Fisher INNERVATOR252 User manual

INNERVATOR252

Constant Current Peripheral Nerve Stimulator

OPERATING INSTRUCTIONS

English

The NS252 provides neuromuscular block monitoring for general
anesthesia required for surgical procedures in the operating
theater.

OPERATOR CONTROL BUTTONS

A. ON/OFF, POWER, MUTE BUTTONS

Switches the INNERVATOR252 on & off.

Sets the amount of current to be delivered by 10mA steps.
If CURRENT UP button is depressed the set current advances to
80mA. If CURRENT DOWN button is depressed the set current
decreases to 0mA. Maximum set current is 160mA,
(To deliver 80 - 160 mA see Programming Features)

Mutes audible pulse delivery sound. To cancel press again.

Cannot be used to mute the audio alarm sound.

B. DEMAND BUTTONS

TW

Delivers a single pulse.

TOF

Delivers a train of four pulses where each pulse is 0.5 seconds
apart

TET

Delivers a tetanus pulse train for as long as the button is
depressed.

DBS

Delivers a Double Burst pulse train. DBS = three pulses 20 ms,
a 750 ms lull then two
features).

OR

three 20ms pulses, (see programming

PTC

Post Tetantic Count. Consists of five sec TET pulse, three sec
pause, twenty twitch pulses at 1 Hz. For safety, PTC can only be
activated once every five minutes.

C. REPEAT BUTTONS

Activates a preset pulse pattern. Press again to terminate the
cycle.

1 SEC TW

Single pulse delivered at one second intervals.

10 SEC TW

Single pulse delivered at ten second intervals

12 SEC TOF

Train of four pulses repeated every 12 seconds.

, (1 Second Twitch (1Hz))

, (10 Second Twitch (0.1Hz))

.

, (12 Second Train-of Four)

D. PROGRAM, PTC BUTTONS

PROG

Activates programming capabilities. Press once to change
settings, twice to store program.

RUN

Starts stored program. Press again to stop. Default program =
Double Burst at 12 sec intervals.

VISUAL INDICATORS

CURRENT

Current delivered to the patient, shown in milliamps

PULSE DELIVERY

Shown as a solid dot in the centre of a circle. It flashes every
time a pulse is delivered.

MUTE

Indicates that audible pulse signal is muted.

.

mA

!

PROGRAM

Indicates INNERVATOR252 is in Programming mode

RUN

Indicates that the stored program is running.

PTC

Flashes to indicates that PTC, Post Tetanic Count pattern is

OR

running

REPEAT

Indicates that one of the three repeat pulse patterns, 1SEC TW,
10 SEC TW or 12 SEC TOF is running.

ERROR

Indicates that the INNERVATOR252 is not able to deliver the
specified current. Indicates excessive impedance, or
disconnected leads or dry patient electrodes.

continuous display if safety lockout is still in effect.

RUN

PTC

REPEAT

ERROR

P

◄

◄

◄

◄

LOW BATTERY

Indicates that the batteries require replacing as soon as possible.

AUDIO INDICATORS

PULSE DELIVERY

Monotone, single beep every pulse.

AUDIBLE ALARM

Half second, monotone beep each time a pulse is delivered
incorrectly AND, at the completion of the pulse train there is a 2
second continuous beep.

Indicates pulse does not fall within the tolerance limits each side
of the set current. May be caused by, excessive impedance,
disconnected leads or dry patient electrodes.

If the alarm sound is occurring repeatedly:

• Do not continue running a repeat function.

• Do not deliver any further pulses until the fault causing

the condition is repaired.

USE & CONNECTION TO A PATIENT

Only shrouded lead sets (200NS033 (supplied), 200NS032
or 200NS031) may be used with the INNERVATOR252.

1. Ensure that the INNERVATOR252 is switched OFF.

2. Connect external lead to the INNERVATOR252, proximal
(red, positive) to red socket and distal (black, negative), to
black socket.

3. Connect the other end of the lead to the patient

electrodes, usually attached along the ulnar nerve.
Proximal (red) connector to proximal (red) electrode, distal
(black) connector to distal (black) electrode.

Red Black

Following the induction of anesthesia

4.
INNERVATOR252 on and increase the current until desired
level of supramaximal stimulation has been attained.

NOTE: A two second continuous tone indicates that alarm
conditions exist. This may be caused by excessive
impedance, dried or faulty electrode(s), or disconnected or
faulty leads.

5. After use, always ensure that the INNERVATOR252 is
switched OFF.

Auto power shut-off after 30 minutes of non-use.

INNERVATOR252 will emit three beeps, if no buttons are pressed
within next minute, INNERVATOR252 will automatically switch
off. Press any button to cancel the automatic shut down for
another 30 minutes.
Will not occur if running a repeat function.

switch the

DEFINITIONS

Type BF ATTENTION 9 3/42/EEC
Applied Part Consult Clas s IIb
ac companying

documents

‘PERIPHERAL NERVE ST IMULATOR’

WITH RESPECT TO ELEC TRIC SHOCK, FIRE,

MECHANICAL HAZARDS ONLY IN ACCORDANCE

WITH UL 2601-1, C AN/CSA C22.2 NO. 601.1

WARNING:

the possibility of injury to the patient or user exists if a procedure
is not followed correctly.

CAUTION:

damage to the equipment exists if a procedure is not followed
correctly.

NOTE:

to clarify points, procedures or instructions.

A WARNING statement refers to the conditions when

A Caution statement indicates the possibility of

A Note statement provides additional information intended

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WARNING

•

•

•

•

•

CAUTION

Interference from electrosurgical units (diathermy), may be
experienced. Ensure that the Nerve Stimulator is positioned
away from electrosurgical unit. Lead-set should not run parallel to
the diathermy lead and should not cross the diathermy lead at
any stage.

Remove batteries if equipment is not likely to be used for some
time. Clean with a damp cloth. All maintenance must be carried
out by qualified personnel. For further information and technical
data contact your Fisher & Paykel Healthcare dealer.

:

This device should not be used in a manner that allows
trans-thoracic stimulation.

Not to be used for Internal Nerve Location. Use
recommended stimulator lead sets only. Do not use with
needle electrodes.

Dangerous voltages may exist within this device for up to ten
minutes after removal of the batteries.

This device i s not suitable f or use in the presence of a
flammable anesthetic mixture with air or with oxygen or
nitrous oxid e.

This product is intended for use by qualified medical
practitioners and such per sons should e nsure that they are
totally familiar with the use of the nerve stimulator before
using the device.

:

HOW TO PROGRAM

A. PROGRAMMING A PULSE PATTERN

1. Push PROG button to enter programming mode, (display will
read P). Press again to store mode, (display will read
P00ma).

2. Use DEMAND BUTTONS* ONLY to deliver desired pulse
pattern. Any number may be pressed in any order.

3. Allow desired time interval between pulses to elapse
between button pushes, (the display will count upwards in
seconds). Each time a demand button is pressed the display
returns to zero. Maximum elapsed time between button
pushes is 99 seconds.

4. Push PROG again to store the program.

5. Reset the INNERVATOR252 to the desired current delivery
level, (current is automatically zeroed during programming).

6. Push RUN to execute the stored program at set output
current. Program will run until RUN is pressed again or unit
is switched off. The RUN indicator will be displayed while
program is running.

*

PTC button cannot be used whe n storing a program.

B. PROGRAMMING TETANUS PULSE TO 50HZ OR

100HZ.

1. Push PROG button ONCE, (display will read P).

2. Push TET button to select Tetanus frequency. The
frequency will be displayed as “50” or “100”.

NOTE: There is no visual indicator to display TET frequency
when in use. However the 100Hz audio indicator has a faster
pulse delivery sound than the 50Hz.

C. PROGRAMMING THE MAXIMUM CURRENT

SETTING TO 80mA OR 160mA.

1. Push PROG button ONCE, (display will read P).

2. Push CURRENT UP button to select maximum current at
80mA. “Lo” will be displayed to indicate the maximum
current is 80mA. Pressing the CURRENT UP button again
will select the maximum current at 160mA and “Hi” will be
displayed.

If 80mA is programmed, depressing the CURRENT UP
button will increase the current in 10mA steps to 80mA.

If 160mA is programmed, depressing the CURRENT UP
button will increase the current in 10mA steps to 80mA. To
set beyond 80mA, the CURRENT UP button

pressed and released

10mA is desired.

each time a further increment of

must be

D. PROGRAMMING THE DOUBLE BURST

STIMULATION PATTERN.

1. Push PROG button ONCE, (display will read P).

2. Push the DBS button to select either the 3:2 or 3:3 pattern.
The display will indicate either “3:2” or “3:3”.

E. IMPORTANT NOTES:

• All programs are retained when unit is switched off.

• Programs are retained for 5 minutes when batteries are

removed to allow sufficient time for battery replacement.

• If batteries removed for longer than 5 minutes, program

features return to default, (see specifications).

BATTERY REPLACEMENT

To replace batteries use three 1.5 volt “AA” batteries

SPECIFICATIONS

OUTPUT CURRENT RANGE:

•

0-160 mA selectable in 10mA steps

TETANUS FREQUENCY:

•

Programmable 50Hz or 100Hz

OUTPUT PULSE FORM:

•

Square wave, constant current, monophasic, unidirectional

OUTPUT PULSE WIDTH:

• 195 µs ± 5µs

OUTPUT PULSE RISE/FALL TIME:

< 10

•

µs

maximum, (resistive load)

OUTPUT VOLTAGE:

•

350 volts, maximum

MAXIMUM LOAD IMPEDANCE

• TW, TOF, DBS - 4K ohms at 80mA, 3.5K ohms at 160mA

TET, PTC – 1.8K ohms at 80mA, 1.3K ohms at 160mA

SET CURRENT OFFSET

• at 0-80mA ± 2.5mA
at 85-160mA ± 5.0mA

ALARM TOLERANCE LIMITS

•

± 2.5mA of the set current

DEFAULT PROGRAM

• 10sec twitch

Temperature 5 °C to 30 °C -10 °C to 60 °C -10 °C to 60 °C

DEFAULT PROGRAM SETTINGS

• TET = 50Hz, Current Max = 80mA, Current steps 10mA,

DBS = 3:3

POWER REQUIREMENT

• Internally powered. Three 1.5 volt “AA” batteries.

Continuous operation.

BATTERY LIFE

•

More than 300 hours continuous use with alkaline
batteries

DIMENSIONS

• Height - 170mm

•

Width - 73mm

• Depth - 43mm

• Weight - 0.18kg, (without batteries)

LEAD SETS (shrouded):

• 200NS033 (supplied): dome connectors.

• 200NS032: pin connectors.

• 200NS031: alligator clips.

ENVIRONMENTAL

Operation Transport Storage

Humidity 0 % to 90 % 0 % to 90 % 0 % to 90 %
‘Ordinary equipment’

CONTACTS

INTERNATIONAL

AUSTRALIA

FRANCE/BENELUX

GERMANY/AUSTRIA

UK/IRELAND

USA

NOTE: US Federal law restricts this device to sale by, or

REF 185042350 Rev B January 2002 Page 2 of 2

Tel: [phone]

on the order of, a physician.

P.O. Box 14-348, Panmure,
Auckland 6, New Zealand
Email: [e-mail]

Web Site: www.fphcare.com
Tel: [phone]
Fax:[phone]

Fax: [phone]

Tel: [phone]
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Tel: [phone]
Fax: [phone]

Tel: [phone]
Fax: [phone]
(EU Authorised Representative)

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