check Internal Battery Assure integrity of patient data and/or settings.
Calendar Clock Reset Invalid clock setting at startup.
Low Battery Reset Voltage < 10V.
High Temperature Reset Internal temperature > 64°C.
NBP Fault Integrity of the NBP pneumatic constants.
Patient Data Erased Integrity of patient data.

VF6 Gamma/Gamma XL C-11

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Checking the NBP Calibration

The NBP parameter box gives you access to the NBP Calibration mode. These checks
must be performed in Adult Mode only.

STEPS: NBP Calibration

1. Click on the NBP parameter box.
2. Click on Calibration Mode.

3. Select ON and click the knob.

4. Replace the cuff with a mercury manometer.
5. Pump the manometer until the mercury column reads 260 mmHg. Verify the
displayed value on the monitor.
6. Release the pressure and read the pressure value at three different points on
the mercury column: the displayed values on the monitor should be within ±3
mmHg of the manometer readings.
7. Close the release valve on the bulb and pump the manometer until the
overpressure release valve opens. This should happen at 300 mmHg ±30
mmHg and the mercury column should fall rapidly to zero. If the release valve
does not open or if it opens at a value lower than 300 mmHg ±30 mmHg, the
overpressure system may be faulty. Remove the monitor from service and
contact DrägerService.
NOTE: If the monitor is left in the calibration mode for more than 128 seconds after a
first measurement has been started, an NBP Fault condition is reported. This message
does not indicate a hardware failure but the activation of the safety timer of the monitor.
To clear the message, turn the monitor off, then on again.

C-12 Gamma/Gamma XL VF6

 BIOMEDICAL SUPPORT

Biomed Menu
The Biomed menu gives you access to basic setup and maintenance tasks. The
Biomed and the Service menus are password-protected. The Biomed menu gives you
access to the following functions:
z Save Setups — to save the current configuration of alarm limits and display
options.
z Locked Options — to activate the demo mode and optional features of the
monitor. Each option requires a password to unlock.
z Diagnostic Logs — to display and to print the diagnostic log.
z Units — to change the units that Temperature, etCO2, Pressures and ST
segment analysis use.
z Service — to access various service functions, including Update Software,
Test Pulse, ECG Baseline, Date and Time, Monitor Setup (Language,
SCIO Port, Data Collection, Line Frequency), and Network Setup (Network
Configuration, Network Information). Access to this menu requires entering
the Service password.
z Monitor Setup — to access various setup functions (see below).

VF6 Gamma/Gamma XL C-13

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Saving a Patient Setup

You can save and re-use the current monitoring configuration. This saved
configuration is automatically restored when a new patient of the same category (e.g.,
pediatric) is admitted.
The monitor saves the following settings: Waveform channel assignments and scales,
alarm limits and on/off status, IBP pressure labels, arrhythmia monitoring settings
(adult or pediatric mode only), respiration mode and markers, apnea time, coincidence
alarm, etCO2 measurement mode, and pacemaker setting and detection.

STEPS: Saving a Patient’s Setup

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Biomed.
4. Dial in the Biomed password and click the knob.
5. Click on Save Setups.
6. Click on Save Setup, select Confirm (or Cancel) and click the knob.

The monitor saves the current monitoring setup for future use. The setup is available
even after the current patient has been discharged from this monitor.
NOTE: You cannot save a setup when an OCRG is displayed on the screen. Exit the
OCRG display before saving.

Locked Options and Demo Mode

The Locked Options menu gives you access to the Demo mode and to a number of
monitoring options that are available for purchase. These options and their order
numbers are listed in the appendix Options and Accessories.

Using the Demo Mode

The monitor provides a demonstration mode to allow the presentation of features and
functions during a product introduction. Before demonstrating or testing the monitor,
disconnect all patient cables from the monitor.
NOTE: In Demo mode, the All Alarms Off key is without function and creates an
error tone when pressed.

C-14 Gamma/Gamma XL VF6

 BIOMEDICAL SUPPORT

STEPS: Enabling the Demo Mode

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Biomed.
4. Enter the Biomed password and click the knob.
5. Click on Locked Options.
6. Click on Enable Option.
7. Select Demo and click the knob.

Upon entering the demo mode, all previous patient data is erased. A yellow banner
Simulated Data appears on the screen, along with parameter values and waveforms. If
the monitor is connected to the network, the central station shows the bedside monitor
as having Simulated Data and the Admit function at the central station is disabled.
WA R N I N G : I f t h e m o n i t o r i s c o n n e c t e d t o t h e n e t w o r k , a l a r m s
g en e r a t e d b y t h e m o n i t o r d u r i n g s i m u l a t i o n a r e t r a n s m i t t e d t o
t h e M u l t i Vi e w Wo r k s ta t i o n .

To disable the Demo Mode, turn the monitor off and on again or enter the Standby
mode and discharge the patient upon resuming monitoring.
NOTE:
z The transfer of simulated data across the network is not possible.
z If the monitor is connected to the network, disabling the demo mode at the
bedside monitor clears the monitor’s data at the MultiView Workstation.

Diagnostic Logs
The diagnostic log records major changes that occur in the monitoring environment,
as well as operational errors.
The diagnostic log stores the most recent 200 errors or conditions, along with date and
time of the occurrence. The most recent messages are displayed first. Turn the rotary
knob to scroll through all entries. The codes that appear in the log help DrägerService
identify the cause of error or condition.

STEPS: Displaying the Diagnostic Log

1. Press the Menu fixed key.
2. Click on Monitor Setup.

VF6 Gamma/Gamma XL C-15

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

3. Click on Biomed.
4. Enter the Biomed password and click the knob.
5. Click on Diagnostic Logs.
6. The monitor displays the diagnostic log. Turn the rotary knob clockwise to
scroll back to previous messages. Turn the knob counterclockwise to scroll
forward to current messages.

Changing Units of Measure

You can change the units of measure for the following parameters:
z Temperature — °C (default) or °F
z etCO2 — Vol.% (default), mmHg or kPa
z Pressures — mmHg (default) or kPa
z ST — mm (default) or mV
Upon changing the unit of measure, the monitor displays the New Patient? prompt.
You must admit a new patient and thereby discharge the current patient, or the change
of units does not take effect.

STEPS: Changing Units of Measure

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Biomed.
4. Enter the Biomed password and click the knob.
5. Click on Units.

6. Change the units for the desired parameter and click the knob.
7. Click on New Patient? Yes.

C-16 Gamma/Gamma XL VF6

 BIOMEDICAL SUPPORT

Turning External Alarm Lights ON/OFF

A set of alarm lights on top of the monitor blink red for life-threatening alarms and
yellow for serious alarms, if the external alarm light function is enabled (default
setting is ON). If more than one alarm occurs at the same time, the lights blink for the
alarm with the highest alarm grade. If the user silences the alarm, the alarm lights
remain lit without flashing. If the user turns all alarms off, the alarm lights are turned
off as well.

STEPS: Turning External Alarm Lights On/Off

1. Press the Menu fixed key.
2. Click on Monitor Setup.
3. Click on Biomed.
4. Enter the Biomed password and click the knob again.
5. Click on Monitor Setup.
6. Click on Alarm Light.

7. Click on Alarm Light again.

8. Select ON or OFF and click the knob again.

VF6 Gamma/Gamma XL C-17

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Parameter Colors
Select the parameter display colors as follows:

1. Press the Menu fixed key.

2. Click on Monitor Setup.
3. Click on Biomed.
4. Enter the Biomed password and click the knob again.
5. Click on Monitor Setup.
6. Click on Parameter Colors.

7. Click on the desired parameter, select the color and click the knob again.
8. To call up additional parameters, click on More....

NOTE:
z You cannot change the color of Multigas parameters (O2, N2O, anesthetic
agent).
z The ST parameter takes on the color selection for ECG.
z The ST reference complex is always purple. Therefore, if you choose purple as
the parameter color for ECG/ST, you won’t be able to distinguish the ST
waveform from the ST reference complex.

C-18 Gamma/Gamma XL VF6

 BIOMEDICAL SUPPORT

NBP/SpO2 Interlock
When NBP/SpO2 Interlock is ON, SpO2 alarms are disabled during an NBP
measurement in order to avoid nuisance SpO2 alarms caused by impeded circulation
in the limb.
Turn NBP/SpO2 Interlock on as follows:

1. Press the Menu fixed key.

2. Click on Monitor Setup.
3. Click on Biomed.
4. Enter the Biomed password and click the knob again.
5. Click on Monitor Setup.
6. Click on NBP/SpO2 Interlock.
7. Turn the function ON or OFF.

ASY/VF Alarms
Set alarms for asystole and ventricular fibrillation as either Always ON or Follow HR.
If you select Follow HR, ASY and VF alarm settings follow those settings selected for
heart rate alarms in the Alarm Limits table. If you select Always ON, the monitor
always alarms for asystole and ventricular fibrillation, even if HR alarms and
arrhythmia monitoring are turned off.
Set ASY/VF Alarms as follows:

1. Press the Menu fixed key.

2. Click on Monitor Setup.
3. Click on Biomed.
4. Enter the Biomed password and click the knob again.
5. Click on Monitor Setup.
6. Click on ASY/VF Alarms.
7. Select Always ON or Follow HR.

VF6 Gamma/Gamma XL C-19

C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT

Pacer Mode
The monitor offers two pacer detection modes, Basic and Advanced. The basic mode
allows you to turn pacer detection on or off in the ECG menu. The advanced mode
adds the selection Fusion, which offers increased detection sensitivity for fused paced
beats.
Enable the basic or advanced pacer detection mode as follows:

1. Press the Menu fixed key.

2. Click on Monitor Setup.
3. Click on Biomed.
4. Enter the Biomed password and click the knob again.
5. Click on Monitor Setup.
6. Click on Pacer Mode.
7. Click on Basic or Advanced.

C-20 Gamma/Gamma XL VF6

D Technical Data

Overview........................................................................................................................ D-2
Regulatory Compliance ......................................................................................... D-2
Basic System Components ................................................................................... D-3
Monitoring Accessories ........................................................................................ D-8
Monitoring Specifications ................................................................................... D-11
Electromagnetic Compatibility .................................................................................. D-22
D TECHNICAL DATA

Overview
This appendix contains technical specifications for the physical and functional aspects
of the Infinity Gamma Series patient monitor and its monitoring accessories. Upon
request, Dräger makes technical information required for maintenance and/or
calibration of serviceable items available to qualified technical personnel.
For specifications of wireless monitoring accessories such as wireless LAN PC cards
and access points, please refer to the documentation of the wireless component’s
manufacturer, Cisco Systems, Inc.

Regulatory Compliance

Regulatory Standards Compliance

z Medical Device Directive (MDD) 93/42 EEC
z IEC 60601-1 and applicable collateral and particular standards
z EN 60601-1-2: Susceptibility -- IEC 801-2, 3, 4, and 5
z Emissions -- EN 55011, Class B

D-2 Gamma/Gamma XL VF6

 OVERVIEW

Basic System Components

Monitor Base Unit

Dimensions Gamma: 215 mm height (8.5 in)

301 mm width (11.9 in)
131 mm depth (5.2 in)
Gamma XL: 215 mm height (8.5 in)
301 mm width (11.9 in)
131 mm depth (5.2 in)
SC 6002XL: 196 mm height (7.7 in)
249 mm width (9.8 in)
134 mm depth (5.3 in)
SC 6802XL: 196 mm height (7.7 in)
267 mm width (10.5 in)
147 mm depth (5.8 in)
Weight Gamma: 3.66 kg (8.07 lb) with lead acid battery
3.46 kg (7.63 lb) with lithium ion battery
3.11 kg (6.85 lb) without battery
Gamma XL: 3.87 kg (8.54 lb) with lead acid battery
3.67 kg (8.10 lb) with lithium ion battery
3.32 kg (7.32 lb) without battery
SC 6002XL: 3.42 kg (7.54 lb) with lead acid battery
3.22 kg (7.10 lb) with lithium ion battery
2.87 kg (6.32 lb) without battery
SC 6802XL: 3.87 kg (8.54 lb) with lead acid battery
3.67 kg (8.10 lb) with lithium ion battery
3.32 kg (7.32 lb) without battery
Materials Plastics: ABS, FR 110
Printed Circuits: glass/epoxy, lead/tin solder, copper etch,
lithium battery
Battery: sealed lead acid, or lithium ion (option)
Heatsink: cast aluminum
NBP assembly: silicon tubing, steel, copper wire
Packing: corrugated cardboard, urethane foam
Disposal All materials must be disposed of or recycled properly and in
accordance with local regulations. There are no known
special disposal requirements for any accessories.
Battery Pack Lead Acid: PANASONIC LC-T121R8PU or equivalent
Li-ion: Dräger Li+ Battery Pack
Protection Class Internally powered, for use with specified Class I power
supply
Mode of Operation Continuous (with external source of power via AC adapter,
CPS, or IDS).
DC Input 11 – 15 VDC, 2.5A
Max. Power Consumption 52 Watts

VF6 Gamma/Gamma XL D-3

D TECHNICAL DATA

Monitor Base Unit (continued)

Battery Operating Time Lead acid: 75 minutes

(With ECG, SpO2, respiration Lithium ion: 210 minutes in Bright Screen Mode and 240
waveforms and NBP in a 15- minutes in Dim Screen Mode
minute interval mode starting with
a fully charged battery)
Battery Recharging Time Lead acid: 5½ hours, typical.
Lithium ion: 8 hours, typical.
Patient Leakage Current < 10μA @ 110 V and 60 Hz
< 10μA @ 220 V and 50 Hz
QRS Sync. Output Output will go high for 100 ms every time a QRS is detected.
QRS detected: +12 V ±5%, 5.1 KΩ source impedance.
Output low (no QRS): < .8 V @ 30 mA sync current.
Alarm Output 12 V 560 Ω output for external alarm indicator (Nurse Call
System)
Recorder UART output to interface with an R 50 Series recorder
through the interface plate.

Monitor Display

Type Color Liquid Crystal Display (LCD)

Size Gamma: 6.5 " (16.5 cm)
Gamma XL: 8.4 " (21 cm)
SC 6002XL: 6.5 " (16.5 cm)
SC 6802XL: 8 " (20 cm)
Display Area Gamma: 132.5 mm x 99.4 mm
Gamma XL: 170.9 mm x 129.6 mm
SC 6002XL: 132.5 mm x 99.4 mm
SC 6802XL: 170.9 mm x 129.6 mm
Matrix 640 x 480 pixels
Pixel Pitch Gamma: 0.207 x 0.207 mm
Gamma XL: 0.267 x 0.270 mm
Number of Channels Gamma: 3 (or 4 as an option)
Gamma XL: 4
Sweep Speeds Fixed 25 mm/s ±20% for ECG, SpO2, and IBP curves
Fixed 6.25 mm/s ±20% for Resp and etCO2 curve
Fixed 1.0 mm/s ±20% for optional OCRG curve
Display Mode Erase bar (updates waveforms from left to right)

D-4 Gamma/Gamma XL VF6

 OVERVIEW

Environmental requirements (Base Unit and AC Power Adapter)

Cooling Convection and cooling chimney (no fan)

Temperature Operating: 0 °C to +45 °C (without recorder)
Storage: –20 °C to 50 °C
Relative Humidity Operating: > 10% and < 95%, non-condensing
Storage: > 10% and < 95% non-condensing
Altitude Operating: -381 to +3048 m (-1250 to +10000 ft.)
525 to 795 mmHg (70 to 106 kPa)
Storage: -381 to +5486m (-1250 to +18000 ft.)
375 to 795 mmHg (50 to 106 kPa)
Transportation Per National Safe Transit Association (NSTA)
(with shipping package)
Sinusoidal Vibration Operating: IEC 68-2-6; 0.040 inch DA,
5 to 32 Hz; 2G peak 32 to 500 Hz
Storage: per ISTA procedure 1
Drop Free fall: 250 mm, 28 repetitions
Shock IEC 68-2-27 50 G, half sine, 11ms, 18 reps
Water Resistance Drip-Proof (IPX 1)

AC Power Adapter (59 53 539 E530U)

Power Requirements 100-120 VAC, 0.8A

200-240 VAC, 0.4A
Output Max. 34 W
Frequency 50-60 Hz
Chassis Leakage Current ≤300 μA @ 110 V and 60 Hz (UL 544)
≤500 μA @ 220 V and 50 Hz (IEC 601-1)
Mode of Operation Continuous
Protection Class Class I

VF6 Gamma/Gamma XL D-5

D TECHNICAL DATA

Infinity Docking Station (IDS)

Power Requirements 0.7 A @12 V with no devices attached

Mains Frequency n/a
Mode of Operation Continuous
Protection Class n/a
Dimensions 228 mm (w) x 210 mm (d) x 102 mm (h)
(9” x 8.25” x 4”)
Weight 2 kg (4.5 lbs)
Environmental Requirements Temperature:
(operating:) 10 to 40 °C (50 to 104 °F)
(storage:) -20 to 50 °C (-4 to 122 °F)
Relative Humidity:
(operating:) 20 to 90%, non-condensing
(storage:) 10 to 95%, with packaging
Atmospheric Pressure:
(operating:) 525 to 795 mmHg (70 to 106 kPa)
(storage:) 375 to 795 mmHg (50 to 106 kPa)
Finish Color: Anthracite gray
Materials: ABS Polycarbonate blend (injection molded
plastic), and die-cast aluminum
Connectors Gamma/Delta Series Monitors, Auxiliary Docking Station,
External VGA display, R50 Recorder, Infinity network
connection, CAN bus, Communication ports 1 & 2.
Chassis Leakage Current n/a

Infinity Docking Station (IDS) Power Supply MS 18 284

CAUTION: This Power Supply has a switch used to select nominal line operating
voltage. Make sure that the switch is in the correct position for your nominal voltage as
indicated on the power supply itself. Incorrect position of the switch could result in
damage to the supply and injury to personnel. For further details, refer to the installation
instructions.
Connections AC Power Connector, DC Power Cable/Connector, Potential
Equalization Conductor
Cooling Convection
Dimensions 135 mm (w) x 111 mm (d) x 270 mm (h)
(5.3” x 4.4” x 10.6”)
Without mounting bracket the depth is 71 mm (2.8”).
Weight 1.85 kg (4.1 lbs)

D-6 Gamma/Gamma XL VF6

 OVERVIEW

Infinity Docking Station (IDS) Power Supply MS 18 284

Power Requirements 100-120VAC, 3.4 A or 200-240VAC, 1.7 A

(switch selectable)
Mains Frequency 50/60 Hz
Power Output +13 VDC, 10.8 Amps
Protection Class Class I
Chassis leakage current <300 µA @120VAC, <500 µA @220VAC
Mode of Operation Continuous
Ingress Protection Ordinary
Environmental Temperature:
Requirements (operating:) 10 to 40 °C (50 to 104 °F)
(storage:) -40 to 70 °C (-40 to 158 °F)
Relative Humidity:
(operating:) 20 to 95%, non-condensing
(storage:) 10 to 95%, with packaging
Atmospheric Pressure:
(operating:) 525 to 795 mmHg (70 to 106 kPa)
(storage:) 375 to 795 mmHg (50 to 106 kPa)

VF6 Gamma/Gamma XL D-7

D TECHNICAL DATA

Monitoring Accessories

SpO2 Pod (Masimo SET)

Size (H x W x D) 39 x 58 x 135 mm (1.5 x 2.3 x 5.3 in.)

Weight 0.15 kg (0.33 lbs.)
Connections PodCom: for power and connection to monitor
Cable Connection: for sensor cable
Power Source Powered directly from monitor
Protection Against Electric Shock IEC 68-2-27: Minimum of 50 G, 11 ms, half sine
Vibration Sinusoidal IEC 68-2-6: 0.040 double amplitude displacement
(5-32 Hz), 2 G peak (32-500 Hz)
Random Vibration IEC 68-2-34: 20-500 Hz, ASD = 0.02G2/
Hz, Low reproducibility, 9 minutes
Mode of Operation Continuous
Environmental Temperature:
Requirements (operating:) 5 to 45°C (41 to 113°F)
(storage:) -20 to 60°C (-4 to 140°F)
Relative Humidity:
(operating:) 10 to 95%, non-condensing
(storage:) 10 to 95%, (with packaging)
Atmospheric Pressure:
(operating:) 485 to 795 mmHg (64.7 to 106 kPa)
(storage:) 375 to 795 mmHg (50 to 106 kPa)

etCO2 Pod

Size (H x W x D) Pod: approx. 140 x 140 x 51 mm (5.5 x 5.5 x 2 in)

CapnostatTM III Sensor (without cable):
33 x 42 x 22 mm (1.3 x 1.7 x 0.9 in.)
Weight Pod: 1.1 lb or .5 kg
CapnostatTM III Sensor: 18 g
Connections Sensor connector, female luer side-stream sampling port,
male luer sample exhaust port
Adult Airway Adapter Dead Space < 5 cc
Neonatal Airway Adapter Dead < 0.5 cc
Space
Moisture Resistance Airway adapter can be immersed in water without damage
Biotoxicity None per ASTM F720 (MTL #2009)

D-8 Gamma/Gamma XL VF6

 OVERVIEW

etCO2 Pod (continued)

Power Source Powered directly from monitor

Protection Against Type CF (per IEC 601-1)
Electric Shock
Mode of Operation Continuous
Defibrillation Protection per IEC 601-1 A2
Mechanical Shock 20 one-meter drops per IEC 68-2-32 (1990), EN 60068-2-32
(1993)
Environmental Temperature:
Requirements (operating:) 10 to 40 °C (50 to 104 °F)
(Readings comply to BTPS = Body (storage:) -20 to 50 °C (-4 to 122 °F)
temperature of 37°C, ambient Relative Humidity:
barometric pressure of 750 mmHg,
and relative humidity of 100%.) (operating:) 20 to 90%, non-condensing
(storage:) 10 to 95% (with packaging)
Atmospheric Pressure:
(operating:) 525 to 795 mmHg (70 to 106 kPa)
(storage:) 375 to 795 mmHg (50 to 106 kPa)

Scio Multigas Module

Size (H x W x D) with watertrap 115 x 190 x 270 mm (4.5 x 7.5 x 10.6 in.)
Weight Scio Four Oxi plus: 3.457 kg (7.62 lbs)
Scio Four plus: 3.037 kg (6.69 lbs)
Scio Four Oxi: 3.444 kg (7.59 lbs)
Scio Four: 3.024 kg (6.66 lbs)
Cooling Fan
Mains Frequency 50/60 Hz
Power Requirement < 0.8 A at 100-120 Vac; <0.4 A at 200-240 Vac
Chassis Leakage Current ≤ 300 μA (per UL 544)
≤ 500 μA (per IEC 60601-1)
Electric Shock Protection Type BF
Protection Class Class 1
Mode of Operation Continuous
Power From specified power supply
Sound Pressure Level ≤ 45 dB(A)
Air Ingression, Leakage < 45 ml during zeroing, < 10 ml/min leakage

VF6 Gamma/Gamma XL D-9

D TECHNICAL DATA

Scio Multigas Module (continued)

Sample Flow Rate 150 ± 20 ml/min

(or 200 ±20 ml/min, if so specified on back-panel)
Environmental Temperature:
Requirements (operating:) 10 to 40 °C (50 to 104 °F)
(Readings comply to ATPS (storage:) -20 to 70 °C (-4 to 158 °F)
conditions = Ambient Temperature Relative Humidity:
Pressure Saturated) (operating:) 5 to 90%
(storage:) 5 to 95%
Atmospheric Pressure:
(operating:) 525 to 795 mmHg (70 to 106 kPa)
(storage:) 375 to 795 mmHg (50 to 106 kPa)

R50 N Network Recorder

Dimensions 180 x 120 x 222 mm (7.1 x 4.72 x 8.74 in.)

Weight 1.64 kg (3.6 lb)
Connections AC Power Connector, Infinity Network, R50 Recorder,
Potential Equalization Connector.
Cooling Convection
Input voltage range 100-240 VRMS
Mains frequency 50/60 Hz
Power Consumption 1.0 A max
Protection Class Class I
Chassis Leakage Current <300 mA @ 120VAC, <500 mA @ 220VAC
Mode of Operation Continuous
Water Resistance Ordinary
Environmental Requirements Temperature:
Operating: 15°C to 40°C (55°F to 104°F)
Storage: -20°C to 40°C (-4°F to 104°F)
Relative Humidity:
Operating: 30% to 95%, non-condensing
Storage: 10% to 95%, non-condensing
with packaging
Atmospheric Pressure:
Operating: 550 to 775 mmHg (73 to 103 kPa)
Storage: 375 to 795 mmHg (50 to 106 kPa)

D-10 Gamma/Gamma XL VF6

 OVERVIEW

Monitoring Specifications

ECG

Accessories 3-,5-, and 6-Lead patient cable

Input Connector 2-pin connector to MultiMed pod
Input Parameters 3-Lead (RA, RL, LA and LL electrodes)
5-Lead (RA, RL, LA, LL and CHEST electrodes)
6-Lead (RA, RL, LA, LL and 2 CHEST electrodes)
Number of Channels 2
Sweep Speed 25 mm/s
Resolution 1/min.
Measurement Range 15 to 300 1/min.
Measurement Accuracy ±5 beats/minute or ±2%, whichever is greater
Response Time < 7 seconds for a step change of 80 to 120 1/min.
< 13 seconds for a step change of 80 to 40 1/min.
• Response time is measured from the onset of the first QRS
complex of the new rate to the time the measurement reads
a value that is the original rate plus 63% of the change.
Report Interval (nominal) 2.1 seconds
Notch Filter Frequency 50/60 Hz
Monitor ±3 dB Bandwidth 0.5 Hz to 28 Hz (50 Hz)
0.5 Hz to 40 Hz (60 Hz)
Dynamic Range AC ±10 mV minimum
Dynamic Range DC ± 1 V minimum
Resolution 10.4 μV
Electrode Off Impedance > 100 MΩ
Electrode On Impedance < 40 MΩ
Calibration Spike 1 mV ±5% amplitude, 20 msec duration
Defibrillation Protection In accordance with IEC 601-2-27
Degree of Protection Against CF
Electric Shock
Pacer Pulse Detection On active ECG lead

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D TECHNICAL DATA

ECG (continued)

Pacer Pulse Detection Level Amplitude: ± 5 to ± 700 mV

Width: 0.1 to 2.0 ms
Separation between pulses: ≥30 ms
Recharge time constant: 4 to 100 ms
Over/Undershoot: 0.025 ap 2 mV maximum
Lead Off Sensing Current <50 nA DC from LL, LA, RA and V Leads

Arrhythmia

Measurement Range 0 to 300 beats/minute

Display Resolution 1 beat/minute
Accuracy ± 5 beats/minute or ± 10% of the rate, whichever is greater
Response Time < 4 seconds

ST Segment Analysis

Measurement Range -15 mm to +15 mm (-1.5 mV to +1.5 mV)

Accuracy ±1mm/0.1mV RTI
Isoelectric Point Range From start of the averaged ST complex to Fiducial Point, in
increments of 4 ms
ST Point Range From Fiducial Point to end of the averaged ST complex, in
increments of 4 ms
Display Resolution 0.1 mm/0.01mV (10μV)
Response Time 15 seconds

Respiration

Method Impedance Pneumography

Sensing Electrodes RA and LL (Lead II)
Number of Channels 1
Sweep Speed 6.25 mm/s

D-12 Gamma/Gamma XL VF6

 OVERVIEW

Respiration (continued)

Resolution 1 breath per minute

Measurement Range 0 to 155 breaths per minute
Measurement Accuracy ± 1 breath per minute, or ± 2%, whichever is greater
Response Time After a step change in respiration rate, it takes 36 seconds to
stabilize to a new respiration rate of 10 breaths per minute
and 18 seconds to stabilize to a new respiration rate of 20
breaths per minute.
Report Interval 2 seconds
Total resistance 0 to 3600 Ω
Input Dynamic Range AC: ± 17.3 Ω ± 10%
DC: 0 Ω to 3.6 kΩ (internal check for high impedance)
Bandwidth 0.25 Hz to 3.5 Hz
Impedance Measuring Current 65 μA RMS ±10% nominal at 48kHz ±1%, rectangular wave

etCO2

Parameter Display etCO2, iCO2, Respiration Rate (RRc)

Measuring Method Dual wavelength, non-dispersive infrared absorption
Measuring Modes Adult and Pediatric: Mainstream and Sidestream
Neonatal: Mainstream only
Warm-Up ≤5 min (at 25 °C)
Measurement Range etCO2: 0-100 mmHg
iCO2: 0-10 mmHg
RRc: 5-145 bpm
Accuracy etCO2: ±2 mmHg for 0-40 mmHg
±5% reading for 41-70 mmHg
±8% reading for 71-100 mmHg
iCO2: ±2 mmHg
RRc: 1 bpm
Stable over 24 hours, over full range of readings at
atmospheric pressure.
Calibration Verify once a day. Calibrate when moving the sensor from
one module to another.
Calibration time: < 20 s

VF6 Gamma/Gamma XL D-13

D TECHNICAL DATA

etCO2 (continued)

Compensation Gas/Anesthetic agent: User-selectable

Atm. pressure: Automatic or user-selectable
(540 - 800 mmHg)
Sampling Flow Rate 180 ±12 ml/min (Sidestream measuring mode)
Apnea Detection Yes
RRc Range (Pod) Mainstream: 0-149 breaths/min
Sidestream: 0-69 breaths/min
Accuracy: ±1 breath/min
Rise Time Mainstream: <100 ms
Sidestream: <200 ms
Delay Time Mainstream: <100 ms
Sidestream: <450 ms
Total System Response Time Rise time plus delay time
Resolution etCO2/iCO2: 1 mmHg, RRc: 1bpm
Average Response Time < 75ms from sensor
Breath Detection Threshold 5 mmHg or greater
Degree of Protection Against CF
Electric Shock
Defibrillation Protection In accordance with IEC 601-1A2

Multigas

Parameter Labels CO2, O2, N2O, HAL, ISO, ENF, SEV, DES
Agents Measured Halothane, Isoflurane, Enflurane, Sevoflurane, Desflurane
Measuring Methods CO2, N2O, Agents: Infrared
O2: Paramagnetic Sensor
Display Inspired and expired concentrations (%) and
etCO2 waveform
Display Ranges CO2: 0% to 10% (resolution 0.1%)
O2: 0% to 100% (resolution 1.0%)
N2O: 0% to 100% (resolution 1.0%)
Agents:
Halothane: 0% to 10% (resolution 0.1%)
Isoflurane: 0% to 10% (resolution 0.1%)
Enflurane: 0% to 10% (resolution 0.1%)
Sevoflurane: 0% to 11% (resolution 0.1%)
Desflurane: 0% to 24% (resolution 0.1%)

D-14 Gamma/Gamma XL VF6

 OVERVIEW

Multigas (continued)

Full Accuracy CO2: ± 0.5 vol% or ± 12% rel.

(after a warm-up period of (whichever is greater)
approximately 7.1 minutes)1, 2, 3 O2: ± 3 vol%
N2O: ± (2 vol% + 8% rel.)
Halothane (up to 8.5 vol%): ± (0.15 vol% + 15% rel.)
Isoflurane (up to 8.5 vol%): ± (0.15 vol% + 15% rel.)
Enflurane (up to 10 vol%): ± (0.15 vol% + 15% rel.)
Sevoflurane (up to 10 vol%): ± (0.15 vol% + 15% rel.)
Desflurane (up to 20 vol%): ± (0.15 vol% + 15% rel.)
Rise Time CO2: <350 ms
(10% to 90% at a flow rate of 150 ml/ O2: <600 ms
min.) N2O: <500 ms
Agents: <500 ms
Delay Time < 4 sec
(with Water Trap and 2.5 m Sampling
Line)
1Due
to the response time of the sensors and the gas sample flow rate, the stated accuracy of O2,
CO2, N2O and the anesthetic agents is limited by the respiratory rate and by the inspiratory to
expiratory ratio (I:E) as follows:
For O2 measurements, accuracy is maintained up to a respiratory rate of 60 breaths/min. with an I/
E ratio of 1:2.
For CO2 measurements, accuracy is maintained up to a respiratory rate of 75 breaths/min. with an
I/E ratio of 1:2.
For N2O measurements, accuracy is maintained up to a respiratory rate of 75 breaths/min. with an
I/E ratio of 1:2.
For agent measurements, accuracy is maintained up to a respiratory rate of 60 breaths/min. with
an I/E ratio of 1:2.
The effect of respiratory rate and I/E ratio settings on accuracy were determined in a simulated
breathing system using square wave gas concentration waveforms.
2Auto zero calibrations automatically compensate for any drift of measurement accuracy.
3There are no effects on gas measurement accuracy at the gas levels listed below.

Gas or Vapor Gas Level (gas levels in %volume fraction)

Nitrous oxide 60
Halothane 4
Enflurane 5
Isoflurane 5
Sevoflurane 5
Xenon not intended for use with Xenon
Helium 50
Metered dose inhaler propellants not inteded for use in presence of metered dose inhaler
propellants
Desflurane 15

VF6 Gamma/Gamma XL D-15

D TECHNICAL DATA

Multigas (continued)

Ethanol 3% blood alcohol level

Isopropanol 1
Acetone 0.1
Methane 3

Pulse Oximetry (SpO2)

Parameter Display Saturation (%SpO2), pulse rate

Measuring Method Absorption-spectrophotometry
Measuring Range SpO2: 1 - 100%
Pulse rate: 30 - 250 1/min
Calibration Range 70-100%
Display Range 0-100%
Display Update Period 2 seconds
Maximum Hold from Previous 30 seconds (in the event of artifact or other error)
Update
Measuring accuracy, Adult mode(1):
SpO2:
0 to 69% not specified
70 to 100% sensor-specific as follows:
Nellcor : (2,3)
D-25/D-25L, D-20, I-20, N-25, OxiMAX MAX-A, -P, -I, -N, -AL ................................... ±2
Nellcor :
DS100A ...................................................................................................................... ±3
Masimo: (2,3)
LNOPADT, LNOPPED, LNOPNEO, LNOPNEO SS,LNOP-YI .................................... ±2
Masimo:
LNOP-DCI, LNOP-DCIP, NR125 ................................................................................ ±2
EAR ......................................................................................................................... ±3.5
Pulse Rate: ................................................................±3 beats/min or ±3% (whichever is greater)
Measuring accuracy, Neonatal mode(1, 2, 3, 4):
SpO2:
0 to 69% not specified
70 to 100% sensor-specific as follows:
Nellcor:
N-25, OxiMAX MAX-N ................................................................................................ ±3
Masimo:
LNOPNEO, LNOPNEO SS, LNOP-YI......................................................................... ±3
Pulse Rate: ................................................................±3 beats/min or ±3% (whichever is greater)

D-16 Gamma/Gamma XL VF6

 OVERVIEW

Pulse Oximetry (SpO2) (continued)

Notes:
1) SpO2 accuracy specification is at 1 SD (standard deviation) and is expressed as ± "X" digits
(absolute) for the established range.
2) Accuracy of saturation measurements on neonates is increased by ±1 digit as compared to
accuracy on adult patients to account for the theoretical effect on oximeter measurements of
fetal hemoglobin in neonatal blood.
SpO2 Alarms High: Adjustable, 20 to 100%
Low: Adjustable, 20 to 100%
Defaults:
Adult and Pediatric: 100-90
Neonatal: 100-90
Nominal Wavelength Red: 660 nm
IR: 910 nm
Power Red: 3 mW (max.)
IR: 4 mW (max.)
Note: LED drive is current limited by hardware mechanisms.
Degree of Protection Against Type CF
Electric Shock
Defibrillation Protection In accordance with IEC 601-1A2

Pulse Oximetry (SpO2) with Masimo SET Pod

Parameter display Saturation (%SpO2), pulse rate, perfusion

Measuring range %SpO2: 1 - 100%
Pulse rate: 25 - 240 /min
Perfusion: 0.02 - 20%
Measuring accuracy:
Saturation (%SpO2) - During No Motion Conditions:(1)
0 to 69% not specified
70 to 100%:
Adults, Pediatrics ±2 digits
Neonates ±3 digits
Saturation (%SpO2) - During Motion Conditions:(2, 3)
0 to 69% not specified
70 to 100%:
Adults, Pediatrics(2) ±3 digits
Neonates(3) ±3 digits
Pulse Rate (bpm) - During No Motion Conditions:(1)
Adults, Pediatrics, Neonates 25 - 240 bpm ±3 digits
Pulse Rate (bpm) - During Motion Conditions:(2, 3)
Adults, Pediatrics, Neonates 25 - 240 bpm ±5 digits

VF6 Gamma/Gamma XL D-17

D TECHNICAL DATA

Pulse Oximetry (SpO2) with Masimo SET Pod (continued)

(1) The Infinity® Masimo SET® SpO2 SmartPod™ pulse oximeter with LNOP-Adt sensors has been validated
for no motion accuracy in human blood studies on healthy adult volunteers in induced hypoxia studies in the
range of 70-100% SpO2 against a laboratory co-oximeter and ECG monitor. This variation equals plus or
minus one standard deviation. Plus or minus one standard deviation encompasses 68% of the population.
(2) The Masimo SET® pod with LNOP-Adt sensors has been validated for motion accuracy in human blood
studies on healthy adult volunteers in induced hypoxia studies while performing rubbing and tapping motions
at 2 to 4 Hz at an amplitude of 1 to 2 cm and a non-repetitive motion between 1 to 5 Hz at an amplitude of 2 to
3 cm in induced hypoxia studies in the range of 70 - 100% SpO2 against a laboratory co-oximeter and ECG
monitor. This variation equals plus or minus one standard deviation. Plus or minus one standard deviation
encompasses 68% of the population.
(3) The Masimo SET® pod with LNOP-Neo and Neo Pt sensors has been validated for motion and no motion
accuracy in human blood studies on healthy adult volunteers in induced hypoxia studies while performing
rubbing and tapping motions at 2 to 4 Hz at an amplitude of 1 to 2 cm and a non-repetitive motion between 1 to
5 Hz at an amplitude of 2 to 3 cm in induced hypoxia studies in the range of 70 - 100% SpO2 against a
laboratory co-oximeter and ECG monitor. 1% has been added to the results to account for the effects of fetal
hemoglobin. This variation equals plus or minus one standard deviation. Plus or minus one standard deviation
encompasses 68% of the population.

Nominal wavelength Red: 660 nm

IR: 905 nm
Radiant Power at 50 mW pulsed Min: 0.13 mW
Max: 0.79 mW
Resolution SpO2: 1%
Pulse rate:1 b/min
Low Perfusion Performance(4) >0.02% Pulse Amplitude:Saturation (%SpO2) ±2 digits
and %Transmission >5%:Pulse rate ±3 digits
(4) The Masimo SET® pod has been validated for low perfusion accuracy in bench top testing against a
Biotek Index 2 simulator and Masimo's simulator with signal strengths of greater than 0.02% and a %
transmission of greater than 5% for saturations ranging from 70 to 100%. This variation equals plus or minus
one standard deviation. Plus or minus one standard deviation encompasses 68% of the population.

Interfering Substances Carboxyhemoglobin may erroneously increase readings. The

level of increase is approximately equal to the amount of
carboxyhemoglobin present. Dyes, or any substance
containing dyes, that change usual arterial pigmentation may
cause erroneous readings.

Temperature

Input Connector 7-pin connector on MultiMed pod

Measurement Range 0 °C to +50 °C (32 °F to 122 °F)
Measurement Accuracy ±0.1 °C for a range of 0 °C to 50 °C
Probe Accuracy ±0.1 °C for a range of 0 °C to 50 °C
Total System Accuracy ±0.2 °C for a range of 0 °C to 50 °C
Average Response Time < 2.5 seconds
Linearity Linearity calculations to 0.02 °C by the software algorithm.

D-18 Gamma/Gamma XL VF6

 OVERVIEW

Temperature (continued)

Excitation Signal DC source

Power to Probe < 50 μW (causing a potential self-heat error factor
of < 0.05 °C)
Test Signals – 5 °C and 50 °C ±0.1 °C with nominal thermistor
Filter Characteristic Low-pass filtering to minimize noise pickup.
Error Detection > 50 °C: high temperature, possibly caused by a shorted
thermistor.
–3 °C: low temperature, possibly caused by an open
thermistor.
Self-test failure
Degree of Protection Against CF
Electric Shock
Defibrillation Protection In accordance with IEC 601-1A2

Non-Invasive Blood Pressure (NBP)

Parameter Display Systolic, Diastolic, Mean

Measuring Method Oscillometric technique
Modes of Operation Manual (single measurement), Continuous (5 minutes), or
Interval
Interval Times 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 30, 45, 60,
120, 180 and 240 min
Measuring Range Heart rate: 30 - 240 bpm
(Adult - 270mmHg) Systolic NBP: 30 - 250 mmHg
Mean NBP: 20 - 230 mmHg
Diastolic NBP: 10 - 210 mmHg
Measuring Range Heart rate: 30 - 240 bpm
(Pediatric - 180mmHg) Systolic NBP: 30 - 170 mmHg
Mean NBP: 20 - 150 mmHg
Diastolic NBP: 10 - 130 mmHg
Measuring Range Heart rate: 30 - 240 bpm
(Neonatal - 140mmHg) Systolic NBP: 30 - 130 mmHg
Mean NBP: 20 - 110 mmHg
Diastolic NBP: 10 - 100 mmHg
Default Inflation Pressure Adult (270): 160 mmHg ±10 mmHg
Pediatric (180): 120 mmHg ±10 mmHg
Neonatal (140): 110 mmHg ±10 mmHg

VF6 Gamma/Gamma XL D-19

D TECHNICAL DATA

Non-Invasive Blood Pressure (NBP) (continued)

Inflation Pressure After a Valid Adult (270): Previous SYS + 25 mmHg (±10)
Measurement Pediatric (180): Previous SYS + 25 mmHg (±10)
Neonatal (140): Previous SYS + 30 mmHg (±10)
Inflation Pressure Adult (270): 160 mmHg ±10 mmHg
After a Technical Alarm Pediatric (180): 120 mmHg ±10 mmHg
Neonatal (140): 110 mmHg ±10 mmHg
Maximum Inflation Adult (270): 265 mmHg ±5 mmHg
Pressure Pediatric (180): 180 mmHg ±10 mmHg
Neonatal (140): 142 mmHg ±10 mmHg
Minimum Inflation Adult (270): 110 mmHg ±10 mmHg
Pressure Pediatric (180): 90 mmHg ±10 mmHg
Neonatal (140): 70 mmHg ±10 mmHg
Maximum Measurement Time Adult (270): 2 min
Pediatric (180): 2 min
Neonatal (140): 90 sec
(60s French homologation)
Maximum Measurement Time Adult (270): 3 min
Including a Retry Pediatric (180): --- (n/a)
Neonatal (140): --- (n/a)
Software Safety Cut-Off Adult (270): 273 ±3 mmHg
Pediatric (180): 215 ±3 mmHg (SWi)*
185-212 (SWh)*
Neonatal 140): 150 ±3 mmHg
Hardware Safety Cut-Off Adult (270): 300 ±30 mmHg
Pediatric (180): 300 ±30 mmHg
Neonatal (140): 158 ±2 mmHg
Static Cuff Accuracy ±3 mmHg
Calibration Range Adult and Pediatric: 10 - 260 mmHg ±3 mmHg
Neonatal: 10 - 150 mmHg ±3 mmHg
Degree of Protection Against Type CF
Electric Shock
Defibrillation Protection per EN 60601-2-30 (IEC 601-2-30)
*SWi refers to instant measurements; SWh refers to measurements lasting more than 5 seconds and less than
15 seconds.

Invasive Blood Pressure (IBP1, IBP2)

Accessories Transducers with a resistance of 300 to 2000Ω and an

equivalent pressure sensitivity of 5 μV/V/mmHg ±10%
Input Connector 7-pin connector on monitor

D-20 Gamma/Gamma XL VF6

 OVERVIEW

Invasive Blood Pressure (IBP1, IBP2) (continued)

Number of Channels 2 max (requires IBP options)

Sweep Speed 25 mm/s
Measured Parameters Systolic, Mean and Diastolic blood pressure
Measurement Range -50 mmHg to 399 mmHg
Measurement Accuracy ±2 mmHg or ±3% (whichever is greater) after successful zero
and calibration (exclusive of transducer).
Resolution 1 mmHg or 0.1 kPa
Response Time ≤35 s (to reach 90% of the change of the lowest pulse rate of
25 1/min.
Zero Balance Range ±190 mmHg
Zero Resolution 0.24 mmHg
Zero Accuracy ±0.48 mmHg
Bandwidth DC to 16 Hz
Defibrillation Protection In accordance with IEC 601-2-34
Degree of Protection Against CF
Electric Shock

VF6 Gamma/Gamma XL D-21

D TECHNICAL DATA

Electromagnetic Compatibility
The separation distances are written with regard to the Infinity Gamma Series monitor.
The numbers provided will not guarantee faultless operation but should provide
reasonable assurance of such. This information may not be applicable to other medical
electrical equipment, and older equipment may be particularly susceptible to
interference.
General Notes
Medical electrical equipment needs special precautions regarding electromagnetic
compatibility (EMC) and needs to be installed and put into service according to the
EMC information provided in this manual.
Portable and mobile RF communications equipment can affect medical electrical
equipment.
Cables and accessories not specified within the instructions for use are not authorized.
Using other cables and/or accessories may adversely impact safety, performance and
electromagnetic compatibility (increased emission and decreased immunity).
The equipment should not be used adjacent to or stacked with other equipment; if
adjacent or stacked use is inevitable, the equipment should be observed to verify
normal operation in the configuration in which it will be used.
When using wireless networking, be aware that the system operates at 2.4 GHz range.
Other equipment, even if compliant with CISPR emission requirements, could
interfere with reception of wireless data. When selecting new wireless systems (e.g.
cell phones, pager systems, cordless phones etc) for use in installations where wireless
networking is used, care should always be used to insure that operating frequencies
are compatible. For example, selecting cordless phones that operate at 2.4 GHz will
likely cause difficulty with the phones and networking components.
NOTE: Detailed radio frequency characteristics: 2412-2472 MHZ, Direct-sequence
spread spectrum (DSSS) IEEE 802.11b compliant, limited to 100 mW. Applicable to
both access points and client adaptors. When used with 802.15.1 wireless, the device
will transmit with the following characteristics: 2400-2485 MHz , Frequency Hopping
Spread Spectrum (FHSS), limited to 2.5 mW. See the documentation that accompanies
the wireless products for further details.

Low level signals such as ECG are particularly susceptible to interference from
electromagnetic energy. While the equipment meets the testing described below, it is
not a guarantee of perfect operation, the ‘quieter’ the electrical environment the better.
In general, increasing the distance between electrical devices decreases the likelihood
of interference.
NOTE: The Infinity Gamma Series monitor is intended for use in the electromagnetic
environments specified below. The user of this equipment should assure that is used in
such an environment.

D-22 Gamma/Gamma XL VF6

 ELECTROMAGNETIC COMPATIBILITY

Electromagnetic Emissions

Emissions Compliance according to... Electromagnetic environment

RF emissions (CISPR 11) Group 1 The equipment uses RF energy

only for its internal function.
Therefore, its RF emissions are
very low and are not likely to cause
any interference in nearby
electronic equipment.*

CISPR Emissions Classification Class B The equipment is suitable for use

in all establishments including
Harmonic emissions Class A domestic establishments and those
(IEC 61000-3-2) directly connected to the public
low-voltage power supply network
Voltage fluctuations / flicker (IEC Complies that supplies buildings used for
61000-3-3) domestic purposes.
*Note that when used with the wireless options, the monitor emits electromagnetic energy in order to
communicate with the Infinity Network. Nearby electronic equipment may be affected. Radio frequency
characteristics are specified above. See the documentation that accompanies the wireless products for further
details.

Electromagnetic Immunity

Compliance
Immunity against... IEC 60601-1-2 test level level (of this Electromagnetic environment
device)

electrostatic discharge, contact discharge: ± 6 kV ± 6 kV Floors should be wood, concrete or

ESD air discharge: ± 8 kV ± 8 kV ceramic tile. If floors are covered
(IEC 61000-4-2) with synthetic material, the relative
humidity should be kept at levels to
reduce electrostatic charge to
suitable levels.

electrical fast transients power supply lines: ± 2 kV ± 2 kV Mains power quality should be that
/ bursts longer input / output lines: of a typical commercial or hospital
(IEC 61000-4-4) ± 1 kV ± 1 kV environment.

surges on AC mains Common mode: ± 2 kV ± 2 kV Mains power quality should be that

lines differential mode: ± 1 kV ± 1 kV of a typical commercial or hospital
(IEC 61000-4-5) environment.

power frequency 3 A/m 3 A/m Equipment which emits high levels

magnetic field 50/60 Hz of power line magnetic fields (in
(IEC 61000-4-8) excess of 3A/m) should be kept at a
distance to reduce the likelihood of
interference.

VF6 Gamma/Gamma XL D-23

D TECHNICAL DATA

Electromagnetic Immunity

Compliance
Immunity against... IEC 60601-1-2 test level level (of this Electromagnetic environment
device)

voltage dips and short dip >95%, 0.5 periods >95%, 0.5 Mains power should be that of a
interruptions on AC periods typical commercial or hospital
mains input lines environment. If user requires
(IEC 61000-4-11) dip 60%, 5 periods 60%, 5 continued operation during power
periods mains interruptions insure that
batteries are installed and charged.
Insure that battery life exceeds
dip 30%, 25 periods 30%, 25
periods longest anticipated power outages
or provide and additional
uninterruptible power source..
dip >95%, 5 seconds >95%, 5
seconds
Conducted RF Portable and mobile RF
rf coupled into lines 150 kHz – 80 MHz: 3 V/m communications equipment should
(IEC 61000-4-6) be used no closer to any part of the,
including cables, than the
radiated rf recommended separation distance
calculated from the equation
(IEC 61000-4-3) 80 MHz – 2.5 GHz 3 V/m applicable to the frequency of the
transmitter as below.
Recommended separation distance

d=1.2/V1]√P

d=1.2/√P 80 MHz to 800MHz

d=2.3√P 800 MHz to 2.5 GHz

where P is the maximum output

power rating of the transmitter in
watts (W) according to the
transmitter manufacturer and d is
the recommended separation
distance in metres (m).
Field strengths from fixed RF
transmitters, as determined by an
electromagnetic site surveya,
should be less than the compliance
level in each frequency rangeb.

Interference may occur in the

vicinity of equipment marked with
the following symbol:

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
equipment is used exceeds the applicable RF compliance level above, the equipment should be observed to
verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as
reorienting or relocating the equipment.
b) Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.

D-24 Gamma/Gamma XL VF6

 ELECTROMAGNETIC COMPATIBILITY

Recommended separation distances between portable and mobile RF communications equipment and
the equipment

Rated maximum output Separation distance according to frequency of transmitterin meters

power of transmitter W

150 kHz – 80 MHz 80 MHz to 800MHz 800 MHz to 2.5 GHz

d=1.2/V1]√P d=1.2/V1]√P d=2.3√P

0.01 0.12 0.12 0.23

0.1 0.38 0.38 0.73

1 1.2 1.2 2.3

10 3.8 3.8 7.3

100 12 12 23

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.

VF6 Gamma/Gamma XL D-25

D TECHNICAL DATA

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D-26 Gamma/Gamma XL VF6

E Glossary

The following list explains terms and abbreviations you may encounter while reading this
guide.
AC Alternating Current
ARR Arrhythmia
ART Arterial Pressure
ASY Asystole
aVF Foot augmented lead
aVL Left arm augmented lead
aVR Right arm augmented lead
Battery-backed memory The circuits inside the monitor that retain information after turning
off the monitor. The monitor uses a special long-life battery to
protect the circuits. Patient settings, for example, are saved in
battery-backed memory.
BRDY Bradycardia
Care Unit Group of devices that have the same department identification,
e.g. CCU, ICU, SICU.
CCU Cardiac Care Unit
Communication Power A hardware component that provides DC power and a
Supply (CPS) communication link to the Infinity™ network.
CVP Central Venous Pressure
D or Dia Diastolic pressure
Docking Station™ A mounting device that supports the monitor mechanically and that
provides connections to the Communication Power Supply (CPS)
module. See also Pick and Go.
ECG Electrocardiogram
ESU Electro-surgical unit
Ethernet A popular baseband local area network (LAN) standard. Dräger’s
Infinity™ network is an Ethernet LAN-based network.
Fixed keys Keys located on the front of the monitor. These keys control
various functions, including display, power, NBP measurements,
and recordings.
G Gravity force
E GLOSSARY

Global recorder A recorder shared by many devices on the network.

GP1, GP2 Generic Pressure1, Generic Pressure 2
hr Hour
Hz Hertz
ICP Intra Cranial Pressure
ICU Intensive Care Unit
IDS Infinity Docking Station
in. Inches
Infinity™ Docking Station A hardware component that provides the functionality of both the
(IDS) CPS and the Docking Station. The IDS provides DC power and a
communication link to the Infinity™ network, as well as serving as
a mounting device that supports the monitor mechanically. See
also Pick and Go.
Infinity™ Network The communication network that links Dräger patient monitors to
central stations and peripheral devices.
Interface plate A hardware connection located under the monitor that enables you
to link the monitor with a nurse-call system, an R50 Series
recorder, or an external device (using Export Protocol).
kPa kilopascals
LA Left Arm
LL Left leg
LP Laser Printer
M or Mean Mean Pressure
μA Micro Ampere
Main Menu The top level menu consisting of the following menu options:
Review, Admit/Discharge, Monitor Setup, and Standby. This menu
is accessed by the Menu fixed key.
Main screen The display of waveforms and values only (no menus).
Memory The circuits inside the monitor that store information. Patient data
and settings are stored in memory, for example.
Menu A list of operational functions available on your monitor.
Menu option An alternative for an operational function available on your monitor.
min Minute
mm Millimeter
mm/s Millimeter per second
mmHg Millimeters of mercury
Monitoring Unit Group of devices sharing patient data in a network installation.
ms Millisecond

E-2 Gamma/Gamma XL VF6

Multigas Monitoring Monitoring of O2, CO2, N2O, and of the anesthetic agents
halothane, isoflurane, enflurane, sevoflurane, and desflurane with
the a multigas module.
MultiMed 5™ The pod that receives the following patient cables: ECG leadset,
SpO2 extension cable and a temperature probe.
MultiMed 6™ The pod that receives the following patient cables: ECG leadset,
SpO2 extension cable and a temperature probe.
MultiView Workstation™ The central station that displays the bedsides monitor’s screen of
an Infinity™ network installation at the nurses’ station. See also
Infinity™ network.
mV Millivolt
μV Microvolt
NBP Non-invasive Blood Pressure
NeoMed™ Similar to MULTIMED series, it is used exclusively with neonatal
patients.
Off-line Not connected to or served by the network. See also Standalone.
On-line Connected to or served by the network.
PA Pulmonary Artery Pressure
Parameter A monitored physiological function (e.g., heart rate).
Parameter boxes The areas of the screen where parameter labels and values are
displayed.
Parameter labels The designation of specific physiological parameters that are
displayed in the parameter boxes (e.g., HR, SpO2). Parameter
labels are used to call up a menu on the screen.
Pick and Go™ A design concept for the bedside monitors. The Dräger PICK AND
GO™ concept makes it possible for the monitors to travel with the
patient from one clinical station to another.
PLS or Pls Pulse Rate
PVC/min Premature Ventricular Contractions per minute
R50 Series Recorder Recorder used to print a paper copy of patient data (alarms and
waveforms). The R50 Series recorder connects to the bedside
monitors via the interface plate, the CPS, or IDS.
RA Right arm
RL Right leg
S or Sys Systolic pressure
sec Second
ST ST Segment
Standalone Bedside monitor operating independently of a monitoring network.
Strip-chart The paper copy of patient data from a recorder.
SYNC or sync Synchronization

VF6 Gamma/Gamma XL E-3

E GLOSSARY

TCP/IP Acronym for Transaction Control Protocol/Internet Protocol.

Communication protocol for the Infinity™ network. See also
Infinity™ network.
TENS Transcutaneous Electric Nerve Stimulators
UPS Acronym for Uninterruptible Power Supply. The UPS is a backup
power source for the central station in case the main electrical
source fails. The UPS ensures that the central station is never off-
line and unable to report alarms.
V Volt
V, V+ Chest
VF or V Fib Ventricular fibrillation
VGA video display A 15-inch video display that is used to view the bedside monitor
display. The VGA display has no rotary knob or fixed keys.
VT or V Tach Ventricular Tachycardia
W Ohm

E-4 Gamma/Gamma XL VF6

INDEX Alternate Speed Key 7-3
Amplitude
ECG 8-9
A etCO2 13-5
IBP 16-5
AC adapter 1-20 Rsp 11-8
Accessories A-1 SpO2 12-6
ACE 9-1 Anesthetic Agent 14-2
Adapter, Airway 13-10 Apnea Time 11-11
Admission 4-3 Arrhythmia
date 4-8 alarms 9-6
menu 4-4 basic functions 9-3
name and ID 4-6 full functions 9-3
patient category 4-5 On/Off 9-4
Adults 4-5 rate and count 9-6
Advisory Alarms 5-4 recordings 9-7
Agent Compensation, etCO2 13-15 relearning 9-7
Agent Monitoring 14-2 setup 9-5
Airway Adapter 13-6 Arrhythmia Classification Expert 9-1
cleaning B-7 ART, pressure 16-2
Airway Gases, etCO2 13-14 Atmospheric Pressure 13-17
Alarm Grades 5-2 Auto Set 5-6
Alarm Groups 5-13 AV Sequential Pacemakers 8-21
Alarm Limits Averaging Mode
menu 1-27 etCO2 13-12
setting upper and lower 5-6 SpO2 12-11
Alarm Limits Table 1-27 Axillary Probes 17-3
Alarm Messages 5-16
Alarm Recordings 5-9, 7-13 B
Alarm Settings 5-5
Back Panel 1-11
Alarm Silence 5-11
Balance, etCO2 13-14
Alarm Validation 5-10
Bar Graph
Alarms
NBP 15-8
advisory 5-4
SpO2 12-10
all alarms off 5-12
Battery 1-20, 2-4
arrhythmia 9-6
charging 2-7
central 5-14
gauge 2-4
colors 1-15
inserting into monitor 2-6
etCO2 13-19
lead acid 2-4
life-threatening 5-2
lithium ion 2-4
NBP 15-12
order numbers A-10
On/Off 5-8, 5-11
removing 2-8
serious 5-3
Battery Charger 2-8
silencing 5-11
order number A-10
ST 10-8
Bed Label 3-13
volume 2-18
Biomed Menu C-15
Alarms 5-5
Biomedical Support C-12
All Alarms Off 5-12
demo mode C-17
INDEX
diagnositc log C-18 temperature probes B-4
locked options C-17 CO2 14-2
units of measure C-19 Coincidence Alarms 11-12
Bottom Channel Display 2-12 Colors 1-15, 1-16
Brackets A-13 of electrodes 8-5
Brightness, of screen 2-5 Communication Power Supply 3-7
Compensation
C agent 13-15
atmospheric pressure 13-17
Cables
Components, of network 3-4
alarm output A-14
Composition Values, etCO2 13-14
cleaning B-3
Conductive Parts 8-3
data export A-14
Configuration, see Setup
ECG 8-8
Continuous Recordings 7-8
SpO2 A-6
Copy to Card 4-14
synchronization A-14
Copy to Monitor 4-15
Cables, pod assembly 2-9
Core Probes 17-3
Calibration
Count, Arrhythmia 9-6
etCO2 13-10
CPS, see Communication Power Supply
IBP 16-7
Cuff, NBP
NPB C-14
order numbers A-10
Cannula, etCO2 13-8
selection and placement 15-4
cleaning B-7
CVP, pressure 16-2
Capnogram 13-4
Capnostat 13-2, 13-6
cleaning B-7
D
Card 4-14 Data Transfer 4-10, 4-13
for transfer 4-13 Date and Time 2-17, 4-8
Card Copy 4-14, 4-15 DDD Pacemakers 8-21
Card, wireless network 3-12 Default Settings C-2
Cardioversion 8-19 Defibrillators, safety 1-6, 8-19
Care Unit 3-13 Dehumidification, etCO2 13-8
Cascaded Display Demo Mode C-17
ECG 8-10 Desflurane 14-2
SpO2 12-7 Device Markings 1-7
Category, of patients 4-5 Diagnostic Log C-18
Central Alarms 5-14 Diastolic Pressure
Central Display, wireless 3-15 IBP 16-4
Channel NBP 15-2
SpO2 display 12-5 Display
Channel Display Menu 1-27 screen brightness 2-5
Charging, of battery 2-7 Discharge 4-9
Checks, safety 1-5 Disinfecting B-2
Cleaning B-2 cables B-3
airway adapter B-7 electrodes B-3
cables B-3 monitor B-2
capnostat B-7 sidestream pump B-9
electrodes B-3 temperature probes B-4
etCO2 Pod B-7 Display 1-15
monitor B-2 battery gauge 2-4
nasal cannula B-7 bottom channel 2-12
pressure transducer B-5 cascade 8-10
sidestream pump B-7 channels 1-27
SpO2 sensor B-4 colors 1-15, 1-16

Index-2 Gamma/Gamma XL VF6

 INDEX

configuration 2-11 lead sets A-3

IBP 16-4 MCL1 configuration 8-6
RESP 11-7 RESP positions 11-3
Rsp markers 11-10 Electrosurgery, safety 1-6, 8-17
SpO2 12-5 EMI, reducing 1-2
sync marks 8-15 EMI, standards 1-2
wireless network 3-15 End-tidal, see etCO2
Display Amplitude Enflurane 14-2
ECG 8-9 ESU, see electrosurgery
etCO2 13-5 etCO2
IBP 16-5 accessories A-6
SpO2 12-6 adapter 13-10
Displays agent compensation 13-15
order numbers A-12 airway adapter 13-6
Planar A-12 airway gases 13-14
remote 1-23 alarms 13-19
Sony A-12 averaging mode 13-12
types of A-12 balance 13-14, 13-15
VGA 1-23 capnogram 13-4
Docking Station 3-7 capnostat 13-6
Docking 3-9 display amplitude 13-5
Undocking 3-9 functions 13-2
inspired CO2 13-3
E instantaneous CO2 13-2
mainstream monitoring 13-7
ECG
measurement mode 13-15
arrhythmia functions 9-3
menu 1-30
cables 8-8
pressure compensation 13-17
cascade 8-10
RRc 13-3
display amplitude 8-9
RRc apnea time 13-13
electrode colors 8-5
sampling cannula 13-8
electrode placement 8-5
sensor 13-10
functions 8-2
setup 13-12
leads 8-8, A-3
sidestream monitoring 13-8
menu 1-27
tubing 13-8
notch filter 8-16, C-12
units C-19
pacemakers 8-14
etCO2 Pod 13-6
patient preparation 8-3
cleaning B-7
pods 1-21, 2-9
Event Recall 7-14
pulse tone 8-12
printing recordings 7-16
relearning 9-7
saving recordings 7-16
safety 8-16
storing recordings 7-16
signal processing 8-11
Extension Cables
sync marks 8-15
SpO2 A-6
TENS 8-22
tone volume 8-13
Electrical Safety 1-4
F
Electrodes Fast Access Menu 1-26
3-Lead configuration 8-5 Fixed Keys, monitor operation 1-18
3-Lead, neonates 8-7 Front Panel 1-10
5-Lead configuration 8-6
6-Lead configuration 8-7 G
cleaning B-3
GP1, pressure 16-2
color coding 8-5
GP2, pressure 16-2

VF6 Gamma/Gamma XL Index-3

INDEX

H Lithium Ion Battery 2-4

Locked Options C-17
Halothane 14-2 Loudness 2-18
HR, see ECG 1-27
M
I Main Menu 1-24
IBP Main Screen Configuration 2-11
accessories A-8 Mainstream Accessories A-7
amplitude 16-5 Mainstream, etCO2 13-7, 13-15
calibrating transducer 16-10 Maintenance, monitor 1-5
calibration 16-7 Making Selections 1-17
display 16-4 Masimo
functions 16-2 sensors and cables A-6
IBP1, IBP2 16-2 MCL1 ECG Config. 8-6
menu 1-32 Mean Pressure
transducer 16-6, A-8 IBP 16-4
units C-19 NBP 15-2
zeroing 16-7 Measurement Mode,etCO2 13-15
IBP Labels 16-2 Measurement Tone, NBP 15-10
iCO2 13-3 Measuring Point, ST 10-5
ICP, pressure 16-2 Memory Card A-14
ID 4-6 transferring data with 4-13
IDS, see Infinity Docking Station Menus 1-19
Infinity Docking Station 3-7 fast access 1-26
Infinity Network 3-2 menu tree 1-24
Inflation, NBP 15-8 navigation 1-17
Infusion Pumps, safety 8-19 Messages 5-16
Inspection, monitor 1-5 arrhythmia (ARR) 5-21
Inspired CO2 13-3 network status 3-17
Instantaneous CO2 13-2 pulse oximetry (SpO2) 5-31
Interface Plate 1-14, 7-3 recordings 7-17
Interval Mode, NBP 15-6 respiration 5-22
Invasive Blood Pressure, see IBP ST segment analysis 5-21
Isoelectric Point, ST 10-5 test C-13
Isoflurane 14-2 mm/s Key 7-3
Monitor
K back panel 1-11
biomedical support C-12
Keys, monitor operation 1-18
cleaning B-2
Knob 1-17
connections 1-12, 1-13
date and time 2-17
L default settings C-2
Labels, Device Markings 1-7 disinfecting B-2
Labels, IBP 16-2 display 1-15
Laser Printer 7-6 front panell 1-10
Latex 17-3 functions 1-8
Lead Acid Battery 2-4 general description 1-8
Lead Sets A-3 interface plate 1-14
Leads keys 1-18
ECG 8-8, 8-9 left side panel 1-12
Life-Threatening Alarms 5-2 line frequency C-12
Limits, alarms 5-6 maintenance 1-5
Line Frequency C-12 menus 1-19, 1-24

Index-4 Gamma/Gamma XL VF6

 INDEX

On/Off 2-10 Network

peripherals 1-9 alarm groups 5-13
pods 1-21 central alarms 5-14
power sources 1-20 components 3-4
regulatory compliance D-2 configurations 3-3
right side panel 1-13 docking station 3-7
rotary knob 1-17 functions 3-2
simulation/demo mode C-17 messages 3-17
site of operation 1-3 operation 3-6
specifications D-2 Pick and Go 3-10
standby mode 2-19 recorders 7-6
startup tests C-13 safety 3-16
volume, of tones 2-18 setups 3-5
Mounting Devices A-13 wireless 3-11
Multigas Modules Neutral Electrode 8-3
connecting 14-8 Non-invasive Blood Pressure, see NBP
Multigas Monitoring 14-1 Notch Filter 8-16, C-12
MultiMed Pod 1-21 NPB
cable assembly 2-9 mode 15-8
types A-2
Muscle Stimulators 8-16 O
N O2 14-2
On/Off 1-18, 2-10
N2O 14-2 Options A-1, C-17
NAFION 13-8 OR Mode 14-9
Name 4-6 Overview, menus 1-24
Nasal Cannula OxyCRG 11-15
cleaning B-7 recordings 7-13, 11-17
Navigation 1-17
NBP P
accessories A-10
PA, pressure 16-2
alarms 15-12
calibration C-14 Pacemakers 8-14, 8-20
AV and DDD 8-21
connector 15-4
safety 1-6, 8-21
cuff placement 15-4
cuff selection 15-4 Pacer Detection On/Off 8-14
Paper Recording 7-4
inflation limit 15-8
Parameters
interval mode 15-6
measurement tone 15-10 colors 1-16
configuration 2-11
measurements 15-6
display 2-11
menu 1-32
neonatal monitoring 15-2 menus 1-27
monitored 1-8
safety 15-5
Patient Admission 4-3
units C-19
Nellcor Patient Category 4-5
NBP inflation 15-8
sensors and cables A-6
Patient Discharge 4-9
NeoMed Pod 1-21
cable assembly 2-9 Patient ID 4-6
Patient Name 4-6
order number A-2
Patient Preparation
Neonates 4-5
ECG monitoring 8-16 ECG 8-3
NPB 15-4
NPB monitoring 15-2
Rsp 11-3
OxyCRG 11-15
SpO2 12-2

VF6 Gamma/Gamma XL Index-5

INDEX
Patient Setup alarm 5-9, 7-13
saving C-16 arrhythmia 9-7
Patient Setup, saving 2-20 continuous 7-8
Patient Transfer 4-10 deleting stored recordings 7-16
wireless 3-15 event recall 7-14
Pediatric Patients 4-5 format 7-9
Peripheral Equipment 1-4, 1-9 messages 7-17
Pick and Go 3-10 network 7-6
Planar Video Display A-12 OxyCRG 7-13, 11-17
Pod printing stored recordings 7-16
etCO2 13-6 saving stored recordings 7-16
Pods 1-21 storing 7-14
assembly 2-9 timed 7-7
Power 1-18, 1-20 trends 7-11
accessories A-10 types of 7-7
battery 2-4 Rectal Probes 17-3
CPS 3-7 Reference Complex, ST 10-7
IDS 3-7 Regulatory Compliance D-2
Power Cords A-11 Relearning 9-7, 11-13
Pressure Labels, IBP 16-2 Remote Displays 1-23
Pressure, atmospheric 13-17 Respiration
Pressure, see NBP or IBP apnea time 11-11
Probes coincidence 11-12
axillary 17-3 display 11-6
cleaning B-4 electrode placement 11-3
disinfecting B-4 functions 11-2
order numbers A-8 markers 11-10
rectal/core 17-3 menu 1-29
safety 17-3 OxyCRG 11-15
sterilizing B-4 patient preparation 11-3
types of 17-3 relearning 11-13
Pulse Oximetry, see SpO2 safety 11-14
Pulse Tone 8-12 sensitivity 11-8
SpO2 12-8 waveform amplitude 11-8
volume 8-13, 12-9 waveform selection 11-7
P-Waves, high 8-19 Respiration Mode 11-9
Rolling Stand A-13
Q Rotary Knob 1-17
RRc 13-3
QRS Amplitude 8-9
RRc Apnea Time 13-13
QRS Sync Marks 8-15
QRS Tone Volume 8-13
S
R Safety
50/60 Hz Notch Filter 8-16
R50 Recorder 1-22
cardioversion 8-19
Rails A-13
defibrillation 1-6, 8-19
Rate, Arrhythmia 9-6 ECG/HR 8-16
Recorder 1-22
electrical 1-4
accessories A-13
electrosurgery 1-6, 8-17
connections 7-3 functional checks 1-5
preparation 7-3
general considerations 1-2
Recording Paper 7-4
infusion pumps 8-19
Recordings inspection 1-5

Index-6 Gamma/Gamma XL VF6

 INDEX

labels 1-7 Silencing Alarms 5-11

monitor 1-5 Simulation, of waveforms C-17
muscle stimulators 8-16 Skin Preparation 8-3, 11-3
NBP 15-5 Sony Video Display A-12
NBP (neonates) 15-2 Speaker Volume 2-18
neonatal ECG 8-16 Specifications D-2
P/T-Waves 8-19 SpO2
pacemakers 1-6, 8-20, 8-21 averaging mode 12-11
peripheral devices 1-4 bar graph 12-10
respiration 11-14 cascaded display 12-7
site of operation 1-3 cleaning B-4
SpO2 12-4 display 12-5
temperature probes 17-3 display amplitude 12-6
TENS 8-22 extension cables A-6
wireless network 3-16 menu 1-31
Sampling Cannula 13-8 pulse tone 12-8, 12-9
cleaning of B-7 safety 12-4
Saving Setups 2-20, C-16 sensor application 12-2
Scio 14-4 sensor cleaning B-4
connections 14-3 signal strength 12-10
warm-up 14-6 SpO2 Sensor 12-2
Screen ST
brightness 2-5 alarms 10-8
configuration 2-11 description 10-2
display channels 1-27 display 10-3
wireless network 3-15 functions 10-4
Select isoelectric point 10-5
channels 1-27 measuring point 10-5
Selections, menu 1-17 menu 1-31
Sensitivity, respiration 11-8 reference complex 10-7
Sensor, SpO2 12-2 setup 10-4
Sensors units C-19
SpO2 A-6 ST Segment Analysis, see ST
Serious Alarms 5-3 Standards D-2
Service, diagnostic log C-18 Standby 2-19
Setup 5-5 Startup 2-10
arrhythmia 9-5 Startup Tests C-13
defaults C-2 messages C-13
ECG 8-5 Sterilizing B-2
etCO2 13-12 cables B-3
main screen 2-11 pressure transducer B-6
network 3-3, 3-5 sidesteam pump B-9
recordings 7-3 temperature probes B-4
saving 2-20, C-16 Stored Recordings 7-14
ST 10-4 Strip Recording 7-4
trend 6-3 Sync Marks 8-15
wireless network 3-11 Systolic Pressure
Sevoflurane 14-2 IBP 16-4
Show Rsp 11-6 NBP 15-2
Sidestream Accessories A-7
Sidestream Pump, cleaning B-7 T
Sidestream, etCO2 13-8, 13-15
Table
Signal Processing 8-11
alarm limits 1-27
Signal Strength Bar Graph 12-10

VF6 Gamma/Gamma XL Index-7

INDEX
Technical Data D-2
Temperature
U
accessories A-8 Undocking 3-9
functions 17-2 Units of Measure C-19
probes 17-3 etCO2 C-19
units 17-2, C-19 pressure C-19
TENS signals 8-22 ST C-19
Time and Date 2-17, 4-8 temperature 17-2, C-19
Timed Recordings 7-7
Tone V
NBP tone 15-10
VGA displays 1-23
pulse tone source 12-8
pulse tone volume 12-9 Volume 2-18, 8-13
pulse tone 12-9
Tone Source 8-12
Tone Volume 2-18
Transducer W
types of A-8 Wall Mount A-13
Transducer, IBP 16-6 Waveform Configuration 2-11
calibrating 16-10 Wireless Card 3-12
cleaning B-5 Wireless Network
sterilizing B-6 bed label 3-13
Transfer 4-10 care unit 3-13
across network 4-11 central display 3-15
wireless 3-15 functions 3-12, 3-13
with memory card 4-13 messages 3-17
Trend patient relocation 3-15
codes 6-8, 6-9 safety 3-16
graphs 6-4 setup 3-11
setup 6-3
table 6-6 Z
Trend Recordings 7-11
Tubing, etCO2 Zeroing, IBP 16-7
cleaning B-7 Zoom, fast access 1-26
Tubing, IBP 16-6
T-Waves, high 8-19

Index-8 Gamma/Gamma XL VF6

 INDEX

This page intentionally left blank

VF6 Gamma/Gamma XL Index-9

These Instructions for Use only apply to
Infinity Gamma Series VF6

with the Serial No.:

If no Serial No. has been filled in by Dräger,
these Instructions for Use are provided for
general information only and are not intended
for use with any specific machine or device.
This document is provided for customer infor-
mation only, and will not be updated or
exchanged without customer request.

Directive 93/42/EEC
for medical devices

Manufactured by Distributed in US by In Europe, Canada, Middle East, Africa,

Latin America, Asia Pacific distributed by
Draeger Medical Systems, Inc. Dräger Medical, Inc. Dräger Medical GmbH
3135 Quarry Road 3135 Quarry Road
Telford, PA 18969-1042 Telford, PA 18969-1042 Moislinger Allee 53 – 55
U.S.A. U.S.A. D-23542 Lübeck
(215) 721-5400 (215) 721-5400 Deutschland
(800) 4DRAGER (800) 4DRAGER +49 451 8 82-0
(800 437-2437) (800 437-2437)
FAX (215) 723-5935 FAX (215) 723-5935 FAX +49 451 8 82-20 80
http://www.draeger.com http://www.draeger.com http://www.draeger.com

MS17670 - RI - 05 EN
© Dräger Medical GmbH
Edition: 2010-09
Dräger reserves the right to make modifi-
cations to the equipment without prior
notice.