Purpose: A pneumogram is used by the physician to diagnose and treat any irregular cardiopulmonary patterns an infant may have. Description: A pneumogram is a recording of the patient's heart rate, respiratory pattern (impedance), respiratory airflow, pulse oximetry. Esophageal pH may also be recorded during the study. The recording is to be scored by the American Healthcare Resources Respiratory Therapist. The report will then be presented to the ordering physician for interpretation. Completed studies will be kept on file with AHR and a copy will be placed in the patients chart. Indications: 1. An infant that is considered at risk for SIDS. 2. An infant that is having significant episodes of apnea and/or bradycardia determine whether to intervention with pharmocologic agents such as caffeine or theophylline is warranted. 3. To determine the efficacy of a pharmocologic agent in preventing apnea and/or bradycardia. 4. In conjunction with a pH probe study to diagnose esophageal reflux. 5. To determine the need for home monitoring. Equipment: 1. Respironics Smart Monitor with accessories. 2. Respironics Smart Recorder with accessories. 3. Respironics patient leads (part number 9510). 4. Masimo pulse oximeter probe. 5. Respironics nasal airfow sensor. Personnel: Respiratory Therapist Procedure: Smart Monitor Set Up 1. Connect patient cable (ECG) to Patient Input. 2. Connect leads to patient cable. 3. Attach patient leads to patient per patient cable configuration. 4. Connect Monitor Power cord to Power Input on the back of the monitor. 5. Attach recorder cable to Recorder Output on the back of the monitor. 6. Turn monitor on. Smart Recorder Set Up 1. Attach recorder cable to Auxiliary on the back of the recorder. 2. Plug in DC power cable t0 DC Power on the back of the recorder. 3. Plug in 6 Channel Patient Cable to the front of the recorder. 4. Plug in pulse oximeter cable to the front of the recorder. 5. Press Power to turn recorder on. Patient Sensors: 1. Place Masimo pulse oximeter probe on the sole of the foot under the fourth toe (detector) to top of the foot (emitter). 2. Insert the sensor tab into the Masimo patient cable. Note: Masimo performs a calibration when oximetry first begins. Should the sensor fall off or be removed from the patient, disconnect the sensor from the patient cable and reconnect. This will ensure that the oximeter performs a calibration and will provide accurate readings. 3. Place airflow sensor cannula in the patients nares. Secure with Tegaderm. 4. Attach airflow connector. 5. Attach the airflow sensor to the light blue socket on the patient cable. 6. Attach electrodes under armpits. 7. Attach electrode connectors to Patient Connection Cable. Navigating the LCD Display: 1. Use the 'up' and 'down' buttons to display the menu for the parameter that you would like to setup or change. 2. Once the menu is displayed, press the ENTER button 3. The displayed menu will blink 4. Use the 'up' and 'down' buttons to view the available parameters for the selected menu. 5. To select a menu setting on the LCD display, press the Enter button to select the displayed parameter. Patient Setup: This is the most commonly used menu. Use it to enter the patient name, enter the medical record number and select the configuration that is to be used. The waveforms may also be checked to verify the signal quality. LCD Display Shows - 'Menu Selections:' - Patient Name This is the default menu. To proceed, press 'up'. To enter the Patient Name: 1. Press Enter to begin entering patient name. 2. Press 'up' or 'down' to browse through the alphabet and select the letter you need. When the letter you want appears, press Enter. Press Enter twice to place a space in between the first and last name. 3. When you have finished the name, press 'up' or 'down' until the ^ appears. Then press Enter. 4. Press 'up' to proceed to the next menu or 'down' to move to the previous menu. LCD Display Shows - 'Patient ID:' - Patient ID 1. Press 'up' or 'down' until Patient ID is displayed. 2. Press Enter to begin entering the medical record number. 3. Press 'up' or 'down' to browse through the numbers and select the digit needed. When the digit displays, press ENTER. 4. When you have finished the medical record number, press 'up' or 'down' until the ^ appears. Then press ENTER. 5. Press 'up' to proceed to the next menu or 'down' to move to the previous menu. LCD Display Shows - 'Select Configuration:' Configuration #1 or Configuration #2 or Configuration #3 To select the correct configuration: 1. Press 'up' or 'down' until Configuration is displayed 2. Press Enter to activate 3. Press 'up' or 'down' to select the configuration needed. When the configuration needed appears, press Enter 4. Press 'up' to proceed to the next menu or 'down' to move to the previous menu. Note: Configuration # 1 will be used for most studies. Configuration #1 will be used for esophageal pH studies. These configurations are pre-programmed. LCD Display Shows - 'Check Waveform?:' To verify the quality of the channel signals before the recording begins: 1. Press 'up' or 'down' until Check Waveforms is displayed. 2. Press Enter to activate. 3. Press 'up' to select 'YES'. 4. Press Enter, the first waveform in the selected configuration displays. 5. Press 'up' to display the next waveform, etc. LCD Display Shows - Press 'RECORD' key to begin. 1. Press the Record button on the front of the Smart Recorder. Ending a Patient Study. 1. Press the 'Power' button to turn the recorder off. 2. Press and hold 'Reset' button on the monitor. 3. While holding 'Reset' button, press 'Off/On' button to turn the monitor off. 4. Disconnect leads, pulse oximeter probe, airflow sensor, and patient sensors. 5. Clean monitor and patient sensors. 6. Repack monitor, recorders and accessories Infection Control: 1. Patient leads, pH probe, and pulse oximeter probe are single patient use only. 2. Smart Monitor, Smart Recorder and accessories are to be cleaned with a hospital approved disinfectant. 3. Infection control guidelines are to be followed while performing studies. References: 1. Smart Monitor Operator's manual. 2. Smart Recorder Operator's manual Cardiopulmonary. |