LARSEN & TOUBRO LIMITED

Skyline
Operating Manual

Cat No. : 3-87-080-0001-05 Issued : MARCH 2003 REV. : 1

All rights reserved:

Technological upgradation is a continuous process at L&T. Hence, the

specifications mentioned in this manual are subject to change without any prior
notice. The content in this manual is strictly not to be reproduced in any form, by
any method, for any purpose.
WORKMANSHIP

L&T offers a warranty for a period of 12 months from the date of

installation or 15 months from the date of shipment, whichever is
earlier under normal use and service. L&T's obligation under this
warranty is limited to repairing, if any part proves defective.

EXEMPTIONS
L&T's liability under this warranty does not include any
transportation 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.

SAFETY, RELIABILITY AND PERFORMANCE

L&T is not responsible for the effects on safety, reliability and

performance of the monitor if :

Assembly operations, modifications or repairs are carried

out by people other than authorised by L&T.
Monitor is not used in accordance with the instructions for
use.
The electrical installation of the relevant room does not
comply with regulations.
Line and neutral fuses of specified ratings are not used.

Several equipment of different makes are interconnected

through the same MAINs power distribution line, the
summation of the resulting leakage currents may exceed
the maximum limits.

Explosion hazards occur due to presence of flammable

anaesthetic agents.
ALARMS

Do not rely fully on the audible alarm systems for patient

monitoring. Adjustment of alarm volume to a low level or
switching them OFF during patient monitoring may result in
alarm conditions going unnoticed. Remember that the most
reliable method of patient monitoring combines close personal
surveillance with correct operation of monitoring equipment.

COPYRIGHT

L&T owns all rights to this unpublished manual and intends to

maintain this manual as confidential. L&T also seeks to maintain
this manual as an unpublished copyright. This manual is to be
used solely for the purpose of reference, operation and
maintenance of L&T equipment.

All product specifications, as well as information in this manual,

are subject to change without 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.

CAUTION
1. Do not run any other applications on the computer when
Skyline is in operation.
2. Do not switch OFF the system without closing the Skyline
application.
3. Please switch the system OFF and ON once in 41 days of
continuous operation as a precaution against a bug in Windows
95.
 General Description

L&T Medicals advanced central nursing station,

Skyline consists of software and hardware
supplied by L&T Medical. This machine works
with a personal computer operating in Windows
95/98 environment. Skyline offers complete data
/ information of the 8/16 bedside monitors
connected to hardware (Skyline box with one
card for 8 beds and two cards for 16 beds)
through RS 485 communication port. Dedicated
Skyline hardware {USB Interface Card (UIC)} is
plugged into the USB port of a PC, and
communicates with the bedside monitor and

Windows operating system. Dedicated device
driver is used to transfer messages between the
user interface and the Skyline hardware. The
driver software ensures error free
communication. Graphical User Interface (GUI)
with most of the operations through mouse
control makes it easy to use. Skyline can
communicate with various patient monitors of
L&T Medical viz. Star, Star-SNT, Planet, Galaxy,
Norbit, Lunar, Lunar-SN, Stellar, Stellar-P, Orbit
and Micromon-N.

Windows is a registered trademark of Microsoft

Corporation.
 INDEX

Page No.

1. Note, Caution and Warning 1

2. Installation 7
- Pre-installation
- PC configuration
- Skyline system connections
- Skyline compatible monitors -Installation

3. General information 15
- Operating instructions
- Controls common to all modes
- Alarms

4. Multibed mode 21

5. Multiparameter mode 37

6. Arrhythmia / ST mode 43

7. Trend mode 49
- Graphical trend
- Tabular trend

8. ECG Recall 57

9. Print formats 61

10. Routine maintenance 69

11. Fault diagnosis 71

12. Interconnections 79

Warranty certificate
- Customer copy
- Engineer copy
- MED service center copy
 NOTE
NOTE
Follow the instructions for PC installation.
Refer page no. 12

NOTE
Kontron version 8/16 Bed Skyline. User Access Verification in the
form of password & will be required to exit Skyline and switch OFF the
Skyline system.
Refer page no. 18

NOTE
Visual indications of all alarms will continue.
Refer page no. 28

NOTE
Parameter selection facility in multibed view is possible for 8 bed
version only.
This facility is provided for STAR, STAR SNT, LUNAR, LUNAR SN,
PLANET & GALAXY bedside monitors.
Refer page no. 29

NOTE
Passwords are case sensitive.
Refer page no. 30

NOTE
Equipment selection feature is disabled for USB compatible system
(for both 8 and 16 beds versions).
Refer page no. 31

NOTE
Only printer models for which the necessary driver softwares are
loaded while configuring the personal computer during the
installation will appear in this list.
Refer page no. 32
Refer page no. 34

NOTE
Alarm indication and Alarm Mute features are not applicable for
Micromon-N.
Refer page no. 35

NOTE
If the bedside equipment is not powered ON or not connected then
the message MONITOR NOT CONNECTED or LINK FAILURE will
be displayed in place of ECG waveform.
If Stellar-P is connected, then the message STELLAR-P
CONNECTED will be displayed in place of ECG waveform.
ECG waveform may overlap the name, in case of higher amplitude.
If the bed number entered by the user is different from the one
received by Skyline from bedside monitor then error message will be
displayed.
Refer page no. 36
NOTE
In multiparameter mode print function will print the selected bed.
ECG waveforms and HR of other 7 beds will not be printed.
Refer page no. 41
NOTE
Visual alarms for a parameter will be indicated by a change in the
background colour of parameter label in multiparameter mode.
(Yellow / Red)
Refer page no. 41
NOTE
Arrhythmia / ST mode is not applicable for Micromon and Stellar - P.
Refer page no. 46

NOTE
ST mode is applicable only for Galaxy and Star bed side monitor.
Refer page no. 46

NOTE
Arrhythmia trend will be available for 24 working hours or from the
time of patient admitted.
The arrhythmia default display will be for 13 hours.
The ECG strip will be shown with the scale for arrhythmia
occurrences with the resolution of 2 minutes.
The background is black for waveform display in all screens but for
arrhythmia screen it is on graph paper.
Refer page no. 47

NOTE
Tabular trend can be accessed through graphical trend screen only.
Refer page no. 51

NOTE
Trend data will be available for 24 hours, prior to the time of entry
into graphical trend mode.
Trend data will be displayed in the form of a bar graph, with a scale.
The default resolution for trend is 6 minutes.
Horizontal scroll bar to scroll through the trend graph is provided at
the bottom. Clicking the left/right arrow button of the scroll bar using
mouse, shifts the graph by 6 minutes.
Records corresponding to the alarms have following colour codes:
Red : In case of patient related alarms
Yellow : In case of machine related alarms.

Refer page no. 53

NOTE
For alarm condition the text colour will be:
Red : For values upper than the set limit.
Pink : For values lower than the set limit.
Horizontal scroll bar is provided to scroll through the parameters.
On clicking right arrow key IBP1 and IBP2 can be viewed. (By
default NIBP and ST are shown)
Vertical scroll bar is given to scroll through the numerical values in
the tabular trend.

Refer page no. 53

NOTE
Interface cable colours subject to change without notice (colours
depend upon availability and the type of cable in market.
Refer page no. 80

NOTE
T-Transmit and R-Receive are junction points for data transmission.
S is a common point (Drain) which needs to be connected to the
common ground point at Skyline end.
Maximum length of RS 485 cable is 200 metres.
R and T are extra pair of cable for future use.
Drain cable should be shorted with the monitor ground at the
bedside end to have better signal transmission.
Please ensure correct connections of R and T throughout the
installation.

Refer page no. 80

 CAUTION

CAUTION
In case of power failure, Skyline will retain the trend data but recall
of last 16 alarms will be lost.
Refer page no. 8
CAUTION
Before making any connections, make sure that the PC is fully
functional & is in power OFF mode. (Interacting Skyline hardware
while the PC is ON can damage the system.)
Ensure that Skyline network cables and power cable and Skyline
cable.
Ensure proper distance between power cable and Skyline cable.
Refer page no. 12
CAUTION
Discharging a patient will erase all the stored data of the patient
(trend, arrhythmia strip storage records etc.), pertaining to that
patient.
Refer page no. 26
CAUTION
Do not use chemicals or abrasive solutions.
Refer page no. 70
WARNING
WARNING
1. Dont move the PC in power ON condition.
It may cause loss of stored data (HDD damage) and damage to
electrical connections.
Skyline being an ICCU equipment, it is not intended to operate in
MRI environment.
2. Performance of Skyline when operating in MRI environment is
not known to the best of our knowledge.
Follow MRI manufacturers advice while using equipment near
MRI.
Refer page no. 13
Pre-installation
For site planning of Skyline two key points are listed below:-
a. Site selection and preparation.
b. Selection of power conditioning equipment.
a. Site selection and preparation
Proposed Skyline site should be selected keeping in mind various
external factors that will affect normal operation of the system in
future. It is advisable to avoid areas of strong Electro magnetic
fields near the proposed site of installation e.g., Transmitting towers,
HT transformer, HT and LT power transmission lines etc.
Electrical connections and bedside monitors to Skyline wiring
should be made with proper care to minimise the interference. 5-
amp sockets with proper grounding (G-N voltage < 2 volts) should
be provided at the site of installation (3 sockets for Skyline and
individual sockets for bed side monitors).
b. Selection of power conditioning equipment
Depending on the voltage supply at your site, you must choose the
appropriate voltage stabilizer. The Skyline requires regulated
stabilized voltage for operation and hence it is required that you
install any one of the following:
Servo voltage stabilizer with high/low trip facility.
CVT (Constant Voltage Transformer)
UPS (Uninterrupted Power Supply)
UPS is recommended for Skyline to avoid loss of data in case of power
failure.
The voltage and power specification for the voltage stabilizing
equipment must be :
Input voltage range : 180V to 260V AC single phase
Output regulated voltage : 230V AC +/- 2% single phase
Power ratings : 2 kVA (This rating is suggested for ICU
layout with 16 monitors and Skyline
The unit should be properly ventilated as mentioned in safety section of
this manual.

CAUTION
In case of power failure, Skyline will retain the trend data but recall
of last 16 alarms will be lost.

The unit should be properly ventilated as mentioned in safety section of

this manual.
PC Configuration
PC Hardware Minimum Configuration Required Recommended Configuration

Operating System Windows 95/98 (licenced version) Windows 98 (licenced version)

PC type IBM PC AT compatible IBM PC AT compatible
Processor Pentium II and above Pentium III and Pentium IV
Processor Speed Greater than 300MHz. Above 1GHz.
RAM 64 MB or more 128 MB or more
CACHE memory 128 KB 128 KB
Display card SVGA colour (built-in motherboard) SVGA colour (built-in motherboard)
Monitor 14", 15" and 17" colour SAGA 15" CRT or colour LCD
Display resolution 1024 X 768 large fonts 1024 X 768 large fonts
USB slots minimum 2 slots 3 slots
Sound blaster card PCI bus compatible Built-in motherboard
Mouse Logitech (3 buttons) Logitech (3 buttons)
Keyboard 105 keys 105 keys
Hard disk 10 GB or more 20 GB or more
CD ROM drive 52X 52X
Speakers 4 Watts, 8ohms 4 Watts, 8ohms
Printer hp series inkjet printer hp series inkjet printer
Installation
a. Unpacking
On receiving the Skyline system check if the packing is in good
condition.

NOTE
Follow the instructions for PC installation.

b. Steps for PC Installation

1. Carefully unpack the CPU, display (monitor), keyboard and
peripheral cables. Check that all the items are as per the packing
list.

2. Connect high resolution colour monitor (display unit) to the rear

panel of the PC. Make both the connections of the monitor (one for
monitor power supply and other for video signal). Also connect the
keyboard, mouse and inkjet printer (optional) to the rear panel of
the CPU.

c. Steps for Skyline kit Installation

CAUTION
Before making any connections, make sure that the PC is fully
functional & is in power OFF mode. (Interfacing Skyline hardware
while the PC is ON can damage the system.)
Ensure that Skyline network cables and power cables are not
entangled.
Ensure proper distance between power cable and Skyline cable.

1. Skyline hardware system (UIC) can be mounted near the rear

panel of CPU which contains 8/16 miniature connectors.
2. Installation of hardware/software of Skyline needs technical
expertise of L&T Medicals authorised personnel.
WARNING
1. Dont move the PC in power ON condition.
It may cause loss of stored data (HDD damage) and damage to
electrical connections.
Skyline being an ICCU equipment, it is not intended to operate in
MRI environment.
2. Performance of Skyline when operating in MRI environment is
not known to the best of our knowledge.
Follow MRI manufacturers advice while using equipment near
MRI.
Operating Instructions

Read the manual carefully before operating Skyline

1. Access to various menus is by using the mouse
2. Skyline can be operated in the following modes:
a) Multibed mode
b) Multiparameter mode
c) Arrhythmia/ST mode
d) Trend mode
Graphical trend mode
Tabular trend mode
e) Full disclosure mode (ECG recall)
4. Menu bar and Status bar is provided for every screen.
5. The status bar is displayed at the bottom of the screen. It displays
the following:

8 Bed Version

16 Bed Version

L & T Medical Logo

Skyline Product Logo

Alarm status (ON / OFF) continuous or 4 seconds
Alarm OFF : No alarm conditions selected.
Alarm ON (Continuous) : Machine will continuously alarm, till
acknowledged by the user.
Alarm ON (4 sec.) : Machine will give alarm for 4 seconds
and stop beeping. Visual indication will be
there.
26.01.2002 Current date
The date is displayed in the following format :
dd/mm/yyyy
 Current time
The time can be seen in 12 hour format :
hh:mm:ss AM
hh:mm:ss PM

6. Menu Bar will change depending on the operating mode and will
be displayed on the top of the screen.
For 16 bed version multiparameter and graphical trend screen will
have status bar as shown earlier with additional information as
shown below

This indicates alarm conditions for bed, whose ECG waveform is

not displayed
Cross indicates alarm disabled at bed side monitor.
Yellow flashing background indicates accessory /
equipment related alarm.
Red flashing background indicates patient related
alarm.
eg.
Multibed Mode

Multiparameter Mode

Graphical Trend Mode

 Features common to all modes
1. Control to mute audio alarm:

Click on to mute Skyline audio alarm.

Click on to mute bed side monitor alarm (This is not

applicable for Micromon N and Micrmon L).

2. Trace speed for all waveforms is 25 mm / second. (fixed)
3. All waveforms will be displayed with a scale marker.
4. Print option is provided to take hard copy of waveforms or data
(except graphical trend mode). Click on to print
desired data.
5. Modes displaying ECG waveform, displays lead and gain
information. (This information is not provided for Micromon N and
Micrmon L).
6. Alarm status at monitor end is displayed as:

alarm enabled.
alarm disabled.

7. button is provided to exit from Skyline operation. This

will shut down the Skyline application and operation of the PC.

NOTE
Kontron version 8/16 Bed Skyline, User Access Verification in the
form of password & will be required to exit Skyline and switch OFF
the Skyline system.

Click Exit to view a user access

verification window
Enter valid password. Default
password is Skyline (lower case)
Click OK to proceed
Click Cancel to return to
Skyline operation
Alarms

1. Alarms are classified as audio & visual alarms.

2. Duration of audio alarm is user programmable. (Continuous or 4
sec. or no alarm)
3. Alarm will be displayed in RED colour for patient related
conditions & in YELLOW colour for equipment/accessory related
faults.
4. Yellow or red background flashing continues till the alarm is
acknowledged by the user. Visual indication of alarm (without
flashing) continues till the alarm condition persists.
5. Alarm status at the monitor end will be displayed in each mode.
MULTIBED VIEW
(16 BED VERSION)
In Multibed mode, the following are displayed :
1. Bed number, alarm status of every bedside monitor and patient
name.
2. ECG waveforms alongwith the selected lead and gain 8 beds : 6
seconds duration and 16 beds : 3 seconds duration.
3. Parameter display of Heart Rate (HR) and 3 selected parameters
(User selectable) this facility depends on the bed side monitor (8
bed version only)
4. A list of last three alarm conditions for each bed will be displayed.
Following conditions/sequence is observed:
latest alarm with white background.
previous alarm in light grey background.
prior to previous alarm in dark grey background.

Menu bar features in Multibed Mode:

8 Bed Version : On clicking multiparameter key, a list of 8 bed

numbers drops down.

Click on the required bed number to view its

multiparameter mode display.
16 BED VERSION :
On clicking multipara key, a sub menu of 3
groups appears viz.
Group 1 : Bed 101 - 108
Group 2 : Bed 109 - 116
User Group : Group of beds selected through
SETUP menu
Click on the required group to view the drop down
list of bed nos.
Click on the desired bed number to go to the
multiparameter mode display for that particular
bed.

Click Admit / Discharge button to enter sub menu

for Admit / Discharge or Transfer Patient

8 BED Version (Admit / Discharge)

Click here, a drop down list of bed numbers
appear.
Click on the desired bed number to view its
present status (occupied or vacant). It enables
the user to:
Admit patient (Enter new patient info.)
Discharge patient (Remove patient info. and
clear trends)
16 BED Version (Admit / Discharge)

Click here, a sub menu of 2 groups of bed numbers appear,

Group 1 : Bed 101 - 108
Group 2 : Bed 109 - 116
Click on the desired group to view a drop down list for required bed nos.
Click on the bed number to view its present status (Occupied or vacant ).
It enables the user to:
Admit patient (Enter new patient info.)
Discharge patient (Remove patient info. and clear trends)
 Discharge patient
I) If the bed is occupied, Discharge patient window appears.

: Click this to confirm discharge.

: Click this to escape.

: This allows the user to

discharge present patient and a
new patient information window
is displayed on the screen.

Discharge Patient Window

To discharge patie nt :
Click Yes
Enter password : Skyline (Lowercase)

[User can set his / her own password. Refer SETUP menu description.]
Click

Admit new patient.

Click
Patient information window will
appear, if the bed is vacant.

Edit patient particulars and

Click to confirm.

Click to escape.

CAUTION
Discharging a patient will erase all the stored data of the patient
(trend, arrhythmia strip storage records etc.) pertaining to that
patient.
 Transfer patient

To shift the patient from one bed to another click Transfer Patient. The
following screen appears :

Enter current bed number of patient in From Bed.

Enter new bed number where the patient is to be shifted in To Bed.

: Click this to transfer data

: Click this to escape

Click here to see setup list.

8 BED version 16 BED version

8 BED VERSION
a] Date & Time: Allows the user to set systems date and time. The
following window is seen:

System Date & Time Setting Window

Enter correct date & time and click to store the settings

b] Alarm duration will display Audio alarm setting window.

Select desired audio alarm duration. (continuous / 4 sec./ no alarm)

Now click

Change in alarm duration is applicable for all

Skyline beds.
Continuous audio alarm till
Continuous : acknowledged by the
user.
Automatic termination of
4 seconds : the audio alarm after 4
seconds of initiation.
No alarm : Disables all audio alarms.

NOTE
Visual indications of all alarms will continue.
c] Parameter settings window is provided to allow selection of 3
parameters which can be viewed next to HR in multibed mode.
(numerical values only)

NOTE
Parameter selection facility in multibed view is possible for 8 bed
version only.

Steps for parameter setting.

i] : Click here to clear parameter settings of all beds.
OR
: Click here to clear parameter settings of selected
bed.

ii] Click here to select a particular bed number.

iii] Select parameters by clicking corresponding blank box below

parameter box.

indicates parameter is selected.

Maximum 3 parameters can be selected.

: Click here to store the details.

: Click here to escape.

NOTE
This facility is provided for STAR, STAR SNT, LUNAR, LUNAR SN,
PLANET & GALAXY bedside monitors.
d] Change bed number will allow you to change the bed number.

: Click to store and

return.

: Click here to
escape.

: Click here to clear

present bed
numbers.

Enter new bed numbers in the

boxes provided against the bed.

e] Password setting allows the

user to set his/her own
password to enter into patient
admit / discharge menu.

Enter password

Click to confirm and

return.

Click to escape.

NOTE
Passwords are case sensitive
f] Select equipment allows the user to select the bedside monitor
model.

Click on , a dropdown list of compatible models appear. Select

correct bedside monitor which is connected by clicking on the model.

Click to store and exit.

Click to escape without storing last changes.

NOTE
Equipment selection feature is disabled for USB compatible system
(for both 8 and 16 beds versions).

g) Select Printer
Allows the user to select a printer model.
Click Select Printer to view a drop down list of available printer
models.
Select the printer model currently in use.
Printer model once selected should not be changed, unless printer
connected to Skyline is changed.
NOTE
Only printer models for which necessary driver softwares are loaded
while configuring the personal computer during the installation will
appear in this list.

16 BED VERSION
a) Date & Time : Refer page no. 28
b) Alarm duration : Refer page no. 28
c) Bed management :

Allows the user to change the bed number and program a group of beds
to form the user group.
Click on Bed Management to view sub menu with the following
options:
Change Bed Number
Bed Select

Change Bed Number

Click here to view list of 16 beds and
their currently assigned bed numbers.
: Click here to clear
current bed numbers.
Enter new bed
numbers in the boxes
against the beds.
: Click here to store and
return.
: Click here to escape.
Bed Select :

Click Bed select to view user group bed selection window.

On clicking , a drop down list of available bed numbers will appear.
Select the required bed number for the bed position (1 to 8).

Click to store and exit.

Click to escape without storing latest changes

Click to clear all the bed positions.

d) Password setting : Refer page no. 30

e) Select equipment
Click to view dropdown list of compatible models. Select appropriate
bedside monitor, which is connected, by clicking on it.
Click to store and exit.
Click to escape, restoring the original settings.
f) Print on alarm : On clicking print on alarm menu,
waveform corresponding to alarm
conditions can be printed.
g) Service : On clicking service menu, a service
screen appears.

On entering the correct password, (default - service) Skyline allows the

user to configure Skyline application on startup or change the password.
Configuration

On clicking against Restore Skyline application on startup the

Skyline application starts as soon as the PC is switched ON.
Change Password

Enter old password, new password and re-enter new password for
verification.

: To store the password and exit.

: Click to implement the selection.

: Click to escape and restore the original settings.

h) Select printer : Refer page no. 31

Click here to take printout of ECG waveforms of

the multibed screen through optional inkjet
printer. (Two pages for 8 bed version and four
pages for 16 bed version)

Click here to mute audio tone of Skyline alarms.

Click here to exit Skyline. This shuts down the

operation of PC and Skyline application. (This
option is not provided for Kontron version)
Following controls are provided for each bed.
(Bed Number). Click on the bed number to see pop up
to take 8 seconds ECG print for that particular bed.
This control can be used to mute the audio alarm.

This also indicates the following conditions:

1. Displays the bedside monitor alarm status.
Indication for enabled alarms.
Indication for suspended alarms.

2. Alarm indication.
Flashing red background indicates patient related alarms.
Flashing yellow background indicates accessory/equipment related
alarms.
Grey background indicates no alarm.

NOTE
Alarm indication and Alarm Mute feature is not applicable for
Micromon-N/L

3. To mute Skyline alarm.

In case of alarm, click on to mute the Skyline alarm. When
an alarm is acknowledged, the flashing of the background colour of
the button stops, but the background colour is retained till the
condition persists.

NOTE
If the bedside equipment is not powered ON or not connected then
the message MONITOR NOT CONNECTED or LINK FAILURE will
be displayed in place of ECG waveform.
If Stellar-P is connected, then the message STELLAR-P
CONNECTED will be displayed in place of ECG waveform.
ECG waveform may overlap the name, in case of higher amplitude.
In the bed number entered by the user is different from the one
received by Skyline from bedside monitor then error message will be
displayed.
Multiparameter mode will display :
1. Maximum of 4 waveforms (if Galaxy/Star/Lunar is connected as the
bedside monitor).

2. Numerical data for maximum of 8 parameters (if Galaxy/Star/Lunar

is connected as the bedside monitor).

3. Alarm status, Bed number and Name of the patient is seen on the
top of the screen for selected bed.

4. 2 seconds ECG waveform of other 7 beds with bed number, alarm

status and name of the patient for each bed.

5. Alarm status indicator of individual parameters for corresponding

bed. Alarm corresponding to a parameter is indicated by blinking
red bar.

Multiparameter screen has following sub menus in the MENU bar.

Click Trend to enter into 24 hours graphical

trend screen for selected bed. Refer chapter 7
for details.

Click Arrhy/ST to display 24 hours of

arrhythmia/ST trend mode for selected bed.
Refer chapter 6 for details.
Click Recall to view last 16 patient related alarm
conditions of the selected bed in following
format. Pink colour indicates values below low
limit while red colour indicates values above
high limit. Black colour or no values indicates
irregular heart rhythm, apnoea. etc

Click for last 24 hours disclosure of ECG for the

selected bed.
This feature facilitates 24 hours of ECG
waveform storage for each bed. Each and
every ECG complex from the last 24 hours
trend can be viewed for all 8/16 beds. Every
complex can be viewed and analysed for further
diagnosis.
 Click to freeze the waveform for the selected
bed. Click again to defreeze.

NOTE
In multi parameter mode freeze function will only freeze the
waveform for the selected bed and not the ECG waveforms for other
freeze.

Click to print all the waveforms alongwith

numerical values for all parameters for the
selected bed.

NOTE
In multi parameter print function will print the selected bed. ECG
waveforms and HR of other 7 beds will be printed.

Click here to go back to multibed mode screen.

Click here to mute alarm at Skyline end.

Click to come out Skyline. This shuts down the

operation of PC and Skyline application.

NOTE
Visual alarms for a parameter will be indicated by a change in the
background colour of parameter label in multiparameter mode.
(Yellow / Red)
 NOTE
Arrhythmia/ST mode is not applicable for Micromon and Stellar P.

NOTE
ST mode is applicable only for Galaxy and Star bed side monitor.

An arrhythmia screen will display :

1. 24 hour arrhythmia screen with all the arrhythmia events occured
in the duration of last 24 hours. (The event summary can be
zoomed for 2 hr.)
2. ECG strip for -6 to +2 seconds for each arrhythmia along with the
information of the selected lead and gain.
3. Arrhythmia count for Tachycardia, Bradycardia, Asystole, Irregular
and Skipped beat.
4. Vertical cursor in graphical arrhythmia trend to scroll left and right.
5. Date and time with respect to vertical cursor.
6. Patient name, bed number and duration (zoom) on top of the
screen.
7. Horizontal scrollbar for scrolling through data.

Arrhythmia trend mode screen will have the following sub menus in the
MENU bar.

Click here to go to multiparameter mode screen

of selected bed.
Click here to zoom in from 13 hours to 2 hours
windows scale and vice versa.
ECG strip will be displayed with the resolution of
2 minutes. (only 8 sec. out of 2 min. is seen on
the screen)

Click to take the printout of currently displayed

ECG strip.
 Click to view the multibed mode.

Click to mute Skyline alarm.

Click to exit Skyline. This shuts down the

operation of PC and Skyline system.

NOTE
Arrhythmia trend will be available for 24 working hours or from the
time of patient admitted.
The arrhythmia default display will be of 13 hours.
The ECG strip will be shown with the scale for arrhythmia
occurrences with the resolution of 2 minutes.
The background is black for waveform display in all screens but for
arrhythmia screen it is a graph paper.
 NOTE
Tabular trend can be accessed through graphical trend screen only.

Click to enter into graphical trend view of the selected

bed. Graphical trend view displays :
1. Alarm status, bed number, date, time, duration of trend and
patient name along with the name of the menu, on the top of the
screen.
2. Graphical trend for HR and 3 selectable (monitor dependent)
parameters.
3. 24 hrs. graphical data in 12 hrs. (6 minute resolution) and when
zoomed, in 2 hrs. (1 minute resolution) format.
4. Vertical cursor for indicating the numerical value and horizontal
scrollbar for scrolling through data.
5. Date, time and numerical values corresponding to the record of
each parameter, at the cursors position.
6. Alarm status of other 7 beds.

Graphical mode screen will have following controls in the MENU bar.

Click Multipara to go to the multiparameter

mode.

Click Table to view the trend in tabular format.

Click Mark to mark starting and ending points on

graphical trend data.
As soon as you mark the end point on the
graphical trend, screen will switchover to the
tabular trend view for the marked area. This area
will be highlighted with white background.
While switching from the graphical trend to the
tabular format, following message will appear on
the screen.
Click Select to see the parameter selection
window.
This function enables the user to select three
parameters (apart from ECG) for display in
graphical trend view. (ECG always remains as
the first parameter)
Select parameters by clicking on the blank boxes
provided against the parameters.
indicates parameter selected.

Click to enter the parameter selection.

Click to escape.

Click to zoom the trend from 12 hours to 2 hours

(trend scale). This will also change the resolution
of the trend display. (6 minutes for 12 hours and 1
minute for 2 hours). i.e. Every cursor movement
will be for 6 min. or 1 min. (depending on the
zoom duration).
Click Multibed to return to the multibed mode
screen.

Click Mute to mute the Skyline alarms.

Click Exit to exit Skyline.

NOTE
Trend data will be available for 24 hours, prior to the time of entry
into graphical trend mode.
Trend data will be displayed in the form of a bar graph, with a scale.
The default resolution for trend is 6 minutes.
Horizontal scroll bar to scroll through the trend graph is provided at
the bottom. Click left/right arrow button to scroll through the trend
graph for reading after every 6 minutes.
Records corresponding to the alarms have following colour code:
Red : In case of patient related alarms
Yellow : In case of machine related alarms
Tabular trend view displays:
1. Maximum 24 hours of numerical data (trend) in tabular format for all
parameters.

2. Alarm status, bed number, patient name and trend resolution.

3. Date and time alongwith numerical values of all the parameters.

4. Vertical scrollbar for scrolling through data.

5. Either HR, SpO2, RESP, EtCO2, FiCO2, T1, T2 along with NIBP and
ST or HR, SpO2, RESP, EtCO2, FiCO2, T1, T2 along with IBP1 and
IBP2 will be displayed.

Tabular trend mode screen will have following sub menus in the MENU
bar.

Click Multipara to go back to the multiparameter

mode.
Click Graph to go back to the graphical trend
screen.
Click Print to take printout in the tabular format.

One minute : On selecting one minute, trend

data for one minute will be
printed.
Six minutes : On selecting six minutes, trend
data for six minutes will be
printed.
Only alarms : On selecting only alarms, values
of parameters only for the alarm
conditions will be printed.
[The options of taking printouts of trend data is
available in tabular format only. To print trend, the
user should mark the required area in graphical
trend screen. Numerical values of the marked
data will be highlighted in tabular trend.]
 Click Multibed to go back to the multibed mode
screen.

Click Mute to mute the Skyline alarm.

Click Exit to exit Skyline. This shuts down the

operation of the PC and Skyline application.

NOTE
For alarm condition the text colour will be:
Red : For values upper than the set limit.
Pink : For values lower than the set limit.
Horizontal scroll bar is provided to scroll through the parameters. On
clicking right arrow key IBP1 and IBP2 can be viewed. (By default
NIBP and ST are shown)
Vertical scroll bar is given to scroll through the numerical values in
the tabular trend.
ECG full disclosure screen:
a. Main menu bar with alarm status, patient bed number and
patients name.
b. 24 hours graphical HR trend (for reference of heart rate).
c. ECG waveforms at any instant (from 24 hr trend) can be
displayed. (Either clicking on time selection table or by actually
entering the time in the time selection box for which ECG
waveform is required to be seen).
d. One hour information of ECG is displayed in the disclosure
screen. 60 boxes are displayed just below the ECG waveform
window. Each box corresponds to 1 minute. Just by clicking on
any box, the corresponding ECG waveforms (for the respective
minute) can be displayed. {dark blue box indicates presence of
data, grey box indicates absence of data and light blue box
indicate the current data (current minute which is displayed)}
Scroll buttons are provided to the right and left of these boxes to
scroll and get the ECG of different minutes.
e. One minute information (selected box) is further divided into 6
ECG strips of 10 seconds each. Every strip has lead/gain, time
and HR indication.
f. Any ECG complex can be zoomed (click on the complex) and
seen in the window above the time selection table.

In ECG disclosure mode, following controls can be seen on the menu

bar.

Click Multipara to return to the multiparameter screen.

On clicking print a sub menu with the following options is seen.

a. Print All : Click Print All to print all 6 ECG strips in the window.
b. Print Strip : Click Print Strip to print selected strip.
Following menu appears
Click Multibed to return to multibed mode
screen.

Click Mute to mute alarm at Skyline end.

Click Exit to come out of Skyline. This shuts

down the operation of PC and Skyline application.
 MULTI-BED SINGLE PATIENT

Name : Mr. PRAKASH JOSHI DATE : 17.09.2002

ID No. : NM23D TIME : 11:06:33

Bed No. : 9
MULTI-BED PATIENTS REPORT
MULTI-PARAMETERS PATIENT REPORT
 ARRHYTHMIA REPORT

Arrhythmia Conditions:
TACHY
IRREG
SKIP BEAT
PATIENT REPORT
 Skyline, an advanced central station has been designed to provide
continuous operation with minimum maintenance.
This section details the routine maintenance procedures to be
carried out by the operator to ensure high level of performance and
safety.

Connections :
Ensure that the mains power cable, monitor cable, keyboard cable
and Skyline to PC USB cables are inspected regularly for signs of
damage. Replace if necessary.

Cleaning :

Maintain a dust free environment.

Air conditioner for the site is preferred.

When required to clean thoroughly, switch OFF the PC and the

monitor. (Use exit button)

Clean the PC and the monitor with a soft cloth lightly moistened in
warm, soapy water with a mild detergent. Vacuum cleaners can
also be used. Carefully dry off any excess moisture with a soft dry
cloth.

CAUTION
Do not use chemicals or abrasive solutions.
FAULT DIAGNOSIS :

SR PROBLEM ACTION TO BE
PROBLEM CAUSE
NO. OBSERVED TAKEN
PC monitor related
1. No display on Check for LED Switch ON the
monitor monitor ON monitor.
indication.
Check for 230V Relocate the
AC supply to supply point OR
monitor. else Replace the
monitor.
2. No signal The signal cable Reconnect the signal
message appears from CPU to monitor cable firmly to the
on screen is disconnected or monitor socket,
or loose. located on the rear
No display on panel of CPU.
monitor screen with
LED glowing.
3. Display on the Screen settings of Refer operating
monitor is not PC monitor are not manual of PC
proper. (Stretched, proper. monitor for setting or
compressed, any else Press Menu key
one or multiple (If provided) located
edges of screen on the front panel of
goes out of screen PC monitor for
range) detailed settings.
Central processing unit (CPU) related
4. CPU hangs Sudden switch OFF Switch OFF the CPU
intermittently of CPU (Improper through EXIT button
shutting down) located on top right
elated corner of Skyline
menu screens.
5. CPU hangs Sudden switch Switch OFF the
showing junk OFF of CPU CPU through EXIT
message on screen (Improper shutting button located on
during or after down). top right corner of
booting CPU is infected each screen of
with VIRUS. Skyline
Contact L&T
service personnel
or authorized
Personal Computer
(PC) technician.
6. CPU does checking Sudden switch OFF Switch OFF the CPU
for errors every of CPU (Improper through EXIT button
time during booting shut down). located on top right
sequence corner of each
screen of Skyline or
else Contact
authorised Personal
Computer (PC)
technician.
7. No sound from PC CPU does not Contact L&T
speakers support audio service personnel
applications. or authorised
Audio cable from Personal Computer
speakers to CPU is (PC) technician.
disconnected. Reconnect the
audio cables firmly
to the audio output
jack located on the
rear panel of CPU
or else Check
speakers for its
functionality.
8. Waveform tracing Improper function- Reboot the system
speed too slow ing of CPU. and let the system
CPU is infected check for Hard disk
with VIRUS. drive errors.
Contact L&T
service personnel
or authorised
Personal Computer
(PC) technician.
9. Only left mouse N.A. Only left mouse but-
button operates, no ton operation
other mouse allowed. Double click
buttons gets of mouse button is
acknowledged not allowed.
Skyline operation related
10. No audio alarms or Audio alarms susp- Click on SETUP
Continuous audio ended. menu in multibed
alarm on alarm Audio alarm durat- mode and select
event ion selected is alarm duration
continuous. submenu to select
the audio alarm
duration as OFF, 4
 seconds or
continuous.
Select alarm dura-
tion as 4 seconds.
11. Printer starts Print on alarm option Click on SETUP
printing on every selected (indicated menu in multibed
alarm event by 9) mode and check 9
print on alarm
status. Click 9 print
on alarm to deselect
it.
12. Parameters Improper equipment Click on SETUP
selected do not selection menu in multibed
appear in multibed mode and select
screen appropriate equip-
ment in select
equipment submenu
13. No marked records Area of graphical Use MARKoption
to print appears on trend is not to select start and
screen when clicked selected for end point of print
on print printing. area.
or No graphical trend Keep the system
No data for data exist for ON along with
printing message printing. PMS monitor
appears in graphical connected to allow
trend mode the system to
collect and store
the online data for
some time.
14. Printer prints whole No data selection Highlight the data to
tabular data when be printed with the
print command help of mouse and
given in Tabular then click print.
trend mode
15. Digital read out field Check for Skyline This option is availa-
area for other version. 8 or 16 ble in 8 bed version.
selected 3 bed. Disconnect one of
parameters missing the USB port, screen
or or will automatically
Other 3 selected shift to 8 bed version
Multiparameter
parameters not showing other 3
monitor not
appearing on parameters.
connected.
multibed screen
16. ECG waveforms of Users application In multiparameter
other beds do not error mode waveforms of
 freeze in multi- that particular bed
parameter screen only will freeze. This
is a safety feature to
view online live ECG
trace without any
delay or loosing any
immediate trace
information
17. Printer does not Users application Click on the para-
print single wave- error. meter ICON whose
form, Print all option Application error. print is to be taken
prints all parameter and click print
waveforms All beds ECG print
or on single attempt is
Print all does not not allowed. Click
print ECG wave on the particular
form of other beds bed no. icon and
click print to take
print of ECG trace
of that bed only.
18. Different trace N.A. (Refer specification
speed on screen as sheet) The trace
that of PMS monitor speed for all wave-
connected forms in all modes
fixed at 25 mm/
second. Do not
correlate speed with
PMS monitor.
19. Patient does not get Check the bed stat- Confirm that the
admitted on clicking us. The same bed is previous patient is
admit / discharge already assigned to discharged or moved
button some other patient. to some other bed.
Discharge the
previous patient to
allow new patient to
get admitted
20. In trend data _ _ No data from PMS Select the time zone
appears in place of from graphical trend
readings where data is
present.
Connectivity related
21. Multibed screen PMS monitor not Connect at least one
appears with no connected to Skyline .PMS monitor to any
tracing for any of of the bed.
the bed
22. Monitor not Disconnection betw- Confirm the connec-
connected een PMS monitor tion of PMS junction
or and Skyline. box cable at both the
ends i.e. from rear
Link failure panel of PMS to Jun-
appears on screen ction box located at
showing flat trace. the bedside. Confirm
or the connection at the
terminal block
No ECG waveform
(connector) located
appearing on
on Skyline interface
screen for
(I/F) module. Confirm
particular bed
the connection for
USB I/F cable from
Skyline I/F module to
the CPU rear panel.
or else contact L&T
authorised service
personnel.
PMS monitor related
23. The gain of the Improper gain setting Select higher gain.
waveform is too at PMS monitor end You can see the
small (Gain selection GAIN and LEAD
possible only at PMS selected at the
end) extreme left of the
waveform in Multibed
screen.
24. Monitor not Check the status of Switch ON the
connected the monitor. It is OFF monitor
or
Link failure
appears on screen
showing flat trace
though the PMS
monitor is
connected and
link is proper
25. No ECG waveform PMS monitor not Contact L&T service
appearing on functioning properly. personnel.
screen for
particular bed (only
flat trace appears)
Connect the ECG
26. The ECG trace is Check the ECG
leads properly. (Do
not proper leads for its
not allow any ECG
connectivity to
lead to hang freely)
patient.
or
Refer trouble
shooting chart of
PMS monitor
connected for prob-
lems during ECG
monitoring

Printer related

27. Printer not Disconnection bet- Confirm the

connected, ween printer and connectivity bet-
message appears CPU. ween printer to
on screen printer port located
on the rear panel of
the CPU.
Check printer ON
LED glowing. Switch ON the
printer.

28. Improper printing Improper printer Click on SETUP

selection. menu in multibed
mode and select
printer submenu to
select the printer.

Contact L&T
Printer not loaded service personnel.
in the system.

29. Printer starts N.A. Refer point 11

printing on every
alarm event

30. Printer keeps on N.A. Refer point 14

printing the tabular
trend
NOTE
Interface cable colours subject to change without prior notice
(colours depend upon availability and the type of cable in the market.

NOTE
z T-Transmit and R-Receive are junction points for data
transmission.
z S is a common point (Drain) which needs to be connected to the
common ground point at Skyline end.
z Maximum length of RS 485 cable is 200 metres.
z R and T are extra pair of cable for future use.
z Drain cable should be shorted with the monitor ground at the
bedside end to have better signal transmission.
z Please ensure correct connections of R and T throughout the
installation.
USB COMMUNICATION FOR Skyline
Introduction :
USB (Universal Serial Bus ) communication facility is a new feature
introduced for L&T Skyline. Due to easy availability of USB port on
Computer, Skyline compatibility with USB became very much a
necessity. L&T provides USB compatible hardware (box - shown in a
picture) along with the 8/16 bed software version.
USB interface facility is applicable for both 8 and 16 bed versions.
Skyline software and hardware both are modified and made compatible
with USB interface for PC.
Installation
Basic hardware is designed for 8 bed, which can be further upgraded to
16 bed. To make a 16 - bed upgradation, user needs to order one more
8 - bed hardware, which can fit in the same Skyline box. PC
requirement is of minimum 2 USB slots for 8 beds or 3 slots for 16 beds
(one USB port can be used for USB mouse connection)
Skyline (Skyline hardware Box) directly interfaces with the USB slot of
PC. 230V AC mains connection is on the rear side of the Skyline box.
Connections:
The previous picture shows TOP VIEW of the Skyline box. Both the
hardware cards are identical. For 16 - bed upgradation, both the
hardware cards are necessary. There are 16 connectors shown at the
rear side of the Skyline box (8 connectors per hardware). Each bed can
be interfaced to the Skyline through these connectors.

At PMS end (monitor end), there is a communication port. Hard wire,

which interfaces between PMS and Skyline, gets connected from here
into the connectors on the rear panel of Skyline.
There are 18 red LEDs on the front panel. 16 out of them represent
beds. Whenever a particular bed is in the network, the corresponding
LED glows.
Standard configuration for Skyline kit:

USB Interface Box : 1 no. (for 8 / 16 bed system)

USB Interface Cable
Skyline software
Bed side interface boxes
PMS interface cables
(monitor to interface box)
Mains cord
Operators Guide
: 1 no. (for 8 bed system )
2 nos. (for 16 bed system )
: 1CD (for 8 / 16 bed)
: 8 nos. / 16 nos.
: 8 nos. / 16 nos.
: 1 no.
: 1 no.

General

Dimension : 400 x 260 x 60 mm

Weight Operating : 3.3 Kg

0
Temperature : 0 to 40 C

Power Conditions : 95 to 165 V AC

Red LED glows to indicate

the mains ON : (1 LED for 8 bed, 2LEDs for 16 bed)
 LARSEN & TOUBRO LIMITED INSTALLATION /
COMMISSIONING
REPORT-CUM-WARRANTY CERTIFICATE

DATE :

Customer Name, Address & Telephone Equipment location

Nearest landmark

User name & details Invoice reference

Sr.
Description Cat no. Machine sr. no.
no.

The above equipment has been installed and handed over to the
customer in satisfactory condition. The warranty period begins on
__________ and ends on _________. The warranty terms and warranty
service terms are as printed on the reverse of the Warranty Certificate

Customer signature & date Engineer signature & date

CUSTOMER COPY
 WARRANTY AND WARRANTY-SERVICE

L&T offers warranty on its medical equipment against manufacturing

defects for a period of 12 (twelve) months from the date of installation or
15 (fifteen) months from the date of despatch, whichever is earlier.
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 claims for compensation, are excluded.
The warranty shall be valid only if installations and repairs are carried
out by L&T's engineers or authorised dealers. The warranty shall not
apply to defects resulting from :

a. Unauthorised modification / misuse / mishandling of the

equipment.
b. Operation of the equipment outside the environmental
specifications of the product (e.g., temperature, electrical
requirements, etc.)
c. Improper site preparation and site maintenance.
d. Any other reason external to the equipment (e.g., accidents,
vibration, etc.)

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.
 INSTALLATION /
LARSEN & TOUBRO LIMITED COMMISSIONING
REPORT
DATE :

Customer Name, Address & Telephone Equipment location

Nearest landmark

User name & details Invoice reference

Sr.
Description Cat no. Machine sr. no.
no.

The above equipment has been installed and handed over to the
customer in satisfactory condition. The warranty period begins on
__________ and ends on _________. The warranty terms and warranty
service terms are as printed on the reverse of the Warranty Certificate

Customer signature & date Engineer signature & date

ENGINEER COPY
 INSTALLATION /
LARSEN & TOUBRO LIMITED COMMISSIONING
REPORT
DATE :

Customer Name, Address & Telephone Equipment location

Nearest landmark

User name & details Invoice reference

Sr.
Description Cat no. Machine sr. no.
no.

The above equipment has been installed and handed over to the
customer in satisfactory condition. The warranty period begins on
__________ and ends on _________. The warranty terms and warranty
service terms are as printed on the reverse of the Warranty Certificate

Customer signature & date Engineer signature & date

MED SERVICE CENTRE COPY

LARSEN & TOUBRO LIMITED
MEDICAL EQUIPMENT & SYSTEMS
Annexe Building, 2nd Floor
Gate No. 7
P. O. Box No. 8901 Telephone : 91 022 28581401/11
Saki Vihar Road Fax : 91 022 28581276
Powai (E) E-mail : ebg-med@lntebg.com
Mumbai - 400 072. Website : www.lntmedical.com