Braun HNS 11 User Manual

Stimuplex® HNS 11

Nerve Stimulator for
Regional Anaesthesia,
Regional Analgesia, Neurology

User manual

Manufacturer:

Stockert GmbH
Bötzinger Straße 72
D-79111 Freiburg
Germany

Distributor:

B. Braun Melsungen AG
P.O. Box 11 20
D-34209 Melsungen
Tel. [phone]
Fax [phone]

Contents Page

Checks before start-up................................................................................................................................................ 4

Technical description..................................................................................................................................................... 6

Operating the nerve stimulator.......................................................................................................................... 7

Switching on / switching off .................................................................................................................................................. 7

Selecting the pulse frequency ............................................................................................................................................... 7

Selecting the pulse width ........................................................................................................................................................ 7

Selecting the current range .................................................................................................................................................... 8

Checking the battery voltage ................................................................................................................................................. 8

Selecting the current display mode .................................................................................................................................... 8

The LED displays.................................................................................................................................................................. 9

Current display mode ................................................................................................................................................................. 9

Current adjustment range ....................................................................................................................................................... 9

Pulse width ...................................................................................................................................................................................... 9

Pulse frequency ............................................................................................................................................................................. 9

Pulse LED display .......................................................................................................................................................................... 10

The LCD display.................................................................................................................................................................... 10

The tone........................................................................................................................................................................................11

Initial set up, maintenance and general advice.................................................................................11

Testing the Stimuplex

Special technical features ....................................................................................................................................................... 12

Technical data ................................................................................................................................................................................ 12

Battery ...............................................................................................................................................................................................13

Cleaning and disinfecting the Stimuplex

Maintenance and safety checks ...........................................................................................................................................14

Safety checks / Local law restricts ..........................................................................................................................15

Caution, Notice ............................................................................................................................................................................. 16

Safety information ...................................................................................................................................................................... 17

Error messages ............................................................................................................................................................................... 17

Instruments and accessories ..................................................................................................................................................18

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HNS 11 before an application ...............................................................................................11

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HNS 11 ...................................................................................................... 14

Stimuplex® HNS 11 and Accessories, Stimuplex® and Contiplex® needles............. 18

Peripheral electrical nerve stimulation...................................................................................................... 20

Performing PNS with the Stimuplex® HNS 11 and the Stimuplex® needles........ 21

Literature.................................................................................................................................................................................... 23

Appendices A to D ............................................................................................................................................................ 24

Checks before start-up

The Stimuplex® HNS 11 is a class lla medical device according to
Council Directive 93/42/EEC. An item of medical equipment may
only be put into operation after the supplier has subjected the
equipment to a function test on site and has instructed the
person responsible for operating the equipment in the use of the
equipment with the aid of the user manual.

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Before putting the Stimuplex
following tests.

1. Turn the control knob clockwise out of the O position to switch

on the Stimuplex® HNS 11.
A brief click signals that this has taken place. At this instant, the

devices automatically starts a self-test. This includes switching
on all segments of the LCD display as a visual check.

When the self-test is completed, the stimulator immediately
switches to its normal operating mode. The LEDs on the button
panel indicate the operating conditions selected. To conserve
power, these extinguish after 8 seconds.

If no display appears when the Stimuplex
on, change the battery immediately. (Refer to the ”Battery”
section, p. 13).

If the self-test detects a defective function, the corresponding
error code will appear in the LCD display and the instrument
will then be inoperative! (Refer to the ”Error messages” section).

When the LEDs are switched off, they can be reactivated by press­ing any button. This does not change the existing operating mode.
The operating mode can only be changed when the LEDs are lit.

HNS 11 into operation, carry out the

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HNS 11 is switched

4

2. Carry out a visual inspection of the electrode cable. Damaged
cables must not be used.

Connect the electrode cable to the front of the nerve stimula­tor. The plug connector configuration prevents wrong polarity
connection.

In the operating mode, the LCD display shows the preselected
stimulation current set on the controller between 0.00 and
approx. 1.00 mA (in the 1 mA range) or from 0.00 to approx.

5.00 (in the 5 mA range). In the operating mode, the Stimu­plex® HNS 11 shows the stimulation current actually flowing

via the stimulation electrodes through the tissue. A ”+” sign on

the LCD display signals this setting. The operating mode is

switched by pressing the ”mA” button.

3. Select operating mode . Set the controller to 5 mA max. and
try to get a connection with the insulated, black 2 mm male plug
with a part of the red clamp. Compare – by briefly switching to
operating mode – the measured value with the set value (ac­tual value and set value). These two values must be the same –
with shorted cables. Reset to 1 mA max. and compare these two
values (see Measuring Accuracy in Appendix A, if neccessary).

symbol appears next to the ▲ symbol in the LCD display

A

~

(Display) and the pulsed LED display (orange light-emitting di­ode) blinks according to the stimulation frequence.

A "+" sign appears
When a current is set at

mA, when 1 mA max. is set, and at 0.10 mA when 5 mA max. is
set.

in front of each measurement displayed.

O, the

orange LED starts to blink at 0.02

5

4. When the stimulation cable is disconnected (when is set),
+0.00 appears in the display and the ~ symbol disappears. The
pulsed LED display is no longer lit.

If the "BAT" symbol appears in the display, then the battery
voltage is getting too low. Current application can be complet­ed without a problem, but exchanging the battery afterwards
should be considered. Press the "BAT" button to display the re­maining battery voltage (in volts).

When the battery voltage is approx. 6 volts, three horizontal
dashes preceded by the "+" sign (or four dashes) appear in the
display in addition to the "BAT" symbol. In this case, the stimu­lator shuts off automatically.

To avoid having to abort a stimulator treatment, you should
replace the 9 volt block battery as soon as the battery volt­age drops to 6.5 volts.

5. To switch off the nerve stimulator, turn the control knob anti­clockwise to position O.

To conserve the battery always switch off the Stimuplex® HNS 11
after use. If you do not use it for a long period of time, remove
the battery to prevent battery leakage.

Technical description

6. Refer to the Safety information section before using the Stimu-

plex® HNS 11 on a patient.
Any instrument behaving abnormally must not be put into

operation. Contact customer service.
Electromedical equipment may only be repaired by the manu-

facturer or by an organization expressly authorized by the manu­facturer.

The Stimuplex
identification and location of nerves for local anaesthesia.

It generates consistent square pulses with selectable frequency,
selectable pulse width and continuously adjustable stimulation
current.

The range of adjustment of the pulse current from 0 to 5 mA peak­to-peak can be reduced to 0 to 1 mA with the ”mA(max)” button.
This 1 mA range allows precise adjustments for extremely thin and
technically sophisticated needles.

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HNS 11 nerve stimulator is designed for reliable

6

The stimulation frequency and the pulse width can be varied for
different applications. The Stimuplex

®

HNS 11 nerve stimulator
offers the facility for selecting a frequency of either 1 Hz or 2 Hz
can be chosen together with pulse widths of 0.1 ms, 0.3 ms or

1.0 ms.

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When the Stimuplex

HNS 11 is switched off, all set parameters

remain stored.

As a visual and audible check, the ▲ symbol and a tick occur in

time with the stimulation. Stimulation current flowing through the
electrodes is signalled by the
in front of the value for current in the display (in operating

symbol next to the ▲ and a + sign

~

mode ).

To conserve battery power, the LEDs on the button panel for the
operating modes are switched off after approx. 8 seconds. They
are reactivated by pressing any button. This does not change the
operating mode setting, which can only be changed when the LEDs
are lit.

Operating the nerve stimulator

Switching on / switching off

Turn the control knob clockwise out of the O position to switch on
the Stimuplex® HNS 11. A brief click signals that this has taken
place. At this instant, the device automatically starts a self-test.
This includes switching on all segments of the LCD display as a
visual check. When the self-test is completed, the nerve stimulator
immediately switches to its normal operating mode. The LEDs on
the button panel indicate the operating conditions selected (see
below). To conserve power, these extinguish after 8 seconds. They
light up again immediately when a button is pressed, but this does
not change the operating mode. The operating mode can only be
changed when the displays are lit.

To switch off the nerve stimulator, turn the control knob
anticlockwise to position O.

Selecting the pulse frequency

7

The selected setting is displayed and stored. You can change the
setting by pressing the "Hz" button when the LED display is lit. The
Stimuplex

®

HNS 11 nerve stimulator offers the facility of selecting

a frequency of 1 Hz or 2 Hz (one or two pulses per second).

Selecting the pulse width

The pulse width can be set by pressing the ”ms” button. It is possible
to set a stimulation of 0.1 ms, 0.3 ms or 1.0 ms.
The selected setting is displayed and stored. Setting can be changed
by pressing the "ms" button when the LED display is lit.

Selecting the current range

8

The maximum current available can be selected by pressing the
”mA (max)” button. The Stimuplex

®

HNS 11 nerve stimulator offers
a choice between a range up to 5 mA max. or up to 1 mA max.
Values between 0.00 mA and 1.00 mA can be selected in the 1 mA
range with the on/off control knob. This also allows precise adjust­ments to be made for extremely thin and technically sophisticated
needles. For safety reasons, while a patient current is flowing, it is
not possible to switch from the 1 mA range to the 5 mA range. If
this is required, turn the control to 0.00 mA and then switch over.

The selected current range is displayed and is stored until the ”mA
(max)” button is pressed again.

Checking the battery voltage

Pressing the ”BAT” button will display the existing battery voltage
on the LCD display. Pressing this button does not affect the Stimu-

®

HNS 11 functions. All settings remain unchanged.

plex

Selecting the current display mode

During operation of the nerve stimulator, the stimulation current is
shown on the LCD display. Pressing the ”mA” button selects the cur­rent display mode: the stimulation current set (mA
current) or the current actually flowing in the tissue (mA

) (displays set

) (dis-

plays actual current). In addition, a ”+” appears in front of the cur­rent on the LCD display in the case of the actual current display.

If a current display mode is set (check this by switching to operat­ing mode

) in the operating mode mA (actual current) and +0.00

appears in the display, then the possible source of the error could be:

- the electrode cable is not connected to the device,

- the adhesive electrode is defective (possible too dry),

- the tissue resistance is very high,

- the connecting cables are defective.

The measuring mode selected is displayed and is stored until the
”mA” button is pressed again.

The LED displays

All LEDs directly assigned to the buttons are used to monitor the
selected operating mode. Since LEDs require relatively high power,
the Stimuplex
Section 7).

The individual displays have the following significance:

Current display mode

The LCD display shows the stimulation current set ( ).

The LCD display shows the stimulation current actually flowing

). In addition, a ”+” appears in front of the current displayed.

(

Current adjustment range

Setting range from 0.00 to 5.00 mA:
Use the controller to dial a stimulation current up to 5 mA. The
current is displayed in 0.02 mA digits.

Setting range from 0.00 to 1.00 mA:
Use the controller to dial a stimulation current up to 5 mA. The
current is displayed in 0.01 mA digits.

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HNS 11 switches them off after 8 seconds (see p. 6

9

Pulse width

Pulse width 1.0 ms: duration of stimulation pulse is 1.0 ms.

Pulse width 0.3 ms: duration of stimulation pulse is 0.3 ms.

Pulse width 0.1 ms: duration of stimulation pulse is 0.1 ms.

Pulse frequency

Pulse frequency 2 Hz (two pulses per second)

Pulse frequency 1 Hz (one pulse per second)