Hill-Rom Flexicair User manual

PROPRIETARY AND CONFIDENTIAL DRAFT 02/07/03
USER MANUAL
FLEXICAIR® Low Airloss Therapy Unit
From Hill-Rom
PROPRIETARY AND CONFIDENTIAL DRAFT 02/07/03
Symbol Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Patient Care Areas of Use . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Pressure Reduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Special Air Cushion Configuration. . . . . . . . . . . . . . . . 12
Automatic Pressure Adjustment . . . . . . . . . . . . . . . . . . 12
Patient Support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Comfort Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Therapeutic Controls—FLEXICAIR® II Low Airloss
Therapy Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Therapeutic Controls— FLEXICAIR MC3 ® Low Airloss
Therapy Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Bed Frame Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Automatic Contour. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Bottoming Signal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Central Brake and Steer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Foot End Caregiver Controls . . . . . . . . . . . . . . . . . . . . . . . . 23
Siderails . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Siderail Storage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Patient Restraint Brackets . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Drainage Bag System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Utility Shelf (FLEXICAIR MC3® Low Airloss Therapy
Unit only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
IV Pole . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Receptacles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
NITE•GARD™ Light (FLEXICAIR MC3® Low Airloss
Therapy Unit Only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
FLEXICAIR® II Low Airloss Therapy Unit Features . . . . 28
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FLEXICAIR MC3® Low Airloss Therapy Unit
Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Safety Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Unit Positioning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Siderails. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Brakes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Spills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Lockout Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Instructions for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Placing the Patient on the Unit . . . . . . . . . . . . . . . . . . . . . . . 35
Transferring the Patient from a Bed or
Stretcher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Transferring the Patient from a Wheelchair. . . . . . . . . . 36
Removing the Patient from the Unit . . . . . . . . . . . . . . . . . . . 37
Transfer r ing the Patient onto the Bed or Stretcher . . . . 37
Transferring the Patient to a Wheelchair . . . . . . . . . . . . 38
Positioning the Patient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Side Lying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Sitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Placing and Removing the Bedpan . . . . . . . . . . . . . . . . . . . . 39
CPR Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Performing CPR When the Patient is on a
FLEXICAIR® II Low Airloss Therapy Unit. . . . . . . . . 39
Performing CPR When the Patient is on a
FLEXICAIR MC3® Low Airloss Therapy Unit . . . . . . 40
Transport Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Transporting a Patient in Transport Mode. . . . . . . . . . . 41
Using CPR in Transport Mode (FLEXICAIR MC3®
Low Airloss Therapy Unit Only) . . . . . . . . . . . . . . . . . . 42
Cardiac Chair Position (FLEXICAIR MC3® Low Airloss
Therapy Unit Only). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Patient Scal e (FLEXICAIR MC3® Low Ai rloss Therapy
Unit Only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
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Using the Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Alarm Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Caregiver Assessment and Intervention . . . . . . . . . . . . . . . . . . . 47
Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Cardiac Arrest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Congestive Heart Failure (FLEXICAIR MC3® Low
Airloss Therapy Unit Only) . . . . . . . . . . . . . . . . . . . . . . . . . 47
Patients on Injectable Diuretics . . . . . . . . . . . . . . . . . . 47
Renal Failure and Dialysis . . . . . . . . . . . . . . . . . . . . . . 47
Multiple Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Patients Who “Travel” . . . . . . . . . . . . . . . . . . . . . . . . . 48
Contractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Flap Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Foot Drop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Grafts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Hyperthermia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Hypothermia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Incontinence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Neurology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Nutritional Def i cienci es (Total Parenteral Nutrition (TPN) or Tube Feedings) (FLEXICAIR MC3® Low Airloss Therapy
Unit Only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Orthopedics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Peripheral Vascular Disease and Leg Ulcers (FLEXICAIR MC3® Low Airloss Therapy Unit Only) . . . 50
Pressure Sores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Trendelenburg and Reverse Trendelenburg
Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Hypotension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Traction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Steam Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Cleaning Hard to Clean Spots . . . . . . . . . . . . . . . . . . . . . . . 52
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Disinfecting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Caregiver Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Hill-Rom Personnel Procedures . . . . . . . . . . . . . . . . . . . . . . 53
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Problem: Unit Does Not Turn On . . . . . . . . . . . . . . . . . . . . . 55
Problem: Bed Frame Controls Do Not Operate . . . . . . . . . . 56
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Symbol Definition

This manual contains different typefaces and icons des igned to improve readabili ty and i ncrease unde rsta nding of it s cont ent. No te the foll owing examples:
• Standard text—used for regular information.
Boldface text—emphasize s a word or phrase.
NOTE:—sets apart s p ecial in f o r mation or impo rt a n t in s tr u ction
clarification.
• The symbol below highlights a WARNING or CAUTION:

Warning and Caution

A WARNIN G identifies situations or actions that may affect
patient or user safety . Disregarding a warning could result in patient or user injury.
A CAUTION points out s pecial procedures or precautions that
personnel must follow to avoid equipment damage.
• The symbol below highlights a CAUGHT HAZARD WARNING:

Caught Hazard Warning

• The symbol below highlights a CHEMICAL HAZARD WA RNING:

Chemical Hazard Warning

• The symbol below highlights an ELECTRICAL SHOCK HAZARD WAR NING:

Electrical Shock Hazard Warning

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PROPRIETARY AND CONFIDENTIAL DRAFT 02/07/03

Intended Use

The management of patients who are particularly vulnerabl e to sk in breakdown, with al l its implications for the recovery process, is complex. The starting point is determining the treatment objectives, assessing the risk, and choosing the prope r support. An inappropriat e choice can re sult in complic ations tha t impede recove ry and inc reas e the length of hospit alization. Difficulties arise because differing clinical conditions and treatment objectives dictate different needs and, in progressing through the recovery process, a patient can require severa l different types of support.
The FLEXICAIR® II Low Airloss Therapy Unit is a wound management system to meet specific pre vention, rehabilitation, and related patient-ma nagement obj ectives for the intermediate-risk patient.
The FLEXICAIR MC3® Low Airloss Therapy Unit is a wound management syst em to help wit h pres sure sore preve ntion an d tre atment when ambulation is a priority or respirati on is compromised.
Based upon the princi ple of low airloss technol ogy, both units offer beneficial features as well as the cl inical consultation and service of Hill-Rom.
The features, appl ications, and instructions for use of the uni ts are described in this user manual. However, this user manual is intended only as a guideline. Remember that your Hill-Rom Clinical Sales Consultant is available around the clock to help assess each of your patients for risk and, on the basis of medical status and treatment objectives, assist you in se lecting the treatm ent modality to achieve maximum patient benefit in the most cost-effect ive way . It is this commitment to serve both the patient and caregiver through products and a level of expe rtise tha t earne d Hill-Ro m its reputat ion as a re source in chronic wound management.
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Introduction

The prevention of pres s ure sore development a nd wound deterioration requires a support that minim ize s the effec ts of the mechanical forces of pressure, shea r, fricti on, and moisture upon fragile tissue.
Low airloss ther apy is achieved by controlling the low-pressure distribut ion and the escape of air through infla table cushions used to support the pat ient. As a result, each patient is supported, according to the individua l nee d, at reduced pressures. The pote ntial for shear and frictio n is reduced, pressure on bony promine nces is mini mized, and the skin is kept comfortably dry.
The FLEXICAIR® II Low Airloss Therapy Unit and the FLEXICAIR MC3® Low Airloss Therapy Unit maxim ize the benefits and safety of low airloss ther apy technology for the pati ent and reduce caregiver involvement in technical, maintenance, and non-nursing activities.
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Features

The FLEXICAIR® II Low Airloss Therapy Unit and the FLEXICAIR MC3® Low Airloss Therapy Unit r educ e pressure and decrease the potential for friction, shear, and macerati on. In addition, their nursing management feat ures and resemblance to a standard hospital bed make the units an efficient and effective preventive and rehabilitative support in the treatme n t of ti s s u e br eakdow n . S el ect patients wi th ex isting pressure sores and/or surgical wounds on the basis of clinical status, treatment objectives, an d priorities.
As a general guideline, use the FLEXICAIR® II Low Airloss Therap y Unit for the following:
• Patients at moderate-to-high risk for the development of pressure sores.
• Patients with existing early-stage pressure sores.
• Patients with advanced-stage or full-thickness pressure sores whose clinical sta tus and treatment objectives require continuous high head elevation, frequent transfer, or frequent ambulation.
As a general guidel ine, use the FLEXICAIR MC3® Low Airloss Therapy Unit for the following:
• Patients who, due to c linical status, may develop pressure sores.
• Patients with existing early stage (Stage I and II) pressure sores.
• Patients with non-infected (Stage III or IV) wounds, when treatment objective s that require frequent am bulation and transfe r take priority.
• Patients whose respiratory status requires continuous high head elevation.
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FLEXICAIR® Low Airloss Therapy Units

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Patient Care Areas o f U se

Conditions that increase the risk of pressure sore development or deterioration are seen in all areas of medicine. However, it is important to recognize the co mmon fac tors that predispose a pat ient to pressure sores, and in which clinical settings they are most likely to occur.
Patient with one or more of the following conditions are at signific ant risk:
• Immobility
• Incontinence
• Poor nutrition
• Diminished level of consciousness
• Reduced subcutaneous tissue
• Dehydration
• Diminished circulation
• Multisystem fail ure
• Use of steroids or seda tives
These conditions are most prevalent in the following clinical settings:
• Gerontology
• Critical care
• Rehabilitation
• Orthopedics
• Neurosurgery
• Oncology
•Burn care
• Dialysis
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Pressure Reduction

A set of cushions inflated to specific air pressures forms the foundation of low airloss therapy. The unit provides support that matches the needs of the individual patient, distributes the body load uniformly over a maximum area, and minimizes pressure concentrations at the bony prominences.
Special Air Cushion Configuration
The segmented desi gn and arrangement of the air cushions compartmentalize support, providing greater flexibility and even displacem ent of the p atien t’ s weight. Cons equent ly, a patient lying in th e supine position is supported below ca pillary closing pressures.
Automatic Pressure Adjustment
For low ai rloss ther apy to b e ef fe ct ive, airf low in to th e cu shions m ust be adjusted when the patient changes head elevation. The units provide automatic pre ssure adjustment at four leve ls of patient elevati on, significantly reducing the potential for human error and eliminating a time-consuming nursing responsibility. The patient can freely change head elevation without compromising pressure relief.

Patient Support

The suspension s ystem of the unit consists of 18 inflatable cus hions divided into five zones corresponding to m ajor body surface areas. When the system is activated, co mpresse d air fills the cushion s. To achieve the lowest skin contact pre ssures and provide optimal patient comfort, airflow is distributed through each zone. The resulting system provides sacral, scapular, and troch anteric support at les s than capillary­closing pressure s and correspondingly low contact pressures acros s all body surfaces.

Comfort Controls

The unit has two sets of controls:
• The controls that manage the therapeutic functions are located at the unit’s footboard and at the center of the frame on each s ide.
• The controls that operate the bed frame are located in the siderails and at the foot end of the unit.
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Therapeutic Controls—FLE XICAIR® II Low Airloss Therapy Unit
FLEXICAIR® II Low Airloss Therapy Unit Control Panel
On/Off S w it ch
To turn the unit on or off, press the On/Off switch in the right-hand corner of the control panel at the foot end of the unit. When the unit is on, the indi cator light on the switch illuminates.
Patient Comfort Adjustment Control
To achieve optimal pressures at four dif ferent head elevation, trained Hill-Rom personn el program t he unit on a patie nt-by-pa tie nt basis at the time of delivery. However, since patient comfort is subjective, the unit permits finer pressure adjustments without compromising its preset effectiveness.
T o adjust the air cushions for comfort, locate the Patient Comfort Adjustment controls on the control panel. The five body zones displayed have independent control knobs to adjust the cushion pressures within ea ch zo ne .
Turning the control knobs counterclockwise deflates the air cushions; turning the control knobs clockwise inflates the air cushions.
NOTE:
After a control is set, a slight delay occurs before the pressures within the cushions adjust. Adjust the cus hion pressure s in gradual increments, and allow the patient approximately 30 s econds between adjustments to experi ence each ch an g e.
The pressure sensor indicators illuminate green to indicat e norm al function. A red light in any zone indicates that the patient is touching the bottom of the surface ( see “Bottoming Signal” on page 22).
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Elevation Indicator
The Elevation indicator shows the degree of elevation. With each change in elevation, the unit registers the patient’s position and automatic ally adjusts the cushion pressure to compensate.
T em p erature Operating Range Indicators
The Temperature Operating Range indicators are locat ed ab o ve th e Elevation indicator:
•A green indicator indicates that the unit is opera t ing at the Normal range for patient comfort.
•A red indicator indicates a High temperature condition. If a High temperature condition occurs, notify Hill-Rom Technic al Support.
NOTE:
When the operating tem perature exceeds a saf e range, the unit shuts down. When the temperature returns to a normal range, the uni t automatically resumes operation. If the unit shuts down, remove the patient from the unit, and notify Hill-Rom Technical Support. To enable easy trans f er, the bed frame controls continue to operate.
Cushion Controls
The following four Cushion Contr ols switches are l o cated at th e control panel:
Seat Deflate Switch—The unit
accommodates ambulatory patients and facilitates wheelcha ir transfer. When Seat Deflate Mode is activated, the seat section deflat es to enable the patient to transfer from the unit in a seated position.
To activate Seat Defl ate Mode, press the Seat De f l at e Swit c h. When Seat Deflate Mode is activated, the Seat Deflate indicator illuminates. To deac ti v at e S ea t D ef l at e Mode, p re ss the Seat Deflate Switch to the Off position to autom atically inflate the cushions to their programmed levels.
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Maximum Inflation Switch—To facili ta te the tra nsfer of pat ients in
the supine position, Maxim um Inflation Mode inflates all se ctions of the unit to their maximum capacity. This provi des a firm surface from which patients ca n more easily be moved.
To transfer a patient onto or off of the unit, press the Maximum Inflation switch to activate Maximum Inflation Mode. When Maximum Inflation Mode is activated, the red M a ximum In flation indicator illuminates, and an al arm sounds briefly. After Maximum Inflation Mode is ac tive for 10 minutes, an alarm sounds for 10 minutes to remind the caregiver to deactivate Maximum Inflation Mode.
To deactivate Maximum Inflation Mode, press the Maximum Inflation switch to the Off position to automatically deflate the cushions to their programmed levels.
• Sid e Lying S w itch— The Side Lying swit ch enables further
protection of pa tients during prolonged periods of side lying of 15 minutes or longer. To provide added support to the trochanter area, the Side Lying switch distributes the cushion pressures appropriate ly. If the Sid e Lying switch is ac ti vated, its la m p illuminates.
When the patient returns to a supine position, press the Side Lying switch to t h e Off position to automatically rever t the pres sures in the air cushions to their programmed values.
CPR Switch—To defl ate t he cushi ons for p erfor ming CPR, pres s the red CPR switch. Wh en the CPR switch is activated, all air cushio ns deflat e rapidly, leav ing the patient on a f i rm surface. A cardiac board is not needed.
T o inflate the cushions, press the CPR sw it ch to th e Off position to automatically return the air cushion pressures to their programmed levels.
Bed Up/Down Switch
Press the Bed Up/Down switch to ra ise or low e r th e bed frame to the desired pos ition.
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Therapeutic Controls—FLEXICAIR MC3® Low Airloss Therapy Unit
FLEXICAIR MC3® Control Panel
On/Off Button
T o t urn the uni t o n or of f, press t he On/Off but ton in the bottom center of the control panel at the foot end of the unit. When the unit is on, the indicator light on the button illum inates.
Power Indicator
Two Power indicator lights in the center of the control panel indicate whether AC or Battery power is running the unit:
•The green indicator indicates that the unit is
plugged into an appropriate power source and is operati ng in its normal mode on AC powe r.
•The red indica tor indicates that the bed is in Trans port Mode and is operati ng on Battery power. Once transport is complete, plug th e unit into an appropriate power source for optimal bat tery charging.
Weight Monitor Indicator
The Weight Monitor indi ca to r il lu mi n ates when the buil t-i n sc al e al ar ms. The ind ic ator flash es when an alar m condition exists for weight los s or gain or bed exit.
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Patient Comfort Adjustment Controls
To achieve optimal pr es s ures at four different hea d ele vations, trained Hill-Rom personn el program t he unit on a patie nt-by-pa tie nt basis at the time of delivery. However, since patient comfort is subjective, the unit permits finer pressure adjustments without compromising its preset effectiveness.
To adjus t th e ai r cushions for comfort, locat e the Patient
Comfort Adjustment
controls on the control panel. The five body zones displa yed have independent buttons to adjust the cush i o n pressures within each zone.
Pressing the bottom arrow of the button deflates the air cushions slightly; pressing the top arrow of th e button infla tes the cushions . Each time the button is pr essed, the light-emi tting diode (LED) increas es or decreases one pos ition to indica te that the zone pressur e is raised or lowered.
NOTE:
After a control is set, a slight delay occurs before the pressures within the cushions adjust. Adjust the cus hion pressure s in gradual increments, and allow the patient approximately 60 s econds between adjustments to experi ence each ch an g e.
Elevation Indicators
The Elevation indicator s indicate that the unit functions properly. The indicator shows the degree of elevation—0°, 30°, 45°, or 60°. With each change in elevation, the unit registers the patient’s position and automatically adjusts the cushion pressures to compensate.
NOTE:
The Elevation indica tors indicate the angle of elevation from the frame of the unit, not the cush i on he ig h t . Th e patient’s actual elevation may differ slightly from the angle indicate d.
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