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1 Quick Reference Guide * * Obtaining further information: This guide is not a replacement of the FORE-SIGHT ELITE User Manual. You must be familiar with the information in the FORE-SIGHT ELITE User Manual prior to operating this device and monitoring patients. Important safety information is contained in the User Manual and Sensor Directions for Use.

2 Oximeter Front View Alarm Indicator System Message Area Reference Value Indicators Display & Touchscreen Channel Number Sensor Location Current StO 2 Reading TPI Indicator Channel Hight/Low Alarm Thresholds Channel StO 2 Reference Value AC Charging Indicator Power Switch Alarm/Silence Buttons Front USB port Event Markers Speaker

3 Oximeter Rear View Video Out port Ethernet port (CASMED use only) RS-232 Serial ports Serial Number label Grounding terminal Removable Battery Preamp cable ports Rear USB port AC power cord AC Fuse compartment Attachment points for optional mounting plate

4 Monitoring Turning the Oximeter On & Off 1. Press the power switch to turn the oximeter on (Fig. 1). 2. To turn off the monitor press and hold the power switch for 1 second. Note: Keeping the FORE-SIGHT ELITE oximeter power cord connected to a power receptacle will assure a full battery charge in the event of a power loss. Start Monitoring 1. Connect the Preamp cable into the oximeter port (Fig. 2). Note: Align the red marks before inserting the Preamp in the port. 2. Apply the Sensor to the patient. Refer to Applying the Sensor (Figs. 4-6). 3. Connect the Sensor to the Preamp (Fig. 7). Configuring the Sensor Location & Alarms 1. To access the Patient Setup screen: a. Touch a numeric or body icon in Channel Numeric area. b. From the Main Menu, touch Patient and then touch Patient Setup. 2. Touch the body icon (in the Loc column) to select the Sensor location (Fig. 3). 3. Touch the button for the channel limit you wish to modify (Fig. 3). 4. Use the keypad to enter the new value. 5. Touch Accept to save your changes. Starting a New Case From the Main Menu, touch Patient and then touch New Patient. Fig. 1 Fig. 2 Fig. 3

5 Sensor Selection Sensor Size LARGE P/N Applying the Sensor Patient Weight 40 kg ( 88 lbs) 1. Remove the Sensor and alcohol pad from the package. 2. Clean the skin and let it dry (Fig. 4). 3. Remove protective liner from the Sensor (Fig. 5). 4. Apply Sensor to patient (Fig. 6). a. Cerebral use - frontal lobe: above each eyebrow and just below the hairline. 5. Insert the Sensor connector into the Preamp Sensor connector until it snaps into place (Fig. 7). Note: For further instructions on how to begin monitoring, consult the User Manual. Please view the warnings and cautions in the Sensor Directions for Use. Silencing Alarms To silence the audible alarm for two minutes, touch Silence. Visual alarms will remain active. Fig. 4 Fig.5 Fig. 6 Fig. 7

6 Main Menu Options Patient Configure sensor location, alarm limits, patient ID, and start a new case. Events Select specific events from a preconfigured list. Data Start/Stop STS data collection, view STS Data, and set a Reference Value. Files Manage patient data files, including saving files to a USB flash drive. Setup Configure view, volume, brightness, date and time, and ports. Help Brief Instructions for common tasks.

7 Cerebral Tissue Oxygen Saturation Levels Cautionary Range Acceptable Range Cautionary Range 0-50 Intervention Range Healthy FORE-SIGHT StO 2 values: 66-80% (70-76% 1SD) 1 Pre-CPB FORE-SIGHT StO 2 values: 61-82% (66-74% 1SD) 2 FORE-SIGHT StO 2 correlation to SjvO 2 : ~ +10% (normothermic) 1 FORE-SIGHT Intervention threshold: <60% 3,4 StO 2 = Cerebral Oxygen Saturation SjvO 2 = Jugular Venous Oxygen Saturation Cerebral Monitoring: Jugular Venous Oximetry 5 Jugular Venous Oxygen Value Neurological Change SjvO2 < 50% Neurologic deficit SjvO2 < 40% Electroencephalographic slowing SjvO2 < 33% Confusion SjvO2 < 30% for > 10 min Decreased Glasgow Coma Scale score SjvO2 26% Lost consciousness 1. MacLeod DB et al. Validation of the CAS adult cerebral oximeter during hypoxia in healthy volunteers. Anesth Analg 2006; 102:S MacLeod DB et al. Pilot study of FORE-SIGHT cerebral oximeter in cardiac patients. Presented at IARS Fischer G et al. Noninvasive cerebral oxygenation may predict outcome in patients undergoing aortic arch surgery. J Thorac Cardiovasc Surg 2011 Mar;141(3): Hemmerling TM et al. Reduced cerebral oxygen saturation during thoracic surgery predicts early postoperative cognitive dysfunction. Br J Anaesth 2012 Apr;108(4): Epub 2012 Feb Schell M et al. Cerebral Monitoring: Jugular Venous Oximetry. Anesth Analog 2000;90(3):

8 Contact Us Customer Service/Product Information US Toll Free: , press 3 US/International: (8:00am-5:00pm EST/-5GMT) After hours: please leave a message and your call will be returned as soon as possible. Fax: custsrv@casmed.com Technical Support US Toll Free: (8:00am-5:00pm EST) US/International: (8:00am - 5:00pm EST) After hours: (before 9:00am/ after 5:00pm EST) techsrv@casmed.com 44 East Industrial Road, Branford, CT Rev01

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