TECHNICAL HANDBOOK
Table of Contents Introduction to NetGuard...2 Terminology...3 Network Options...4 Server Specifications...6 PC Specifications...6 Switch Specifications...6 Software Requirements...7 Frequently Asked Questions...8 Questionnaire... 13
INTRODUCTION TO NETGUARD NetGuard is a Clinical Alert system. It requires a reusable device which is the transmitter and a disposable electrode that contains the reusable device connector and coin cell battery. In the event of a life threatening arrhythmia, the NetGuard Device alerts the clinician that the patient is experiencing a significant event. The event also appears on the PC at the nurse station. The data from the transmitter is received by Access Points which communicate in the 802.15.4 specification. This specification is known as ZigBee. ZigBee was chosen for NetGuard for the low power and small data packets. The Access Points contain visual LED indicators for power status, ethernet status, and communication status. The data received by the Access Points are kept in a database on the Server. This data is also distributed to the client PC s at the nurse station. AP1 AP2 AP3 Ceiling Power Data Switch Server Hospital Network 2
TERMINOLOGY Access Point is a node within a network. It connects the wireless transmitter device into the network and is usually connected via Ethernet cable. Acronym for Access Point is AP. Ethernet cable is used to connect the network components (e.g. Access Point to network switch). It includes four (4) twisted pair of 24 gauge wire within a cable jacket. The cable lengths are limited to a maximum of 328 ft (100m). For longer runs of Ethernet cable, another switch has to be used within the run. Ethernet cable is also referred to as CAT5 or CAT5e cable. Network Switch is a device that joins multiple components. Network switches are capable of inspecting data packets, determine the source and destination of that data packet and forward it appropriately. A POE switch (Power Over Ethernet) performs the same functions as a Network switch but also provides power to components such as Access Points. Reusable Device is the transmitter used to transmit data packets to the AP s. Used in NetGuard, the reusable device sends small ECG data packets once per second. In the event of a life threatening arrhythmia, the reusable device alarms with a flashing LED. These devices contain a MAC Address that is used by other network components to know who they are. They can be cleaned per recommended cleaning procedure. Disposable Device is an electrode designed to accept the reusable device. The dual electrode is an elongated adhesive patch that is placed at the sternum with a third electrode via a lead wire which is placed between the V4 and V5 positions. The disposable device contains a battery that when mated to the reusable device, provides power to the reusable device. ZigBee is an 802.15.4 protocol within the 2.4GHz radio band. It allows for small data packets and less power, unlike other devices used within the 2.4GHz radio band which allows for constant radio use and more power. 3
NETWORK OPTIONS The limitation for the amount of PC s allowed to run the NetGuard Monitor application is five (5). Depending on how many alarms/alerts are active, and how many reports are generated, will increase the bandwidth. This option keeps the NetGuard network separate from the hospital network but the hospital network has to contain a 1GB switch (or available 1GB port). This allows a tolerable bandwidth of the PC s and Server for current running applications along with alerts/reports generated from NetGuard. Network Option 1 4
Network Option 2 This option is the NetGuard network not linked to the hospital network. The PC(s) run only the Netguard Monitor application. AP s NetGuard Switch NetGuard Server X X X X X x x x x x Client PC s 5
SPECIFICATIONS The following specifications may help to determine the network options. These are the minimum requirements for the Server, PC, and switch. Server Specifications Processor: 2.8 GHz or greater Dual Core processor or 2.0 GHz or greater Quad Core processor Memory: 2 GB minimum Hard Drive: 70GB (non-partitioned) minimum Two NIC: 1 Gbps CD/DVD: DVDwriter PC Specifications Processor: 2 GHz Pentium 4 processor Memory: 768 MB available (needed for the NetGuard application) Disk Space: 55 MB disk space available NIC: 1 Gbps Capabilities: Playing.wav audio files Displaying 1024 x 768 resolution video Connecting to 1 Gbps network Hard disk space required: 55 MB available (needed for the NetGuard application) Switch Specifications RJ-45 Port that delivers up to 200 Mbps of throughput per port 10/100 Mbps ports available for Access Points and Server POE (power over Ethernet) capable Cable The minimum requirements for plenum rated 4-pair solid unshielded twisted pair (UTP) cable which meet ANSI/TIA/EIA 568-B.2 specification requirements 6
for enhanced Category 5e Ethernet Cable. Cable installation must be tested and certified. Note: CAT6 can be used. Cable Connectors RJ-45 Connectors are used at each end of the CAT5e cable to allow connections between the Access Point and Client PC s to the Network Switch and Server. Optional Items Digital Scanner capable of decoding 2-Dimensional codes and bar code Mounting Rack Wall mount or existing rack with dimension of 19" width Software Requirements Server: MS Windows Server 2003, R2 0S, SP2.NET Framework 2.0 Internet Information Services (IIS 6.0) WSE 2.0 SP3 SQL Server 2005 Express/Management Studio or Standard Internet Explorer 6.0 NetGuard Server software Note: Windows updates must be set to manual or managed by hospital IT personnel. Client PC s: Operating System: Windows XP Pro, SP2 Internet Explorer 6.0.NET Framework 2.0 NetGuard Client software Note: Windows updates must be set to manual or managed by hospital IT personnel. 7
FREQUENTLY ASKED QUESTIONS Access Points / Cable What is an Access Point? Access Points (AP s) are nodes on wireless local area networks. They act as a central transmitter and receive radio signals. They can be configured for an IP Address, Subnet Masks, and RF channels and are connected to the network via Ethernet cable. What are the cabling requirements for the installation? The minimum requirements are a standard Ethernet cable (CAT5), as 4-pair solid unshielded twisted pair (UTP) cable. The cable can be plenum (fire retarded) if the hospital has this requirement. How does the Access Point mount to the ceiling? After the installation of the CAT5 cable and mounting sleeve, connect the Access Point by connecting the CAT5 cable, insert the Access Point into the sleeve, and twist lock into position. What is the range of the Access Point? The Access Point is designed to cover 30 or more in open-space. As with all wireless networks, the coverage will vary and may be reduced to 15-20 due to wall construction or other interference. How is the Access Point powered? The Access Point is powered via the Ethernet connection to a POE Switch (Power Over Ethernet). Can the Access Point be programmed to any IP Address scheme? Yes, the IP Address for the Access Point is configurable to any scheme. This also includes the Subnet Mask and the RF Channel. Server / Client PC / Switch What happens if the PC workstation running the Client Application crashes? 8
Because the device still communicates to the Server, and the information to the Client Application is redundant, no patient information or data is lost. Due to the Server being Windows based, what occurs when Windows does its periodic updates? It is recommended that the Windows Update is configured not to update automatically. Configuration should be set to will install later. Otherwise the update will occur and the Server will reset, thus allowing all monitoring to cease and alarm. Note: The Server 2003 requires user intervention upon power-up. The time update should be turned off as well. This will create a time mismatch between the logs and the actual server time. ZigBee How much bandwidth is there? ZigBee has 16 channels (11 through 26) in the 2.4GHz band at 5MHz per channel. How do we know we won t contend with interference and ensure coexistence in the hospital with other ZigBee or 2.4GHz components? ZigBee based products can access up to 16 separate channels. The duty cycle of the device is usually extremely low meaning very few packet data units are transmitted reducing the likelihood of an unsuccessful transmission. It will be determined during the site-survey if there are other ZigBee or 2.4GHz components running in the area. If so, the channel of the Access Points will be selected to avoid interference. What is the difference between WiFi networks and ZigBee? WiFi networks are used for streaming large amounts of data which requires more power (e.g. less battery run time). The ZigBee network is used for periodic data. This supports much lower power consumption (e.g. more battery run time). 9
Can I use the Netguard system on my current 2.4GHz antenna network? The Netguard system, while utilizing the 2.4GHz band, is based on the 802.15.4 standard for low-rate wireless personal area networks (LR-WPANs), optimized for low power, and will not operate on existing antenna infrastructure. Reusable Device Can the reusable device be discharged and removed from the system if it was lost or removed from the hospital? Yes. Simply discharge the patient, remove the device from the Network Management selection of the Administration page and replace with it another one. Who will be the one to add another device to the system? The simple procedure of adding the device to the system will likely be the User, but will be decided per hospital protocol. How will I know if the reusable device is communicating if I am not near the PC? There are LED s on the reusable device that give indications for ECG and network communication. Upon connection to the disposable, the Network LED will blink green indicating power has been established. The normal sequence of the LED s will occur with the ECG and Network blinking for 30 seconds, then turn off. This indicates that ECG and connection to the Network has been established. Note: If the LED s do not function as described, refer to the User Installation Guide or Service Installation Guide for troubleshooting. By viewing the reusable device after the power up sequence has been established, the LED s will not be illuminated. If it was not communicating, the Network LED would be in constant illumination. In the event that the patient had a life-threatening event, the ECG LED would illuminate and the device would alarm. ECG Network 10
Are there alarms on the device? Both the device and the client application have alarms. The device will alarm during V-Fib and Asystole, while the client application will display and enunciate alarms during V-Fib and Asystole, two levels of high and low heart rate alarms, and technical alarms. The side-buttons on the device can silence the V-Fib and Asystole alarm by pressing and holding them for a minimum of 3 seconds. How will I know if the patient goes out of range or an electrode comes off? The system will display and enunciate technical alarms in the event that a patient goes into communications loss or leads off condition. Is the device water resistant? Yes, the device has been tested to meet IPx4 standards, which allows for patients wearing the device to take a shower and still remain monitored. Note: While showering is allowed, it is not recommended that the device be submerged in bath or pool. If the reusable devices go to Lost Communication, what is the likely cause? The reusable devices transmit and receive data via the Access Point. A Lost Comm indicates that the device has not communicated to the Access Point, therefore indicating Lost Communication. The cause could be due to a blocked view between the reusable device and Access Point, the reusable device is outside of the coverage area, the power to the reusable via the battery in disposable is spent, or the power to the Access Point has been compromised. Can I adjust the volume on the device? No, the volume is not adjustable. Disposable Electrode What type of battery is used in the disposable, and where is it located? The battery is a 3V coin cell battery. It is located inside the disposable 11
behind the connector for the reusable device. The battery is not rechargeable and does not come in contact with the patient. How should we dispose of the disposable electrode considering it has a battery that s not removable? The disposable electrode should be disposed according to the regulations of the hospital facility for battery disposal. How long can the disposable be worn for? The disposable can be worn for 24 hours, and possibly longer, due to the life of the battery. The adhesive is not meant for long-term use. General Questions What type of option is in place for hospital facilities that do not have a network system? The Netguard system can be its own network. The components required to complete a network are a network Server, switch, and PC. See the Network Options section of this handbook. Aren t you concerned about implementing this onto the open hospital network? While there are concerns with implementing this on an open network, the communication between the device and the server is a closed network. The server is a dedicated server that maintains the alarm settings and propagates the alarms to the terminals. For redundancy, we recommend having the Client application software installed on multiple PC s but contained to the limit of 5 PC s. Additionally, in the event of V-Fib or Asystole, the device also has a local alarm tone that is independent of the network. Can we run the Netguard Monitor application on our existing telemetry monitor instead of a PC? Typically, a telemetry monitor is a proprietary component to the system it is connected to. The software could be written such that it won t allow installation of anything other than the required software for that system. 12
QUESTIONNAIRE The following are questions that will help to determine which network option would best serve your needs, as well as the possibility of updating the network components. For the server: Make and model: NIC card speed (10/100/1000?) and type. OS (Windows Server 2003, Windows Server 2003 SR2, Windows Server 2008, Web Edition, Enterprise Edition ) OS Edition (Standard, Web, Enterprise Edition ) Database (SQL Server Express, SQL Server 2005, Oracle.) CPU Type and Speed, Front Side Bus Speed Memory amount and speed Disk drive capacity, speed, bus type (ATA, SATA, SCSI..) Available disc space RAID configuration if any. IIS version (5.0, 6.0 ) What other services are running on the server? 13
What is the typical method of updating server software and how often does it occur? Is the database data on the same server as the Database application or is it on a separate disk server? Is the Virus Scanner enabled? Manufacturer and version. Is there firewall software installed? Manufacturer and version. Is SQL Server being used by any other applications? If so what are the applications? Is IIS being used for any other applications? If so what are the applications? Does the Server have multiple NIC cards? Is Receive Side Scaling enabled on the NIC card? Are Windows Updates controlled? For the client PC s: NIC card speed (10/100/1000?) and type. OS (Windows XP Pro, Windows XP, Windows 2000 ) Service Pack 2 CPU Type and Speed, Front Side Bus Speed Memory amount and speed 14
Disk drive capacity, speed, bus type (ATA, SATA, SCSI..) Available disc space RAID configuration if any. Laptop or Desktop? Make / model. Is the Virus Scanner enabled? Manufacturer and version Is there firewall software installed? Manufacturer and version. What other applications are running on the client? Does the PC have multiple NIC cards? Is Receive Side Scaling enabled on the NIC card? Are Windows Updates controlled? For the Network: What is the topology for the area NetGuard is to be deployed (including wireless coverage area, client area, and network closet) Make and Model of the network switches being used. Class of cable used (CAT5, CAT5e, CAT6 ) Link speeds used 15
Where is the network closet in relation to the coverage area? Currently use VLANs? Current network capacity being used? VoIP over the network in the NetGuard area? Are large images (X-Rays, CAT scans, etc.. ) pushed over the network in this area? Are there any other real-time applications running over the network? Remote access capabilities? If so can DPM be provided with remote access to the server/clients? Scheduled backups which run on the clients or server? 16
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Mindray DS USA, Inc. 800 MacArthur Blvd. Mahwah, NJ 07430 1.800.288.2121 www.mindray.com 2010 Mindray DS USA, Inc. PN: 0002-08-18011 Rev D