Larsen & Toubro Planet 55 Monitor - User Manual

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LARSEN & TOUBRO LIMITED

Planet 55

Operating Manual
Planet 55
LARSEN & TOUBRO LIMITED

Planet 55
4 Channel Color Multiparameter Monitor

Operating Manual
Planet 55
0843
CAT NO. : 3-89-020-0007-84 ISSUED : April 2010 Rev. :06
© 2010 Larsen & Toubro Limited

Larsen & Toubro Limited


Medical Equipment & Systems
Gate #5, Mysore Campus,
Plot #358-360,
KIADB Industrial Area, Hebbal,
Mysore - 570018.
Karnataka, India.
All rights reserved
L&T medical reserves the right to make changes in specifications and features shown
herein or discontinue the product described at any time without notice or obligation. The
contents in this manual are strictly not to be reproduced in any form, by any method, for
any purpose.

Planet 55
Introduction
Congratulations on becoming one of the proud
customers of L&T Medical’s multiparameter color
monitor Planet 55.

Planet 55 offers continuous monitoring for ECG (3/5


lead), Respiration, Temperature, Non-Invasive Blood
Pressure, Pulse Oximetry and Optional Capnography
(microstream) with an inbuilt two-channel thermal array
recorder which can record on-line data (any two
waveform out of ECG waveform, plethysmograph and
respiration/capnography along with numerical values
of all parameters).

Planet 55 is a four channel monitor except incase of


AAMI with selectable waveform display facility for ECG
Cascade, Respiration waveform, Plethysmograph and
Capnograph. It also displays the digital values of HR/PR,
SpO 2, Respiration Rate, Non-Invasive Blood Pressure
(Systolic, Diastolic and Mean), Temperature and CO 2
(EtCO 2 and FiCO 2) readings. Planet 55 has graded and
color coded alarms. It has the option of 72 hours tabular
and graphical trends for 200 patients of ECG (HR/PR),
Respiration rate, SpO 2 ,Temperature and CO 2 (EtCO 2
and FiCO2). Planet 55 has special tabular trend for NIBP
to store last 240 readings. Alarm recall feature offers
storage of last 24 critical alarm conditions.

Planet 55 also has a feature of SD Card (Optional).

Planet 55 has various communication modules for


various external connectivity and software upgrade
options. Planet 55 also has a connectivity to external
printer through USB port (optional). Planet 55 allows
the user to print the trend data and last 24 patient
related alarm conditions in tabular format.

Planet 55
Table Of Contents
Exemptions . . . . . . . . . . . . . . . . . i
Copyright. . . . . . . . . . . . . . . . . . i
Standards . . . . . . . . . . . . . . . . . i
Disposal Instructions . . . . . . . . . . . . . . i
Caution . . . . . . . . . . . . . . . . . . ii
WARNING . . . . . . . . . . . . . . . . . iii
Unpacking . . . . . . . . . . . . . . . . . iv
Indication For Use . . . . . . . . . . . . . . . v
Handling Precautions . . . . . . . . . . . . . . vi
Symbols . . . . . . . . . . . . . . . . . . vii
Abbreviations . . . . . . . . . . . . . . . . ix

1. Display, Controls And Connections . . . . . . . . . . 1.1


• Front Panel . . . . . . . . . . . . . . . . . 1.3
• Rear Panel . . . . . . . . . . . . . . . . . 1.6
• Left Side Panel . . . . . . . . . . . . . . . . 1.8
• Right Side Panel . . . . . . . . . . . . . . . 1.10
• Procedure To Connect And Disconnect The Connectors . . . 1.12
• Recorder (Optional) . . . . . . . . . . . . . . 1.16
• Remote . . . . . . . . . . . . . . . . . . 1.18

2. Application Guide . . . . . . . . . . . . . . . . 2.1


• ECG . . . . . . . . . . . . . . . . . . . 2.3
• Respiration . . . . . . . . . . . . . . . . . 2.8
• Temperature. . . . . . . . . . . . . . . . . 2.10
• Pulse Oximetry . . . . . . . . . . . . . . . . 2.11
• Non Invasive Blood Pressure . . . . . . . . . . . 2.13
• Capnography (Optional) . . . . . . . . . . . . . 2.15

3. Operations And Main Screen. . . . . . . . . . . . . 3.1


• Operation . . . . . . . . . . . . . . . . 3.3
• Main screen . . . . . . . . . . . . . . . . . 3.4

4. Parameter Setting . . . . . . . . . . . . . . . . 4.1


• ECG . . . . . . . . . . . . . . . . . . . 4.3
• Respiration . . . . . . . . . . . . . . . . . 4.5

Planet 55
• Temperature . . . . . . . . . . . . . . . . 4.6
• Pulse Oximetry . . . . . . . . . . . . . . . . 4.7
• Non Invasive Blood Pressure . . . . . . . . . . . 4.8
• Capnography (Optional) . . . . . . . . . . . . . 4.10

5. System Functions . . . . . . . . . . . . . . . . 5.1


• System Functions . . . . . . . . . . . . . . . 5.4
• Menu . . . . . . . . . . . . . . . . . . . 5.5
• Trend . . . . . . . . . . . . . . . . . . . 5.13
• Display . . . . . . . . . . . . . . . . . . 5.20
• Volume . . . . . . . . . . . . . . . . . . 5.22
• Recall . . . . . . . . . . . . . . . . . . 5.23
• Autoset . . . . . . . . . . . . . . . . . . 5.23

6. Maintenance Schedule . . . . . . . . . . . . . 6.1

7. Accessories . . . . . . . . . . . . . . . . . . 7.1
• ECG . . . . . . . . . . . . . . . . . . . 7.3
• Respiration . . . . . . . . . . . . . . . . . 7.3
• Temperature . . . . . . . . . . . . . . . . 7.4
• Pulse Oximetry . . . . . . . . . . . . . . . . 7.5
• Non Invasive Blood Pressure . . . . . . . . . . . 7.6
• Capnography (Optional) . . . . . . . . . . . . . 7.7
• Grounding Cable . . . . . . . . . . . . . . . 7.9

8. Trouble Shooting And Waveforms . . . . . . . . . . . 8.1


• Troubleshooting Chart . . . . . . . . . . . . 8.3
• Error Messages . . . . . . . . . . . . . . 8.5
• Problems Observed During ECG Monitoring . . . . . . . 8.11
• Problems Observed During CO 2 Monitoring . . . . . . . 8.17

9. Technical Specifications . . . . . . . . . . . . . . 9.1


• System Specifications . . . . . . . . . . . . . 9.3
• Electro Magnetic Compatibility Information And Manufacturer’s Declaration 9.15

10.Warranty And Warranty Service . . . . . . . . . . . . 10.1


Exemptions
L&T's liability under this warranty does not include any transportation damage
or other charges or liability for direct, indirect or consequential damages or
delay resulting from improper use or application of the product or the substitution
upon it of parts or accessories not approved by L&T.

Copyright
L&T owns all rights to the manual and intends to maintain this manual as
confidential. L&T also seeks to maintain this manual as a copyright. This manual
is to be used solely for the purpose of reference, operation and maintenance of
L&T equipment.
The contents of this manual are proprietary. Reproduction or distribution of any
part of this manual in any form is prohibited.
Due to continuous updating of technology, the specifications, as well as
information in this manual, are subject to change without prior notice.
All information in this manual is believed to be correct. L&T shall not be liable for
errors contained herein with the performance or use of this manual.

Standards
This equipment has been designed to meet the following International standards:
Class 1 equipment requirement of IEC 60601-1.
EMI/EMC requirements as per IEC 60601-1-2.
IEC 60601-2-27 requirements for ECG.
IEC 60601-2-30 requirements for NIBP.
IEC 60601-1-8 requirements for alarm systems.
IEC 60601-2-49 requirements for multifunction patient monitor systems.
ISO 9919 requirements for SpO2.
ISO 21647 requirements for CO2.
AAMI EC 13 for ECG.
AAMI SP 10 for NIBP.

Disposal Instructions
• Follow the local regulations and procedures for the disposal of the unit and battery.

Planet 55 i
Read all the Cautions, Warnings and Notes provided throughout the Operating Manual
before using the monitor.
Caution
Cautions are intended to alert you to the importance of following correct operating
procedures to prevent the risk of damage to the system.

z Electrical installation of the room or the building in which the equipment is to be used,
should comply with regulations specified by the country in which the equipment is to
be used.
z If earthing arrangements are suspected, the monitor must be connected to a mains
line with proper earth connection to ensure correct readings.
z The equipment should be used in accordance with the "instruction for use" provided
by L&T and as specified on the rear panel of the monitor.
z If any function of the monitor fails, then consult L&T Medical authorized service engineer.
z Failure to meet ventilation requirement may cause equipment failure and intern
jeopardise the functions of automated monitoring. Do not place equipment in an
enclosed area that could restrict heat dissipation from the front or rear of the unit.
z Keep pacemaker patients under close observation. Rate meters may continue to
count the pacemaker rate during cardiac arrest and some arrhythmia.
z This equipment is meant for use by qualified medical personnel only.
z For the disposal of battery after its life, follow the local regulations and procedures.
z Use L&T approved Accessories and Batteries.

ii
WARNING
WARNINGs are intended to alert you to the importance of following correct operating
procedures where risk of injury to the patient or system user exists.

z All modifications and repairs should be carried out by authorized L&T personnel or
authorized agents.
z Alarms:
Adjusting the alarm volume to a low level or switching OFF alarms during patient
monitoring may result in alarm conditions going unnoticed. Hence do not rely fully on
audible alarm.
The most reliable method of patient monitoring combines close personal
surveillance with correct operation of monitoring equipment.
z After AC power is resumed keep the monitor ON for 16 hours to charge the battery,
if low battery indicator is displayed.
z When 'low battery' indication comes on screen, connect the unit to main supply and keep the
unit for charging.
z Use only L&T approved accessories and batteries.
z Do not use damaged cables/sensors, cuffs and contaminated accessories.
z When several equipment of different companies/makes are interconnected through the
same mains power distribution line, the summation of the resulting leakage
currents may exceed the maximum limits.
z Explosion hazards are possible if used in the presence of flammable anesthetics.
z For continued protection against fire hazard, use fuses of only specified type and rating.
z 'Electrical shock hazard'. Do not remove cover. Refer to qualified personnel for servicing.
z Patient safety and performance of this unit when connected to patients undergoing magnetic
resonance diagnostic procedures is unknown. We advice that all sensors and cables
used with this unit should be removed from patient during such procedures.
z L&T medical does not assume responsibility for damage to the equipment caused by
improperly ventilated cabinets, improper or faulty power or insufficient wall strength incase
of wall mounted units.
z Do not use the machine with nuclear spin tomography (MRT, NMR, NMT) as the function of the
machine may be disturbed.
z Pay extra attention if the parts of the equipment are provided with protections against burning
the patient when used with High Frequency (HF) surgical equipment.
z Observe extreme caution when a defibrillator is used on a patient. Do not touch any part
of patient, table or monitor when a defibrillator is in use.

Planet 55 iii
Unpacking
Check for any signs of transportation damage after removing the Patient Monitor from
the packing carton. Verify the material in the packing carton as per the packing list
sent along with the monitor.
Preserve the packing carton as it may required/useful for future use.

iv
Indication For Use
The Planet 55 multiparameter Patient Monitoring system is intended to monitor a single
adult, pediatric or neonatal patient’s vital signs at the bedside or during Intra-hospital
transport along with the appropriate accessories mentioned / supplied with the unit.
Vital signs parameters include ECG (3 lead / 5 lead), SpO2, Respiration, Temperature
and Capnography (CO2). It can also display the digital values of HR/PR, SpO2, RR, Non-
Invasive Blood Pressure (Systolic, Diastolic and Mean), Temperature, EtCO2 and FiCO2
readings.

The user, responsible to interpret the monitored data made available, will be a
professional health care provider. The device permits patient monitoring with adjustable
alarm limits as well as visible and audible alarm signals. The monitor is not intended
for home use.

Planet 55 v
Handling Precautions
This monitor is intended for use by only qualified medical personnel and a monitor is
restricted to one patient at a time.
Please read these precautions thoroughly before attempting to operate this monitor.
1. To satisfactorily and effectively use monitor, its operation must be fully understood.

2. While installing or storing the monitor, take the following precautions.


• Avoid moisture or contact with water, extreme atmospheric pressure, excessive
humidity and temperatures, poorly ventilated areas, and dusty air.
• The monitor should be placed on an even, level floor. Vibration and mechanical
shock should be avoided even during moving.
• Avoid placing in an area where chemicals are stored or where there is danger of
gas leakage.
• The power line source to be applied to the monitor should correspond in frequency
and voltage to specifications, and have allowable current capacity.

3. Before Operation
• Check that the monitor is in perfect operating order.
• Check that the monitor is grounded properly.
• Check that all accessories are connected properly.
• Pay extra attention when the monitor is in combination with other instruments to
avoid misdiagnosis or other problems.
• All circuitry used for direct patient connection must be doubly checked.
• Check that the unit is not indicating low battery.

4. During Operation
• Both the monitor and the patient must receive constant, careful attention.
• Turn power OFF or remove electrodes and cables when necessary to assure the
patient's safety.
• Avoid direct contact between the monitor and the patient.
• Extra care should be taken when the monitor is in use with the HF Surgical
Equipment.
Note
The applied parts of NIBP and CO2 are protected against HF surgical burns and the
applied parts of ECG, SpO 2 and Temperature are not protected.
5. To Shutdown After Use
• Turn power OFF with all controls returned to their original positions.
• Remove all accessories gently, do not use force to remove them.
vi
Symbols

Logo

~ Mains 110 / 230 Volts ON indicator

Unit ON indicator

Equipotential ground

! Attention, refer to manual

Defibrillation – Proof type-CF of Applied Part

Defibrillation – Proof type-BF of Applied Part

Global Alarm suspended

Alarm Acknowledge

Indicates valid QRS/Pulse detection

* Indicates detection of PR from Plethysmograph

Indicates detection of PR from NIBP

$ Indicates detection of PR from IBP

Manufacturer

Authorised representative in the european community

Planet 55 vii
viii
Abbreviations

SpO2 Oxygen Saturation in %

HR Heart Rate (derived from ECG)

BPM Beats Per Minute (HR/PR)

BPM Breaths Per Minute (RR)

FLT Fault

SYS Systolic Blood Pressure

DIA Diastolic Blood Pressure

MEAN Mean Blood Pressure

PR Pulse Rate

RR Respiration Rate

EtCO2 End Tidal Carbon dioxide

FiCO2 Fractional Inspired Carbon dioxide

DPI Dot Per Inch

CNS Central Nursing Station

PA Physiological Alarm

TA Technical Alarm

CIC Communication Interface Card

NA No Alarm

Planet 55 ix
1

DISPLAY, CONTROLS,
CONNECTIONS
AND OUTPUTS

Planet 55 1.1
Notes:

1.2
Front Panel

17 16 15 14

13

1 234 5 6 7 8 9 10 11 12
Figure 1.1

Planet 55 1.3
Front Panel Description

1 Monitor ON/OFF switch To switch ON or switch OFF the monitor (Unit should
be connected to the mains supply or to the internal
battery).
2 Mains Indicator Amber color LED turns ON when Mains is connected.
3 Remote sensor To sense the remote signals.
4 Monitor ON indicators Amber LED ON indicates Mains ON.
Green LED ON indicates Monitor ON.
Amber LED OFF and Green LED ON indicates unit
is ON in battery operation mode.
5 Alarm Acknowledge On pressing this key, all audio alarms are muted or
suspended. When Audio/Visual alarms are indicated
by the unit, this key acts as alarm acknowledge key.
6 NIBP Start/Stop This key is used to start/stop the Auto/Manual NIBP
measurement.
7 Freeze/Defreeze To Freeze / Defreeze the screen, this key is used.
8 Record To Start / Stop recorder.
9 Goto This key used as a short cut key for Menu option.
10 Stand By This key is used for the monitor to go to stand by
mode. Press again this key to monitor real time
screen. Stand By mode is a power saving option.
11 Home To come back directly to the Main screen, from any
other screen.
12 Optical Encoder This is a special rotating knob used for multipurpose
applications. Rotating the Optical Encoder in clockwise
or anti-clockwise direction, moves the cursor
(highlighted rectangular block) right or left in the Menu
area of the screen. Pressing the Optical Encoder
selects the particular function.
13 Menu Display Area Displays Main menus.
14 Parameter/Numeric Displays numerical values for all parameters which
are present.

1.4
15 Alarm Indicator Gives flashing Yellow color indication for cable /
accessory related alarms like cable coming off patient
and flashing Red color indication for patient related
alarms, e.g. when the value of any parameter being
monitored goes above or below the set alarm limits.

Audio frequency [AAMI 4.1.2.1(i)] :


Red alarm: 1.7 kHz
Yellow alarm : 1.4 kHz
Video frequency :
Red alarm : 2 Hz (250ms ON, 250ms OFF)
Yellow alarm : 0.5 Hz (1s ON, 1s OFF)
Fixed 3 minutes realarm facility is present.
Crossed bell indication for alarm silence.
16 Waveform Display Area Displays waveforms. Maximum 4 channel
monitor.
17 Message Display Area Displays error messages.

Planet 55 1.5
Rear Panel

0843

3
1

Figure 1.2

1.6
Rear Panel Description

Connector Function

1 Equipotential Ground For external grounding.


2 Mains Plug Connection for 95-265V AC, 50Hz/60Hz + 5%.
3 CIC Communication Interface Card.

CIC available in Planet 55:

CIC Connectors
CIC-4 PC Dump + CNS

Usage of the connectors as shown below:

Connector Description

DB9 PC Dump.
USB Central Nursing Station.

Planet 55 1.7
Left Side Panel

1 4

5
2

3
6

Figure 1.3

1.8
Left Side Panel Description

Connector Function

1 SpO2 To interface SpO2 sensor to the monitor with the help of


extension cable.
2 NIBP To interface NIBP cuff to the monitor with the help of
hose tube.
3 CO2 Exhaust To vent for CO2 gas sample.
4 ECG To interface ECG 3lead or 5lead cable with monitor.
5 TEMP To interface Temperature probe to the monitor.
6 CO2 To Input for gas sample.
7 USB To connect external Printer# (Refer Figure 1.4) / for
software upgradation*/ for Trend download*.
8 SD Memory** To transfer the trend data from one monitor to another.

Figure 1.4

* Use 1GB or 512 MB of Sandisk make.


** Use 1GB, 2GB or 512 MB of Sandisk make.
# Use USB Printer which supports PCL5e and PCL6.

Planet 55 1.9
Right Side Panel

Figure 1.5

1.10
Right Side Panel Description

Connector Function

1 Recorder To print the waveform with the digital values.


2 Nurse Call Configurable relay to activate nurse call.
3 Defib. Sync For synchronizing monitor with defibrillator.

Planet 55 1.11
Procedure To Connect And Disconnect The Connectors
ECG :

Connect Disconnect
Align the notch of the ECG cable connector Gently pullout the ECG cable connector
with the connector slot on the Side panel as shown below.
with the unit and insert the cable as shown
below.

Figure 1.6 Figure 1.7

Temp :

Connect Disconnect
Insert the Temperature connector in the Gently pullout the Temperature connector
slot (Temp 1 / Temp 2) provided on the as shown below.
Side panel of the unit as shown below.

Figure 1.8 Figure 1.9

1.12
NIBP :

Connect Disconnect
Insert the NIBP connector in the slot Press the NIBP connector on the side
provided on the side panel of the unit as panel of the unit and remove the connector
shown below. as shown below.

Figure 1.10 Figure 1.11

SpO2 :

Connect Disconnect
Align the SpO2 connector with the D-type Press the release notch of the connector
connector slot on the side panel of the unit and remove the connector as shown
and insert as shown below. below.

Figure 1.12 Figure 1.13

Planet 55 1.13
CO2 :

Connect Disconnect
a) Open the CO2 inlet shutter in the a) Turn the CO2 connector in anticlockwise
direction as shown below. direction to unlock as shown below.
b) Insert the CO2 connector and turn b) Gently pullout the CO2 connector
clockwise direction to lock as shown as close the inlet shutter.
below.

Figure 1.14 Figure 1.15

Power cord :

Connect Disconnect
Insert the Power cord connector in the Gently pullout the Power cord connector
solt provided on the Rear panel of the as shown below.
unit as shown below.

Figure 1.16 Figure 1.17

1.14
Grounding cable :

Connect Disconnect
Insert the Grounding cable connector in Gently pullout the Grounding cable
the slot provided on the Rear panel of connector as shown below.
the unit as shown below.

Figure 1.18 Figure 1.19

Planet 55 1.15
Recorder
Green LED
Red LED

Feed Key

Figure 1.20

Function

Green LED Indicates Power ON.


Red LED It blinks if recorder cover is not properly closed or paper is
not present.
Feed Key Step feeding of paper (approx. 0.5 cm jump)

On-line Recording Output:


i. Delayed recording : Any two waveforms out of ECG, plethysmograph,
respiration/capnograph can be selected for recording
along with digital values, unit and alarm status of all
parameters in Delayed recording.

ii. Trend data recording : The status of any three parameters can be selected
for recording in tabular format.

iii. NIBP data recording : The status of NIBP along with any two other parameters
can be selected for recording in tabular format.

1.16
i. Delayed recording ii. Trend data recording iii. NIBP data recording
- - - - - - - - - DELAYED - - - - - - - - - - - - - - - TABULAR TREND - - - - - - - - - - - - - - - NIBP TREND - - - - - - - - -

-------------------------------------------- -------------------------------------------- --------------------------------------------


DATE : 26 OCT 2006 TIME : 09 : 00 DATE : 26 OCT 2006 TIME : 08 : 58 DATE : 26 OCT 2006 TIME : 08 : 58
NAME : SMITH JOHN NAME : SMITH JOHN NAME : SMITH JOHN
ID NO : 21119 99979 ID NO : 21119 99979 ID NO : 21119 99979
BED NO : 302 SEX : M BED NO : 302 SEX : M BED NO : 302 SEX : M
AGE : 0 Y 0 M 0D AGE : 0 Y 0 M 0D AGE : 0 Y 0 M 0D
WT : 111.8 kg WT : 111.8 kg WT : 111.8 kg
HT : 28.12 inch HT : 28.12 inch HT : 28.12 inch
-------------------------------------------- -------------------------------------------- --------------------------------------------
* PR SOURCE : SpO2 * PR SOURCE : SpO2
# PR SOURCE : NIBP # PR SOURCE : NIBP
* RR SOURCE : ECG * RR SOURCE : ECG
-------------------------------------------- --------------------------------------------
DATE HR SpO2 RESP DATE NIBP HR SpO2
TIME (bpm) (%) (bpm) TIME (mmHg) (bpm) (%)
HH : MM : SS HH : MM : SS
-------------------------------------------- --------------------------------------------
26 OCT 06 20 * 74 -- 26 OCT 06 127/81 20 * 74
08 : 58 LOW 08 : 11 ( 96) LOW
-/-

26 OCT 06 20 * 74 -- 25 OCT 06 126/81 20 * 100


08 : 57 LOW 18 : 38 ( 96)
-/-

26 OCT 06 20 * 100 -- 25 OCT 06 127/81 20 * 100


08 : 57 LOW 17 : 38 ( 96)
-/-

26 OCT 06 20 * 100 -- 25 OCT 06 124/80 20 * 100


08 : 56 LOW 17 : 19 ( 95)
-/- FLT

26 OCT 06 20 * 74 -- 25 OCT 06 124/80 20 * 100


08 : 55 LOW 16 : 49 ( 95)
-/- FLT

26 OCT 06 20 * 74 -- 25 OCT 06 124/80 20 * 100


08 : 55 LOW 16 : 19 ( 95)
-/- FLT

26 OCT 06 20 * 100 -- 25 OCT 06 124/80 -- --


08 : 54 LOW 15 : 49 ( 95)
-/- FLT FLT

26 OCT 06 20 * 100 -- 25 OCT 06 - -/- - -- --


08 : 54 LOW 15 : 48 ( --)
-/- FLT FLT
-------------------------------------------- 26 OCT 06 20 * 74 --
* PR SOURCE : SpO2 08 : 53 LOW 25 OCT 06 - -/- - -- --
# PR SOURCE : NIBP 15 : 48 ( --)
* RR SOURCE : ECG -/- FLT FLT
-------------------------------------------- 26 OCT 06 20 * 74 --
W/F1 : LEAD II W/F2 : SpO2 08 : 53 LOW 25 OCT 06 125/79 -- --
SCALE1 : X1 SCALE2 : X1 15 : 42 ( 94)
HR : 80 bpm HIGH -/- FLT FLT
SpO2 : 74 % LOW 26 OCT 06 20 * 100 --
EtCO2 : -- mmHg 08 : 52 LOW 25 OCT 06 125/80 20 * 100
FiCO2 : -- mmHg 15 : 11 ( 95)
RESP : - - bpm -/- FLT
TEMP1 : 114.0 0
F 26 OCT 06 20 * 100 --
TEMP2 : 77.3 0
F 08 : 52 LOW 25 OCT 06 125/80 20 * 74
NIBP : 127/ 81 mmHg 14 : 41 ( 95) LOW LOW
( 96 ) -/- -/- FLT

Figure 1.21 Figure 1.22 Figure 1.23

Planet 55 1.17
Remote

Figure 1.24
21 hotkeys along with Standby key and an LED is provided on the wireless
hand-held remote.
Maximum distance in which the remote can operate is as shown below:
Maximum distance at zero degree to (remote sensor) IR detector is 12ft.
Maximum distance at 62 degree to IR detector is 5ft on each side.
Maximum distance at 21 degree to IR detector is 10ft on each side.

Caution
The Remote is based on IR technology and is
common for all 55 Series monitors.
Use the Remote in straight line (Preferably) with
the remote sensor in the monitor keyboard to
avoid changes in other monitors (55 Series)
kept nearby.

1.18
2

APPLICATION GUIDE

Planet 55 2.1
Notes :

2.2
ECG
Electrode placement (3 lead):

RA LA

LL

Figure 2.1

Position Symbol IEC AAMI


AAMI(IEC) Colour Coding Colour Coding
Right intraclavicular fossa RA (R) Red White
Left intraclavicular fossa LA (L) Yellow Black
Between 6th and 7th
intercostal space on the LL (F) Green Red
left midclavicular line

Lead I Lead II Lead III


Figure 2.2(a) Figure 2.2(b) Figure 2.2(c)

Planet 55 2.3
Electrode placement (5 lead)
Chest electrode positions
C1 (V1) : Fourth intercostal space at the right
border of the sternum.
C2 (V2) : Fourth intercostal space at the left
border of the sternum.
C3 (V3) : Halfway between C2 (V2) and C4 (V4).
C4 (V4) : Fifth intercostal space of the left
midclavicular line.
C5 (V5) : Left anterior axillary line at the same
level as C4 (V4).
C6 (V6) : Left midaxillary at the same level as
Figure 2.3
C4 (V4).

Position Symbol IEC AAMI


AAMI(IEC) colour coding colour coding
Right intraclavicular fossa RA (R) Red White
Left intraclavicular fossa LA (L) Yellow Black
Between 6th and 7th
intercostal space on the LL (F) Green Red
left midclavicular line
Between 6th and 7th
intercostal space on the RL (N) Black Green
right midclavicular line
Any of the chest electrode
positions (C1 TO C6) C1-C6 (V1-V6) White Brown

2.4
Bipolar Limb Leads Unipolar Limb Leads Unipolar Chest Leads
Lead I Lead aVr Lead V1-6

Figure 2.4(a) Figure 2.5(a) Figure 2.6


Lead II Lead aVl

Figure 2.4(b) Figure 2.5(b)


Lead III Lead aVf

Figure 2.4(c) Figure 2.5(c)

Note

• Place the electrodes on the patient before the electrode cable is plugged into the
monitor.
• Special consideration should be given to electrode placement when an
electrosurgical unit is used. The active electrodes should be equidistant from
the proposed cutting line, but situated as away as possible. The conductive parts of
Electrodes and associated connectors for applied parts, including the Neutral
Electrode, should not contact other conductive parts including earth. Care should
be taken to ensure that the diathermy return plate is clean and makes good
contact with patient. Though spikes may be observed in the ECG trace when
diathermy is used on the patient, but there is instantaneous recovery of the ECG
trace when diathermy electrodes are removed from the patient.
• Always ensure ECG cables are properly placed to avoid which may cause
interference signals resembling cardiac waveforms, from other equipment.
• Poor ECG trace can occur due to dry electrodes. To rectify, remove the electrodes,
apply gel and reattach with new tape. (Replace incase of disposable electrodes).
This monitor meets the safety requirements for direct cardiac monitoring.

Planet 55 2.5
Steps for application of ECG electrodes :
Proper skin preparation is necessary for good quality signal pick up and display. Please
follow the guidelines as listed below:
1. Wash electrode site and shave surface hair.
2. Gently rub skin surface with a prep pad to remove outer epidermal layer.
3. Thoroughly clean site with soap and water, depending on your patient's skin type
and sensitivity.
4. Allow site to dry thoroughly.
5. Check the expiry date on the electrode package. Ensure that the electrode gel is fresh
before placing the electrode on the patient.
6. Use one electrode brand for all electrodes placed on a single patient. Mixing electrode
brands may cause a fuzzy base f line or a lead fault message.
7. Place an electrode on a flat, nonmuscular area to avoid motion artifact.
8. Procedure for applying the electrodes may vary with the type of electrode:
• Wet gel type-press down along the edge of the electrode so that all edges adhere
firmly to the skin. Do not press central contact area of electrode.
• Solid gel type-begin by pressing on the gelled area, then apply pressure toward
outside of electrode.
9. Replace the electrodes at least every 48 hours.
10. Reusable ECG electrodes can be applied after applying a little bit of ECG gel on the
cup of the electrodes and then securing the electrode at site using sticking tape or
suitable adhesive tape.
11. Fasten the electrode leads with surgical tape (with an extra length of wire between
the tape and the electrode).

Figure 2.7

12. In operation theatres, please ensure that the disinfecting/cleaning solutions do not
come in contact with ECG electrodes.

2.6
Clinical Limitations :
• Shivering patients or patients giving exceptionally low signals can be difficult to
monitor.
• Although the monitor is provided with exceptionally good filters against the effects of
electrosurgery, this technique can affect readings.
• Defibrillation causes temporary disruption of the waveform display.
• Patients with burns may need special needle electrodes.

Planet 55 has 3 lead / 5 lead ECG options for monitoring ECG. L&T offers either of
these cables:
• 3 lead ECG cable (I, II, III) .
• 5 lead ECG cable (I, II, III, aVr, aVl, aVf, V).

Planet 55 2.7
Respiration
(When sourced from ECG cable)

Tests of respiratory functions are carried out for various reasons, including the
assessment of lung disease, monitoring the condition of patients under
anesthesia or under intensive care and the investigation of normal lung
physiology.
The body, in particular the brain requires a constant supply of blood with dissolved
oxygen and carbon dioxide of around 100 and 40 mmHg respectively. For
maximum efficiency, perfect matching of air and blood flow is required in each of
the lungs alveolar compartments, with overall ventilation rate of 18-20 breaths
per minute.
There are several ways to measure respiration. In Planet 55, respiration can be
measured either through Capnography or ECG. Priority is given to Capnography.
If Capnography option is not provided then respiration is measured from ECG.
When measured from ECG, respiration measurement is based on impedance
pneumography. This method comprises of passing a low current, high frequency
carrier signal between two ECG electrodes on either side of the chest wall. The
impedance or resistance of the chest changes as the lungs expand and contract
and as the volume of air in the lung changes. The change in impedance creates
a change in voltage across the carrier signal which is interpreted as a breath
and displayed as an analog waveform. Respiration Rate is displayed as a digital
value.
The ECG electrodes are to be placed as shown in the diagram below. However,
in order to improve the respiration measurement, it may be found useful to move
the Right Arm electrode (R) within the area shown in the diagram.

Figure 2.8

2.8
Respiration can be monitored through same ECG cables (3/5 lead) or through
Capnography. Priority for respiration is given to Capnography, if the option is installed.

Planet 55 2.9
Temperature
Temperature is one of the important parameters of multiparameter monitor. L&T
offers dual temperature monitoring facility in Planet 55. It is a useful diagnostic
tool and specially true when differential temperatures needs to be monitored.
Ex:
• Body temperature of premature baby and temperature of the incubator.
• Core temperature (Oral and Oesophageal) and temperature of periphery (Skin).
• Temperature difference between oral and rectal reading (for e.g., if suspected
appendicitis)

Although temperature is an easy parameter to monitor, for realistic interpretation


of data, it is important to bear in mind the influence of such factors as:
• Part of body, where temperature is monitored. (Extremities are always at lower
temperature than core temperature.)
• Body temperature change throughout the day.
0
• Menstrual cycle. A rise of about 0.3 C takes place during ovulation.

The three zones most commonly used for measuring temperature are:
0
1. Rectal (typically 37 C)
0
2. Oral (typically 37 C)
0
3. Axillary (underarm) (typically 36 C)

Preference is given to rectal measurement since, it is the most accurate, being


least subject to patient movement. Axillary is least favored.

L&T Planet 55 is compatible with YSI 400 series of temperature probes.


YSI 401 : Rectal/Oesophageal temperature probe (Adult).
YSI 402 : Rectal/Oesophageal temperature probe (Neonatal).
YSI 409A : Tape-on skin probe.

Note

Apply gauze piece and sticking plaster to cover temperature sensor of YSI 409A
(tape-on skin) for better results.

2.10
Pulse Oximetry
Principles Of Operation
The Planet 55 monitor helps in monitoring continuous, non-invasive, automatically
calibrated measurements for both functional oxygen saturation of haemoglobin and
pulse rate.
The instrument combines the principles of spectrophotometric oximetry and
plethysmography. It consists of an electro-optical sensor that is applied to the patient
and a microprocessor based monitor that processes and displays the measurements.
The electro-optical sensor consist of two low-voltage, low intensity light-emitting diodes
(LEDs), one red and one infrared, that serves as light sources and one photodiode as
a detector.
With each heart beat, a pulse of oxygenated arterial blood flows to the sensor site. This
oxygenated haemoglobin differs from deoxygenated haemoglobin in the amount of red
and infrared light that it absorbs. The Planet 55 measures absorption of both red and
infrared light and uses those measurements to determine the percentage of functional
haemoglobin that is saturated with oxygen.
Initially, light absorption is determined when the pulsatile blood is not present. This
measurement indicates the amount of light absorbed by tissue and nonpulsatile blood
absorption that does not change substantially during the pulse. This is analogous to
the reference measurement of a spectrophotometer. Absorption is then measured
when the pulsatile blood is present. In that measurement, light absorption at both
wavelengths is changed by the presence of the pulsatile, arterial blood. The Planet 55
then corrects the measurement obtained during the pulsatile flow for the amount of
light that was absorbed at the initial measurement. The ratio of the correct absorption
at each wavelength is then used to determine functional oxygen saturation.

SpO2 Sensors

WARNING

Use only L&T approved sensors. Use of sensors produced by other manufacturers
may result in improper oximeter performance.
Incorrect application or use of a sensor may cause tissue damage or improper
operation of Planet 55. Carefully read the “WARNING” section of this manual and the
directions for use provided with the sensor.

Planet 55 2.11
Selecting a sensor
Each sensor is designed for application to a specific site(s) on patients within a
designated weight range. To select the appropriate sensor, consider the patient's weight
and which sensor application sites are available, as well as the level of patient activity,
whether sterility is required, the anticipated duration of monitoring, and the adequacy of
the patient's perfusion.
• Dura sensor DS100 (Adult).
Dura-Y (Infant to adult).
Dura-Y (Neonate).
Extension cable.
• Prepare the application site, remove nail-polish, clean surface area of contact incase
of neonates and apply the oxygen transducer using the sensor application guide of
pulse oximetry transducer.
• The perfusion indicator fills up the bar and plethysmographic waveform will be displayed
accompanied by an audible beep and numerical values of SpO2 and PR* (pulse rate)
are displayed on the screen. (*Incase ECG is not connected.)
• SpO2 sensor comprises of two parts :
(a) Patient end (Main Sensor).
(b) Monitor end (Extension Cable).

Accessories for Pulse Oximeter


• DS 100™ (Dura Sensor) for adults application (patients above 40 Kg).
• Dura Y™ for universal application (patients above 1 Kg to 80 Kg).
• Extension cable.

WARNING

SpO2 sensor may not get recognized, if the sensor is plugged and unplugged rapidly
when the monitor is ‘ON’.

Note

Do not connect the SpO2 sensor and NIBP cuffs to the same limb of the patients.

2.12
Non Invasive Blood Pressure
Preparation for NIBP monitoring :
1. Place the patient in supine position and connect the BP cuff to the arm.
2. If the cuff is not placed at level of the heart then the pressure values obtained will not
reflect the true physiological pressure.

Note

Accuracy of NIBP performance / results depends on patients pre clinical condition and
the technique used (oscillometric method of calculating NIBP).

Precautions with automatically cycled bp measurements :


1. Place the limb in such a way to minimize stretching and avoid weight exertion on
affected nerves.
2. Select a measurement interval that provides adequate venous drainage during cuff
deflation.
3. The limb on which the cuff is connected must be inspected periodically in order to
detect venostasis.

Note

Do not measure NIBP continuously, as it might result in prolonged impairment of the


blood circulation of the patient.

4. An accurate BP determination might be difficult if the patient has irregular cardiac


rhythm.
5. Cuff size selection is a very important criteria to get accurate blood pressure readings.
6. Avoid compression or restriction of NIBP pressure tube.

Note

Cuffs become soft after use. They sometimes develop folds which are permanent
and hence leave temporary marks on the limb. Any cuffs that exhibit this effect should
be replaced.
If NIBP is used with SpO2, (PR) pulse rate is derived from Plethysmograph.
If NIBP, SpO2 and ECG all three are connected to patient; then (HR) heart rate is
derived from ECG.

Planet 55 2.13
Caution

Extreme caution must be taken when NIBP is set to STAT mode on all types of
patients. Reports have been made of nerve injury occurring during use of automatically
cycled blood pressure measurements.

Caution

For NIBP measurements :


• The cuff selected must fit the upper limb properly and must overlap to encircle
the limb on which it is applied. There should not be any air gap in between the
cuff and the limb. It can be fastened using the Velcro strap.
• The usual application sites of the cuff is the brachial artery. The right size of cuff
should be wrapped around the arm to achieve the best result.
• The cuff is designed to inflate only when it is wrapped on the limbs. Do not inflate
the cuff when not supported by the extremity.

WARNING

The cuff should not be applied on a limb being used for an intravenous infusion.

NIBP basic configuration comprises of following accessories:


• Adult cuff (14 cm x 37 cm) (Reusable)
• Child cuff (9 cm x 27 cm) (Reusable)
• Neonate cuff (3 cm x 9 cm) (Disposable)
• Hose tube (3 meters) (Reusable)

2.14
Capnography
Theory of operation
The principle of Capnography is based on the absorption of infrared radiation
by CO 2. The technique is known as non-dispersive infrared absorption technique.
The spectral region is particularly appropriate for measuring carbon dioxide
because it has a strong absorption band in the near Infrared wavelength. CO 2
selectively absorbs specific wavelengths of Infrared light. The main part of the
system is CO 2 bench, which consist of one IR source and detector. A sample of
patient's expired gas that consists of CO 2 , Water vapors, Nitrogen, Anaesthetic
Agents, etc. is drawn from a lightweight T-piece through a sample line into the
CO 2 bench. Expired air is aspirated into measuring chamber (CO 2 bench) by a
small pump. The amount of light passing through a sample cell varies according
to the concentration of CO 2 in the sample cell. When concentration of CO 2 in
sample cell is high, more light is absorbed by the sample and therefore a
small amount of light reaches the detector as compared to low concentration
of CO 2. The amount of light absorbed is proportional to the concentration of
CO 2. The CO 2 concentration measured by the monitor is usually expressed as
end tidal concentration of CO2 (EtCO 2), expressed in terms of mmHg or percentage
(%) or Kilopascal (Kpa).

Capnogram - Nature of waveform


CO 2 waveform reflects various stages in breathing. Capnograph is an important
diagnostic tool because its shape is virtually identical in all basically healthy
people.

Inhalation Exhalation

Figure 2.9

Planet 55 2.15
End tidal CO 2 is the concentration of CO 2 measured at the end of tidal volume
expired (Point D in above diagram).
A-B : The base line, that is the level of minimum CO 2 concentration,
observed immediately after inspiration.
B-C : The expiration phase of respiration cycle.
C-D : The expiratory plateau, that is the period during which the level
of CO 2 in the lungs ceases to increase significantly.
D : The end-tidal concentration point, that is the point at the end of
the expiration phase, at which EtCO 2 is measured.
D-E : The onset of the inspiration phase of the respiration cycle.

The production, transportation and elimination of CO 2

Figure 2.10

CO 2 is produced by all the cells in all the tissues in body as a by-product of


metabolism. From the cell, CO 2 diffuses into capillary blood, from where CO 2
is transported into venous circulation. During contraction of heart, venous blood
is pumped through pulmonary circulation to the lungs for gas exchange. Lungs
are made up of millions of alveoli, which permits easy gas diffusion from
pulmonary blood to alveolar gas space. CO 2 diffuses into this space because
continuous breathing keeps CO 2 concentration in alveoli lower than that in
pulmonary circulation. During exhalation, gas leaving lungs mixes thoroughly,
so Capnograph measures average concentration of CO 2 from all the alveoli.
Capnography gives an excellent pictures of respiratory process.

2.16
Arterial to alveolar difference of CO 2
Although end tidal CO 2 closely follows blood CO 2 level, they are not exactly
same, Normally, the arterial blood CO 2 level (PaCO 2 ) is higher by 3-4 mmHg
than the alveolar CO 2 (PaCO 2 ). The AADCO 2 is due to a mismatch of ventilation
and perfusion of the alveoli in the lungs. (Even in healthy patient, there are
some part of lungs which are not perfused as well as they are ventilated). In
such case when patient exhales, CO 2 gas from the unperfused part of the
lungs will dilute the CO 2 rich alveolar gas coming from rest of the lungs, lowering
the EtCO 2 , hence AADCO 2 increases. This is known as alveolar dead space
ventilation.

Arterial Blood CO 2 : PaCO2


Alveolar CO2 : PaCO2
Arterial to alveolar difference AADCO 2 which is normally 3-4 mmHg.

Technology Used
Capnography measurement is done with the help of microstream technology
in this unit.

Microstream Capnography
In microstream capnography method, the optical sensor is incorporated in the
module. Gas sample is aspirated from the patient at a flow rate of 50 ml/min
with the help of Filter Line (connected to endotracheal tube with the help of ‘T’
connector or directly from nose with the help of Nasal prongs) and is given to
module. The CO 2 measurement takes place at the CO 2 bench. After the
measurement, the waste gas exhausted from the rear panel.

Respiration Rate
The respiration rate is defined as the average rate of the patient's last 8
significant measured breaths. During the first 8 breaths the respiration rate is
calculated by averaging the available data. The module measures the RR in
range of 0 to 150 bpm.

Planet 55 2.17
Initialization Time
The module requires a typical time of 30 seconds before entering into the first
operating mode. During this time, the module completes self test and initialization
procedures required for proper operation of the module.

"Auto Zero" Interval


The Auto zero process is performed only during measurement mode. The module
updates the ambient pressure that is measured during auto zero process. The
auto zero is triggered.
• During the first hour after entering measurement mode, periodically for durations
of typically 15 seconds at a rate which limits the total time consumed by auto
zeros to less than 2 % of the time in which active measurements are taken.
Following the first hour after entering measurement mode, periodically for
durations of typically 15 seconds at a rate of at most once per hour.
• If a change of 8 0C from the last auto zero is detected.
• If a pressure change of 20 mmHg relative to the last auto zero (less than the
purge threshold) for a period of 30 seconds is detected. The module will be
able to detect a real change in the ambient pressure and a pressure change
due to partial blockage of the Filter Line.
The module prevents the triggering of an auto zero in the following situations:
• Incase of purging until the end of this state.
• 20 seconds to 3 minutes from the last detected breath.
• While wait up to 5 minutes for host auto zero enable command.

Leak Tightness
The leak rate of the module flow system is less than 40 mBr/min when a 30%
vacuum is invoked on the flow system.

Filter Line Recognition Safeguard (FRS)


The "FRS" enables the module to detect the presence of the Filter Line at start-
up and in normal operation. The pump does not draw in gas from the input
port when a Filter Line is not connected. While in normal operating mode the
"FRS Lock" detection time is no longer than 1 second.

2.18
Purge
The module performs a purging whenever it detects an occlusion in the Filter
Line or in the airway adapter. The module informs the host of the purge situation
by setting the "Purging in progress" bit in the Wave Message While purging,
the CO 2 values are invalid. The duration of the purging is up to 30 seconds.
If the occlusion is not removed, the module sets the fault bit in the wave message
and sets the "Occlusion in gas input lime" WARNING code. The module recovers
from occlusion when Filter Line is replaced. The module then shifts to
initialization mode for typically less than 5 seconds and then goes to normal
measurement mode.

Definitions
Breath : A rise and fall in the carbon dioxide concentration
of at least one percent carbon dioxide is no less
than 0.4 seconds.
One inhalation + One exhalation = One Breath.
Respiration Rate (RR) : Number of Breaths per Min.
End Tidal Carbon dioxide : The level of CO 2 in the airway at the end of
(EtCO2) expiration. In L&T's Capnography one breath is
the sampling interval, therefore monitor will report
the CO 2 level at the end-respiration point of each
breath.
Fractional Inspired : The amount of CO 2 inspired during inspiration
Carbon dioxide (FiCO 2) i.e. re-breathing of CO 2.

Machine Preparation
1. Switch ON the unit.
2. Make sure the patient connection to the unit with the help of Filter Line and
T Connector.
3. Machine takes approx. 30 seconds for its initialization. During this time sensor
gets warmed up and ‘initializing module’ message will appear on the screen.
4. Then monitor will perform Auto Zero (if required) and ‘Auto Zero’ message
will appear on the screen.
5. Monitor is ready for Capnography monitoring.

Planet 55 2.19
Patient Preparation
1. Prepare the patient for CO 2 measurement. Use recommended accessories.
2. Screw up one end of the ‘T’ Connector to the unit through Filter Line. Use
proper types for adults and neonatal accessories.

Figure 2.11 Figure 2.12

Patient with ‘T’ connector connected Patient with Nasal Prong


to Endotracheal tube. (Adult and Pediatric nasal prongs
are available).

Caution

• Do not strain the Filter Line during the measurement. Connection should
be done in such-a-way that Filter Line will not surround any part of the body.
• Ensure that the Filter Line does not have blockage or occlude with moisture
before use.

Following accessories are provided for Capnography along with Planet 55 monitor.
• Capno Line
- Adult
- Paediatric
- Infant - Neonate
• Filter Line
- Adult / Paediatric
- H set Adult / Paediatric
- H set Infant / Neonatal

2.20
3

OPERATIONS
AND
MAIN SCREEN

Planet 55 3.1
Notes:

3.2
Operation
Connect the unit to a mains supply socket with a proper ground / earthing
connection.

Power ON Press monitor ON/OFF switch ( ) on the front panel


so that green indicator turns ON and the unit runs the
self-test and displays main (home) screen.

Use the Optical Encoder on right side to move the


cursor (highlighted small rectangular block) and select
the desired functions, by pressing optical encoder.

Planet 55 3.3
Main Screen 1

Figure 3.1

Note
Main screen with a SpO 2 , CO 2 and two ECG waveforms.

3.4
Main Screen 2

Figure 3.2

Note
Main screen with a single ECG waveform and 4 digital values when CO2
present.

Planet 55 3.5
Main Screen 3

Figure 3.3

Note
Main screen with a single ECG waveform and 4 digital values when RESP
present.

3.6
Menu Trend Display Volume Recall Autoset

Planet 55
Pat Info Graphical Format 1 Alarm Vol
System Tabular Format 2 Beep Vol
Record NIBP Format 3 Exit Rec
All Info
Offline Options Patient User Format Exit
Alarm Info
Color Parameter Exit
Exit
Setup PC Dump
Exit Exit
Mode Exit
Print To
Parameter 1 Resolution
ECG Waveform 1 Display
Parameter 1 Display
Waveform 2 Parameter 2
SpO2 Parameter 2 Edit
Alarm Record Parameter 3 Exit
CO2 Display Exit
Timer Exit
RESP Exit Exit
NIBP Save
TEMP Display
Trend Rec
EXIT ECG Filt Mode
ID Exit
Waveform Speed Monitor Setting Exit
Bed No Format SD Card
RESP Speed
New Patient First Name Exit
Default SD Card Transfer Duration
Patient Mode Last Name
Pacer Det USB Download Display
Patient CLR Age
PR Source Exit Exit
Exit Sex
Alarm Vol Confirm
Weight Beep Vol Scroll
Cancel
Height Limit Display Zoom
Clear All Exit Rec
Save Exit
Exit

3.7
Exit
Menu Select this to go to Monitor Settings / System Functions.
Trend Select this to retrieve the data of the patients recorded.
Display Select this to choose the Display Formats.
Volume Select this to adjust the Alarm Volume and Beep Volume.
Recall Select this to Recall last 24 patient related alarm conditions
in tabular format.
Autoset Select this to set alarm limits automatically for all parameters
except NIBP.

ECG :
HR/PR high limit = Present HR value X 8/10 + 76
HR/PR low limit = Present HR value X 8/10 + 2

SpO2 :
SpO2 high limit = 100
SpO2 low limit = (Present SpO2 value – 8) or
80 (Whichever is greater)

Respiration :
Respiration high limit = Present RR + 5
Respiration low limit = Present RR – 5

Temperature :
Temperature high limit = Present Temp value + 2
Temperature low limit = Present Temp value – 2

Capnography :
EtCO2 high limit = Present value + 5
EtCO2 low limit = Present value – 5
FiCO2 high limit = Present value + 2
FiCO2 low limit = 0

WARNING

Check if the current alarm preset value is appropriate, prior to use on each patient.

3.8
ECG Select this to enter into ECG menu.
RESP Select this to enter into Respiration menu.
SpO 2 Select this to enter into SpO2 menu.
NIBP Select this to enter into NIBP menu.
CO2 Select this to enter into Capnography menu.
TEMP Select this to enter into Temperature menu.

Monitor Setup Menu Is Displayed If Optical Encoder Is Pressed During


Self Test (Start-up Sequence)

Setting Date Time Commn. Demo Exit

Setting : Select this to choose the default settings in the unit like selecting
Date Format, measurement unit for the parameters etc.
Date Format : Select this to choose the Date Format from the list. The different
Date formats in the list are as given below.
• DD\MM\YYYY
• DD MMM YYYY
• MM\DD\YYYY

HR Alarm Con ON : Select ON to continuous ON HR alarm.

SpO2 For NIBP : Select this to enable / disable SpO2 monitoring during NIBP
measurement

Language : Select this to choose the Languages from the list. The different
languages in the list are as given below.
• English
• French
• Spanish
• Italian
• Bhahasa*
• Russian*
• German
• Chinese*
• Turkish

* Future upgrade
Planet 55 3.9
NIBP Test : This should be used by L&T authorized service engineer only.

CO2 Cal : This should be used by L&T authorized service engineer only.

ECG/TEMP Cal : This should be used by L&T authorized service engineer only.

Alarm Type : Select this to choose either Latched or Non Latched as


Alarm Type.

Unit : Select this to choose the measurement unit for the parameter
from the list. The different parameters and the units in the list
are as given below.
Parameters Unit
NIBP mmHg and kPa
CO2 mmHg, kPa and Vol%
Temp Centigrade and Fahrenheit
Height inch and cm
Weight kg and lb

Default Setting : Select this to choose either Hospital or Factory settings as

Note
Press Alarm Ack and Home keys simultaneously in Monitor
Setup menu to store the current settings as Hospital setting.
The Factory Default Settings are as follows:

Factory Default Settings:


ECG:
Alarm : Disable
Gain : 1mV
Lead : II
Trace Speed : 25 mm/sec
HR Upper Limit : 150 (A) 160(P) 180(N)
HR Lower Limit : 50(A) 60(P) 80(N)
Pacer : OFF

3.10
SpO2:
Alarm : Disable
Gain : X1
Response : Normal
Trace Speed : 25 mm/sec
HR Upper Limit : 100(A) 100(P) 100(N)
HR Lower Limit : 85(A) 85(P) 85(N)

CO2:
Alarm : Disable
Scale : 40
Unit : mmHg
Trace Speed : 12.5 mm/sec
EtCO2 Upper Limit : 40(A) 40(P) 40(P)
EtCO2 Lower Limit : 25(A) 25(P) 25(N)
FiCO2 Upper Limit : 4(A) 4(P) 4(N)
RR Upper Limit : 30(A) 100(P) 100(N)
RR Upper Limit : 10(A) 10(P) 50(N)
No Breath : 30 sec(A) 30 sec(N) (If enabled)

NIBP:
Alarm : Disable
Mode : Manual
Auto Timer : 2 min
SYS Upper Limit : 150(A) 135(P) 120(N)
SYS Lower Limit : 95(A) 95(P) 50(N)
DIA Upper Limit : 100(A) 100(P) 80(N)
DIA Lower Limit : 65(A) 65(P) 20(N)
Unit : mmHg

Temp:
Alarm : Disable
Unit : °F
Upper Limit : 104.0(A) 104.0(N)
Lower Limit : 89.6(A) 89.6(N)

Planet 55 3.11
Resp:
Alarm : Disable
Gain : X4
No Breath : Disable
No Breath Timer : 30 sec
RR Upper Limit : 30(A) 100(P) 100(N)
RR Lower Limit : 10(A) 10(P) 50(N)
Resp Speed : 12.5 mm/sec

General:
Trend parameters shall be HR, SpO2 and Resp.
Recorder mode shall be Delayed.
Recorder waveform shall be None.
Alarm volume shall be 6th step.
Beep volume shall be 6th step.
ECG filter mode shall be Mon.
CO2 pump shall be ON.
Rec ON Ala shall be OFF.
Tabular Trend resolution shall be 30 sec.
Graphical trend scale shall be 2 Hrs.
Resp Scurce shall be RA-LA for respiration.
Resp Source shall be CO2 for CO2 module.
Display shall be in Format1 for 3/5 lead ECG cable.

Non Disp Para Alm: Select this to choose either Audio/LED ON or Audio/LED OFF
alarm for Non displayed parameter.

Monitor id : Select this to set monitor id.

Exit : Select this to quit from Setting option.

Date : Select this to set Year, Month and Date.

Time : Select this to set Hour and Minute.

3.12
Commn. : Select this to configure Ethernet and Serial ports.
Ethernet* : Select this to set MAC ID, IP Config, Subnet Mask and Default
Gateway by drop down list.

Serial : Select this to choose serial port (RS 232) for PC Dump and
Nurse Call* output.

Demo : This should be used by L&T authorised service engineer only.

Exit : Select this to quit from Configuration Mode.

* Future upgrade

Planet 55 3.13
4

PARAMETER SETTING

Planet 55 4.1
Notes:

4.2
ECG
When ECG option is selected in the Main screen, ECG Setup window will pop-up
on the screen as shown below.

Figure 4.1
Lead : When Lead is selected, depending upon the Cable mode chosen
3/5 Lead setup window will appear as shown below. Select max.
one lead with its cascade waveform in 3 Lead setup and select
max. four leads in 5 Lead setup.

Figure 4.2

Figure 4.3
OK : Select this to save the settings and exit from Lead setup.

Exit : Select this to exit from the Lead setup without saving the settings.

Gain : Select this to change the height of the ECG waveform in scales
X0.2, X0.5, X0.75, X1, X2, X5 and Auto.
X0.2 will provide the lowest amplitude and X5 will have maximum
amplitude.
Note

Select ECG gain so that entire ECG waveform should appear without clipping at top
or bottom as seen on the display or on print-out.

Planet 55 4.3
Alarm : Select this to enable / disable HR alarm detection from the
drop down list.

High Limit : Select this to set upper alarm limits for HR from Numeric keypad
as shown below (To use this function, ensure that alarm is enabled).

Figure 4.4

Low limit : Select this to set lower alarm limits for HR from the Numeric keypad
(To use this function, ensure that alarm is enabled).

Cal : Select this to enable (switch ON) or disable (switch OFF) Cal
option. When it is selected, Cal pulse of 1mV amplitude will be
displayed on the screen.

Note

Cal is possible only for Lead II, Lead III and Lead V.

Cable Mode : Select this to choose 3 / 5 Lead ECG cable.

Note

Flashing heart in parameter display area indicates valid QRS / Pulse detection.
ECG speed (6.25/12.5/25/50 mm/sec) and ECG Mode (Mon / Diag / OT) options are
provided in Setup menu and displays value after window averagingf of last 8 QRS
peaks.
Exit : Select this to save the settings and return to main screen.

4.4
RESP (When sourced from ECG cable)

When RESP is selected in the Main screen, Resp setup window will pop-up on the
screen as shown below.

Figure 4.5

Alarm : Select this to enable / disable Respiration alarm detection from


the drop down list.

High Limit : Select this to set upper limits for Respiration Rate alarm from
Numeric keypad (To use this function, ensure that alarm is enabled).

Low Limit : Select this to set lower alarm limits for Respiration Rate from
Numeric keypad (To use this function, ensure that alarm is enabled).

Gain : Select the gain so that waveform does not clip.

Note

The last set gain level is saved in memory. This setting will remain even when
the unit is switched OFF.

RR Source : Select this to choose the source for Respiration rate between
RA-LA and RA-LL.

No Breath : Select this to choose time limit for nobreath detection.

Exit : Select this to save the settings and return to main screen.

Planet 55 4.5
TEMP
When TEMP is selected, Temp setup window will pop-up on the screen as shown
below.

Figure 4.6

Alarm : Select this to enable / disable Temperature alarm detection


from the drop down list.

High Limit : Select this to set upper limit for Temperature alarm from
Numeric keypad (To use this function, ensure that alarm is enabled).

Low Limit : Select this to set lower limit for Temperature alarm from
Numeric keypad (To use this function, ensure that alarm is enabled).

Delta T : Select this to enable or disable Delta T.

Cal : Select this to enable or disable calibration of temperature.

Exit : Select this to save the settings and return to main screen.

4.6
SpO2

When SpO2 is selected, SpO2 setup window will pop-up on the screen as shown
below.

Figure 4.7

Response : Select this to set the response mode for SpO2 readings from
the drop down list.
Normal : Preferred for adults.

Fast : Preferred for sleep studies.

Alarm : Select this to enable / disable SpO2 alarm by drop down list.

High Limit : Select this to set upper alarm limits of SpO2 from Numeric
keypad (To use this function, ensure that alarm is enabled).

Low Limit : Select this to set lower alarm limits of SpO2 from Numeric
keypad (To use this function, ensure that alarm is enabled).

Gain : Select this to change the amplitude of the SpO2 waveform in


scales of X1 and X0.5.

Exit : Select this to save the settings and return to main screen.

Planet 55 4.7
NIBP
When NIBP is selected, NIBP Setup window will pop-up on the screen as shown
below.

Figure 4.8

Mode : Select this to choose Manual, Stat or Auto mode from drop down
list.
Manual : Select this to take individual BP readings. After selecting this function,
press start NIBP measurement key on front panel to begin manual
NIBP measurement. To abort NIBP measurement midway, press
the same key again.

Stat : Select this to take as many readings of NIBP as possible in


5 minutes of continuous operation.

Auto : Select this to take BP readings automatically after set intervals


(Timer set). Press Start on the front panel to take the first
reading. Next NIBP reading starts after the set time interval. The
time left before the next measurement to begin is displayed on
screen. This displayed time is decremented every minute.
Timer can be set only if Automatic is selected.

Alarm : Select this to enable / disable NIBP alarm detection from the
drop down list.

Sys High Limit : Select this to set upper limit for Systolic alarm from Numeric
keypad (To use this function, ensure that alarm is enabled).

4.8
Sys Low Limit : Select this to set lower limit for Systolic alarm from Numeric
keypad (To use this function, ensure that alarm is enabled).

Dia High Limit : Select this to set upper limit for Diastolic alarm from Numeric
keypad (To use this function, ensure that alarm is enabled).

Dia Low Limit : Select this to set lower limit for Diastolic alarm from Numeric
keypad (To use this function, ensure that alarm is enabled).

Timer : Select this to set timer for Automatic mode. This function allows
the user to set the time interval (2, 3, 4, 5, 10, 15, 30, 60 and
90 minutes) between two readings.

Exit : Select this to save the settings and return to main screen.

Note

In NIBP auto mode, time left before the next measurement is displayed at
the timer display area. Time displayed is decremented every minute.

Planet 55 4.9
CAPNOGRAPHY

When CO 2 is selected CO 2 setup window will pop-up on the screen as shown below.

Figure 4.9

RR Alarm : Select this to enable / disable the RR alarm from the drop down list.

CO2 Alarm : Select this to enable / disable the CO2 alarm from the drop down list.

RR High Limit : Select this to set upper limit for RR alarm from Numeric keypad
(To use this function, ensure that RR alarm is enabled).

RR Low Limit : Select this to set lower limit for RR alarm from Numeric keypad
(To use this function, ensure that RR alarm is enabled).

FiCO2 High Limit : Select this to set upper limit for FiCO2 alarm from Numeric keypad.
(To use this function, ensure that CO2 alarm is enabled).

EtCO2 High Limit : Select this to set upper limit for EtCO2 alarm from Numeric keypad.
(To use this function, ensure that CO2 alarm is enabled).

EtCO2 Low Limit : Select this to set lower limit for EtCO2 alarm from Numeric keypad.
(To use this function, ensure that CO2 alarm is enabled).

Scale : Select this to change the amplitude of the CO2 waveform in


scales 20, 40, 60, 80 or 100 mmHg from the drop down list.

4.10
RR Source : Select this to choose the source of Respiration Rate either from
the CO2 (if connected) or from ECG (RA-LA or RA-LL).

Pump : Select this to Start / Stop the CO2 pump.

No Breath : Select this to choose time limit for No breath detection.

Exit : Select this to save the settings and return to Main screen.

Planet 55 4.11
5

SYSTEM FUNCTIONS

Planet 55 5.1
Notes:

5.2
Menu Trend Display Volume Recall Autoset

Planet 55
Pat Info Graphical Format 1 Alarm Vol
System Tabular Format 2 Beep Vol
Record NIBP Format 3 Exit Rec
All Info
Offline Options Patient User Format Exit
Alarm Info
Color Parameter Exit
Exit
Setup PC Dump
Exit Exit
Mode Exit
Print To
Waveform 1 Parameter 1 Resolution
ECG Parameter 1 Display
Waveform 2 Parameter 2 Display
SpO2 Alarm Record Parameter 2 Edit
Parameter 3 Exit
CO2 Timer Display Exit
Exit
Exit
RESP Exit
NIBP Save
TEMP Display
Trend Rec
EXIT ECG Filt Mode
ID Exit
Waveform Speed Monitor Setting Exit
Bed No Format SD Card
RESP Speed
New Patient First Name Exit
Default SD Card Transfer Duration
Patient Mode Last Name
Pacer Det USB Download Display
Patient CLR Age
PR Source Exit Exit
Exit Sex
Alarm Vol Confirm
Weight Beep Vol Scroll
Cancel
Height Limit Display Zoom
Clear All Exit Rec
Save Exit
Exit

5.3
Exit
System Functions

Menu Trend Display Volume Recall Autoset

Menu : Select this to go to Monitor Settings / System Functions.

Trend : Select this to retrieve the data of the patient recorded.

Display : Select this to choose the Display Formats.

Volume : Select this to adjust the Alarm Volume and Beep Volume.

Recall : Select this to Recall last 24 patient related alarm conditions in


tabular format.

Autoset : Select this to set alarm limits automatically for all parameters
except NIBP.

5.4
Menu

Pat Info System Record Offline Options Color Setup Exit

Pat Info : Select this to get Patient Info Menu to enter patient details.

Figure 5.1

New Patient : Select New Patient menu, Planet 55 will display new patient
entry panel as shown below.

Figure 5.2

ID : Select this to enter patient’s identification number from the


Alpha-Numeric keypad.
Bed No : Select this to enter patient’s bed number from Alpha English
keyboard.
First Name : Select this to enter patient’s first name from Alpha English
keyboard.
Note
The Default name will appears as Patient 1 to Patient 200
in the field First Name, each time it increments by
one.

Planet 55 5.5
Last Name : Select this to enter patient’s last name from Alpha English
keyboard.
Age : Select this to enter patient’s age from Numeric keypad. The
age will be in years for adults and days for neonates.
Sex : Select this to enter patient’s sex from drop down list.
Weight : Select this to enter patient’s weight from Numeric keypad.
Height : Select this to enter patient’s height from Numeric keypad.
Clear All : Select this to reset entered data.
Save : Select this to save the entered data.
Exit : Select this to return to the Patient Info Menu.

Patient Mode : Select this to choose Adult, Neonate or Pediatric mode from
drop down list.

Patient CLR : Select this to clear all recorded trend data of selected patient
from drop down list. Confirmation window will be displayed.

Exit : Select this to return to the Patient Info Menu.

System : Select this to view all system information and alarm information.

Note
No changes can be made in system Info screen.

All Info : Select this to view the information about the settings of the
monitor.

Alarm Info : Select this to view the information about the status of alarm
conditions. [Enable / Disable, limits (High and Low)] and the unit of
all the parameters.

Exit : Select this to return to the Main Menu.

Record : Select this to set recorder related settings. Planet 55 will


display Recorder menu as shown below.

5.6
Figure 5.3
Mode : Select this to choose Direct, Delayed or Continuous recording
from drop down list.
Direct : Select this to record real time data for 8 seconds after pressing
recorder hot key.
Delayed : Select this to record 8 seconds (previous 6 seconds and real
time 2 seconds) after pressing recorder hot key.
Continuous : Select this to record real time data for 30 seconds after pressing
recorder hot key.

Print to : Default will be recorder.

Waveform 1 : Select this to choose the waveforms to be recorded from drop


Waveform 2 downlist.

Alarm Record : Select this to ON/OFF recording during patient alarm condition.

Timer : Select this to choose the time interval between two consecutive
recordings.

Exit : Select this to return to the main Menu.

Planet 55 5.7
Offline Options : Select this to transfer the Trend data into removable devices.
Planet 55 will display the Offline Transfer Options Menu as
shown below.

Figure 5.4
Trend : Select this to get the window for choosing the device. The
window will appear as shown below.

Figure 5.5
SD Card Transfer : Select this to transfer the trend data between similar
patient monitors. The following window will appear
when SD Card Transfer is selected.

Figure 5.6
Trend Download : Select this to download the trend to the SDCard.
When Trend Download is selected, the window
will appear as shown.

5.8
Figure 5.7
Select All Patients or particular patient to download the maximum of 72 hours of trend
data. The trend data consists of Alarm Recall, NIBP Trend and Tabular Trend for all
parameters. When patient is selected , the window with the message will appear as
shown below.

Figure 5.8
Confirm : Select Confirm to overwrite the data into the SD
Card. Wait till the data is transferred into the SD
Card. On completion message “ Patient data
transferred to SD Card” will appear.
Cancel : Select Cancel to exit from the window.

Trend Upload : Select this to upload the trend to the monitor. A


Confir mation window with the message as shown
below. Select Confirm to proceed further or Cancel to
exit from the window.

Figure 5.9
Caution

Ensure that the Monitor is switched OFF before connecting / Disconnecting Thumb
drive /SD Card.

Don’t remove SD card during data transfer.

Planet 55 5.9
USB Download : Select this to download the trend data into thumb drive.
Planet 55 has the option to download the trend data of 72
hours (max) of Single patient or All patients at a time. The
data consists of Alarm Recall, NIBP Trend and Tabular Trend
of all parameters for selected patients. The data will be in
csv format and can be opened in Microsoft ® Excel.

Exit : Select this to return to the Offline Transfer Options Menu.

Monitor Setting : Select this to upload and down load the settings of the
monitor between two monitors using USB thumb drive.

Format SD Card : Select this to format SD Card. Confirmation message “All


data in the SD Card will be deleted” will appear. Select
Confirm to proceed further.

Exit : Select this to return to the main Menu.

Color : Select this to choose the color of the parameter from the color box.

Setup : Select this to set the general settings. Planet 55 will display the Setup
menu as shown below.

Figure 5.10
ECG Filt Mode : Select this to choose the bandwidths for ECG monitoring from
drop down list.
Mon ( Monitoring - 0.5 Hz to 120 Hz)
Diag ( Diagnostic - 0.05 Hz to 120 Hz)
OT (0.5 - 20 Hz)

5.10
Note
ECG waveform amplitude may reduce marginally
5.8 when filter mode selected is OT
due to narrow (20Hz) ECG filter bandwidth. OT mode should not be used for
diagnostic application and recommended to be selected only when Electrosurgery
interferences are present in ECG waveform.

Waveform Speed: Select this choose the waveform speed for all parameters except
CO2 / RESP from drop down list.

RESP Speed : Select this choose the waveform speed of CO2 / RESP from drop
down list.

Default : Select this to set default (either Hospital or Factory) settings based
on the selection in Monitor Setup menu.
Confirm : Select this for the confirmation to set the default settings.

Cancel : Select this for the cancellation of default settings.

Pacer Det : Select this to choose pacer detection ON/OFF from drop down list.

PR Source : Select this to choose PR Source either NIBP or SpO2 from drop
down list.

Alarm Vol : Select this to adjust alarm volume. Planet 55 will display volume menu.
: Select this to increase the alarm volume.

: Select this to decrease the alarm volume.

Exit : Select this to return to the Setup panel.

Beep Vol : Select this to adjust beep volume. Planet 55 will display volume menu.
: Select this to increase the beep volume.

: Select this to decrease the beep volume.

Exit : Select this to return to the Set up panel.

Planet 55 5.11
Limit Display : Select this to enable / disable the Display limits.

ST : Select this to enable / disable the ST option.

Exit : Select this to return to the Main menu.

Exit : Select this to return to the Main screen.

5.12
Trend

Graphical Tabular NIBP Patient Parameter PC Dump Exit

Planet 55 will display the Trend menu as shown below.

Figure 5.11

Graphical : Select this to view graphical representation of the selected


parameters (not applicable for NIBP).
Duration : Select this to choose duration of required Graphical Trend data
from drop down list.

Display : Select this to view the graphical trend of the parameters selected.
Planet 55 will display Graphical Trend screen as shown in Figure 5.11.
Scroll : Select this to scroll through the graphical trend.
Zoom : Future upgrade
Exit : Select this to return to the Graphical Trend Duration menu.

Exit : Select this to return to the Trend menu.

Planet 55 5.13
Figure 5.12

The Graphical Trend taken from the External Printer is as shown in the Figure 5.13.

5.14
Figure 5.13

Planet 55 5.15
Tabular : Select this to view tabular representation of the selected
parameters (not applicable for NIBP).
Resolution : Select this to choose resolution from the drop down list.

Display : Select this to view tabular trend of the parameters selected.


Planet 55 will display Tabular Trend screen as shown in Figure 5.14.
: Select this to go to the previous page of the trend.
: Select this to go to the next page of the trend.

Figure 5.14

Rec : Select this to record the current page of the tabular trend.
Exit : Select this to return to the Tabular Resolution menu.

Exit : Select this to return to the Trend menu.

The Tabular Trend taken from the External Printer is as shown in the Figure 5.15.

5.16
- - - -TABULAR TREND- - - -

DATE : 05 NOV 2006 TIME : 03:55


NAME : Patient 67
ID NO : BED NO : SEX : F
AGE : 1Y 1M 1D WT : 1Kg HT :
*PR SOURCE : SpO2 # PR SOURCE : NIBP *RR SOURCE : ECG

DATE TIME HR RESP SpO2


HH : MM : SS (bpm) (bpm) (%)

05 NOV 2006 07 : 17 : 54 84 22 95

05 NOV 2006 07 : 17 : 49 86 20 93

05 NOV 2006 07 : 17 : 44 85 20 95

05 NOV 2006 07 : 17 : 39 84 22 95

05 NOV 2006 07 : 17 : 34 84 24 98

05 NOV 2006 07 : 17 : 29 80 23 95

Figure 5.15

NIBP : Select this to view the stored NIBP readings along with parameters
selected.
Parameter1 : Select this to choose any one of the parameters for which the trend
data required from the drop down list.

Parameter2 : Select this to choose any one of the parameters for which the trend
data required from the drop down list.

Display : Select this to view tabular trend of the parameters selected.


Planet 55 will display NIBP Trend screen as shown in Figure 5.15.
: Select this to go to the previous page of the trend.
: Select this to go to the next page of the trend.
Rec : Select this to record the current page of the tabular trend.
Exit : Select this to return to the NIBP Parameter Selection menu.

Planet 55 5.17
Figure 5.16

Exit : Select this to return to the Trend menu.

Note
When the external USB Printer is connected with the monitor, internal recorder will be
disabled. All prints will be obtained on the external printer. The data will be printed in
internal recorder if printer is not connected.

Patient : Select this to choose patient name for which the trend data is required
from drop down list.

Parameter : Select this to choose parameters from parameter selection panel


for which the trend is required. Three parameters can be selected
in the parameter selection panel at a time from drop down list.
Exit : Select this to save and return to the Trend menu.

PC Dump : Select this to Start / Stop PC Dump.

Start : Select this to download real time data of all parameter into the PC.

Stop : Select this to end the downloading process.

Exit : Select this to return to the Main screen.

5.18
PC Dump Application
PC Dump application should exist in the computer and will display the PC Dump menu
as shown below.

Figure 5.17

Status : Displays Data dumping in progress / IDLE.


Change : Select this to choose the communication port.
Browse : Select this to choose the location of the file to be saved.
Exit : Select this to save and exit from the PC Dump application window.

The file will be saved as CSV format and can be opened in Microsoft ® Excel. The down
loaded data is as shown below.

Note
PC Dump application should exist in the computer.
Contact L&T authorised service personnel for installation of software.
Date and Time will be the default file name if the file name is not entered.

Planet 55 5.19
Display

Format 1 Format 2 Format 3 User Format Exit

Planet 55 will display the Display Format panel as shown below.

Figure 5.18

Format 1 : Select this to set the standard display format which includes ECG,
SpO2, CO2, NIBP and Temp parameters.

Format 2 : Select this to set the standard display format which includes ECG,
SpO2, Resp (3 Lead setup) / CO2 (5 Lead setup), NIBP and Temp
parameters.

Note
Following waveforms will be displayed for ECG:
Lead II and Cascaded waveforms for 3 lead setup
Lead II and Chest Lead (V1) waveforms for 5 lead setup

Format 3 : Select this to set the standard display format which includes
ECG (Lead II), NIBP, SpO2 and Temp.

User Format : Select this to view or edit pre-configured user defined display
formats.

Display : Select this to view the pre-configured user defined display formats.

5.20
Edit : Select this to edit the pre-configured user defined display formats.
Three main display formats can be configured by the user.
Planet 55 will display the User Format menu as shown below

Lead III

Figure 5.19

User Format1 : Select 4 parameters in the Waveform field and number of ECG
waveforms i.e, Field 1 to Field 4 from the dropdown list.
Select 2-3 parameters in the Digital field i.e, Digit1 to Digit3 from
the dropdown list.
User Format2 : Select 1-3 parameters in the Waveform field and number of ECG
waveforms i.e, Field 1 to Field 3 from the dropdown list.
Select 2-3 parameters for each row in the Digital field i.e, Digit1
to Digit6 from the dropdown list.
User Format3 : Select 1-3 parameters in the Waveform field and number of ECG
waveforms i.e, Field 1 to Field 3 from the dropdown list.
Select 2-3 parameters in the Digital field i.e, Digit1 to Digit3 from
the dropdown list.

Note
No. of Digits field has four options:
2 Digit / 3 Digit / LW, SW and SW, LW
where, SW - Small Window
LW - Large Window

Save : Select this to save the changes user defined display formats.
Display : Select this to view the pre-configured user defined display formats.
Exit : Select this to return to the Display Menu.

Planet 55 5.21
Exit : Select this to return to the Display Menu.

Exit : Select this to return to the Main screen.

Volume

Planet 55 will display the Volume Setup menu as shown below.

Alarm Vol Beep Vol Exit

Figure 5.20

Alarm Vol : Select this to adjust alarm volume. Planet 55 will display volume menu.
: Select this to increase the alarm volume.

: Select this to decrease the alarm volume.

Exit : Select this to return to the Volume Setup menu.

Beep Vol : Select this to adjust beep volume. Planet 55 will display volume menu.
: Select this to increase the beep volume.

: Select this to decrease the beep volume.

Exit : Select this to return to the Volume Setup menu.

Exit : Select this to return to the Main screen.

5.22
Recall

Rec Exit
Select this to recall last 24 patient related alarm conditions in tabular format. Planet 55
will display the Recall Setup menu as shown below.

Figure 5.21

: Select this to go to the previous page.

: Select this to go to the next page.

Rec : Select this to record the current page.

Exit : Select this to return to the Main screen.

Autoset

Select this to set alarm limits for all the parameters (except for NIBP) .

Planet 55 5.23
6

MAINTENANCE
SCHEDULE

Planet 55 6.1
Notes:

6.2
Routine Maintenance
L&T products have been designed to operate continuously with minimum
maintenance.
However, in order to ensure better performance and safety, the routine
maintenance should be performed. A summarized schedule and full details of
this maintenance is covered in this section.

Caution

Maintenance involving removal of the outer case or access covers must not be
attempted by the operator, but referred to a Qualified L&T medical's
representative.

Following action should be carried out in routine maintenance. Aestrix ( * ) indicate


that the following action is required.

Action General ECG, SpO 2, Temp,


NIBP

A B

1. Check patient connections and *


accessories
2. Cleaning and sterilization *
of accessories
3. Clean monitor exterior *
4. Check power cord *
5. Check battery *
6. Check monitor operation * *
7. Check monitor calibration *

Planet 55 6.3
Action Details
1B) Leads, sensor and probes should be carefully checked for any signs of
damage. Damaged leads should be replaced. Do not attempt to repair.

2B) All accessories must be cleaned before use. Following precautions must
be observed while cleaning and sterilizing of accessories.

Cleaning

WARNING

Do not use sharp instrument for cleaning cables.

ECG:
a. ECG leads should be cleaned with a cloth slightly moistened with soap water.
Always allow the cable to dry thoroughly before use.
b. Clean blood from all external surfaces.

SpO2, NIBP and Temp:


Refer relevant accessory instruction leaflet provided along with the accessories for
any specific cleaning procedures.

Sterilization
ECG:
a. Clean as detailed above.
b. Wrap the connector lead in a polythene bag to prevent moisture penetration.
c. Loosely coil the cable to avoid any kinks.
d. Wrap cable in the recommended way for ethylene oxide sterilization.

SpO2, NIBP and Temp:


Refer relevant accessory instruction leaflet provided along with the accessories for
any specific sterilizing procedures.

3A) Isolate equipment from mains supply before cleaning. Clean the case and
front panel with a soft cloth lightly moistened with warm soap water. Use
only mild soaps or detergents. Allow the machine to dry thoroughly before
use. Do not use chemicals or abrasive cleaning agents.

Note

On accidental wetting of the monitor,


1. Wipe the surface of the monitor with a clean and dry cloth.
2. If the monitor malfunctions, refer the monitor to L&T authorized service personnel.

6.4
4A) Inspect the power cord for any signs of damage to cable or connectors. If
damaged, replace with a L&T replacement part. Do not attempt to repair.

5A) Isolate monitor from the mains supply. Switch ON the monitor and observe
the battery status area in the display. If that area blinks with red colour,
connect monitor to mains supply. Leave the unit for charging. If low battery
indication still remains on the screen,refer the monitor to service personnel
for battery replacement.

6AB) Connect the power cable to the mains supply, switch ON the monitor and
check the following:

Caution

Batteries will be permanently damaged if left discharged.

 Adjustment of alarm volume.


 Adjustment of Beep volume.
 Adjustment of alarm limits. Enabling and disabling of individual alarms.
 Operation of alarm functions.
 Operation of recorder functions (optional).
 Operation of fault function (patient cable disconnected).
 Selection of trace speed for ECG and SpO2.
 Selection of waveform parameters.
 Selection of graphical/tabular trend view.
 Selection of ECG, Resp and SpO2 gains.
 Selection of SpO2 response.
0 0
 Selection of TEMP unit (either C or F).
 Selection of NIBP mode.
 Selection of CO 2.
 Return all adjustments to the desired settings after the checks.

Planet 55 6.5
7B) Perform the following checks to ensure that the monitor is calibrated correctly.
i. ECG
• Select CAL option from the menu list of ECG and observe the display.
• Square pulses will be produced of 1mV amplitude.

Note

ECG CAL is associated for Lead II, III and V for 5Lead and Lead II and III for
3Lead ECG cable.

ii. Temperature
• Select Cal option from the menu list of Temp and observe the display.
0 0
• T will read 98.6 F or 37 C.

Capnography Maintenance Schedule


• Sample line is disposable and single use only.
• Incase of any water condensation in sample line please replace the sample
line with a new one.
• Check the accessories before use.
• Use specified accessories only.
• CO2 module should be calibrated every one year or 4000 hours of usage, which
ever is earlier. This calibration should be done by authorized L&T personnel.

Note

Use L&T authorised accessories and batteries only.

6.6
Capnography Maintenance Schedule
• Use specified accessories only.
• Check the accessories before use.
• Sample line is disposable and for single use only.
• Incase of any water condensation in sample line, replace the sample
line with a new one.
• CO2 module should be calibrated once in a year or 4000 hours of usage, which
ever is earlier. This calibration should be done by authorized L&T personnel.
The calibration must be performed with a manufacturer approved calibration
kit. The manufacturer approved calibration kit must be purchased from Scott
Medical. Calibration gas contains 5% CO2, 21% O2 and balance N2. Switch
ON the Monitor.

Procedure for calibrating Capnography Module


• Switch ON the monitor.
• Go to set up screen by pressing optical encoder during self test.
• Press CO 2 CAL from the Setting menu.
• Connect filter line from calibration kit to the monitor.
• Press start CAL and Confirm for further proceedings.
• Message " Keep pressing cylinder knob to deliver the gas" will display. Press
the knob of the cylinder kit and select OK.
• Message "Calibrating... Please wait" will display.
• Message "Calibrating ... Please remove gas" will display.
• After calibration , message "Calibration succeded" will display
• Remove filter line from the monitor.

Check the last calibrated date in Menu System All Info

Planet 55 6.7
Recorder Paper Replacement

Figure 6.1

The instructions below describe the replacement of recorder paper. Use only
recommended recorder paper. This ensures that the print quality is acceptable
and reduces print head ware.
Step 1: Press and open the recorder cover as shown in the Figure 6.1.
Step 2: Remove empty paper spool by pulling it out gently.
Step 3: Insert new paper roll into the paper holder with the sensitive (shiny) side
of the paper facing the print head at the top of the recorder.
Step 4: Unroll approximately 4 inches of paper.
Step 5: Align the paper across the top of the metal bar.
Step 6 : Holding the paper in place, close the recorder cover.
Step 7 : To ensure that the paper is aligned properly and has not been pinched in the
recorder, pull the loose edge out a couple of inches. If the paper jams, open
the recorder cover and return to Step 5.

6.8
7

ACCESSORIES

Planet 55 7.1
Notes:

7.2
ECG
Planet 55 offers 3 lead ECG monitoring facility.
• 3 lead ECG cable (I, II, III)
• 5 lead ECG cable (I, II, III, aVR, aVL, aVF, V)

Figure 7.1 : 3 Lead ECG Cable Figure 7.2 : 5 Lead ECG Cable*

Respiration
Respiration can be monitored through same ECG cables 3/5 lead or through
Capnography. Priority for respiration is given to Capnography, if the option is
installed.

Figure 7.3: 3 Lead ECG Figure 7.4: 5 Lead ECG Figure 7.5: Filter Line Adult
Cable Cable* Adult Paediatric

Note

• ECG RESP can be measured only through 5 Lead ECG Mode, if Capnography
is installed.
• ECG RESP can be measured either through 5 Lead or 3 Lead ECG Mode, if
Capnography is not installed.
* Optional
Planet 55 7.3
Temperature
Planet 55 is compatible with YSI 400 series of temperature probes.
YSI 401 : Rectal/Oesophageal temperature probe (Adult).
YSI 402 : Rectal/Oesophageal temperature probe (Neonatal).
YSI 409A : Tape-on skin probe.

Figure 7.6 : Rectal/Oesophageal Temperature Probe (Adult)*

Figure 7.7 : Rectal/Oesophageal Temperature Probe (Neonatal)*

Figure 7.8 : Tape-on Skin Probe*

* Optional

7.4
Pulse Oximetry
Accessories for Pulse Oximeter
• DS 100™ (DURA SENSOR) from NELLCOR for adults application (patients above 40 Kg).
• DURA Y™ for universal application (patients above 1 Kg to 80 Kg).
• Extension cable.

Figure 7.9 : DS 100 TM

Figure 7.10 : Dura Y TM *

Figure 7.11 : Extension Cable

* Optional
Planet 55 7.5
Non Invasive Blood Pressure
NIBP basic configuration comprises of following accessories:
• Adult cuff (14 cm x 37 cm) (Reusable)
• Child cuff (9 cm x 27 cm) (Reusable)
• Neonate cuff (3 cm x 9 cm) (Disposable)
• Hose tube (3 meters) (Reusable)

Figure 7.12 : Adult Cuff Figure 7.13 : Child Cuff

Figure 7.14 : Neonate Cuff Figure 7.15 : Hose Tube

7.6
Capnography (Optional)
Following accessories are provided for Capnography (microstream) along with
Planet 55 monitor.
• Capno Line
- Adult
- Paediatric
- Infant - Neonate

Figure 7.16 : Capno Adult

Figure 7.17 : Capno Paediatric

Figure 7.18 : Capno Infact - Neonatal

Planet 55 7.7
• Filter Line
- Adult / Paediatric
- H set Adult / Paediatric
- H set Infant / Neonatal

Figure 7.19 : Adult / Paediatric Filter Line

Figure 7.20 : H Set Adult / Paediatric Filter Line

Figure 7.21 : H set Infant / Neonatal Filter Line

7.8
Grounding Cable

Figure 7.22 : Grounding Cable

Standard Accessories

ECG 3 Lead Cable


SpO2 Durasensor
SpO2 Extension Cable
NIBP NIBP Hose
Adult Cuff

Optional Accessories

ECG 5 Lead Cable


CO2 Capnoline H - Infant/Neo
Capnoline H - Adult
Capnoline H - Pediatric
Filterline Set Adult/Pediatric
Filterline H - Set Adult/Pediatric
Filterline H - Set Infant/Neonatal
Temperature Rectal/Esophageal probe - Adult
Rectal/Esophageal probe - Neonatal
Tape on skin probe
SpO2 Dura Y Sensor

Planet 55 7.9
8

TROUBLESHOOTING
AND
WAVEFORMS

Planet 55 8.1
Notes:

8.2
Troubleshooting Chart
Problems Cause Corrective Action
No display, mains not Mains supply not OK. Change the plug point. If
available. problem persists, call L&T
authorized service personnel.
Fuse blown. Call L&T authorized service
personnel.
No audio alarm Alarm is disabled Enable alarm.
Low battery indication Battery is getting Connect the unit to mains
on screen. discharged. Monitor will and allow the battery to
stop functioning in few charge.
minutes.
No QRS tone QRS volume set to Adjust beep volume.
minimum.
Poor ECG waveform Electrode sites are Clean the area and resite
incorrect. the electrodes.
Poor electrode contact. Resite electrodes.
Dried electrodes. Remove electrodes. Apply
gel and reattach properly.
Faulty ECG cable. Replace patient cable.
Noise in ECG trace area Noise pickup due to Check the mains plug for
improper grounding. proper ground connections.
Check that grounding cable
is connected properly.
Poor respiration waveform Electrode sites RA-LA/ Clean the area and resite
RA-LL are incorrect. electrodes.
Poor electrode contact. Resite electrodes.
Dried electrodes. Remove electrodes. Apply gel
and reattach properly.
Faulty ECG cable. Replace ECG cable.
Respiration alarms not Respiration alarm is Enable the alarm.
responding. disabled.
Monitor is not responding SD Card not detected Format the SD Card through
when SD Card connected file system in PC. If still
problem persists,
change the SD Card.
Not getting download/ SD Card not functioning Format the SD Card through
upload the trend / monitor properly Monitor and Check for
settings. functioning. If still problem
persists change the SD
Card.

Planet 55 8.3
Problems Cause Corrective Action
After NIBP measurement Cuff not connected properly. Check cuff for proper connection
is taken, unit displays (- -) and position. The cuff must be
in NIBP readings box. properly wrapped around the
limb and must not be loosely
attached.
Temperature alarms not Alarm is disabled Enable the alarm.
responding
Not recording and red Recorder paper roll Insert recorder paper roll.
indicator in recorder module empty.
is blinking.
Recorder cover is open Close the recorder cover.
Recorder module not Call L&T authorized service
connected. personnel.

8.4
Error Messages
Problem Cause Corrective Action Alarm Type
ECG
Patient HR / PR value Patient needs medical
exceeding higher alarm attention (Acknowledge
limit. the alarm). Reset the
limit, if require. PA
Patient HR / PR value Patient needs medical
below the lower alarm attention (Acknowledge
limit. the alarm). Reset the
limit, if require. PA
Check HR The difference between Patient needs medical
PR from SpO2 and HR attention.
from ECG is more than NA
30 BPM. NA
HR-RR coincidence The difference between Patient needs medical
HR and RR is less than attention.
30 BPM. NA NA
Communication Module not responding. Call L&T authorized
Error service personnel. TA
Leads OFF Cable not connected Connect the cable
properly to the unit. properly to the unit. TA
Fault messages Respective leads are Connect respective
i. LA Fault disconnected from the leads properly.
ii. RA Fault patient.
iii. LL Fault
iv. RL Fault
v. CL Fault TA
Respiration
Patient RR value Patient needs medical
exceeding higher alarm attention. (Acknowledge
limit. the alarm). Reset the
limit, if require. PA
Patient RR value below Patient needs medical
the lower alarm limit. attention (Acknowledge
the alarm). Reset the
limit, if require. PA
Fault RA-LA or RA-LL leads Connect the leads
are not connected properly to the patient.
properly to the patient. TA

Planet 55 8.5
Problem Cause Corrective Action Alarm Type
Temperature
Patient Temperature Patient needs medical
value exceeding higher attention (Acknowledge
alarm limit. the alarm). Reset the
limit, if require. PA
Patient Temperature Patient needs medical
value below the lower attention (Acknowledge
alarm limit. the alarm). Reset the
limit, if require. PA
OFF Cable not connected Connect the cable
properly to the unit. properly to the unit. TA
-?- Range has exceeded. Patient needs medical
attention. NA
SpO2
Patient SpO2 value Patient needs medical
exceeding higher alarm attention (Acknowledge
limit. the alarm). Reset the
limit, if require. PA
Patient SpO2 value below Patient needs medical
the lower alarm limit. attention (Acknowledge
the alarm). Reset the
limit, if require. PA
Check Probe Site Sensor not connected Connect the sensor
properly to the patient. properly to the patient. PA
Sensor OFF Cable not connected Connect the cable
properly to the unit. properly to the unit. TA
Communication Module not Call L&T authorized
Error responding. service personnel. TA

8.6
Problem Cause Corrective Action Alarm Type
NIBP
Patient systolic pressure Patient needs medical
value exceeding higher attention (Acknowledge
alarm limit. the alarm). Reset the
limit, if require. PA
Patient systolic pressure Patient needs medical
value below the lower attention (Acknowledge
alarm limit. the alarm). Reset the
limit, if require. PA
Patient diastolic pressure Patient needs medical
value exceeding higher attention (Acknowledge
alarm limit. the alarm). Reset the
limit, if require. PA
Patient diastolic pressure Patient needs medical
value below the lower attention (Acknowledge
alarm limit. the alarm). Reset the
limit, if require. PA
Time Exceeded Measurement time Restart the NIBP
exceeded. measurement. TA
Air leak Removal of NIBP tube Check the connections
from the unit. and tighten if required.
Leakage in tube or cuff. Replace the tube or cuff
if required. TA
Pneumatic Bent or block in NIBP Replace the tube if
Blockage tube. required. TA
Over Pressure Use of inappropriate Use the appropriate cuff.
cuff. TA
Loose Cuff Cuff is loosely wrapped. Wrap the cuff properly. TA
Cuff Position Error Cuff placement is not at Place the cuff in proper
the proper position. position. TA
Communication Module not Call L&T authorized
Error responding. service personnel. TA

Planet 55 8.7
Problem Cause Corrective Action Alarm Type
CO2
Patient EtCO2 value Patient needs medical
exceeding higher alarm attention (Acknowledge
limit. the alarm). Reset the
limit, if require. PA
Patient EtCO2 value Patient needs medical
below the lower alarm attention (Acknowledge
limit. the alarm). Reset the
limit, if require. PA
Patient FiCO2 value Patient needs medical
exceeding higher alarm attention (Acknowledge
limit. the alarm). Reset the
limit, if require. PA
CO2 No tubing Sample line not Connect sample line to
connected to the unit. the unit. TA
CO2 Purging Sample line blocked. Change the sample line. TA
Change sample Purging continues for Change the sample line.
line more than 30 Sec. TA
No breath RR is zero. Patient needs medical
attention (Acknowledge
the alarm). Reset the
limit, if require. PA

Note

Physiological Alarms (PA) and Technical Alarms (TA) are should be treated
as High Priority and Medium Priority alarms respectively.

8.8
Message displayed in white message area

Parameter Message Condition Display Position

CO2 Initializing CO2 Module Initialization Real time Screen.

CO2 Module Not ready Module Not Ready for Service screen.
calibration.

CO2 Calibration Calibration is Service screen.


Success successful.

CO2 Calibration Error Calibration failed Service screen.

CO2 CO2 Warm Up When the CO2 module Service screen.


is preparing itself for
operation

CO2 CO2 Ready Before the first Real time Screen.


measurement of CO2,
after the filterline is
connected, and before
patient breathing is
sensed, “CO2 Ready”
will replace the “CO2
Warm-up” message.

CO2 CO2 Cal Reqd. Shown if CO2 Real time Screen.


calibration is overdue.

CO2 CO2 Maintenance Shown if CO2 Real time Screen.


Reqd..” maintenance is
overdue.

CO2 Auto Zeroing During auto zeroing on


calibration((Module
sends the request for Real time Screen
zeroing and
automatically zeroing
command is sent
from the host to the
module.)

Planet 55 8.9
Parameter Message Condition Display Position

RR/ CO2 No Breath When there is no Real time screen


breath detected.

HR/PR Check HR Difference between Real time screen


HR (from ECG) and
PR (taken from SPO2)
is more than 30.

HR-RR-coincidence When HR and RR Real time screen


alarm difference is less
than 30.

RR No Breath When RR value is zero Real time screen


and RR source is CO2

PC Dumping PC Dumping During data dumping Real time screen

8.10
Problems Observed During ECG Monitoring
Patient Related

A. Involuntary Movement

Graph 8.1

Identification:
Muscle movement near the electrodes generates myoelectricity or additional
background electrical patterns. Notice the irregular height and width of the
spikes.

Corrective Action:
Involuntary movement is usually a result of patient discomfort and is caused
by chill or muscle tremors, coughing or other nervous reactions. Assuring the
patient that the procedure will not hurt and setting his mind at ease will help
relieve natural anxieties. Ensure the room temperature is warm enough for the
patient.

B. Voluntary Movement

Graph 8.2

Planet 55 8.11
Identification:
Gross body movement will cause base line deviation. The signal will be present
but, there will be baseline wanders. Myoelectricity may be present as well.

Corrective Action:
The patient should be comfortable and relaxed. Again, reassuring the patient
that the monitoring will not hurt him, will restore confidence. Usually voluntary
movement is of short duration. Normal ECG waveform will return when movement
stops. If severe artifact results from slightest body movements, check the
electrode application.

C. Poor Skin Preparation

Graph 8.3

Identification:
Failure to prep a patient with oily skin will cause low amplitude, wandering
base line and 60 Hz frequency interference. Poor skin preparation may not
show problems immediately, but effects the signal in long term monitoring.

Corrective Action:
Cleaning the body oils and dead tissues are essential for proper adhesion
and contact of electrodes. The prep area should includes the electrodes site
under the adhesive as well as the contact area. Preferred scrub solutions for
skin preparation are: abrasion, special detergent solutions and saline wash.
While using solutions, ensure that the area is dried before the application of
electrodes.

8.12
Electrodes Related

A. Loose Electrode

Graph 8.4

Placement on bony area:


Electrode placed on a bony area will show abrupt base line deviation or complete
loss of signal. A loose electrode usually have a full amplitude signal with several
artifacts. It also happens if electrodes are not placed properly.
Line Transients : When electrodes or lead wires are loose or detached, the
transients may be transmitted to the monitor through patient cable and can
resemble ECG waveform. This may also inhibit heart rate alarms and may
indicate false information.

Corrective Action:
Electrodes should be placed on fleshy areas which will help to place electrodes
properly. Check that the patient cables are not pulling the electrodes and the
electrode is attached properly to the body of the patient.

Graph 8.5

Planet 55 8.13
B. Dried Out Electrode
Identification:
This signal usually degenerates with time. Characteristics such as low amplitude,
diphasic QRS complexes, 60 Hz frequency interference and base line wander
will usually be present.

Corrective Action:
Check the electrode to make sure that the electrolyte is moist and is in sufficient
quantity and is in proper contact with the electrode and skin.

Equipment Related

Graph 8.6

A. Poor Connection
Identification:
Poor connection will indicate muscle artifact on entire trace.

Corrective Action:
Check lead wires, junction of cable and electrode to ensure proper connection.

8.14
B. Broken Lead Wire

Graph 8.7

Identification:
Broken lead wire or completely detached electrode will cause pure 60 Hz
frequency interference. The QRS complex is almost masked by the extremely
wide base line.

Corrective Action:
Check the lead wires, cables and connections. Replace with new cable if required.
The use of shielded cables is recommended, to protect lead wires from interfering
current.

C. Bad Grounding

Graph 8.8

Identification:
Bad grounding may cause 60 Hz frequency interference which is distinguishable
because of wide base line.

Planet 55 8.15
Corrective action:
Bad grounding may also create a shock hazard. If grounding is doubtful, request
for an electrical maintenance check. TV sets, electrical cords and fluorescent
bed lamps near the bed may also cause 60 Hz frequency interference.

D. Static Electricity

Graph 8.9

Identification:
Static electricity may throw the trace off the screen abruptly. The trace will gradually
recentre itself within few seconds.

Corrective Action:
Synthetic fabrics in bed sheets and clothing may generate static electricity.
This can disturb the trace abruptly without patient movement, especially when
cables without proper shieldings are used.

8.16
Problems Observed During CO2 Monitoring
Cardiogenic Oscillations:
Cardiogenic oscillations appears during the final phase of the alveolar plateau and
during the descending limb. They are caused by the heart beating against the
lungs.

Graph 8.10

Characteristics:
a. Rhythmic and equal to heart rate
b. May be observed in pediatric patients, mechanically ventilated at low respiratory
rates with prolonged expiratory times.

Hyperventilation
An decrease in the level of the End Tidal CO 2 from previous levels.

Graph 8.11

Possible Causes:
a. Increase in respiratory rate
b. Increase in Tidal volume
c. Decrease in metabolic rate
d. Fall in body temperature

Planet 55 8.17
Note

Exponentially decrease in CO 2 can also be because of cardiac arrest or


severe hypotension (massive bleeding).

Hypoventilation
An increase in the level of the End Tidal CO 2 from previous levels.

Graph 8.12

Possible Causes:
a. Decrease in respiratory rate
b. Decrease in tidal Volume
c. Increase in metabolic rate
d. Rapid rise in body temperature (malignant hyperthermia)

Muscle Relaxants
Clefts are seen in the final third portion of the alveolar plateau. They appear when
the action of the muscle relaxants are affected by spontaneous ventilation.

Graph 8.13

8.18
Characteristics:
a. Depth of the cleft is inversely proportional to the degree of drug activity
b. Position fairly constant on same patient but may not be present in every capnogram.

Rebreathing:
Rebreathing is characterized by an elevation in the baseline with a corresponding
increase in End Tidal CO 2. It indicates the rebreathing of the previously exhaled
CO2.

Graph 8.14

Possible Causes:
a. Insufficient expiratory time
b. Faulty expiratory valve
c. Inadequate inspiratory flow
d. Malfunction of a CO 2 absorber system
e. Partial rebreathing circuits.

Obstruction in Breathing Circuit or Airway


An obstruction to the expiratory gas flow noted as a change in the slope of the
ascending limb of the capnogram. The expiratory portion may diminish without
a plateau.

Graph 8.15

Planet 55 8.19
Possible Causes:
a. Partial obstruction in the expiratory limb of the breathing circuit
b. Presence of a foreign body in the upper airway
c. Partially kinked or occluded artificial airway
d. Herniated endotracheal/tracheostomy tube cuff
e. Bronchospasm

Endotracheal Tube Kinked

Graph 8.16

Waveform Evaluation:
a. Any obstruction will cause an abrupt change in the ascending limb resulting in
either a diminished plateau or no plateau. EtCO 2 and slope will depend on the
degree of obstruction.

Inadequate Seal Around Endotracheal Tube


A Capnogram in which the downward slope of the plateau blends in with the
descending limb.

Graph 8.17

8.20
Possible Causes:
a. A leaky or deflated endotracheal or tracheostomy cuff
b. An artificial airway that is too small for the patient

Endotracheal Tube in Oesophagus

Graph 8.18

Waveform Evaluation:
a. A normal capnogram is the best available evidence that the Et tube is correctly
positioned and that ventilation is occurring. When the Et tube is placed in the
oesophagus, either no CO 2 is sensed or any small transient capnograms are
present.

Faulty Ventilator Circuit Valve

Graph 8.19

Waveform Evaluation:
a. Baseline elevated
b. Sloping descending limb of capnogram
c. Allows patient to rebirth exhaled gas.

Planet 55 8.21
Paediatric Capnogram

Graph 8.20

Typical Capnogram for a Paediatric Patient.

8.22
9

TECHNICAL
SPECIFICATIONS

Planet 55 9.1
Notes:

9.2
System Specification:
1. Equipment Classification:
Mode of operation : Continuous
Degree of mobility : Portable
Types of protection against : Class 1
electric shock
Degree of protection against : Type CF- ECG, Temperature, Respiration,
electric shock Type BF- NIBP, SpO2 and Capnography
(all with defib protection)
Degree of protection against : Not protected
hazards of explosion
Degree of protection against : Drip proof - IPX1
ingress of liquids

2. Power Supply:
Input voltage : 95-265V AC, 50Hz/60Hz + 5%
Fuse : 3.15A Fast blow
Indicator : Amber LED ON indicates Mains ON
Green LED ON indicates Monitor ON
Amber LED OFF and Green LED ON
indicates Unit is ON in battery mode.
Current : 0.7 A Max
Wattage : 100 Watts

3. Battery:
Type : 14.8 V (4AH / 8AH) Lithium ion
No. of battery : One pack
Two packs
Charging time (min) : 12 Hrs (One pack)
Discharge time : 2/4 hrs

For 2 hrs backup:


One pack fully charged new batteries at 25 0C.
Discharge condition:
ECG, Resp, SpO 2, Temp, NIBP running at 15 min interval, without CO2 and recorder
printing.

Planet 55 9.3
For 4 hrs backup:
Two packs fully charged new batteries at 25 0C.
Discharge condition:
ECG, Resp, SpO 2, Temp, NIBP running at 15 min interval, without CO2 and
recorder printing.
Low battery indication voltage : 13.3 +/- 0.2V
Battery cut-off voltage : 12.2 +/- 0.2V

4. Indicator:
Green LED ON and Yellow LED OFF indicates Battery operation.
Green LED ON and Yellow LED ON indicates Mains operation and Battery charging.

Note

Monitor shows battery capacity at 2 instances:


1) When the monitor is operated on battery
(Green LED ON and Yellow LED OFF) with
no alarm condition, battery capacity is more
than 20%.
2) When the monitor displays Low battery
indication, the monitor continues to work for
10-15 mins depending upon the load on the
battery. Monitor turns OFF when the battery
reaches cutoff voltage.

5. Controls:
Front panel : 1 switch for unit ON/OFF control
1 switch for Goto
1 switch for NIBP start and stop
1 switch for Recorder
1 switch for Freeze and Defreeze
1 switch for Alarm acknowledgment
1 switch for Home screen
1 switch for Stand by
1 Optical Encoder with switch

9.4
6. Display:
Screen : 8.4" color TFT display
Dot Pitch 0.213 mm
Active Display Area 170.4 (H) * 127.8 (V) mm
(800H * 600V Dots)
Trace speed : 6.25,12.5, 25 and 50 mm/sec for ECG,
SpO , Respiration / CO
2 2

SpO2 strength indicator : Bar graph showing the pulse strength


Waveform sampling rate : 400 samples/sec for ECG (max)
100 samples/sec for SpO2 (fixed)
100 samples/sec for Respiration (fixed)
10 samples/sec for Capnography
Recording indication : Recording… message in the message
area indicate recording in progress
Alarm detection status : Crossed Bell symbol shown if disabled

7. Trends:
Data storage : 5 sec for 72 hrs
HR, SpO2%, TEMP1, RESP, EtCO2, : 72 hrs graphical and Tabular trend
FiCO2, TEMP2
NIBP : Last 240 readings will be displayed in
tabular format
Graphical trend:
Time scales : 2 Hrs, 4 Hrs, 12 Hrs, 18 Hrs, 24 Hrs, 48 Hrs
and 72 Hrs
View resolution : 30 sec, 1 min, 3 min, 4.5 min, 6 min, 12 min
and 18 min (respectively)
Tabular trend view resolution : 5 sec, 10 sec, 15 sec, 30 sec, 1 min, 2 min,
4 min and 8 min
Alarm trend (Recall) : Tabular trend for display of last 24 patients
alarms
Auto setting of alarms : Provided for HR, SpO 2, Temp1, Temp2,
Respiration, EtCO2, FiCO2

Formula Used:
HR high limit = Present HR value X 8/10 + 76
HR low limit = Present HR value X 8/10 + 2

Planet 55 9.5
SpO2 high limit = 100
SpO2 low limit = (Present SpO2 value – 8) OR
80 (Whichever is greater)

Temperature high limit = Present T1 + 2


Temperature low limit = Present Temperature – 2

Respiration high limit = Present RR + 5


Respiration low limit = Present RR – 5

EtCO2 high limit = Present value + 5


EtCO2 low limit = Present value – 5

FiCO2 high limit = Present value + 2


FiCO2 low limit = 0

RR high limit = Present value + 5


RR low limit = Present value – 5

Note

For NIBP auto set is not applicable.

8. Inputs:
Side panel : Nicolay type connectors for ECG /
Respiration
D-type for SpO2
Female coupling for NIBP
YSI connector for TEMP
CO2 filter line
Rear panel : Standard 3-pin IEC power connector
Live and neutral lines protected by fuse

9.6
9. ECG:
Input : Isolated and floating 3/5 leads (depending
on ECG cable). Protected against surges
produced by ESU and defibrillator
potentials.
Input Impedance : >2.5 M ohms at 10 Hz
CMRR : < 15 mm Max
(Allowable noise on the screen for 3Vpp
applied sine wave of 20 Hz)
Type of averaging : Moving window averaging
Patient applied risk current : < 10 µA (Isolated normal condition)
< 50 µA (Isolated single fault condition)
Patient isolation risk current : < N/A (Isolated normal condition)
50 µA (Isolated single fault condition)
Overload recovery : < 8 sec
Fault indication : Individual lead fault detection
Cal : On screen cal indicator for all gains in
a. Lead II, III and Chest Lead for 5 Lead
b. Lead II and III for 3 Lead
Bandwidth : 0.5 - 40 Hz for Monitoring mode
0.05 - 120 Hz for Diagnostic mode
0.5 - 20 Hz for OT mode
Gain : X0.2, X0.5, X0.75, X1, X2, X5,Auto -User
selectable
Tall T wave rejection : Upto 1.2 mV or QRS amplitude (whichever
is higher)
QRS beep volume control : 12 steps (OFF to High)
Leads : 3 leads for 3 lead ECG cable
5 leads for 5 lead ECG cable
QRS indicator : Beep and flashing heart symbol for
every QRS complex detected

Planet 55 9.7
10. Heart Rate:
Range : 20-350 BPM
Accuracy : 2 BPM or 2% whichever is greater
Source of HR : ECG, SpO2 and NIBP
HR Alarms : Adjustable alarm limits
Upper 50 to 350 BPM
Lower 20 to 320 BPM
4 seconds delay for HR alarms
Time between the silencing of the alarm
and reactivation is 14 seconds.
Heart rate meter response time : Change from 80 to 120 BPM (6 to 7 sec).
Change from 80 to 40 BPM (11 to 12 sec).
Pacemaker pulse rejection/ : When pacer is ON the monitor will display
detection capability the HR for all single and double pacemaker
pulses either 150 or 250 msec apart, with
a pulse width of 0.1 to 2 m sec and amplitudes
±2 mV to ±500 mV without overshoot. Lower
threshold of slew rate for detection of pacer
pulse is 2.2 V/s.

Note

Do not rely on the displayed HR value when pacer


is OFF and pacer pulses are detected as QRS.

11. Respiration: (When source is from ECG)


Input : From ECG cable (RA-LA / RA-LL)
Leakage Current : <10 µA at 240V AC, 50 Hz
Excitation Current : <300 µA at 50 kHz
Sensitivity (Max) : 0.2 Ohms/cm
Sensitivity (Min) : 4 Ohms/cm
Range : 0–150 BPM
Accuracy : Up to 30, +1 BPM, from 30 to 60 +2 BPM,
>60 + 4 BPM
Fault indication : Cable/Electrode fault indication
Gain : Options X1, X2, X3, X4 and Auto (User
selectable)
No Breath Alarm Limit : 10 - 90 sec (selectable) in steps of 5 Sec

9.8
12. Temperature:
Inputs : Isolated and floating
Leakage Current : <10 µA at 240V AC, 50 Hz
Measurement Range : 0 0C to 50 0C
Scale value : Displays direct readings of Temperature
input. ‘∆T’ value displayed in place of T2.
Warm up : <10 min (Excluding probe)
Accuracy : ±0.2 0C or ±0.4 0F
Alarms : Temperature limits adjustable
Upper : 15.0 0C to 50.0 0C
Lower : 12.0 0C to 47.0 0C
0
Unit : C or 0F user selectable
Probe fault : Display shows ‘OFF’ if the probe not
connected
Display shows out of range condition
(-?-) in the event of short circuit or open
circuit probes
Out of range condition also indicated if the
Temperature raises above 50 0C or falls
below 1 0C
Calibration : Injects signal of (37.0 +0.1) 0C into both
inputs

13. SpO2:
Tone variation with change in SpO2 : Provided
Measurement range : 1 - 100%
Accuracy : Adults : (+1 Std. Dev.)
70 - 100% +2 digits
0 - 69% unspecified
Neonates : (+1 Std. Dev.)
70 - 100% +3 digits
0 - 69% unspecified
Alarms : Adjustable alarm limits
Upper : 55 to 100%
Lower : 50 to 95%
Pulse rate range : 20 to 250 BPM
Accuracy (+ 1 Std. Dev.) : +3 BPM

Planet 55 9.9
14. Capnography (Microstream):
Measurement Range:
EtCO2 : 0-99 mmHg
FiCO2 : 0-20 mmHg
RR : 0-150 BPM
Measurement Accuracy :

Time CO2 Partial pressure Customer Accuracy

0-20 min 0-38 mmHg +4 mmHg


39-99 mmHg +12% of Reading
20 min and up 0-38 mmHg +2 mmHg
39-99 mmHg +5% of reading +0.08%
for every 1 mmHg
(above 38 mmHg)

• At sea level.
• Accuracy applies for breath rates of up to 80 BPM.
For breath rates above 80 BPM, accuracy complies with EN 864/ISO 9918 (4 mmHg
or ± 12% of reading whichever is Greater for EtCO2 values exceeding 19 mmHg. To
achieve the specified accuracies for breath rates above 60 BPM, the Microstream@
neonatal airway adapter M1996A must be used in neonatal mode

Units : mmHg or kPa or Vol %


Scale : 20, 40, 60, 80 and 100 mmHg or 2.6,
5.3, 8, 10.6 and 13.3 kPa/Vol%
Flow rate : 50 ml/min
Warm up time : 40 sec (Typical)
Alarms :
EtCO2
Upper : 5 - 80 mmHg
Lower : 0 - 75 mmHg
FiCO2
Upper : 2 - 20 mmHg
RR
Upper : 10 - 150 BPM
Lower : 5 - 145 BPM

9.10
Accuracy : 0-70 (±1) BPM
71-120 (±2) BPM
121-150 (±3) BPM
Calibration :
Zero calibration : Automatically performed by the module.
Indicated to the user through a message
on the screen.
Calibration interval : Initially calibrate after 1200 operating hours,
then once a year or after 4000 operating hours,
whichever comes first.

Note

No Breath alarm limit is 10 - 90 with step of 5 sec.

15. NIBP:
Method : Oscillometric
Display : Systolic, Diastolic and Mean
Modes of measurement : Manual, Auto and Stat mode
• In Auto mode intervals of 2, 3, 4, 5, 10, 15, 30, 60 and 90 min are user
selectable
• In Stat mode unit will take as many readings as possible in 5 min
• Duration between measurements is 10-12 sec
Unit (User selectable) : mmHg or kPa
Range : 20 - 250 mmHg
Accuracy : +5 mmHg with a standard deviation not
greater than 8 mmHg
Cuffs : Single quick connect hose
Auto zero : Zero pressure reference is automatically
established after every reading
Cuff inflation :
Initial inflation :
Adult : 160 mmHg
Neonates : 90 mmHg
Pediatric : 120 mmHg
Subsequent inflation approximately 30 mmHg greater than previous systolic pressure

Planet 55 9.11
Cuff deflation : Automatic
Alarms : Adjustable alarm limits (for both Sys and Dia)
Upper : 30 to 250 mmHg
Lower : 20 to 240 mmHg
Safety features :
Automatic deflation if, cuff pressure exceed
• 300 mmHg (Adult and Pediatric mode)
• 150 mmHg (Neonate mode)
• Measurement time exceeds more than 1 min to deflate

16. Alarms:
Accessory alarms : Audio (Alarm beep), Visual (Flashing
Yellow LED and message indication)
Patient alarms : Audio (Alarm beep), Visual (Flashing Red
LED alarms and message indication)
Re-alarm : 3 min after an alarm is acknowledged
Alarms suspend : Continuous Yellow LED to indicate “Alarms
Suspend” condition with display of alarm
cross mark
SYNC : ECG waveform is displayed

Alarm volume control : 12 steps (min to high)

17. Outputs (Optional):


ECG Sync : Provides 5V P-P pulse for synchronizing
with defibrillator
External monitor : 15 pin D-type sub connector (Female)
CNS communication : USB type
Ethernet : RJ45 type*
Nurse call : Stereo phono jack
PC Dump : 9 pin D-type (Female)
Software upgrade and Printer : USB type
External memory storage : SD Card

* Future Upgrade

9.12
18. Recorder:
Recorder : Two channel
• Make : Woosim (Port - P40)
• Printing method : Thermal recording
• Dot density : 203 DPI
• Paper Width : 58 mm
• Printing Width : 48 mm
• Speed : 25 mm/sec
Recording modes : Direct, Delayed / Continuous modes
On red alarm
Recording duration : Direct : 8 sec
Delayed : -6 to +2 sec
Continuous : 30 sec
On alarm : -6 to +2 sec

19. Communication:
CNS Interface : Communicating with Skyline (L&T’s CNS)
USB : USB connector
Ethernet port : RJ45 connector*
PCDUMP : Dumping of all trend data (9-pin D-type)

20. General:
Dimensions (H X W X D) : 235 mm X 260 mm X 160 mm
Weight : 4.86 Kg (approx) with battery and recorder,
without accessories
Mounting option : GCX option
Operating temperature : 5 to 40 0C
Operating humidity : 10 to 90% RH (Non condensing)
Storage and Transportation : -10 to 50 0C
temperature
Storage and Transportation : 0 to 90% RH (Non condensing)
humidity
Operating pressure : 500 to 760 mmHg
Storage pressure : 500 to 760 mmHg

* Future Upgrade

Planet 55 9.13
21. Accessories Supported:
ECG/Respiration : 3 lead cable with electrodes
SpO2 : DS (Dura sensor) 100A (Adult)
Oxy-A / N (Adult / Neonate) (Optional)
Dura Y (Universal) – ear clip (Optional)
NIBP : Reusable blood pressure cuffs
(Infant to large adult sizes)
Temperature (Optional) : YSI 400 series temperature probes
CO2 : Microstream filter lines
Remote (Optional) : Infrared

22. Standards:
Designed to confirm to the following international standards
Class 1 equipment requirement of IEC 60601-1
EMI/EMC requirements as per IEC 60601-1-2
IEC 60601-2-27 requirements for ECG
IEC 60601-2-30 requirements for NIBP
IEC 60601-1-8 requirements for Alarm systems
IEC 60601-2-49 requirements for multifunction patient monitor systems
ISO 9919 requirements for SpO2
ISO 21647 requirements for CO2
AAMI EC 13 for ECG
AAMI SP 10 for NIBP

9.14
Electro Magnetic Compatibility Information And Manufacturer’s Declaration:
Electromagnetic Compatibility :
Emission Test Compliance level
Radiated Emission Class A, Group1
CISPR 11
Conducted Emission Class A, Group1
CISPR 11
Harmonic Distortion Class B
IEC 61000-3-2
Voltage fluctuations / flicker emissions Complies
IEC 61000-3-3
Electromagnetic Immunity:
Immunity test IEC 60601 test level Compliance level
Electro Static Discharge ± 6 KV Contact Level 3
(ESD) ± 8 KV Air ± 6 KV Contact
IEC 61000-4-2 ± 8 KV Air

Radiated Susceptibility 3 V/m Field Strength 3 V/m Field Strength


IEC 61000-4-3 80 MHz-2.5 GHz Frequency 80 MHz-2.5 GHz Frequency

Electrical Fast Transient ± 2 KV for power supply lines Level 3


IEC 61000-4-4 ± 1 KV for input/output lines ± 2 KV Voltage

Surge ± 1 KV line(s) to line(s) ± 1 KV line(s) to line(s)


IEC 61000-4-5 ± 2 KV line(s) to earth ± 2 KV line(s) to earth

Voltage dips, short <5% UT (>95% dip in UT) <5% UT (>95% dip in UT)
interruptions and for 0.5 cycle for 0.5 cycle
Voltage variations on 40% UT (60% dip in UT) for 40% UT (60% dip in UT)
power supply Input 5 cycles for 5 cycles
lines 70% UT (30% dip in UT) for 70% UT (30% dip in UT)
IEC 61000-4-11 25 cycles for 25 cycles
<5% UT (>95% dip in UT) <5% UT (>95% dip in UT)
for 5 cycles for 5 cycles

Power Frequency (50/ 3 A/m 3 A/m magnetic field


60 Hz) magnetic field strength
IEC 61000-4-8

Conducted RF Immunity 3 Vrms 3 Vrms Voltage150 KHz to


IEC 61000-4-6 150 KHz to 80 MHz 80 MHz Frequency

Planet 55 9.15
10

WARRANTY
AND
WARRANTY SERVICE

Planet 55 10.1
Notes:

10.2
Warranty And Warranty Service
L&T warrants its Medical equipment against only manufacturing defects for a period of
12 (Twelve) months from the date of installation or 13 (Thirteen) months from the date
of despatch from L&T whichever is earlier, unless specified otherwise by separate
document from L&T.
During the warranty, L&T will, at its option, either repair or replace the defective
components/assemblies free of charge. The defective part shall be sent duly packed to
L&T's concerned office/service station at purchaser's cost including freight, insurance
and forwarding charges. Other claims, particularly for compensation, are excluded.
The warranty shall be valid only if installation and repairs are carried out by L&T's
Engineer or Authorized Service Franchisee.

The warranty shall not apply to defects resulting from:


1. Unauthorized modification/misuse/mishandling of the equipment.
2. Operation of the equipment outside the environmental specifications of the product
(e.g. Temperature, Electrical requirement, etc.) as specified in the operating manual.
3. Improper site preparation and maintenance.
4. Any other reason external to the equipment (e.g. accidents, vibrations, etc.)
5. Any mechanical damage to the unit and/or accessories.

Following items are specifically excluded from the warranty:


1. Battery of any type.
2. Mains Cord/Power supply cable.
3. Consumable of any type.

L&T shall not be liable for any special or consequential damages of any kind or nature.
L&T will not be liable in any manner for use of or failure in the performance of other
equipment to which the product is attached/connected.

Planet 55 10.3
EUROPE
Business Manager
M/S Larsen & Toubro Infotech Limited Tel : 0044 207 517 1610
Suite 11.01, 11th Floor, Exchange tower Fax : 0044 207 538 3883
1 Harbour exchange square, Limeharbour,
London - E149GE. United Kingdom.

USA
Medical Equipment & Systems
1051 Perimeter Drive, Tel : 001 847-230-1058
Suite 470, Schaumburg, IL 60173 Fax : 001 847-517-9238

INDIA
Larsen & Toubro Limited
Medical Equipment & Systems Tel : 91 22 67051223
Powai campus, Annexe Building, 91 22 67053226
Gate No.7, Saki-Vihar Road, Fax : 91 22 67051276
Mumbai - 400 072. Website: www.lntmedical.com

For immediate assistance please contact our Customer Interaction Center (CIC)
Toll Free No : 1800 200 5858 / 1800 233 5858
Tel No. : +91 22 6774 5858
Fax : +91 22 6774 5859
E-Mail : [email protected]

10.4

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