Mindray accutorr plus Operating Instructions
Accutorr
®
Operating Instructions
0070-01-0428-02_revC.indd 1 4/8/10 11:51:13 AM
Accutorr
Datasc ope
®
Accutorr
®
Operating Instructions
Accutorr Plus™ is a U.S. trademark of Mindray DS USA, Inc.
f
Masimo SET
Nellcor
Oxisensor
Velcro
®
and LNOP® are registered trademarks of Masimo Corporation.
®
, Oxiband®, and Durasensor® are U.S. registered trademarks of Nellcor Puritan Bennett Inc.
™
is a trademark of Nellcor Puritan Bennett Inc.
®
is a registered trademark of Velcro Industries B.V.
©
Copyright
Mindray DS USA, Inc., 2008. All rights reserved. Contents of this publication may not be reproduced in any
orm without permission of Mindray DS USA, Inc.
0070-10-0692-02 Accutorr Plus™ Operating Instructions
Table of Contents
Foreword....................................................................................................................................................... v
Warnings, Precautions and Notes..................................................................................................................... vi
Warnings ......................................................................................................................................................vi
Cautions ........................................................................................................................................................ viii
Safety Designations.........................................................................................................................................xi
Product Limitations ..........................................................................................................................................xii
Unpacking .....................................................................................................................................................xii
Symbols and Descriptions ................................................................................................................................xiii
General Description .......................................................................................................... 1 - 1
General Description ........................................................................................................................................ 1 - 1
Controls and Indicators ..................................................................................................... 2 - 1
Front Panel..................................................................................................................................................... 2 - 3
Rear Panel ..................................................................................................................................................... 2 - 9
Predictive Thermometer Module (PTM) ............................................................................................................... 2 - 10
Recorder Module ............................................................................................................................................ 2 - 11
Operation......................................................................................................................... 3 - 1
Setting-up / Turning Power On ......................................................................................................................... 3 - 1
Patient Setup and Room/Bed Assignment........................................................................................................... 3 - 3
Selecting the Patient Size.......................................................................................................................... 3 - 3
Cuff Inflation Pressure............................................................................................................................... 3 - 3
Room Number and Bed Letter ................................................................................................................... 3 - 4
Manual NIBP Measurements and General NIBP Measurement Information............................................................. 3 -5
NIBP Pressure Limit Fail Safe ..................................................................................................................... 3 - 7
Cuff Inflation Time.................................................................................................................................... 3 - 7
Automatic Adjustment of Cuff Inflation Pressure (Adaptive Inflation)................................................................ 3 - 7
Automatic NIBP Measurements (Interval Mode)................................................................................................... 3 - 8
Canceling an Automatic NIBP Measurement ............................................................................................... 3 - 8
Changing the Interval Setting .................................................................................................................... 3 - 9
Effects of Changing the Room Number and/or Bed Letter on the Interval Setting.............................................. 3 - 9
START and DEFLATE Functions .................................................................................................................. 3 - 9
Alarms........................................................................................................................................................... 3 - 10
Setting Alarm Limits.................................................................................................................................. 3 - 10
Alarm Violations...................................................................................................................................... 3 - 12
How to Mute Alarms ................................................................................................................................ 3 - 12
Alarms and Changing the Room Number and/or Bed Letter ......................................................................... 3 -12
To View and Delete Stored Data (Trend Mode)................................................................................................... 3 - 14
To View the Stored Measurements on the Accutorr Plus, basic model ............................................................. 3 -14
To View the Stored Measurements on the Accutorr Plus, advanced models...................................................... 3 - 14
To Delete the Stored Measurements on the Accutorr Plus............................................................................... 3 - 15
Setting the Alarm Volume and Beep Volume....................................................................................................... 3 - 16
Setting the LCD Contrast (View Angle Adjustment)............................................................................................... 3 - 17
Display Time Out Mode................................................................................................................................... 3 - 17
Measurements (Accutorr Plus advanced models) ........................................................................................ 3 - 18
SpO
2
Pulse Oximetry Sensors ............................................................................................................................ 3 - 18
Sequence for establishing SpO
Sequence for Establishing SpO
Temperature Measurement (Optional)................................................................................................................ 3 - 25
Predictive Thermometer Measurements ....................................................................................................... 3 - 25
How to Apply the Probe Cover (PTM)......................................................................................................... 3 - 25
How to take Oral, Rectal, and Axillary Temperatures ................................................................................... 3 - 26
Storing Temperature Measurements ........................................................................................................... 3 - 28
Recorder (Optional) ........................................................................................................................................ 3 - 29
with Nellcor® Pulse Oximetry...................................................................... 3 - 20
2
with Masimo® Pulse Oximetry..................................................................... 3 - 21
2
Accutorr Plus™ Operating Instructions 0070-10-0692-02 i
Table of Contents
How To Set The Clock (Date and Time).............................................................................................................. 3 - 30
Battery Operation ........................................................................................................................................... 3 - 32
User Configuration.......................................................................................................................................... 3 - 33
Status and Error Codes.................................................................................................................................... 3 - 36
How to Attach Optional Thermometer and Recorder Modules............................................................................... 3 - 38
To Attach the Recorder Module: ................................................................................................................ 3 - 38
To Attach the Thermometer Module:........................................................................................................... 3 - 38
Placement Of The Quick Reference Card ........................................................................................................... 3 - 39
Placement of Recorder Paper Loading Label ....................................................................................................... 3 - 40
User Maintenance............................................................................................................. 4 - 1
Introduction.................................................................................................................................................... 4 - 1
Care and Cleaning Of Monitor ........................................................................................................................ 4 - 1
Decontamination of the Accutorr Plus ......................................................................................................... 4 - 1
Sterilization and Cleaning of Reusable Cuffs ...................................................................................................... 4 - 2
Cleaning Cuffs with Bladders .................................................................................................................... 4 - 2
Cleaning Bladderless Cuffs ....................................................................................................................... 4 - 2
Battery Maintenance and Replacement .............................................................................................................. 4 - 4
Battery Maintenance ................................................................................................................................ 4 - 4
Battery Replacement ................................................................................................................................ 4 - 5
Recorder Paper Replacement............................................................................................................................ 4 - 6
To Install Paper........................................................................................................................................ 4 - 6
Thermal Paper Durability ................................................................................................................................. 4 - 7
Accutorr Plus Versions and Accessories ............................................................................. 5 - 1
Accutorr Plus Versions ..................................................................................................................................... 5 - 1
Accutorr Plus with Lithium Ion Battery ......................................................................................................... 5 - 1
®
Accutorr Plus with Nellcor
Accutorr Plus with Masimo SET
Pulse Oximetry and Lithium Ion Battery................................................................ 5 - 1
®
Pulse Oximetry and Lithium Ion Battery......................................................... 5 - 2
Accessories.................................................................................................................................................... 5 - 3
Hoses, Non Invasive Blood Pressure........................................................................................................... 5 - 3
Cuffs, Non Invasive Blood Pressure, Latex Free............................................................................................ 5 - 3
Oximetry Sensors and Accessories............................................................................................................. 5 - 5
Recorder Module..................................................................................................................................... 5 - 6
Temperature Modules/Probes ................................................................................................................... 5 - 7
Manuals ................................................................................................................................................. 5 - 8
Nurse Call Connector .............................................................................................................................. 5 - 8
Mounting Assemblies ............................................................................................................................... 5 - 8
Recorder Paper ....................................................................................................................................... 5 - 8
Battery ................................................................................................................................................... 5 - 9
Appendix ......................................................................................................................... 6 - 1
Phone Numbers and How To Get Assistance...................................................................................................... 6 - 1
Specifications................................................................................................................................................. 6 - 2
Systolic Pressure Readout.......................................................................................................................... 6 - 2
Diastolic Pressure Readout ........................................................................................................................ 6 - 2
NIBP Measurement Cycle Time.................................................................................................................. 6 - 2
Pulse Rate............................................................................................................................................... 6 - 2
Maximum Cuff Pressure ............................................................................................................................ 6 - 2
Temperature (Predictive) ........................................................................................................................... 6 - 3
- Nellcor® Performance Specifications............................................................................................... 6 - 3
SpO
2
– Masimo® Performance Specifications ............................................................................................. 6 - 4
SpO
2
Battery ................................................................................................................................................... 6 - 6
Real Time Clock ...................................................................................................................................... 6 - 6
Physical Characteristics ............................................................................................................................ 6 - 7
ii 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Table of Contents
Environmental Characteristics.................................................................................................................... 6 - 7
Electrical Ratings ..................................................................................................................................... 6 - 8
Safety Characteristics............................................................................................................................... 6 - 8
Agency Compliance ................................................................................................................................ 6 - 9
Electromagnetic Compatibility .......................................................................................................................... 6 - 10
Indirect Blood Pressure Measurements and Associated Errors ............................................................................... 6 - 14
Precautions With Using Automatically Cycled Blood Pressure Cuffs ....................................................................... 6 - 14
Cuff Size ................................................................................................................................................ 6 - 14
Other Factors .......................................................................................................................................... 6 - 14
User Verification Of The Accutorr Plus NIBP Measurements .................................................................................. 6 - 15
Warranty....................................................................................................................................................... 6 - 16
Manufacturer’s Responsibility ........................................................................................................................... 6 - 16
Accutorr Plus™ Operating Instructions 0070-10-0692-02 iii
Table of Contents
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iv 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Foreword Introduction
Foreword
This operating instructions is intended to provide information for the proper operation of the
Accutorr Plus.
This manual describes three models—one basic and two advanced—of the Accutorr Plus:
1. Accutorr Plus with Lithium Ion Battery—the Accutorr Plus basic model, which
measures non-invasive blood pressure (NIBP) and Pulse Rate
2. Accutorr Plus with Nellcor® Pulse Oximetry and Lithium Ion Battery—the
Accutorr Plus advanced model, which includes basic model features, and adds Liquid
Crystal Display (LCD), Trend Screen, and SpO
3. Accutorr Plus with Masimo SET® Pulse Oximetry and Lithium Ion
Battery—the Accutorr Plus advanced model, which includes basic model features, and
adds Liquid Crystal Display (LCD), Trend Screen, and SpO2 (Masimo)
In this manual, when a described feature refers to a particular model, it will be noted. When
the name Accutorr Plus is used, it refers to all three models.
General knowledge of monitoring and an understanding of the features and functions of the
Accutorr Plus are prerequisites for its proper use.
(Nellcor)
2
DO NOT OPERATE THIS UNIT BEFORE READING ALL INSTRUCTIONS.
Information for servicing this instrument is contained in the Accutorr Plus Service Manuals:
Part Numbers 0070-00-0691 (0998-00-0444-9XX). For additional information or
assistance, please contact an authorized representative in your area.
U.S. Federal Law restricts this device to sale by or on the order of a physician or other
practitioner licensed by state law to use or order the use of this device.
NOTE: In order to ensure proper performance and safety, and to
prevent the voiding of the warranty, only approved parts
and accessories are to be used with the Accutorr Plus.
NOTE: Potential hazards due to errors in software or hardware
have been minimized by actions taken in accordance with
IEC 60601-1-4.
Mindray DS USA, Inc. maintains a policy of continual product improvement and reserves the
right to change materials and specifications without notice.
Masimo Patents: This device (MASIMO SpO
Module) is covered under one or more of the
2
following U.S.A. patents: 5,758,644; 5,823,950; 6,011,986; 6,157,850; 6,263,222;
6,501,975; and other applicable patents listed at: www.masimo.com/patents.htm.
Possession or purchase of this device does not convey any expressed or implied license to
use this device with replacement parts that would, alone or in combination with this device,
fall within the scope of one or more of the patents relating to this device.
Accutorr Plus™ Operating Instructions 0070-10-0692-02 v
Introduction Warnings, Precautions and Notes
Nellcor Patents: This device (Nellcor SpO2 Module) is covered under one or more of the
following U.S.A. patents: 4,802,486; 4,869,254; 4,928,692; 4,934,372; 4,960,126;
5,078,136; 5,485,847; 5,743,263; 5,865,736; 6,035,223; 6,298,252; 6,463,310;
6,591,123; 6,675,031; 6,708,049; 6,801,797; Re.35,122; and non-U.S.A. equivalents.
Possession or purchase of this device does not convey any expressed or implied license to
use this device with replacement parts that would, alone or in combination with this device,
fall within the scope of one or more of the patents relating to this device.
Warnings, Precautions and Notes
Please read and adhere to all of the warnings and precautions listed throughout this manual.
A WARN ING is provided to alert the user to potentially serious outcomes (death, injury or
serious adverse events) to the patient or the user.
A CAUTION is provided to alert the user that special care should be taken for the safe and
effective use of the device. They will include actions to be taken to avoid effects on patients
or users that will not be potentially life threatening or result in serious injury, but about which
the user should be aware.
A NOTE is provided when additional general information is available.
Mindray DS USA, Inc. maintains a policy of continual product improvement and reserves the
right to change materials and specifications without notice.
Warnings
WARNING: Internal Electrical Shock Hazard - This unit does not contain
any user-serviceable parts. Do not remove instrument
covers. Refer servicing to qualified personnel.
When the integrity of the protective earth conductor, in the
installation or its arrangement, is in doubt, the equipment
should be operated from its internal battery.
Observe all CAUTION and WARNING labels on the unit.
WARNING: Possible explosion hazard. Do not operate machine near
WARNING: Communications Connector - Connection of non-isolated
WARNING: Always place the unit on a flat, rigid surface or onto a
flammable anesthetic agents or other flammable
substances. Do not use flammable anesthetic agents (i.e.,
ether or cyclopropane.)
devices to the Communications Connector on this unit may
cause chassis leakage to exceed the specification standards.
stable mounting pole.
WARNING: Never place fluids on top of this unit. In case of accidental
wetting, remove power, dry it immediately and have the
unit serviced to insure no hazard exists.
WARNING: If fluid spills on the unit or if the unit is damaged, refer to
vi 0070-10-0692-02 Accutorr Plus™ Operating Instructions
qualified service personnel.
War nin gs Introduction
WARNING: Observe extreme caution when a defibrillator is in use. Do
WARNING: Do not leave the patient unattended for long periods of time
WARNING: Use only approved accessories with this product. Use of
WARNING: This instrument may have trouble obtaining pulse rate and
WARNING: Wrapping the cuffs too tightly may cause a hazard to the
WARNING: Only connect cuffs with approved quick connect type
WARNING: The Accutorr Plus is not intended for use in a magnetic
WARNING: Do not incinerate battery, possible explosion may occur.
WARNING: Route cables neatly. Ensure cables, hoses and wires are
not touch any part of the patient, table or monitor when a
defibrillator is in use.
while using this instrument.
other accessories may result in erroneous readings.
NIBP readings on patients undergoing intra-aortic balloon
pump treatment.
patient.
connectors.
resonance imaging (MRI) environment and may interfere
with MRI procedures.
kept away from patient’s neck to avoid strangulation. Keep
floors and walkways free of cables to reduce risk to
hospital personnel, patients and visitors.
WARNING: Do not use a damaged or broken unit or accessory.
WARNING: Do not clean the monitor while it is on and/or plugged in.
WARNING: Operation of the Accutorr Plus below the minimum
amplitude or value of PATIENT physiological signal may
cause inaccurate results.
WARNING: Use of ACCESSORIES, transducers and cables other than
those specified in the manual may result in increased
Electromagnetic Emissions or decreased Electromagnetic
Immunity of the Accutorr Plus. It can also cause delayed
recovery after the discharge of a cardiac defibrillator.
WARNING: The Accutorr Plus should not be used adjacent to or stacked
with other equipment. If adjacent or stacked use is
necessary, the Accutorr Plus should be observed to verify
normal operation in the configuration in which it will be
used.
WARNING: Perform the decontamination or cleaning process with the
unit powered down and power cord removed.
WARNING: When attached to other products ensure that the total
chassis leakage currents of all units (combined) do not
exceed 300µa.
WARNING: Use only authorized accessories. Use of unauthorized
accessories may result in erroneous measurements.
WARNING: It is essential that a single use disposable probe cover is
Accutorr Plus™ Operating Instructions 0070-10-0692-02 vii
used when taking temperature measurements.
Introduction Cautions
WAR NIN G: P erf orm this proc ess with the unit powered down and
power cord removed.
Cautions
CAUTION: The unit should be checked periodically for obstructed vents.
If an obstruction is found refer to qualified service
personnel.
CAUTION: Operation of the Accutorr Plus below the minimum
CAUTION: Use of accessories, transducers and cables other than those
CAUTION: This battery type may be subject to local regulations
CAUTION: It is the user’s responsibility, when changing the room/bed,
CAUTION: Do not place the sensor on an extremity with an invasive
amplitude or value of patient physiological signal may
cause inaccurate results.
specified in the manual may result in increased
Electromagnetic Emissions or decreased Electromagnetic
Immunity of the Accutorr Plus. It can also cause delayed
recovery after the discharge of a cardiac defibrillator.
regarding disposal. At the end of the battery life dispose of
the batteries in accordance with local regulations.
to assure the patient size and alarm settings are set as
required.
catheter or blood pressure cuff in place.
CAUTION: A pulse oximeter should not be used as an apnea monitor.
CAUTION: A pulse oximeter should be considered an early warning
device. As a trend towards patient deoxygenation is
indicated, blood samples should be analyzed by a
laboratory co-oximeter to completely understand the
patient’s condition.
CAUTION: Ensure proper routing of the patient cable to avoid
entanglement and/or strangulation.
®
CAUTION: When equipped with Nellcor
oxygen transducers including Nellcor
dedicated adhesive sensors. Use of other oxygen
transducers may cause improper oximeter performance.
CAUTION: Tissue damage or inaccurate measurements may be caused
by incorrect sensor application or use, such as wrapping it
too tightly, applying supplemental tape, failing to inspect
the sensor site periodically, or failing to position it
appropriately. Carefully read the sensor directions for use,
the Accutorr Plus operating instructions, and all
precautionary information before use.
CAUTION: Excessive ambient light may cause inaccurate
measurements. Cover the sensor with opaque materials.
SpO2, use only Nellcor®
®
Oxisensor® patient
viii 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Cautions Introduction
CAUTION: Inaccurate reading may be caused by incorrect sensor
application or use; significant levels of dysfunctional
hemoglobins, (i.e. carbohemoglobins or methemoglobin); or
intra-vascular dyes such as indocyanine green methylene
blue; exposure to excessive illumination, such as surgical
lamps (especially ones with a Xenon light source), bilirubin
lamps, fluorescent lights, infrared heating lamps, or direct
sunlight; excessive patient movement; venous pulsations;
electro-surgical interference; and placement of a sensor on
an extremity that has a blood pressure cuff, arterial
catheter, or intra-vascular line.
CAUTION: In certain situations in which perfusion and signal strength
are low, such as in patients with thick or pigmented skin,
inaccurately low SpO
readings will result. Verification of
2
oxygenation should be made, especially in preterm infants
and patients with chronic lung disease, before instituting
any therapy or intervention.
CAUTION: If the sensor or patient cable is damaged in any way,
discontinue use immediately. To prevent damage do not
soak or immerse the sensor in any liquid solution. DO NOT
ATTEMPT TO STERILIZE.
®
CAUTION: When equipped with MASIMO
oxygen transducers including MASIMO LNOP
SpO2, use only MASIMO®
®
patient
dedicated adhesive sensors and MASIMO PC Series Patient
Cable. Use of other oxygen transducers may cause
improper Oximetry performance.
CAUTION: Many patients suffer from poor peripheral perfusion due to
hypothermia, hypovolemia, severe vasoconstriction,
reduced cardiac output, etc. These symptoms may cause a
loss in vital sign readings.
CAUTION: The SpO2 sensor site should be checked at least every eight
(8) hours (every two (2) hours with the Adult re-usable
finger sensor). Ensure proper adhesion, skin integrity, and
proper alignment. Exercise extreme caution with poorly
perfused patients. Skin erosion and pressure necrosis can
be caused when sensors are not frequently monitored.
Assess the site every two (2) hours with poorly perfused
patients and neonates.
CAUTION: If the sensor or patient cable is damaged in any way,
discontinue use immediately. To prevent damage do not
soak or immerse the sensor in any liquid solution. Do not
attempt to sterilize.
CAUTION: Use only authorized probe covers. Use of any other probe
cover may result in erroneous readings or damage to the
probe.
CAUTION: Changing any part of the time or date will cause all stored
patient information (trend data) to be permanently erased.
Viewing the time or date does NOT cause data to be erased.
CAUTION: To avoid loss of patient data (trend), do not replace the
battery unless the Accutorr Plus is connected to an AC
receptacle. Hospital defaults and the time are unaffected by
battery replacement.
Accutorr Plus™ Operating Instructions 0070-10-0692-02 ix
Introduction Cautions
CAUTION: It is the users responsibility, when changing the room/bed,
CAUTION: Do not get the detergent into any vent openings.
CAUTION: Some disinfectants may cause skin irritation. Please rinse
CAUTION: Using dark colored soaks may stain the cuffs. Test a single
CAUTION: When ironing or pressing the cuffs, be aware that the
CAUTION: Cuffs with bladders contain natural rubber latex which may
CAUTION: When cleaning sensors do not use excessive amounts of
CAUTION: Li-Ion batteries are intended for replacement by qualified
CAUTION: Batteries used in this device may present a risk of fire or
to assure the patient size and alarm settings are as
required.
cuff thoroughly with water to remove any residual
disinfectants.
cuff to ensure that no damage will occur.
Velcro® fasteners can melt at temperatures above 325°F
(162°C).
cause allergic reactions.
liquid. Wipe the sensor surface with a soft cloth, dampened
with the cleaning solution.
service personnel only.
chemical burn if mistreated. Do not disassemble, heat above
100°C (212°F), or incinerate. Replace Lithium Ion battery
with P/N: 0146-00-0069 only. Use of another battery may
present a risk of fire or explosion.
CAUTION: Dispose of used battery promptly in accordance with local
laws. Keep away from children. Do not disassemble and do
not dispose of in fire.
CAUTION: Recharge the Lithium ion battery while in the unit at room
CAUTION: Remove the battery if the Accutorr Plus is not likely to be
CAUTION: The Communications Connector on the Accutorr Plus is only
CAUTION: Removing the battery from the Accutorr Plus while the AC
temperature. If the Accutorr Plus is being used in a hot
environment, the Lithium Ion battery may not charge when
the unit is connected to AC. This safety feature is important
because charging a hot battery shortens the battery’s life
span.
used for an extended period of time.
for use with IEC 60601-1 compliant equipment.
line cord is disconnected may cause the alarm settings to be
reset to their defaults.
x 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Safety Designations Introduction
Safety Designations
Safety designations per IEC 60601-1 Standard:
Type of protection against electric shock Class 1 with internal electric power source.
Where the integrity of the external protective
earth (ground) in the installation or its
conductors is in doubt, the equipment shall be
operated from its internal electric power
source.
Degree of protection against electric shock Monitor - Type B applied part.
NIBP - Type BF defibrillation protected
applied part.
SpO2 - Type BF protected applied part.
Supply Connection 100-120 VAC / 220-240 VAC
50-60 Hz; 0.85 / 0.5 A
11.1 VDC Lithium Ion Internal Battery
Mode of Operation Continuous
Protection Against Hazard of Explosion Not Protected (Ordinary)
Protection Against Ingress of Liquids Meets the requirements specified by IEC
60601-1, clause 44.3 and IEC 60601-2-30:
Non Protected Equipment (IPX1) as specified
in EN 60529.
Degree of Electrical Connection Between
Equipment and Patient
Degree of Mobility Mobile and/or hand held
Equipment designed for direct electrical and
non-electrical connection to the patient.
Accutorr Plus™ Operating Instructions 0070-10-0692-02 xi
Introduction Product Limitations
Product Limitations
Non-invasive blood pressure (NIBP) accuracy depends on the application of the proper cuff
size. See Section 3.0 for detailed information.
The Accutorr Plus will not operate effectively on patients who are experiencing convulsions or
tremors.
The Accutorr Plus is a portable device intended for intra-hospital use.
If the pressure cuff is not placed at the patient’s heart level, the NIBP measurement may be
subject to error, due to the hydrostatic effect.
The pulse rate data displayed on the Accutorr Plus is computed from the measurement of
peripheral pulses (peripheral pulses taken only during a measurement cycle). The rate
measured by the Accutorr Plus may differ from the rate of an ECG monitor. This is because
the ECG is an electrical signal that may not always result in a peripheral pulse.
Administration of certain vasoconstrictive drugs (for example, norepinephrine), may reduce
peripheral perfusion to a level that prevents the Accutorr Plus from taking pulse rate
measurements.
Arterial compression, tricuspid regurgitation, or other conditions may reduce perfusion to a
level that prevents the Accutorr Plus from taking pulse rate measurements.
The presence of arrhythmias may increase the time required to complete a measurement and
may extend this time to a point where a measurement cannot be completed.
The Accutorr Plus is not intended for use during CPR. The monitor uses an oscillometric
technique based on normal peripheral circulation to compute blood pressure.
On occasion, increased motion, prolonged crying, or hyperactivity may produce
measurements with a status code of 8810 (RETRY-UNABLE TO MEASURE) or 8813 (STOPUNABLE TO MEASURE). See section 3.16 for a list of status and error codes.
Unpacking
Remove the instrument from the shipping carton and examine it for signs of shipping
damage. Save all packing materials, invoice, and bill of lading. These may be required to
process a claim with the carrier. Check all materials against the packing list. Contact the
Customer Service Department (800) 288-2121 (U.S.A and Canada) or (201) 265-8800
(outside U.S.A. and Canada) for prompt assistance in resolving shipping problems.
xii 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Symbols and Descriptions Introduction
- - - -
Symbols and Descriptions
Most of the symbols in the table below are defined in the IEC Publication 878 and ISO
Standard 7000. These symbols are used on all models of the Accutorr Plus.
SYMBOL DESCRIPTION SYMBOL DESCRIPTION
Attention, Consult
Accompanying Documents /
Refer to Manual
Type BF Equipment
Refer Servicing to Qualified
Service Personnel
Equipotentiality Pulse Rate
Alternating Current (AC) Adult
Direct Current (DC) Pediatric/Child
Temperature Neonate
Interval Setting / Timer Alarm Volume
Cont. Continuous NIBP Mode Beep Volume
Defibrillator-proof Type
BF Equipment
Electrical connectors Off
Battery Recycle
Accutorr Plus™ Operating Instructions 0070-10-0692-02 xiii
Introduction Symbols and Descriptions
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xiv 0070-10-0692-02 Accutorr Plus™ Operating Instructions
1.0
General Description
1.1 General Description
FIGURE 1-1 Accutorr Plus, advanced model (Historical Trend Display and Oximeter
optional features)
Accutorr Plus™ Operating Instructions 0070-10-0692-02 1 - 1
General Description General Description
The Accutorr Plus is available in three models—one basic and two advanced:
1. Accutorr Plus with Lithium Ion Battery—the Accutorr Plus basic model, which
measures non-invasive blood pressure (NIBP) and Pulse Rate
2. Accutorr Plus with Nellcor® Pulse Oximetry and Lithium Ion Battery—the
Accutorr Plus advanced model, which includes basic model features, and adds Liquid
Crystal Display (LCD), Trend Screen and SpO
(Nellcor)
2
3. Accutorr Plus with Masimo SET® Pulse Oximetry and Lithium Ion
Battery—the Accutorr Plus advanced model, which includes basic model features, and
adds Liquid Crystal Display (LCD), Trend Screen and SpO
(Masimo)
2
In this manual, when a feature is described and it only refers to a particular model, it will be
noted. When the name Accutorr Plus is used, it refers to all three models.
All Accutorr Plus models are supplied with Lithium Ion Battery Technology. All models
measure NIBP and pulse rate. The Accutorr Plus features front panel digital displays for Mean
Arterial Pressures, Temperature, and Time; and extra large displays for the Systolic, Diastolic,
Pulse Rate, and SpO
. The Accutorr Plus advanced models incorporate an LCD to view
2
stored measurements (trend); to access a menu system for setting the alarm volume and SpO2
beep volume; and to display the view angle. Advanced models also add automatic SpO
measurement function with your choice of Nellcor or Masimo SpO
, depending upon your
2
2
model.
On all units, temperature can be measured with the optional Predictive Thermometer Module
(PTM) or the optional AccuTemp IR Infrared Thermometer Module. All units can also be
optionally equipped with a recorder module for documenting NIBP, pulse rate, SpO
and
2
temperature information. Each printout includes the time and date of each measurement
taken.
The Accutorr Plus can store up to 100 measurements in memory. These 100 measurements
are shared by the number of patients that are monitored by the Accutorr Plus. When only one
patient is monitored, then that one patient can have up to 100 measurements stored. When
more than one patient is monitored each patient can have any number of measurements
stored as long as the total number of stored measurements for all patients equals 100 or less.
The Accutorr Plus has an Interval Mode which enables the unit to take automatic NIBP
measurements at timed intervals.
The Accutorr Plus allows setting of alarm limits. All alarm violations are indicated by an
audible alarm tone, flashing front panel displays and brackets around the violated parameter
on the recorder print outs.
The Accutorr Plus also has the capability of operating from a battery.
1 - 2 0070-10-0692-02 Accutorr Plus™ Operating Instructions
General Description General Description
Some key features of the Accutorr Plus are:
• Non-Invasive Blood Pressure (NIBP)
• Pulse Rate
• Nellcor or Masimo SpO
(advanced models only)
2
•Alarms
•Interval Mode
• Large Light Emitting Diode (LED) Displays
• Trend Memory - Up to 100 Measurements
• Communications - DIAP
• Nurse Call function
• Universal Power Supply
• Automatic Power Saver
• User Configured Settings
• Thermometry, PTM or AccuTemp IR (Optional)
• Recorder (Optional)
• High Contrast LCD (advanced models only)
• Customer Replaceable Lithium Ion Battery
• Universal mounting adapter for rolling stands and wall mounts
Accutorr Plus™ Operating Instructions 0070-10-0692-02 1 - 3
General Description General Description
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1 - 4 0070-10-0692-02 Accutorr Plus™ Operating Instructions
2.0
Controls and Indicators
This section of the Operating Instructions identifies and describes each control and display of
the Accutorr Plus. For step-by-step operating instructions, see Chapter 3.0, “Operation”.
The following is a list of all controls, connectors and indicators, their item number and the
page number. The item number refers to the call-outs on the drawings within this chapter. The
page number refers to the page where the description of the item can be found.
Accutorr Plus™ Operating Instructions 0070-10-0692-02 2 - 1
Controls and Indicators
FRONT PANEL PAGE PAGE
1. NIBP SYSTOLIC DISPLAY 2-3 29. SET ALARMS KEY 2-6
2. NIBP DIASTOLIC DISPLAY 2-3 30. MUTE KEY 2-7
3. NIBP MAP DISPLAY 2-3 31. Mute Indicator 2-7
4. PULSE RATE DISPLAY 2-4 32. TIMER/TEMP KEY 2-7
5. NIBP/SpO2 Pulse Rate Indicator 2-4 33. Interval/Elap. Time/Temp Display 2-7
6. SpO2 Display (optional feature with
2-4 34. INTERVAL KEY 2-7
the Accutorr Plus advanced models)
7. LIQUID CRYSTAL DISPLAY (LCD)
2-4 35. Interval Indicator 2-7
(optional feature with the Accutorr Plus
advanced models))
8. MENU KEY (optional feature with the
2-4 36. DEFLATE KEY 2-7
Accutorr Plus advanced models)
9. LCD Up Arrow Key (optional feature
2-4 37. PATIENT SETUP KEY 2-8
with the Accutorr Plus advanced
models)
10. LCD Down Arrow Key (optional feature
2-4 38. START NIBP KEY 2-8
with the Accutorr Plus advanced
models)
11. Select Key (optional feature with the
2-4 39. Start NIBP Indicator 2-8
Accutorr Plus advanced models)
12. PRINT KEY 2-4 40. Patient Size Indicators 2-8
13. PRINT INDICATOR 2-5 REAR PANEL
14. DEFAULTS KEY 2-5 41. Thermometer Module Connector 2-12
15. SpO2 Connector (optional feature with
2-5 42. Equipotential Lug 2-9
the Accutorr Plus advanced models)
16. AC Power Indicator 2-5 43. AC Power Connector 2-9
17. Battery Indicatorr 2-5 44. Communications Connector 2-9
18. NIBP Connector 2-5 45. Service Connector 2-9
19. ON/STANDBY KEY 2-5 46. Recorder Module Connector 2-9
20. Memory Full Indicator 2-5
21. DELETE INFO. KEY 2-5 PREDICTIVE THERMOMETER MODULE (PTM)
22. DATA SCAN KEY 2-6 47. Probe Cover Holder 2-10
23. Data Scan Indicator 2-6 48. Probe Chamber 2-10
24. ROOM/BED NUMBER KEYy 2-6 49. Probe Connector 2-10
25. Bed Letter Display 2-6
26. Room Number Display 2-6 RECORDER MODULE
27. Patient Info. Down Arrow Key 2-6 50. Paper Door 2-11
28. Patient Info. Up Arrow Key 2-6 51. Paper Tear Edge 2-11
2 - 2 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Controls and Indicators Front Panel
2.1 Front Panel
40
1
2
3
4
5
6
7
8
38 39
34
32
36
27
31
25
37
35
33
30
29
28
26
24
23
22
21
20
9
10
11 12 13 14 15 16 17 18
19
FIGURE 2-1 Accutorr Plus, advanced model — NIBP with Trend Screen and SpO2 with
Recorder Module (Historical Trend Display and Oximeter Optional Features)
1. NIBP SYSTOLIC DISPLAY
Displays the systolic blood pressure data from NIBP measurements. It is also used to display
NIBP error codes and systolic alarm limits.
2. NIBP DIASTOLIC DISPLAY
Displays the diastolic blood pressure data from NIBP measurements. It is also used to display
diastolic alarm limits.
3. NIBP MAP DISPLAY
Displays the mean arterial pressure (MAP) information from NIBP measurements. During a
measurement, it will display the cuff pressure. It is also used to display the MAP alarm limits
and the inflation pressure when selecting the initial inflation pressure.
Accutorr Plus™ Operating Instructions 0070-10-0692-02 2 - 3
Front Panel Controls and Indicators
4. PULSE RATE DISPLAY
Displays the pulse rate information from either the NIBP measurement or the SpO
reading
2
(Accutorr Plus advanced model). It is also used to display pulse rate alarm limits.
5. NIBP/SpO2 PULSE RATE INDICATOR
When the pulse rate displayed is based on an NIBP measurement, then NIBP is illuminated.
When the pulse rate displayed is based on an SpO2 measurement (Accutorr Plus advanced
model), then SpO
is illuminated.
2
6. SpO
Displays the %SpO
DISPLAY (optional feature with the Accutorr Plus advanced models)
2
measurement information. This area is also used to display the %SpO2
2
alarm limits.
7. LIQUID CRYSTAL DISPLAY (LCD) (optional feature with the Accutorr Plus
advanced models)
The Liquid Crystal Display (LCD) is used to display previous measurements (trend list) for the
selected patient, or a menu that controls the beep volume and alarm volume.
8. MENU KEY (optional feature with the Accutorr Plus advanced models)
This key is used to toggle between the trend list screen and the menu screen in the LCD.
When the back light in the LCD is off, pressing this key turns it on. This key is also used to
adjust the LCD contrast. Press and hold the key for two beeps to enter the adjustment mode.
Use the Arrow keys (9 & 10) to change the contrast.
9. LCD UP ARROW KEY (optional feature with the Accutorr Plus advanced
models)
This key is used to scroll the trend data so that more recent measurements are displayed in
the LCD. When the back light in the LCD is off, pressing this key turns it on. This key is also
used to adjust the LCD contrast when in the adjustment mode. Use the Menu key (8) to enter
the adjustment mode.
10. LCD DOWN ARROW KEY (optional feature with the Accutorr Plus
advanced models)
This key is used to scroll the trend data so that older measurements are displayed in the LCD.
When the back light in the LCD is off, pressing this key turns it on. This key is also used to
adjust the LCD contrast when in the adjustment mode. Use the Menu key (8) to enter the
adjustment mode.
11. SELECT KEY (optional feature with the Accutorr Plus advanced models)
When the menu screen is displayed in the LCD, this key is used to select the menu items.
When the back light in the LCD is off, pressing this key turns it on.
12. PRINT KEY
Press this key to print all stored information for the selected patient. Press to stop a printing
that is in process. Press and hold this key (2 single beep tones, approx. 3 seconds) to change
the print mode between Continuous and Request. When in the Continuous mode, the PRINT
Indicator LED is illuminated. When loading in a new roll of recorder paper, press this key to
feed the paper through the printer.
2 - 4 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Controls and Indicators Front Panel
13. PRINT INDICATOR
This indicator is illuminated when continuous printing of measurements is selected.
14. DEFAULTS KEY
Press and hold this key (2 single beep tones, approx. 3 seconds) to reset all parameters back
to the hospital default settings. This includes alarms, inflation pressure, interval, etc. When in
the process of making a change to a setting, you can return to the original setting by
momentarily pressing this key. To enter the User Configuration, press and hold this key (1
beep tone), while turning the unit on. See section 3.15 for details on default settings and
User Configuration.
15. SpO
Connector (optional feature with the Accutorr Plus advanced
2
models)
This connector is used to attach SpO2 sensors.
16. AC Power Indicator
This green LED illuminates whenever AC power is applied to the unit.
17. Battery Indicator
This green LED illuminates whenever the unit is operating on battery power. The LED will flash
when the battery requires charging. When the LED begins flashing, at least 10 minutes
minimum of battery time remain on the Accutorr Plus.
18. NIBP Connector
This connector is used to attach specified NIBP hoses.
19. ON/STANDBY KEY
This key is used to activate the unit, enabling it to begin taking measurements. The unit does
not have to be “ON” for the internal battery to charge. However, the unit does need to be
plugged into an AC receptacle for the battery to be charging.
20. Memory Full Indicator
This LED indicator flashes when 80 - 99 of the 100 available entries of trend are used. This
LED is on continuously when 100 are used. Delete measurements manually using the DELETE
INFO. key or the unit will automatically delete the oldest measurement for the current patient.
NOTE: The unit will also automatically delete data that is 24 hours
old.
21. DELETE INFO. KEY
Press the DATA SCAN key to enable the Delete Info. key (Accutorr Plus basic model only).
Once enabled, press and hold this key (1 beep tone, approx. 3 seconds) to delete the most
recent reading when it is displayed. When displaying any measurement, press and hold this
key (2 beep tones, approx. 6 seconds) to delete all information for the currently selected
patient. Press and hold at power up to delete all information for all patients.
Accutorr Plus™ Operating Instructions 0070-10-0692-02 2 - 5
Front Panel Controls and Indicators
22. DATA SCAN KEY
Press this key (1 beep tone) to view previous measurements for the selected patient on the
Accutorr Plus and to enable the Delete Info. key (Accutorr Plus NIBP only). The LED indicator
next to the key illuminates. On the Accutorr Plus NIBP, use the Patient Info. Up & Down Arrow
keys (27 & 28) to scroll through the stored measurements for the selected patient. On all
models of the Accutorr Plus, press and hold this key (2 beep tones, approx. 6 seconds) to
scan all of the rooms and beds for stored measurements. Press the DATA SCAN key again
to stop on a particular room/bed. Press the DATA SCAN key again to exit this view mode.
23. Data Scan Indicator
This LED indicator is illuminated when viewing prior data.
24. ROOM/BED NUMBER KEY
Press this key to change the displayed Room/Bed. After pressing this key use the Patient Info.
Up & Down Arrow keys (27 & 28) to change the Room/Bed. This key is also used when
selecting a User Configuration item.
25. Bed Letter Display
This display is used to show the current patient bed letter. It is also used to display status
codes for NIBP, SpO
and Temperature and to display User Configuration items.
2
26. Room Number Display
This display is used to show the current patient room number. It is also used to display status
codes for NIBP, SpO
and Temperature, indicates which alarm is being set (Hi or Lo), and
2
displays a User Configuration item.
27. PATIENT INFO. Down Arrow KEY
This key is used to decrement the alarm limits when they are shown on the LED displays and
to decrement the hours, minutes, month, day and year in the clock set mode. This key is also
used to change the Room/Bed, to scroll through previous data and to change initial inflation
pressure.
28. PATIENT INFO. Up Arrow KEY
This key is used to increment the alarm limits when they are shown on the LED displays and to
increment the hours, minutes, month, day and year in the clock set mode. This key is also
used to change the Room/Bed, to scroll through previous data and to change initial inflation
pressure.
29. SET ALARMS KEY
This key is used to select the NIBP and SpO
(Accutorr Plus advanced models only) alarms to
2
be changed. Repeated presses of this key sequences through the choices of Systolic Hi,
Systolic Lo, Diastolic Hi, Diastolic Lo, Map Hi, Map Lo, Pulse Rate Hi, Pulse Rate Lo, SpO
and SpO
Lo. After the last available parameter, the next press returns the unit to normal
2
2
Hi
operation. Once the desired parameter is flashing, use the Patient Info. Up & Down Arrow
keys (27 & 28) to increment or decrement the alarm values.
2 - 6 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Controls and Indicators Front Panel
30. MUTE KEY
Press this key (one beep tone), to silence the current alarm tone for 2 minutes. If a new alarm
is detected during the 2 minutes, a new alarm tone will sound. Press and hold (2 beep tones,
approx. 3 seconds) to permanently silence all alarm tones. Press this key again (1 beep
tone), to activate alarm tones.
31. Mute Indicator
This LED indicator is illuminated when the alarm tone has been silenced permanently and
when the alarm volume is set to OFF.
32. TIMER/TEMP KEY
This key is used to switch between viewing the elapsed time or the temperature in the
Interval/Elap. Time/Temp Display. When viewing stored measurements on the Accutorr Plus
NIBP, press this key to switch between viewing the temperature and time of the measurement.
33. Interval/Elap. Time/Temp Display
This displays the time, in minutes since the last successful NIBP measurement (Elap. Time is
illuminated). When the Interval key is pressed, the Elap. Time changes to the current Interval
setting (Interval is illuminated). When the Predictive thermometer probe is removed from its
holder, the Elap. Time changes to Temp (Temp is illuminated). Either “85.0" (°F) or ‘‘29.4’’
(°C) will display; this is an internal self test feature.
As the Predictive thermometer is taking a measurement, the display will flash as the number
increases. When the final temperature measurement is determined, the display will no longer
flash and a beep tone is generated. When the AccuTemp IR thermometer is used, the
temperature is not displayed until after the measurement is taken and the thermometer is
placed back into its holder. This display will also show the current time and date when setting
the clock.
34. INTERVAL KEY
Press to enter the set time interval mode. An interval is set for automatic NIBP measurement
cycles. To sequence through the interval choices of: OFF (——, when set to display graphics),
CONT (Continuous), 1, 2.5, 5, 10, 15, 20, 30, 60, 120 and 240 minutes, repeatedly press
the INTERVAL key. When the desired interval is displayed in the Interval/Elap. Time/Temp
Display the TIMER/TEMP key may be pressed to enter the interval setting or, the displayed
setting will be entered when 15 seconds have elapsed without pressing the Patient Info. Up
or Down arrow keys (27 & 28).
35. Interval Indicator
When an interval setting is selected, except for Off, the Interval Indicator flashes. When the
interval mode is activated the Interval Indicator illuminates continuously.
36. DEFLATE KEY
Press this key to stop an NIBP measurement that is in progress and deflate the cuff. A new
measurement cycle will not be allowed for 10 seconds following the use of this key. The Start
NIBP LED indicator is illuminated when a new measurement can begin. Press this key while in
the interval mode to suspend the interval operation.
Accutorr Plus™ Operating Instructions 0070-10-0692-02 2 - 7
Front Panel Controls and Indicators
37. PATIENT SETUP KEY
Press this key (1 beep tone) to select the patient size. Each time the key is pressed the patient
size will change. The choices will cycle from Adult, Pediatric, Neonate, Adult, Pediatric,
Neonate, etc.
CAUTION: It is the user’s responsibility, when changing the room/bed,
to assure the patient size and alarm settings are set as
required.
This key is also used to view the cuff inflation pressure for an NIBP measurement. Press and
hold (2 beep tones, approx. 3 seconds) to display the current inflation pressure in the MAP
display. Use the Patient Info. Up & Down Arrow keys (27 & 28) to change the cuff pressure.
38. START NIBP KEY
Press this key to initiate an NIBP measurement. If a measurement is already in progress, a
new measurement can not be initiated until a minimum of 10 seconds after the end of the one
in progress (30 seconds when in the interval mode). The Start NIBP LED indicator is
illuminated when a measurement can begin.
39. Start NIBP Indicator
This LED indicator is illuminated when the Accutorr Plus is ready to initiate an NIBP
measurement.
40. Patient Size Indicators
One of theses LEDs illuminates to indicate the selected patient size.
2 - 8 0070-10-0692-02 Accutorr Plus™ Operating Instructions
Controls and Indicators Rear Panel
2.2 Rear Panel
41
46
42
43
44
45
FIGURE 2-2 Rear Panel - All Units
41. Thermometer Module Connector
Used to attached one of the optional thermometer modules (PTM or AccuTemp IR).
42. Equipotential Lug
Provides equipotential bonding between hospital equipment.
43. AC Power Connector
Allows for A.C. power cord connection.
44. Communications Connector
Provides compatible communications to external devices and hospital’s nurse call and
information system.
CAUTION: The Communications Connector on the Accutorr Plus is only
for use with IEC 60601-1 compliant equipment.
45. Service Connector
Used by Technical Service Personnel.
46. Recorder Module Connector
Used to connect the optional recorder module.
Accutorr Plus™ Operating Instructions 0070-10-0692-02 2 - 9
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