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Instructions for use

Before using the devices for the first time, read the instructions carefully and follow all their recommendations and suggestions. This chapter contains all the information required for safe, cor rect and accurate measurement with the MESI mTABLET VITALS. It includes a detailed description of all features, the safety instruc tions, and all information required to understand the operation of the devices and the system.

4.1 FIRST-TIME USE

4.1.1 ACTIVATION OF MODULES

When setting up the MESI mTABLET VITALS system for the first time, the devices need to be activated out of the shipping mode. The measurement modules (THERMOMD, SPO2MD and CUFFMD) will not respond until the CS4SYS charging plate is connected with the AC/DC power supply to a wall socket with a mains voltage of 100-240 V at 50-60 Hz, and the modules are placed on the charging plate. This makes the multifunctional buttons on each device illuminate, which indicates that the battery is charging. During this process, the light on the module flashes orange. When the device is fully charged, the multifunctional button starts flashing green. It is recommended that the measurement modules are fully charged before initial use

NOTE: The battery inside a new device is probably not completely empty and can provide enough power to start up the device. Nevertheless, connect the de vice to the mains electricity using the AC/DC power supply before its first use.

4.1.2 ACTIVATION OF MODULES

Before any measurements can be performed, the THERMOMD, SPO2MD and CUFFMD modules need to be paired to the MESI mTABLET UNIT, as described below

Step 1

Log in to the User’s profile on the MESI mTABLET UNIT.

Step 2

Go to User Profile > Settings > Modules > +Add Module.

MESI mTABLET Thermo - Pairing - Step 1

Step 3

Press the button at the top of the module.

MESI mTABLET Thermo - Pairing - Step 2

Step 4

When the MESI mTABLET UNIT establishes a connection with the module, the light at the top of the module will change. Confirm the pairing process by pressing that button again.

MESI mTABLET Thermo - Pairing - Step 3

Step 5

The final screen shows a successful connection between the MESI mTABLET UNIT and the module. You can access all technical information about the connected modules in User profile > Settings > Modules.

MESI mTABLET Thermo - Pairing - Step 4

Step 6

Repeat for all modules.

NOTE: When operating one MESI mTABLET UNIT only, this operation is only required once. In case of more MESI mTABLET UNITS, this process has to be repeated on each MESI mTABLET UNIT

NOTE: The pairing process needs to be performed with all modules being used.

4.2 PREPARATION FOR MEASUREMENT

4.2.1 CONNECTING THE SENSOR TO THE PULSE OXI METER UNIT

FingerClip Sensor (CS10299) is disconnected during storage and transportation. Before first use connect the sensor to the port on the MESI PULSE OXIMETER UNIT. Ensure that the sensor is securely connected.

MESI mTABLET SpO2 - Connecting the sensor

NOTE: MESI SPO2 MODULE comes with a Finger Clip Sensor (CS10299), used for measuring SpO₂ on the finger. For instructions on other types of sensors, please observe the manual supplied with the sensor package.

4.2.2 CONNECTING THE CUFF TO THE BLOOD PRESSURE UNIT

During shipping and transportation, the conical cuff is disconnect ed from the CUFFMD module. Before first use, connect the cuff to the port on the module, as shown on the image below. Ensure that the cuff is securely attached.

MESI mTABLET TBI - assembly of the cuff

⚠️Use only accessories and other parts recommended or supplied by MESI. Use of other than recommended or supplied parts may result in injury, inaccurate information and/or damage to the unit. This product is not designed for sterile use.

4.2.3 PREPARING THE MESI mTABLET THERMO DEVICE

Before using the MESI mTABLET CONTACT PROBE (CTMD), apply the MESI disposable contact probe shield, as shown below, to prevent cross-contamination.

Step 1

Hold the probe shield and insert the thermometer between the two tabs. Slide to the farthest point.

MESI mTABLET Thermo - Using the MESI disposable contact probe shield - Step 1

Step 2

Hold the thermometer and the back of the shield firmly. Peel away the front paper protective shield.

MESI mTABLET Thermo - Using the MESI disposable contact probe shield - Step 2

Step 3

Peel away the paper backing. The thermometer is now protected and ready for use.

MESI mTABLET Thermo - Using the MESI disposable contact probe shield - Step 3

Step 4

After use, remove the disposable probe shield without touching the contaminated part and dispose of it.

MESI mTABLET Thermo - Using the MESI disposable contact probe shield - Step 4

Using the MESI non-contact thermometer does not need additional preparation for performing a measurement.

NOTE: The contact probe must always be used with the MESI contact probe shield. Do not use it without a shield or with other brands. The probe shield does not affect measurement accuracy.

4.2 PREPARATION FOR MEASUREMENT


Step 1 - Choose the right colour of the cuff

Select the appropriate cuff, depending on the description and colour of the cuff:

Choose the right colour of the cuf
PositionDescription on the cuffColour
Right armRightt armRed
Left armLeft armYellow

Step 2 - Place the cuff on the appropriate arm

  • Position the cuff 1-2 cm above the elbow joint and align the Artery marking on the cuff with the artery on the inner side of the arm. Apply the cuff snugly, allowing space for approximately two fingers between the cuff and the arm.

  • Verify that the correct cuff size has been selected by checking the SIZE marking and ensuring the arm circumference falls within the OK range indicated on the cuff.

Hold the thermometer and the back of the shield firmly. Peel away the front paper protective shield.

NOTE: Observe instructions for use that are provided with the cuff.

Step 3 - Prepare SpO2

Select the appropriate SpO₂ sensor, depending on the patient’s category, weight and application site.

Clean the application site and remove any barriers (e.g. coloured nail polish, dried blood). Apply the sensor to the patient’s index finger on the arm opposite to the one where the blood pressure cuff is placed.

Step 4 - Prepare the infrared thermometer

Ensure the patient has rested indoors for at least 5 minutes, has no recent heat or cold exposure, and that the forehead is clean, dry, and unobstructed before measurement.

Step 5 - Prepare the contact thermometer

Alternatively, if body temperature is measured using a contact thermometer instead of an infrared thermometer, first apply the MESI disposable contact probe shield, as described in the chapter “Using the disposable contact thermometer probe shields”, then place the thermometer in one of the measurement sites, as described below.

Axillary measurement:

Place the contact thermometer with its metal point in the middle of the armpit, and the other end of the thermometer facing the patient’s head.

axillary

Oral measurement:

Place the contact thermometer with its metal point on either side under the patient’s tongue.

oral

Rectal measurement:

Insert the contact thermometer 1.5 to 3 cm into the rectum. Hold the thermometer in place and make sure the patient remains still and relaxed throughout the measurement.

rectal

The patient is now correctly prepared, and the measurement may be performed.

4.4 PATIENT SELECTION

4.4.1 SELECTING A PATIENT

Step 1

Press the Patient tab button on the home screen.

select-patient-step1

Step 2

Use the search bar (1) or scroll (2) to the patient who is having the Vitals measured.

select-patient-step2

Step 3

Select the patient.

select-patient-step3

4.4.1 ADDING A PATIENT

Step 1

On the home screen, press the + button in the Patient tab.

adding-patient-step1

Step 2

Fill out required fields (Name, Surname, Date of Birth and Gender) and any additional information regarding the patient.

adding-patient-step2

Step 3

Save the patient by pressing the ✔️ or ”SAVE” button. Cancel adding the patient by pressing the ”X” or ”Delete patient” button.

adding-patient-step3

4.5. PERFORMING THE MEASUREMENT

Open the Vitals application as described. When the application opens, it may take a few moments for the paired measurement modules to connect. When connected, the modules appear at the bottom of the screen.

Step 1

On your MESI mTABLET UNIT, select an existing patient (1) or add a new one (2) and press the “APPLICATIONS” button on the bottom of the screen (3).

performing-the-measurement-step1

Step 2

After selecting the patient, select the Vitals application in the application menu.

performing-the-measurement-step2

4.5.1 MEASUREMENT SETTINGS

Before performing the Vitals measurement for the first time, make sure to go through the measurement and Early Warning System (EWS) settings, as described below.

To access the measurement settings, press the gears button in the lower right corner of the Vitals measurement screen.

measurement-settings-vitals

The measurement settings are used to set up the basic parameters of the blood pressure and temperature measurement, as well as some general instructions for performing all three measurements.

4.5.1.1 Blood pressure measurement settings

To use Standard inflation, select the “Standard inflation” option. In this mode, the blood pressure cuff automatically inflates to the pressure required for the measurement. This setting is recommended when the patient’s approximate blood pressure is unknown.

To use Custom inflation, select the “Custom inflation” option, and use the “+” and “-“ buttons to set the target inflation pressure. In this mode, the cuff inflates only to the preset pressure, which can make the measurement faster than with the Standard inflation setting. This setting is recommended when the patient’s approximate blood pressure is known.

The set target inflation pressure can be saved as the default by selecting “Use as default”. When enabled, this pressure is applied automatically each time the Vitals app is opened. If not selected, the pressure resets to 180 mmHg on each app launch.

To choose the arm for the blood pressure measurement, select the “Left arm” or “Right arm” option.

bp-left-arm

NOTE: After selecting the arm for the blood pressure measurement, the Vitals app needs to be reopened, in order for the measurement module to recognise the correct cuff.

4.5.1.2 Temperature measurement settings

Using the dropdown menus, you can select the following three parameters:

  • Default measurement method

- Infrared

- Contact

  • Units of temperature

- Celsius

- Fahrenheit

  • Units of distance

- Centimeters

- Inches

thermo-dropdown-menu

4.5.1.3 Early warning system settings

To access the EWS settings, press the EWS button in the lower left corner of the Vitals measurement screen. Here, one of the three different EWS calculators can be selected using a dropdown:

  • National Early Warning Score (NEWS) 2 - Scale 1

  • National Early Warning Score (NEWS) 2 - Scale 2

  • Modified Early Warning Score (MEWS)

To set the default EWS, which will be selected every time the Vitals app is is opened, press the “Use as default” option.

early-warning-system-settings-vitals

Tables with EWS scores, parameters, and parameter results are included in the EWS settings for each EWS calculator, as well as below.

NEWS2 Scale 1:

NEWS2 Scale 1

NEWS2 Scale 2:

NEWS2 Scale 2

MEWS:

MEWS

The selected EWS is presented on the main measurement screen, below the ACVPU scale section.

Enabling or disabling the use of EWS calculators during the meas urement, as well as setting which EWSs are available for selection, can be configured in the Advanced settings of the MESI mTABLET.

4.5.2 PERFORMING VITALS MEASUREMENT

The Vitals app measurement screen is divided into different sections, each dedicated to a specific measurement parameter:

  • Blood pressure

  • SpO2

  • Pulse rate

  • Temperature

  • Respiratory rate

  • ACVPU scale

  • Pain scale

NOTE: All measurements can be performed simultaneously and all measurement results can be entered manually, without using the MESI measurement modules

4.5.2.1 Performing the Blood pressure measurement

NOTE: The measurement results are coloured based on the selected EWS. If no EWS is selected, the result is based on the default MESI colour-coding.

Step 1

The patient can sit or lie down. Instruct the patient to remain still and quiet throughout the blood pressure measurement If the measurement is being performed with two blood pressure modules and two cuffs, the left or right arm cuff can be selected by pressing the “Switch cuff” button

bp-measurement

STEP 2

After properly placing the blood pressure cuff, the measurement can be started by pressing the “START” button in the blood pressure measurement section.

performing-the-bp-measurement-step2

STEP 3

The measurement can be stopped by pressing anywhere on the Blood pressure section and confirming it by pressing “Stop”. To continue the measurement, press “Cancel.”

bp-measurement-graph

STEP 4

After the measurement is finished, the result is presented as systolic (SYS), diastolic (DIA), and mean arterial pressure (MAP).

bp-measurement-result

STEP 5

The result can also be entered manually by first pressing the “Manual entry” button, entering the values on the pop-up, and pressing “Save”.

blood-pressure-manual-entry

STEP 6

The measurement can be repeated by pressing the “Redo” button and confirming it on the pop-up.

performing-the-bp-measurement-step6

4.5.2.2 Performing the SpO2 measurement

Step 1

The SpO2 measurement is started automatically when the SpO2 probe is correctly placed on the patient’s finger. When the measurement is started, the result is presented, along with the heartbeat indicator.

spo2-sensor-on-finger

STEP 2

If using the NEWS2 Scale 2, the “Supplemental O2” option can be selected, indicating that the patient is using supplemental oxygen

spo2-status

STEP 3

The measurement can be stopped by simply removing the SpO2 probe from the patient’s finger.

STEP 4

The result can also be entered manually by first pressing the “Manual entry” button, entering the value on the pop-up, and pressing “Save”.

spo2-manual-entry

STEP 5

The measurement can be repeated by pressing the “Redo” button and confirming it on the pop-up

performing-the-spo2-measurement-step5
4.5.2.3 Performing the Pulse rate measurement

Step 1

Pulse rate measurement starts automatically when either a Blood Pressure or SpO₂ measurement begins.

If only SpO₂ is measured, or if Blood Pressure and SpO₂ are measured simultaneously, the pulse rate is derived from the SpO₂ measurement. If only Blood Pressure is measured, the pulse rate is derived from the Blood Pressure measurement.

This is indicated by the “BP” or “SpO2” tag in the Pulse rate section.

Pulse-rate-1pulse-rate-bppulse-rate-spo2

STEP 2

Pulse rate can be entered manually by first pressing the “Manual entry” button, entering the value on the pop-up, and pressing “Save”.

pulse-rate-manual-entry

4.5.2.4 Performing the Temperature measurement

Step 1

Infrared or contact measurement can be selected by pressing the “Switch” button.

STEP 2

Infrared measurement:

The infrared measurement is performed by placing the infrared thermometer approximately 3 cm from the center of the patient’s forehead and pressing the measurement button on the thermometer.

infrared-measurement

Contact measurement:

The contact measurement is performed by placing the contact thermometer in one of the measurement sites, as described in chapter “ Patient preparation”, and selecting the measurement site.

contact-measurement-1contact-measurement-2

STEP 3

When the measurement is completed, the result is presented in the Temperature section, along with the thermometer and measurement site used.

1-temp

STEP 4

Temperature can also be entered manually by first pressing the “Manual entry” button, entering the value on the pop-up, and pressing “Save”.

temperature-manual-entry

STEP 5

The measurement can be repeated by pressing the “Redo” button and confirming it on the pop-up.

performing-the-temp-measurement-step5

4.5.2.5 Performing the Respiratory rate measurement

Step 1

The respiratory rate measurement is started by pressing “Start,” which activates a 15-second timer. During this period, the healthcare professional counts the patient’s breaths.

respiratory-rate-1respiratory-rate-2

STEP 2

When the timer ends, the counted number of breaths is entered using the slider. The respiratory rate in breaths per minute is then calculated automatically.

respiratory-rate-3

STEP 3

Raspiratory rate can also be entered manually by first pressing the “Manual entry” button, entering the value on the pop-up, and pressing “Save”.

respiratory-rate-manual-entry

STEP 4

The measurement can be repeated by pressing the “Redo” button and confirming it on the pop-up.

performing-the-respiratory-rate-measurement-step4

4.5.2.6 Performing the ACVPU measurement

Step 1

The ACVPU parameter can be selected by pressing one of the five options. The colour of the options is based on the selected EWS calculator.

respiratory-rate-3

NOTE: ACVPU stands for Alert, Confusion, Verbal, Pain, and Unresponsive and indicates the patient’s level of consciousness.

4.5.2.7 Performing the Pain scale measurement

Step 1

The pain level can be selected by sliding the slider to one of the ten values (0 – no pain, 10 – very painful).

Pain-scale-measurement

4.5.3 CLEARING AND CONFIRMING THE VITALS MEASUREMENT

When one or more Vitals measurements are completed, they can be cleared by pressing the “Clear” button at the bottom of the measurement screen, and confirming it by pressing “Clear” on the pop-up.

attention-popup-clear-measurements

When one or more Vitals measurements are completed, the result can be saved by pressing the “Next” button at the bottom of the measurement screen. Pressing the “Cancel” button at the bottom of the measurement screen closes the Vitals application. This can only be done once the measurement results are cleared.

incomplete-measurement-popup

4.6 RESULTS

Once the measurement has been taken, the system automatically switches to the results screen. By scrolling the results page, the measurement parameters, as well as the EWS score, can be viewed.

vitals-results

4.7 EARLY WARNING SYSTEM ON THE RESULTS PAGE

If the EWS calculator was selected during the measurement, the EWS score is presented on the results page. It consists of two parts:

  • Score, assigned to each parameter, which is represented with a coloured number, based on how far it deviates from normal ranges

  • Overall EWS, displayed as a coloured banner, representing the sum of the individual scores and guiding clinical response and escalation of care

Information about the selected EWS, including colour coding, physio logical parameters, and the scoring scale, can be accessed by pressing the “i” icon on the EWS banner

National-early-warning-score-news2

4.8 MULTIFUNCTIONAL BUTTONS

4.8.1 LED INDICATORS

Although most of the MESI mTABLET Vitals control takes place through the MESI mTABLET UNIT interface, there is also a multi functional LED button at the top of the each module. In addition to the basic colour light notification functionalities of this button, it is also possible to perform some additional operations. These operations are based on the current status of each module.

4.8.1.1 Standby

Green 🟩: The battery capacity is at more than 25%.

Red 🟥: The battery is at less than 25%. Please recharge the battery as soon as possible.

4.8.1.2 Charging

Orange 🟨: The battery is charging.

Green 🟩: The battery is fully charged.

4.8.1.3 Pairing

Blue 🟦: The unit is waiting for conformation from the MESI mTABLET.

4.8.2 BUTTON FUNCTIONS

4.7.2.1 Standby
Button functions - Standby
Status checkA quick press on the status button in standby mode performs a basic status check of the module. A green button means a more than 25% battery charge. A red button means that less than a 25% charge is left, and the module should be charged.
Pairing modeHolding the status button for 4 seconds puts the module into pairing mode, so that it can be connected to the MESI mTABLET UNIT (for more information, go to chapter 4.2.5 Pairing).
Resetting the moduleTo reset the module, press and hold the status button for 10 seconds until the LED lighchanges to red. The unit is ready to use in a few seconds.

4.8.2.2 Measurement mode
Measurement mode
Stop measuringThe measurement is stopped by quickly pressing the top button on the module while performing the measurement.