Table 1.
Changes in default settings of the cardiac monitors at the transplant/cardiac intensive care unit.
| Type of change | Parameter | Default setting | Changed to... |
| Limit tightening |
|
|
|
|
|
PVCsa/minute | 10 bpm | 6 bpm |
| TachyClampb | 200 bpm | 180 bpm | |
| Limit increase | ExtremeTachyb | 20 bpm > Heart Rate High Limit | 40 bpm > Heart Rate High Limit |
| Changing the source of alarm detection |
|
|
|
|
|
ABPc | Source: Systolic | Source: Systolic and Mean |
| NBPd | Source: Systolic and Mean | Source: Systolic | |
| Changing the measurement mode |
|
|
|
|
|
System Pulsee | SpO2f | Auto (from ABP, SpO2, etc) |
| Asystole | Standard | Enhanced | |
| Alarm delay | SpO2: Averageg | No | Yes: 10 seconds |
| Disabling alarms |
|
|
|
|
|
STh Analysisi | On | Off |
|
|
Run PVCs | On | Off |
|
|
Pair PVCs | On | Off |
|
|
Bigeminy PVCs | On | Off |
|
|
Trigeminy PVCs | On | Off |
|
|
Multiform PVCs | On | Off |
|
|
Pause | On | Off |
|
|
Missed Beat | On | Off |
|
|
AFIBj | On | Off |
|
|
NBP Done Tone | On | Off |
| Decrease alarm volume | Yellow Alarm Volume | 5 | 3 |
| Increase alarm volume | Red Alarm Volume | +0 | +2 |
aPVC: premature ventricular contraction.
bThese alarms are not amenable to change by clinicians. All other alarms can be customized by clinicians based on the patient condition.
cABP: arterial blood pressure.
dNBP: noninvasive blood pressure.
eIf the peripheral capillary oxygen saturation (SpO2) had a poor waveform, the pulse from the pleth would not pick up and would therefore alarm. Changing to Auto allows the monitor to detect a pulse from other sources before alarming.
fSpO2: peripheral capillary oxygen saturation.
gSpO2 will be averaged over 10 seconds to determine a value instead of alarming the second the SpO2 drops below the limit. The nurse can also manually increase this to 20 or 30 seconds.
hST: ST segment in the electrocardiogram.
iThe ST Analysis alarm was disabled but should be turned on for all interventional cardiology cases (eg, require cardiac catheterization) or acute coronary syndrome patients. For these specific patients, the original limit of +/-2.0 mm should be tightened to +/- 1.6 mm as per physicians’ requests.
jAFIB: atrial fibrillation.