Getinge Arjohuntleigh Nimbus 3 Professional, Arjohuntleigh Nimbus 3 Instructions For Use Manual
Product Photo
NIMBUS®3
NIMBUS
Instructions For Use
®
3 PROFESSIONAL
Contents
General Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
About this Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
About Nimbus 3 and Nimbus 3 Professional . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Nimbus 3 Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Nimbus 3 Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Nimbus 3 Professional Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Clinical Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Care of the patient when sitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Preparing the Nimbus 3 and Nimbus 3 Professional Systems for Use . . . . . . . . . . . 7
Installing the Nimbus 3 or Nimbus 3 Professional Mattress . . . . . . . . . . . . . . . . . . . 7
Installing the Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Connecting the Tubeset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Disconnecting the Tubeset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
System Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Controls, Alarms and Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Pump Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Pump Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Mattress Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Additional Controls on the Nimbus 3 Professional Mattress . . . . . . . . . . . . . . . . . . 14
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Installing the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Inflating the Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Testing the Power Fail Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Deflating the Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
System Optimisation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Selecting the Operating Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Silencing Audible Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Comfort Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Transport Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
CPR Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Patient Positioning Guidance for the Nimbus 3 Professional Mattress . . . . . . . . . . 21
Decontamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Routine Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Nimbus 3 and Nimbus 3 Professional Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Nimbus 3 Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Nimbus 3 and Nimbus 3 Professional Mattresses . . . . . . . . . . . . . . . . . . . . . . . . . 25
(i)
Serial Number Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Technical Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Cover Specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Cleaning Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
(ii)
GENERAL SAFETY
Before you connect the system pump to a mains socket, read carefully all the installation
instructions contained within this manual.
The system has been designed to comply with regulatory safety standards including:
• EN60601-1:1990/A13:1996 and IEC 60601-1:1988/A2:1995
• UL60601-1, UL2601-1 and CAN/CSA C22.2 No. 601.1-M90
Safety Warnings
• It is the responsibility of the care giver to ensure that the user can use this product
safely.
• Whilst the patient is unattended, safety sides should be used based on clinical
assessment and in line with local policy.
• Alignment of the bed frame, safety sides and the mattress should leave no gap
wide enough to entrap a patient's head or body, or to allow egress to occur in a
hazardous manner where entanglement with the mains power cable and tubeset or
air hoses may result. Care should be exercised to prevent occurrence of gaps by
compression or movement of the mattress. Death or serious injury may occur.
• Make sure that the mains power cable and tubeset or air hoses are positioned to
avoid causing a trip or other hazard, and are clear of moving bed mechanisms or
other possible entrapment areas. Where cable management flaps are provided
along the sides of the mattress, these should be used to cover the mains power
cable.
• Electrical equipment may be hazardous if misused. There are no user-serviceable
parts inside the pump. The pump's case must only be removed by authorised
technical personnel. No modification of this equipment is allowed.
• The mains power socket/plug must be accessible at all times. To disconnect the
pump completely from the electricity supply, remove the plug from the mains
power socket.
• The CPR control and/or the CPR indicator tag must be visible and accessible at all
times.
• Disconnect the pump from the mains power socket before cleaning and inspecting.
• Keep the pump away from sources of liquids and do not immerse in water.
• Do not use the pump in the presence of uncontained flammable liquids or gasses.
• The cover of this product is vapour permeable but not air permeable and may
present a suffocation risk.
• Only the pump and mattress combination as indicated by ArjoHuntleigh should be
used. The correct function of the product cannot be guaranteed if incorrect pump
and mattress combinations are used.
• To avoid the risk of electric shock, this equipment must only be connected to a
supply mains with protective earth.
• Due to the inherently lower flame retardancy of the high performance eVENT
®1
fabric, it is NOT suitable for use in the homecare environment.
Precautions
For your own safety and the safety of the equipment, always take the following
precautions:
1. eVENT® is a registered trademark of BHA Technologies Inc.
(iii)
• Placing extra layers between the patient and the mattress potentially reduces the benefit s
provided by the mattress and sh ould be avoid ed or kept to a minimum. As p art of sens ible
pressure area care, it is advisable to avoid wearing clothing which may cause areas of
localised high pressure due to creases, seams, etc. Placing objects in pockets should be
avoided for the same reason.
• Do not expose the system, especially the mattress, to naked flames, such as cigarettes,
etc.
• In the event of a fire, a leak in the seat or mattress could propagate the fire.
• Do not store the system in direct sunlight.
• Do not use phenol-based solutions to clean the system.
• Make sure the system is clean and dry prior to use or storage.
• Never use sharp objects or electrically heated under blankets on or under the system.
• Store the pump and mattress in the protective bags supplied.
Electromagnetic Compatibility (EMC)
This product complies with the requiremen ts of applicable EMC Standa rds. Medical ele ctrical
equipment needs special precautions regarding EMC and needs to be installed in accordance
with the following instructions:
• The use of accessories not specified by the manufacturer may result in increased
emissions by, or decreased immunity of, the equipment, affecting its performance.
• Portable and mobile radio frequency (RF) communications equipment (e.g. mobile/cell
phones) can affect medical electrical equipment.
• If this equipment needs to be used adjacent to other electrical equipment, normal
operation must be checked before use.
• For detailed EMC information contact ArjoHuntleigh service personnel.
Environmental Protection
Incorrect disposal of this equipment and its component parts, particularly batt eries or other
electrical components, may produce substances that are hazardous to the environment. To
minimise these hazards, contact ArjoHuntleigh for information on correct disposal.
Service Information
ArjoHuntleigh recommend that th is system sh ou ld b e se rviced e ver y 12 ca le nd ar m on th s or,
where applicable, when the service indicator is illuminated.
Design Policy and Copyright
® and ™ are trademarks belonging to the ArjoHu ntleigh g roup of co mpanies. As our pol icy is
one of continuous improvement, we reserve the right to modify designs without prior notice.
© ArjoHuntleigh 2009.
(iv)
1. Introduction
About this Manual This manual is your introduction to the Nimbus
Nimbus 3 Professional systems. Use it to initially set up
the system, and keep it as a reference for day-to-day
routines and as a guide to maintenance.
About Nimbus 3 and Nimbus 3 Professional
Nimbus 3 and Nimbus 3 Professional are Dynamic
Flotation Systems for the prevention, treatment and
management of pressure ulcers.
Nimbus 3 and Nimbus 3 Professional systems comprise
a pump and mattress replacement which can be used on
standard hospital and normal domestic beds. Beds can
be adjusted or profiled with the mattress in position.
Nimbus 3 Professional mattress has the following
The
additional features to enable the patient to be proned,
and to assist with pressure area and patient care
management:
• A Head Section Deflate Control to allow the three
head cells to be fully deflated.
®
3 and
• Individual Vent Valves to allow 16 of the 20 cells to
be independently deflated.
Nimbus 3 and Nimbus 3 Professional mattresses
The
incorporate an advanced
AutoMatt® sensor pad which
makes sure that the patient is automatically supported at
optimum pressures regardless of size, height, position or
weight distribution.
If cardiac arrest occurs, the
Professional mattresses can be deflated in less than 10
Nimbus 3 and Nimbus 3
seconds to allow cardiac resuscitation procedures to be
performed.
Caution
Federal law restricts this device to sale by or on the order of a
physician.
1
Nimbus 3 Pump The same pump is used on the
Hi
mmHg
Lo
mmHg
-
+
mmHg
Front Panel
Mains Power Switch Alarm Indicators
Tubeset
Mains Power Cord
Carry Handle
Professional systems.
The pump comprises a moulded case with non-slip feet
on the base and rear, and an integral carry handle.
Nimbus 3 and Nimbus 3
The pump has two modes of operation:
•
Dynamic mode that cycles the support surface
beneath the patient every 10 minutes providing
periods of pressure relief for the whole body.
Static mode where the support surface remains
•
constant (all cells equally inflated).
The controls and indicators are located on the front
panel, and a sophisticated alarm system differentiates
between normal operation and genuine system faults. If
an alarm situation is detected a flashing indicator will
illuminate, together with an indication of the cause of
alarm, and an audible warning will sound.
The pump can be fixed to the foot end of a hospital bed
by the separate bed bracket. The bed bracket fits in the
pump handle and then clips onto most common bed
frames. The pump can also be stood on the floor, either
upright or on its rear cover.
2
Nimbus 3 Mattress The
CPRCPR
1
3
N
O
R
M
A
L
NORMAL
T
R
A
N
S
P
O
R
T
TRANSPORT
2
FAS
T
D
E
F
L
A
T
E
FASTDEFLATE
Detachable Cover
CPR Control
Transport Control
Carry Handle
Securing Strap
Pump Tubeset
5 “Heelguard” Cells
3 Head Cells
8 Torso Cells
4 Thigh Cells
Head End
Foot End
Drag Handle
components:
Nimbus 3 mattress comprises the following
Detachable Cover The standard protective cover comprises a 2-way stretch
cover zipped to a durable anti-slip base. The zips are
protected by flaps to prevent ingress of contaminants,
and allow easy removal of the cover for cleaning.
Alternative covers with advanced properties, such as
®
Advantex
and eVENT®, are also available (Refer to
“Cover Specification” on page 30).
Cells The Nimbus 3 mattress comprises 20 polyurethane (PU)
cells providing support to the user in either Alternating
or Static modes. The cells are grouped in four sections,
each of which has a specific function:
• The three Head cells remain at a constant pressure
for pillow stability and patient comfort.
• The eight Torso cells combine alternating and static
pressure characteristics to support patients fully in
both lying and sitting positions without the risk of
‘bottoming’.
• The four Thigh cells cycle dynamically to maximise
pressure relief.
• The five
Heelguard
maximise the pressure relief under the heels.
®
cells are specially powered to
3
AutoMatt The advanced AutoMatt sensor pad is under the cells,
Detachable Cover
CPR/Transport
Shoulder Support Cell
Carry Handle
Securing Strap
5 “Heelguard” Cells
3 Head Section Cells
7 Torso Cells
4 Thigh Cells
Head End
Foot End
16 Vent Valves
Head Section Deflate Control
Control
Drag Handle
(with Central Cutout)
(“Power-Down” Cells)
and makes sure that the patient is automatically
supported at optimum pressures regardless of size,
height, position or weight distribution.
CPR Control The CPR (Cardio-Pulmonary Resuscitation) Control is
at the foot end of the mattress, and allows the air to be
evacuated in under 10 seconds.
Transport Control The Transport Control is next to the CPR Control. When
operated, it seals the mattress so that air is not exhausted
when the tubeset is disconnected and also creates an
even pressure in all the cells.
Tubeset The tubeset incorporates a flexible, compact anti-kink
tube that is resistant to crushing and any subsequent
obstruction of air flow. Each end has a quick-lock
system for easily connecting and disconnecting the air
supply at the pump and mattress.
Nimbus 3 Professional Mattress
Nimbus 3 Professional mattress is of similar
The
construction to the
Nimbus 3 mattress, with the addition
of a Head Section Deflate Control, individual Vent
Valves on 16 of the 20 cells and a Shoulder Support
Cell.
4
Head Section Deflate
Control
Cells The Nimbus 3 Professional mattress has the same
This is a two-position rotary-action control at the head
end of the mattress:
• Dynamic (Normal) Mode. The three cells in the Head
Section are inflated at a constant pressure and the
remaining 17 cells alternate.
T riCell Head Section Deflate. The three cells in the
•
Head Section are fully deflated to assist with patient
care management, and the Shoulder Support Cell (the
fourth cell, next to the Head Section) is inflated to a
constant pressure to support the patient’s shoulders.
The remaining 16 cells alternate.
number of cells as the
Nimbus 3 mattress (20 cells). The
function of the first four cells at the head end of the
mattress is different on the
Nimbus 3 Professional:
• The three cells in the Head Section are either fully
inflated or fully deflated, depending on the position
of the Head Deflate Control, to assist with patient
care management. The cells are specially powered to
enable them to be fully deflated.
• The single Shoulder Support Cell (the fourth cell,
next to the Head Section) has a shallow cutout in the
mid-section of the cell. This is to allow access to the
neck area for clinical procedures and to ensure the
smooth, uniform extension of the neck during
deflation. Its operation is controlled by the Head
Section Deflate Control: the cell is either fully
inflated to support the patient’s shoulders or
alternates (together with the remaining 16 cells).
• The remaining 16 cells (seven T orso cells, four Thigh
cells and five
function as on the
Vent Valves The seven Torso cells, four Thigh cells and five
Heelguard cells have individual Vent Valves to allow
Heelguard cells) have the same basic
Nimbus 3 mattress.
each cell to be independently deflated, to assist with
pressure area and patient care management.
5
2. Clinical Applications
Indications The Nimbus 3 and Nimbus 3 Professional systems are
indicated for the prevention and management of all
categories1 of pressure ulcer when combined with an
individualised monitoring, repositioning and wound care
programme.
The
designed for patients weighing up to 250 kg (550 lb).
The
designed for patients weighing up to
Nimbus 3 and Nimbus 3 Professional mattress is
Nimbus 3 and Nimbus 3 Professional cushion is
250 kg (550 lb).
Contraindications Do not use
for patients with unstable spinal fractures.
Cautions If patients have other unstable fractures, or conditions
which may be complicated by a soft or moving surface,
advice should be sought from an appropriate clinician
before use.
While the
have been designed to manage patients up to the weight
limits indicated above, those approaching this upper limit
are likely to have additional care and mobility needs and
may be better suited to a specialist bariatric system.
Active therapy (alternating) cushions may be unsuitable
for patients with poor sitting posture or pelvic deformity;
advice from a seating specialist should be sought.
Care of the patient
when sitting
Seated patients are at increased risk of pressure ulcers
particularly if they are immobile or have wounds over the
seating area. For optimal outcome, provide a pressure
redistributing seat cushion in a chair which promotes a
good sitting posture and has a level base seat to support the
cushion, in addition to an individualised repositioning
programme.
Nimbus 3 and Nimbus 3 Professional systems
Nimbus 3 and Nimbus 3 Professional systems
The above are guidelines only and should not replace clinical judgement.
The
Nimbus 3 and Nimbus 3 Professional systems represent one aspect of a
pressure ulcer management strategy; if existing wounds do not improve or the
patients condition changes the overall therapy regimen should be reviewed by
the prescribing clinician.
Mattress and cushion combinations may have different upper weight limits.
Cushions should be used in combination with pressure-redistributing
mattresses to provide 24-hour therapy.
1. NPUAP/EPUAP International Pressure Ulcer Guideline, 2009.
6
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