GymnaUniphy Combi 200 User manual

User Manual

Pasweg 6A

B-3740 Bilzen

Tel.: (+32) (0) 89/510.510

Fax: (+32) (0) 89/510.511

www.gymna-uniphy.com E-mail: [e-mail]

Your dealer:

COMBI 200

Combi 200

User Manual Combi 200

Device for electrotherapy, ultrasound therapy and combination therapy

Manufacturer	GymnaUniphy N.V.
Main office	Pasweg 6A
	B-3740 BILZEN
Telephone	+(32) (0)89-510.510
Fax	+(32) (0)89-510.511
E-mail	[e-mail]
Website	www.gymna-uniphy.com

Version 1.1

March 2005

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		Combi 200
Abbreviations
AQ	Accomodation Quotient
CC	Constant Current
CO	Combination therapy
CP	Courte Période
CV	Constant Voltage
DF	Diphasé Fixe
EL	Electrode
EMC	Electromagnetic Compatibility
ESD	Electrostatic Discharge
ET	Electrotherapy
HAC	Hospital Antiseptic Concentrate
LP	Longue Période
MF	Medium Frequency: with unidirectional and interferential currents
	Monophasé Fixe: with diadynamic currents
MTP	Myofascial Trigger Point
NMES	Neuro Muscular Electro Stimulation
TENS	Transcutaneous Electrical Nerve Stimulation
US	Ultrasound
VAS	Visual Analogue Scale

Symbols on the equipment

Read the manual

Manufacturer

Symbols in the manual

Warning or important information.

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Combi 200

TABLE OF CONTENTS

1	SAFETY ............................................................................................		7
	1.1	PURPOSE ....................................................................	7
	1.2	SAFETY INSTRUCTIONS ...................................................	7
	1.3	MEDICAL DEVICES DIRECTIVE ...........................................	9
	1.4	LIABILITY ..................................................................	10

2	INSTALLATION ..............................................................................		11
	2.1	RECEIPT ....................................................................	11
	2.2	PLACING AND CONNECTION ...........................................	11
	2.3	PERFORMING THE FUNCTIONAL TEST .................................	11
	2.4	SETTING CONTRAST AND SELECTING LANGUAGE ..................	11
	2.5	TRANSPORT AND STORAGE ............................................	12
	2.6	RESELLING .................................................................	12

3	DESCRIPTION OF THE EQUIPMENT ............................................		13
	3.1	COMBI 200 AND STANDARD ACCESSORIES ........................	13
	3.2	COMPONENTS OF COMBI 200 ........................................	14
	3.3	DISPLAY ...................................................................	15
	3.4	DISPLAY SYMBOLS .......................................................	16
	3.5	SYMBOLS FOR CURRENT SHAPES IN MEMORY MENU ..............	16
	3.6	PARAMETER SYMBOLS ..................................................	17
	3.7	CURRENT SHAPES ........................................................	18

4	OPERATION ...................................................................................		19
	4.1	THERAPY SELECTION ....................................................	19
	4.2	PERFORMING THERAPY ..................................................	22
	4.3	ELECTROTHERAPY ........................................................	24
	4.4	ULTRASOUND THERAPY .................................................	32
	4.5	COMBINATION THERAPY ................................................	34
	4.6	DIAGNOSTIC PROGRAMS ................................................	34
	4.7	PROGRAMS ................................................................	36
	4.8	SYSTEM SETTINGS .......................................................	39

5	INSPECTIONS AND MAINTENANCE ...........................................		43
	5.1	INSPECTIONS ..............................................................	43
	5.2	MAINTENANCE ............................................................	45
6	MALFUNCTIONS, SERVICE AND GUARANTEE .........................		47
	6.1	MALFUNCTIONS ..........................................................	47
	6.2	SERVICE ...................................................................	48
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Combi 200

	6.3	GUARANTEE ...............................................................	48
	6.4	TECHNICAL LIFE TIME ...................................................	49
7	TECHNICAL INFORMATION .........................................................		51
	7.1	GENERAL ..................................................................	51
	7.2	ELECTROTHERAPY ........................................................	51
	7.3	ULTRASOUND THERAPY .................................................	54
	7.4	ENVIRONMENTAL CONDITIONS .........................................	55
	7.5	TRANSPORT AND STORAGE ............................................	55
	7.6	STANDARD ACCESSORIES ..............................................	56
	7.7	OPTIONAL ACCESSORIES ELECTROTHERAPY .........................	57
	7.8	OPTIONAL ACCESSORIES ULTRASOUND THERAPY ..................	58
8	APPENDICES .................................................................................		59
	8.1	AGENTS FOR IONTOPHORESIS .........................................	59
	8.2	DIAGNOSTIC I/T-CURVE ................................................	60
	8.3	EMC DIRECTIVE ..........................................................	61
	8.4	TECHNICAL SAFETY INSPECTION ......................................	65
	8.5	DISPOSAL .................................................................	69
9	REFERENCE ...................................................................................		71
	9.1	FUNCTION OVERVIEW ....................................................	71
	9.2	LITERATURE ...............................................................	76
	9.3	TERMINOLOGY .............................................................	76
10	INDEX .............................................................................................		81

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Combi 200

1 SAFETY

1.1Purpose

The Combi 200 is intended solely for medical applications. You can use the Combi 200 for electrotherapy, ultrasound therapy and combination therapy. The device is suited for continuous use.

1.2Safety instructions

1.2.1General

•Only qualified people who are trained in the application of the therapies may use the appliance.

• Only a technician authorised by GymnaUniphy N.V. may open the equipment or the accessories.

•Follow the instructions and directions in these user instructions.

•Place the equipment on a horizontal and stable base.

•Keep the ventilation openings at the bottom and rear of the equipment free.

•Do not place any objects on the equipment.

•Do not place the equipment in the sun or above a heat source.

•Do not use the equipment in a damp area.

•Do not let any liquid flow into the equipment.

•Do not disinfect or sterilise the equipment. Clean the equipment with a dry or moistened cloth. See §5.

•Only treat patients with electrical implants (pacemaker) after obtaining medical advice.

•The 'Directive on Medical Devices' from the European Commission (93/42/EEG) requires that safe devices are used. It is recommended to perform a yearly technical safety inspection. See §5.1.2.

•For optimum treatment, a patient investigation must first be performed. On the basis of the findings of the investigation, a treatment plan with objectives will be formulated. Follow the treatment plan during the therapy. This will limit possible risks, related to the treatment, to a minimum.

•Always keep these user instructions with the equipment.

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Combi 200

1.2.2Electrical safety

•Only use the equipment in an area with facilities that meet the applicable legal regulations.

• Connect the equipment to an outlet with a protective earth terminal. The outlet must meet the locally applicable requirements for medical areas.

1.2.3Prevention of explosion

•Do not use the equipment in an area where combustible gases or vapours are present.

• Switch off the equipment when it is not used.

1.2.4Electromagnetic Compatibility

•Medical electrical equipment requires special precautions for Electro Magnetic Compatibility (EMC). Follow the instructions

for the installation of the equipment. See §2

•Do not use mobile telephones or other radio, shortwave, or microwave equipment in the vicinity of the equipment. This kind of equipment can cause disturbances.

•Only use the accompanying accessories that are supplied by GymnaUniphy. See §7.6, §7.7 and §7.8.

Other accessories can lead to an increased emission or a reduced immunity.

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Combi 200

1.2.5Electrotherapy

•Do not use the equipment simultaneously with high frequency surgical equipment. This combination can cause burning of

the skin under the electrodes.

•Do not use adhesive electrodes with currents that have a galvanic component, such as galvanic, diadynamic, MF rectangular, pulsed rectangular and triangular currents. With these currents, etching of the skin can occur.

•Check the electrode cables and the electrodes at least once a month. Check whether the insulation is still intact. See §5.1.

•The safety standards for electrical stimulation advise not to exceed the current density of 2.0 mArms/cm2.

However, with iontophoresis treatments, we advise a maximum current density of 0.25 mÂ/cm2, because of using the MF rectangular current. Exceeding this value can result in skin irritation and burns.

•Always use sterilised gauze with iontophoresis treatments.

1.2.6Ultrasound therapy

•Move the US head evenly over the skin during the treatment. This prevents internal burns.

• The US treatment heads are exchangeable. The device detects the characteristics and supplies the right power at the right frequency.

•Handle the US heads carefully. With rough handling, the characteristics can change. Test the US head if it falls on the ground or knocks against something. See §5.1.1.

•Check the US head at least once a month. During the check, look for dents, cracks and other damage that could allow liquids to ingress. Check whether the insulation of the cable is still intact. Check whether all pins are present and straight in the connectors. Replace the US head if the head, the cable or the connector is damaged. See §5.1.

1.3Medical Devices Directive

The device complies with the essential requirements of the Medical Device Directive of the European Committee (93/42/EEC) as most recently changed.

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Combi 200

1.4Liability

The manufacturer cannot be held liable for injury to the therapist, the patient or third parties, or for damage to or by the equipment used, if for example:

•an incorrect diagnosis is made;

•the equipment or the accessories are used incorrectly;

•the user instructions are wrongly interpreted or ignored;

•the equipment is badly maintained;

•maintenance or repairs are performed by people or organisations that are not authorised to do so by GymnaUniphy.

Neither the manufacturer nor the local GymnaUniphy dealer can be held liable, in any way whatsoever, for the transfer of infections via the vaginal, anal and rectal probes and/or other accessories.

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Combi 200

2 INSTALLATION

2.1Receipt

1.Check whether the equipment has been damaged during transport.

2.Check whether the accessories are intact and complete. See §7.6, §7.7 and §7.8.

•Inform your supplier of any damage or defects by no later than within 3 working days after receipt. Report the damage by telephone, fax, e-mail or letter.

•Do not use the equipment if it is damaged or defective.

2.2Placing and connection

1.Place the equipment on a horizontal and stable base.

•Keep the ventilation openings at the bottom and rear of the equipment free.

•Do not place the equipment in the sun or above a heat source.

•Do not use the equipment in a wet area.

2.Check whether the mains voltage that is stated on the rear of the equipment corresponds with the voltage of your mains supply. The equipment is suited for a nominal mains voltage from 100 V to 240 VAC / 50-60 Hz.

3.Connect the device to an outlet with protective earth terminal.

2.3Performing the functional test

1.Switch the equipment on with the switch at the rear of the equipment.

2.When the equipment is switched on, it automatically performs a test. Check whether the indicator lamps next to A and B light briefly during the test.

3.If the lamps do not light up: See §6.

2.4Setting contrast and selecting language

1.Press for 5 seconds. The System setting menu appears. See §4.8.

2.Press next to Contrast, 1st key from the top.

3.If necessary, change the contrast with and .

4.Press next to Language.

5.If necessary, change the language with and .

6.Press to return to the start menu.

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Combi 200

2.5Transport and storage

Take account of the following matters if the equipment has to be transported or stored:

•Transport or store the equipment in the original packaging.

•The maximum period for transport or storage is: 15 weeks.

•Temperature: -20 °C to +60 °C.

•Relative humidity: 10% to 100%.

•Atmospheric pressure: 200 hPa to 1060 hPa.

2.6Reselling

This medical equipment must be traceable. The equipment, the US head and some other accessories have a unique serial number. Provide the dealer with the name and address of the new owner.

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Combi 200

3 DESCRIPTION OF THE EQUIPMENT

3.1Combi 200 and standard accessories

	10	1	2
9
8			3
7	6	5	4

1.Combi 200. See §3.2.

2.Power cord

3.Contact gel

4.US head

5.VAS score card

6.Elastic fixation straps (4 pieces)

7.EL sponges for rubber electrode (4 pieces)

8.Rubber electrodes (4 pieces)

9.Two-ply electrode cable (2 pieces)

10.Test connector

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Combi 200

3.2Components of Combi 200

		1
2							18
3					17	19 21 22		23
4
5					16
6		A		B	15	20
7	A			!	14		26
	B
	8	9	10 11	12 13		A	B
						24 25 27 28

1.	Display. See §3.3.	17.	Select parameter or menu
2.	Electrotherapy	18.	Connector for US head
3.	Ultrasound therapy	19.	On/off switch
4.	Combination therapy	20.	Fuse holder
5.	Memory	21.	Connection to mains supply
6.	Start menu	22.	Type plate
7.	Channel selection: A or B	23.	Ventilation opening
8.	Stop	24.	Connector for electrotherapy,
9.	Intensity of channel A		channel A
10.	Pause	25.	Indicator lamp for channel A
11.	Return to previous menu	26.	Indication: Floating patient
12.	Intensity of channel B		circuit
13.	Enter	27.	Connector for electrotherapy,
14.	Indication: Read manual		channel B
15.	Down	28.	Indicator lamp for channel B
16.	Up

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Combi 200

3.3	Display
	1	2	3	4	5
	10
9	11
	12
					6
	13
				8	7

1.	Channel	8.	Explanation or recommendation
2.	Therapy	9.	Screen for channel A (here,
3.	Current shape		electrotherapy). See §4.3.5.
4.	Title of the screen	10.	Remaining treatment time
5.	Program number	11.	Polarity
6.	Parameters with selection	12.	Set intensity
	knobs	13.	Screen for channel B (here,
7.	Use to go to the next		ultrasound therapy). See §4.4.2.
	parameters

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Combi 200

3.4Display symbols

3.4.1General

Electrotherapy

Ultrasound therapy

Combination therapy

Sequential current SEQ shapes

3.4.2Current shape groups

Unidirectional currents

Diadynamic

TENS currents

NMES currents

AChannel A

BChannel B

Channel A and B

A + B simultaneously

Treatment time

0:00 Treatment completed

2-pole medium frequency

4-pole Interferential

4-pole interferential with vector

Diagnostic programs

3.5Symbols for current shapes in memory menu

Medium frequency										Burst TENS
unidirectional current
Unidirectional rectangular										Rectangular surge
current										current
Unidirectional triangular										Triangular surge current
current
Conventional TENS										Biphasic surge current
Low frequency TENS										Intrapulse interval surge
										current
Random TENS										2-pole medium frequency
										surge current

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Combi 200

CP	CP (diadynamic)
DF	DF (diadynamic)
LP	LP (diadynamic)
MF	MF (diadynamic)

CHR

AQ

2-pole medium frequency

4-pole interferential with rotating vector

Rheobase and chronaxie

Rheobase and AQ

3.6Parameter symbols

3.6.1Electrotherapy

Red+							Polarity indication
Red-
+					-		Alternating polarity
							Biphasic pulse shape,
							symmetrical
							Biphasic pulse shape,
							asymmetrical

Sweep mode

12 12s/12s

12

6 6s/6s

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3.6.2Ultrasound therapy

							10%	US duty cycle 10%
	1
			10ms
							20%	US duty cycle 20%
	2
			10ms
							30%	US duty cycle 30%
	3
			10ms
							40%	US duty cycle 40%
	4
			10ms				50%	US duty cycle 50%
	5
			10ms

		CC		Constant Current
		CV		Constant Voltage
		mA		mA peak
		V		Volt peak
1		1		1s/5s -1s/5s
5		5
			1	1s/1s
	1

100% US duty cycle 100%

Set US intensity

set

Ppk	Peak US output power

Unit of the set US

W/cm2 intensity

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Combi 200

3.7Current shapes

3.7.1Unidirectional currents

Rectangular pulse current

Triangular pulse current

2-5 current (UltraReiz)

Medium frequency rectangular current

2 ms

5 ms

3.7.2Diadynamic currents

MF	CP
MF	DF
DF	LP
MF	DF

3.7.3Interferential currents

2-pole medium frequency

4-pole interferential with rotating vector

4-pole Interferential

3.7.4	TENS currents
	Conventional TENS,	Conventional TENS,
	asymmetrical	alternating symmetrical
	Conventional TENS,	TENS burst
	alternating asymmetrical
	Conventional TENS,	TENS burst, alternating
	symmetrical
3.7.5	NMES currents
	Rectangular surge	Biphasic surge current
	current
	Triangular surge current	Intrapulse interval surge
		current
	Medium frequency surge
	current (2- and 4-pole)

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Combi 200

4 OPERATION

4.1Therapy selection

You can select a therapy in different ways, with the therapy keys or with the parameters in the Start menu:

•Therapy keys: Quickly select a therapy with therapy keys , and .

See §4.1.1.

•Objectives: Select a therapy on the basis of an objective. See §4.1.2.

•Indication list: Select a therapy on the basis of a medical indication.

See §4.1.3.

•Program number: Select a certain program number or a program number that you previously saved. See §4.1.4.

•Diagnostic programs: Perform a diagnosis, for example to determine the rheobase and the chronaxie. See §4.1.5.

•Contra indications: Display an overview with contra indications for the different therapies. See §4.1.6.

Besides this, you can change the system settings. See §4.8.

4.1.1Therapy keys

Electrotherapy, direct selection

1.Press : Electrotherapy.

2.Select the current shape group with .

3.Select the current shape with

.

Ultrasound therapy, direct selection

1.Press : Ultrasound therapy. The Ultrasound screen appears.

Combination therapy, direct selection

1.Press : Combination therapy.

2.Select the current shape with . See §4.5.1.

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Combi 200

4.1.2Therapy selection via objectives

1.Press to go to the start menu.

2.Select Objectives.

3.Select Electrotherapy or Ultrasound therapy.

4.Select the desired treatment with .

4.1.3Therapy selection via indication list

1.Press to go to the start menu.

2.Select Indication list.

3.Go to the following indications with or . See §9.1.4.

4.Select the desired indication with .

•ET: Electrotherapy

•US: Ultrasound therapy

•CO: Combination therapy

4.1.4Program number selection

1.Press to go to the start menu.

2.Select Program number.

3.Select the desired program with or . See §9.1.

4.Press . See §4.7.

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Combi 200

4.1.5Diagnostic program selection

With the diagnostic programs, you can localise and treat pain points, and look for stress fractures, etc.

1.Press to go to the start menu.

2.Select Diagnostic programs.

3.Select the desired diagnosis with . See §4.6.

4.1.6Contra indication selection

1.Press to go to the start menu.

2.Select Contra indications.

3.Select the therapy for which you want to see the contra indications.

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Combi 200

4.2Performing therapy

4.2.1Set and start therapy

1.Press to go to the start menu.

2.Select the desired menu with until the treatment appears.

3.Select the desired parameters

with . You can only change the outlined parameters.

4.Set the Treatment time as

follows: Press once on to set the minutes, press twice on to set the seconds.

5.Change the value of the parameter

with and . The setting range of the parameter is shown at the bottom of the screen. You can change the parameter as long as the parameter has a black background.

6.Rotate intensity knob A or B to start the treatment and to set the desired intensity. The set intensity is displayed in the screen.

4.2.2Set channels A and B

The Combi 200 has two separated electrotherapy channels A and B. The only restriction is that both are in the CC mode or the CV mode.

The channels A and B can be used independently. You can treat two different indications simultaneously with two different treatments.

1.Press for 5 seconds. The System setting menu appears. See §4.8.

2.If necessary, change the parameter Copy parameters to OFF.

3.The selected channel has a black background. If desired, press A B to change the first channel.

4.Select a treatment. See §4.1.

5.Set the parameters for the first channel. See §4.2.1.

6.Press A B to select the other channel.

7.Select a treatment for the second channel. See §4.1.

8.Set the parameters for the second channel. See §4.2.1.

Both channels are selected simultaneously and automatically in case of:

•4-pole current shapes

•Combination therapy

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Combi 200

Copy channel

On the second channel, you can set the same parameters for electrotherapy as for the first set channel.

1.Press for 5 seconds. The System setting menu appears. See §4.8.

2.If necessary, change the parameter Copy parameters to ON.

3.Select a treatment. See §4.1.

4.Set the parameters for the first channel. See §4.2.1.

5.Press A B to select the other channel. The treatment including the settings are copied to the other channel.

6.If desired you can change the parameters or the treatment of the selected channel.

Clear channel

1.Make sure that the intensity is set to zero.

2.Press A B to select the channel that you want to clear.

3.Press . The channel is cleared.

4.2.3Opening the intensity screen

1.Set the treatment. See §4.2.1.

2.Rotate intensity knob A or B to start the treatment.

3.Press . The intensity screen appears.

The left part of the screen shows channel A. The right part of the screen shows channel B.

4.Press to return to the setting menu.

4.2.4 Temporary interruption of treatment

1.	If the other channel has to pause: Select this channel with A B .
2.	Press	during the treatment. The treatment time of the selected
	channel is stopped. Pause appears on the screen. The parameter
	settings are retained.
3.	Press on	again to restart the treatment. The intensity now increases

gradually to the set level and the treatment time continues again.

4.2.5 Immediately stop treatment

1.Press . All active treatments are stopped immediately. Stop appears on the screen. The parameter settings are retained.

2.Set the intensity of the channel again to continue the treatment.

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Combi 200

4.3Electrotherapy

4.3.1Performing electrotherapy with electrodes

1.Select the desired electrotherapy program.

2.Place the electrodes. See page 24: Placing rubber electrodes and page 25: Placing the adhesive electrodes. With some treatments, the

Electrode placing parameter refers to the number in the placing diagrams.

3.Rotate intensity knob A or B to start the electrotherapy and to set the desired intensity. See §4.1.2.

4.Check the patient's reaction. Repeat this check regularly during the treatment.

5.The equipment stops the treatment and indicates that the treatment is completed. Remove the electrodes.

Placing rubber electrodes

1.Moisten two EL sponges. Use water with a saline solution to improve the conductivity of the EL sponges.

2.Slide a rubber electrode into each sponge.

3.Place the sponges on the part of the body that must be treated.

4.Fasten the sponges to the part of the body with the elastic fixation straps.

5.Connect the rubber electrode with the red connector to the red connector of the two-ply electrode cable.

6.Connect the rubber electrode with the black connector to the black connector of the two-ply electrode cable.

7.Connect the two-ply cable to connector A or B of the Combi 200.

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Combi 200

Placing the adhesive electrodes

Do not use adhesive electrodes with currents that have a galvanic component, such as galvanic, diadynamic, MF rectangular, pulsed rectangular and triangular currents. These currents can cause skin etching.

1.If possible, disinfect the parts of

the body where the adhesive electrodes are to be placed.

2. Place the electrodes on the part of the body that must be treated.

3. Connect the connectors of the adhesive electrodes to the adapter cables.

4. Connect the adapter cables to the two-ply electrode cable.

5.Connect the two-ply electrode

cable to connector A or B of the Combi 200.

4.3.2Perform electrotherapy with vaginal, anal or rectal stimulation probe

•Considering the very personal and intimate character of these treatments, a probe may only be used for one patient.

• Never disinfect the probes in an autoclave. The probes can be damaged by the extreme temperature.

1.Clean the probe carefully with

soap and water.

2. Select the desired electrotherapy program.

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Combi 200

3.Connect the probe to the Combi 200. The vaginal and anal probes are immediately detected by the equipment. To prevent unpleasant stimulations, you can only set alternating currents with a Constant Voltage (CV) setting, such as TENS, NMES, and 2-pole interferential currents.

The rectal stimulation probe is not detected by the equipment. With a rectal stimulation probe, select only alternating currents with a Constant Voltage (CV) setting, such as TENS, NMES, and 2-pole interferential currents. This prevents skin etching and unpleasant stimulations.

4.Apply an antiseptic lubricant to the probe.

5.Place the probe.

6.Rotate intensity knob A or B to start the treatment and to set the desired intensity.

7.Check the patient's reaction. Repeat this check regularly during the treatment.

8.The equipment stops the treatment and indicates that the treatment is completed. Remove the stimulation probe.

9.Clean the stimulation probe. See §5.2.4.

4.3.3Electrotherapy with sequential steps

A treatment with sequential steps consists of a succession of the same current form, but additional with different parameter settings. You can set the time between the steps.

Advantages

Electrotherapy with sequential steps has several advantages:

•In one electrotherapy, you can realise several objectives.

•In a treatment with one objective, you can place different accents in the objective.

•You can distinguish between different phases in a treatment, for example preparation, core effect and cooling.

Set new intensity between sequential steps

The intensity determines the peak value during the treatment. When changing to a following step, the intensity is retained if safety allows. Sometimes, it is necessary to increase the intensity for the following step. If the intensity cannot be maintained for safety reasons, the intensity returns to zero. In this case, the treatment is stopped. You must now set the intensity again.

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Combi 200

Setting a treatment with sequential steps

1.Select a treatment whereby you can set sequential steps, for example with Objectives,

Electrotherapy, Muscular training, Specific muscle functions, Endurance.

You can also select a program directly with the program number.

2.Set the Step time and

Stimulation beep parameters for the different steps.

Select Seq. step. nr. to select a different step.

3.Rotate intensity knob A or B to start the treatment and to set the desired intensity.

Skip step in treatment

1.Press to temporarily interrupt the treatment.

2.Select Seq. step nr. and select the desired step.

3.Rotate intensity knob A or B to continue the treatment again and to set the desired intensity.

4.3.4Performing iontophoresis

1.Apply the medicament on a sterile gauze. See §8.1. Care must be taken in administering medicaments (allergies, contra indications, ... ).

2.Place the gauze on the electrode. Make sure that the polarity corresponds with the medicament used.

3.Place the electrodes. See page 24: Placing rubber electrodes and page

25: Placing the adhesive electrodes.

4.Select Electrotherapy, Unidirectional, Medium freq. constant.

5.Set the intensity between 0.1 and 0.25 mÂ/cm2. The intensity

depends on the surface area of the electrodes. With electrodes of

6 x 8 cm (=48 cm2), the current setting must be between 4.8 and 12 mÂ.

To prevent etching or burns, never exceed 0.25 mÂ/cm2.

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