Mindray accutorr plus Operating Instructions

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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.

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.

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

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

with Masimo® Pulse Oximetry..................................................................... 3 - 21

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

– Masimo® Performance Specifications ............................................................................................. 6 - 4

SpO

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)

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

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

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)

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)

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

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

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

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)

•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

38 39

11 12 13 14 15 16 17 18

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

(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.

6. SpO

Displays the %SpO

DISPLAY (optional feature with the Accutorr Plus advanced models)

measurement information. This area is also used to display the %SpO2

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

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.

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

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

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

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

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

Predictive Thermometer Module (PTM) Controls and Indicators

2.3 Predictive Thermometer Module (PTM)

FIGURE 2-3 Predictive Thermometer Module

47. Probe Cover Holder

Used to store a box of probe covers.

48. Probe Chamber

Used to store the temperature probe when not in use.

49. Probe Connector

Used to connect the thermometer probe to the PTM module.

2 - 10 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Controls and Indicators Recorder Module

2.4 Recorder Module

FIGURE 2-4 Recorder Module

50. Paper Door

Open this door when loading recorder paper.

51. Paper Tear Edge

The paper tear edge is used to tear off printed recorder strips. The edge can be removed in the event of a paper jam that needs to be cleared.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 2 - 11

Recorder Module Controls and Indicators

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2 - 12 0070-10-0692-02 Accutorr Plus™ Operating Instructions

3.0

Operation

This section of the Operating Instructions provides guidelines and step-by-step instructions for proper operation of the Accutorr Plus. The numbers in parentheses ( ) refer to the items described in section 2.0, “Controls and Indicators”. 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.

3.1 Setting-up / Turning Power On

1. Before turning the power on, check the rear panel for voltage requirements. Confirm proper voltage is available.

2. Before turning the power on, install battery and connect any required modules (recorder, thermometer). For instructions on connecting modules, see section 3.17.

Upon installation of any optional modules, a test is required after power up (step 5). For the recorder, press the PRINT key and the recorder will feed the paper to verify proper function. For the Predictive thermometer, remove the probe from its holder and verify

85.0 (29.4) appears in the Interval/Elap. Time/Temp display.

3. If additional communications capabilities are required, attach a communications interface cable to the rear panel COMMUNICATIONS CONNECTOR (44) and to the corresponding interface connector on the peripheral instrument.

WARNING: The Communications Connector on the Accutorr Plus is only

4. Attach the AC power cord into the rear panel AC POWER CONNECTOR (43) and into

a grounded (3-prong) Hospital Grade AC receptacle. Do not use an adapter to defeat the ground. The green AC POWER INDICATOR (16) illuminates, indicating AC power has been applied. The internal battery charges automatically when AC power is applied.

WARNING: When attached to other products ensure that the total

for use with IEC 60601-1 compliant equipment.

chassis leakage currents of all units (combined) do not exceed 300µa.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 1

Setting-up / Turning Power On Operation

5. Press the ON/STANDBY key (19) to activate the unit. If it is required to enter the User Configuration mode, press and hold the DEFAULTS key (14) while the unit is powering on. See section 3.15 for more details on the User Configuration mode.

6. The unit will count down from 20, display all 8’s in the LEDS and perform internal diagnostic tests. Any status codes are displayed in the appropriate LED. See section

3.16 for a list of status codes. At the end of power up, all of the displays illuminate and then blank, except the Bed Letter and Room Number displays (25 & 26) which does not blank. A beep tone will sound during the power up sequence to confirm the operation of the audio indicator. If the time and date need to be set, see section 3.13 for instructions.

7. On Accutorr Plus advanced models, adjust the contrast on the LCD if necessary. To adjust the contrast, press and hold the MENU key (8) (2 beep tones, approx. 3 seconds). Use the LCD Up & LCD Down Arrow keys (9 & 10) to adjust the contrast. See section 3.8, Setting the LCD Contrast (View Angle Adjustment), for more details.

3 - 2 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation Patient Setup and Room/Bed Assignment

3.2 Patient Setup and Room/Bed Assignment

3.2.1 Selecting the Patient Size

The Patient Size is selected using the PATIENT SETUP key (37).

Adult Pediatric Neonate

PATIENT

SETUP

FIGURE 3-1 Patient Size Graphics and Indicators

1. Press the PATIENT SETUP key (37) to select the Patient size. Three choices are

available: Adult, Pediatric and Neonate. Each time the key is pressed the patient size changes. The indicator under the graphic of the patient size illuminates to indicate which size is selected. The factory default setting for the Patient size is Adult. See section 3.15, “User Configuration” to set a custom default setting.

NOTE: Do not press and hold the PATIENT SETUP key to change the

patient size. Pressing and holding this key enters the initial cuff inflation pressure change mode.

3.2.2 Cuff Inflation Pressure

The initial cuff inflation pressure depends on the Patient Size setting. The initial cuff inflation pressures are listed in the table below. The initial cuff inflation pressures can be modified from the default (custom or factory) settings. When the Accutorr Plus is powered down, these modifications are deleted.

1. To modify the initial cuff inflation pressure, press and hold the PATIENT SETUP key (37) (2 beep tones, approx. 3 seconds). The current initial cuff pressure for the selected patient size displays in the MAP display.

2. Use the Patient Info. Up and Down Arrow keys (27 & 28) to change the pressure.

3. Once the desired pressure is displayed, press the PATIENT SETUP key (37) to enter this

value.

NOTE: Waiting 15 seconds will also enter this value.

INITIAL FACTORY PATIENT SIZE SETTING

Adult 180 mmHg 100 mmHg 260 mmHg 5 mmHg

Pediatric 140 mmHg 60 mmHg 160 mmHg 5 mmHg

Neonate 100 mmHg 40 mmHg 120 mmHg 5 mmHg

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 3

DEFAULT CUFF

INFLATION VALUES

LOWEST SELECTABLE PRESSURE

HIGHEST SELECTABLE PRESSURE INCREMENT

Patient Setup and Room/Bed Assignment Operation

NOTE: The default patient size and initial cuff inflation pressure can

be customized. See section 3.15, “User Configuration” for Room Number and Bed Letter

3.2.3 Room Number and Bed Letter

To monitor more than one patient, assign each patient to a particular room number and bed letter. Use the ROOM/BED key (24) to set the room number from 0 to 99 and the bed letter as a, b, c or d. On initial power up (no stored patient data), the room number and bed letter default to 0,a.

PATIENT I NFO.

ROOM BED

MEMORY FULL

FIGURE 3-2 Room Number and Bed Letter Keys and Indicators

ROOM

BED

DATA SCAN

DELETE

INFO.

HOLD TO CLEAR.

Press to increase or decrease the Room Number and Bed Letter

Press to change the Room Number and Bed Letter

1. Press the ROOM/BED key (24). The ROOM LED flashes indicating that the room

number can now be changed.

2. Press the PATIENT INFO. Up or Down Arrow key (27 & 28) to increment or

decrement the room number.

3. Press the ROOM/BED key again. The BED LED flashes.

4. Press the PATIENT INFO. Up or Down Arrow key (27 & 28) to increment or

decrement the bed letter.

5. Press the ROOM/BED key a third time to exit this mode, or do not press the key for 15

seconds.

Once measurements have been taken, and the unit is powered off and on, the room number and bed letter will default to the lowest room and bed where data is currently stored.

3 - 4 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation Manual NIBP Measurements and General NIBP Measurement Information

3.3 Manual NIBP Measurements and General NIBP Measurement Information

1. Select a pressure cuff that is appropriate for the size of the patient. Use the chart below

as a guideline.

LIMB CIRCUMFERENCE (CM)

DISPOSABLE CUFFS - QUICK CONNECT - LATEX FREE

10 - 19 Small Child 0683-14-0001-01

18 - 26 Small Adult 0683-14-0002-01

25 - 35 Adult 0683-14-0003-01

33 - 47 Large Adult 0683-14-0004-01

46 - 66 Adult Thigh 0683-14-0005-01

25 - 35 Adult Long 0683-14-0006-01

33 - 47 Large Adult Long 0683-14-0007-01

3 - 6 Neonatal, Size 1 0683-

5 - 8 Neonatal, Size 2 0683-

7 - 10 Neonatal, Size 3 0683-

9 - 13 Neonatal, Size 4 0683-

12 - 17 Neonatal, Size 5 0683-

REUSABLE CUFFS** - QUICK CONNECT - LATEX FREE

10 - 19 Small Child 0683-15-0001-01

18 - 26 Small Adult 0683-15-0002-01

25 - 35 Adult 0683-15-0003-01

33 - 47 Large Adult 0683-15-0004-01

46 - 66 Adult Thigh 0683-15-0005-01

25 - 35 Adult Long 0683-15-0006-01

33 - 47 Large Adult Long 0683-15-0007-01

* When using the thigh cuff, this product may not comply with product specifications listed in chapter 6. ** The limb circumferences of cuffs adhere to the AHA guidelines for size. They also incorporate index and

range lines to assist in cuff selection.

DESCRIPTION / CUFF NAME PART NUMBER

23-0001-01

23-0002-01

23-0003-01

23-0004-01

23-0005-01

A cuff that is too small for the limb will result in erroneously high readings. The correct size of the pressure cuff for a given patient has, among other considerations, a direct bearing on the accuracy of the obtained NIBP measurements. Base your selection of the cuff size on the limb circumference of the patient. The table above indicates the available cuffs for use with the Accutorr Plus. The design dimensions of the cuffs and their intended uses are based on recommendations of the American Heart Association.

NOTE: The cuffs that are used with the Accutorr Plus use special

snap on connectors.

WARNING: Use only authorized accessories. Use of unauthorized

accessories may result in erroneous measurements.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 5

Manual NIBP Measurements and General NIBP Measurement Information Operation

The pressure on the limb may not fall to zero between measurements if the cuff is wrapped too tightly. Therefore, assure that the cuff is properly applied.

The skin is sometimes fragile (i.e., on pediatrics, geriatrics, etc.). In these cases, a longer timer interval should be considered to decrease the number of cuff inflations over a period of time.

NOTE: In extreme cases, a thin layer of soft roll or webril cotton

padding may be applied to the limb in order to cushion the skin when the cuff is inflated. This measure may affect NIBP performance and should be used with caution.

2. Attach the cuff hose to the NIBP cuff connector (18). To do this, hold the hose behind the

knurled pressure fitting (female). Push onto the male connector until a click is heard. To remove, hold the knurled female fitting and pull firmly to release.

3. Apply the cuff to the patient. To reduce errors, the cuff should fit snugly, but with enough

room for two fingers to be placed between the cuff and the patient’s arm (on adults), and with little or no air present within the cuff. Cuff should fit loosely on neonates. Apply the cuff so that the center of the inflation bag (bladder) is over the brachial artery. Be sure that the INDEX line on the cuff falls between the two RANGE lines. If not, a larger or smaller cuff is required. Be sure the cuff lies directly against the patient’s skin. For best results, the cuff should be placed on the arm at heart level and no clothing should come between the patient and the cuff.

NOTE: Avoid compression or restriction of the pressure hose. The

NIBP cuff should not be placed on a limb that is being utilized for any other medical procedure. For example, an I.V. Catheter.

4. If required, select the patient size with the PATIENT SETUP key (37). On initial power up,

the configurable default setting is used. Otherwise, the last selected patient size is used. Initial default cuff inflation pressures depend on the Patient Size setting. See section

3.2.2 for details on changing the initial cuff inflation pressure.

5. Press the START NIBP key (38) to begin an NIBP measurement. A beep is sounded

after a completed measurement.

NOTE: Inflate the cuff only after proper application to the patient’s

limb. Cuff damage can result if the cuff is left unwrapped and then inflated.

The cuff begins to inflate to the selected cuff pressure. After reaching the selected pressure, the cuff begins to slowly deflate and the Accutorr Plus collects oscillometric pulsations.

If the initial cuff inflation is found to be inadequate, the unit retries with a higher inflation pressure (+50 mmHg in the adult mode; +50 in the pediatric mode; +40 mmHg in the neonate mode). A triple beep tone is generated.

NOTE: Any time there is an unsuccessful NIBP measurement, a

triple beep tone is generated.

Have the patient remain still to avoid unnecessary motion artifact. After the cuff pressure drops below the diastolic pressure, the results of the measurement are displayed and the cuff is vented to atmosphere.

3 - 6 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation Manual NIBP Measurements and General NIBP Measurement Information

If an error code displays in the Systolic Display or a status code in the Room/Bed Display, refer to Section 3.16, Status and Error Codes, for its explanation. A successful measurement clears a status code. To clear a status code, press the ROOM/BED NUMBER key (24).

6. When required, press the DEFLATE key (36) to interrupt a measurement. The cuff will

deflate.

NOTE: Once the initial measurement is taken for a room/bed, the

Accutorr Plus will continue to use the selected patient size.

NOTE: Check the patient’s limb for any indications of circulation

impairment.

3.3.1 NIBP Pressure Limit Fail Safe

If the cuff is over-pressurized, it will automatically deflate and the status code 8812 (STOP CUFF OVER PRESSURE) or error code 987 (STOP - HARDWARE OVER PRESSURE) will be displayed in the Room/Bed or systolic display.

The unit must be turned off and back on again to reset the hardware over-pressure switch (error code 987) before any new measurements can be taken.

3.3.2 Cuff Inflation Time

If the cuff pressure does not attain 20 mmHg within 40 seconds of the start of inflation or if the target pressure is not reached within another 60 seconds, then the cuff is deflated and status codes will be displayed in the Room/Bed display. See section 3.16 for a list of error and status codes.

3.3.3 Automatic Adjustment of Cuff Inflation Pressure (Adaptive Inflation)

The unit adjusts the inflation pressure according to the previous reading of the systolic pressure. After the first successful measurement, the inflation pressure is the previous systolic +50 mmHg in the adult mode, +50 mmHg in the pediatric mode and +40 mmHg in the neonate mode. When not in Interval mode the Adaptive inflation may be disabled.

To view the current inflation pressure, press and hold (2 beep tones, approximately 3 seconds) the Patient Setup Key (37). The current inflation pressure is shown in the MAP display. If required, use the Patient Info. Up & Down arrow keys (27 & 28) to change the inflation pressure. It is also possible to permanently override this adjustment in the User Configuration. See section 3.15 for details.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 7

Automatic NIBP Measurements (Interval Mode) Operation

3.4 Automatic NIBP Measurements (Interval Mode)

The Accutorr Plus can be set to automatically take NIBP measurements. On initial power up, the interval setting will default to OFF. The User Configuration mode can be used to set custom defaults for the Interval Mode. See section 3.15, User Configuration for details. In this mode, the adaptive inflation is always enabled.

Follow Steps 1 - 4 in the Manual Procedure, section 3.3, to select, attach and apply the cuff and to adjust the initial cuff inflation pressure.

5. Press the INTERVAL key (34). The current selection is displayed in the Interval/

Elap.Time/Temp. display (33). Press the INTERVAL key to scroll to the next available interval selection. The selections are: Off (—— when set to graphic display), CONT (continuous), 1, 2.5, 5, 10, 15, 20, 30, 60, 120 and 240 minutes. When an interval setting is selected, except for Off, the Interval Indicator (35) flashes. When the interval mode is activated the Interval Indicator illuminates continuously.

6. The displayed interval time is entered when the INTERVAL key has not been pressed for

15 seconds or, when the TIMER/TEMP key (32) is pressed, which changes the display back to Elap. Time or, when the START NIBP key (38) is pressed, which initiates an NIBP measurement, activates the Interval Mode, and changes the display back to Elap. Time.

7. If the START NIBP key (38) has not already been pressed, press to take a measurement

and to activate the interval mode.

NOTE: If the interval time is changed, the START NIBP key does not

need to be pressed for the new interval to initiate. When the new time interval has elapsed, a measurement will be taken.

NOTE: When the NIBP continuous interval is chosen, the Accutorr

Plus will take back to back (one right after the other) blood pressure readings. As a safety precaution, a five minute limit is placed on continuous measurements. After 5 minutes, the NIBP interval will automatically switch to measurements taken once every 5 minutes. This is done to reduce the chance of surface vessel rupture (petechia).

If it is desirable to maintain a fixed cuff inflation pressure, the adaptive inflation feature may be disabled when not in Interval mode.

3.4.1 Canceling an Automatic NIBP Measurement

To cancel a scheduled measurement, press the DEFLATE key (36). This will suspend the timed NIBP measurements until the START NIBP key (38) is pressed. The interval indicator will flash. See section 3.4.4 for more details on the start and deflate function.

NOTE: Pressing the DEFLATE key (36) will also end a measurement

cycle that is already in progress.

To take an immediate measurement and to reactivate the Interval mode, press the START NIBP key (38). The next timed measurement will be taken at the time set by the interval. For

example, if the interval was set to 30 minutes, the next timed measurement will be 30 minutes after the START NIBP key was pressed.

3 - 8 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation Automatic NIBP Measurements (Interval Mode)

NOTE: If the Interval mode is no longer required, set the interval to

NOTE: If the DEFLATE key (36) is pressed, it will take 10 seconds

NOTE: When in the Interval mode and the Room/Bed is changed,

“OFF” prior to pressing the START NIBP key. See section 3.4 for details on changing the interval mode.

before another measurement can be taken. The START NIBP INDICATOR (39) will be illuminated, when ready.

the interval mode is suspended (interval indicator flashes) until the NIBP Start key is pressed.

3.4.2 Changing the Interval Setting

If the interval time is changed while the Accutorr Plus is in the interval mode, the new interval time is used once it is entered. For example: The interval time is set to 60 minutes. Thirty minutes have elapsed since the last timed automatic measurement and the interval time is changed to 10 minutes. Once the interval time is entered, the Accutorr Plus will take an automatic NIBP measurement in 10 minutes and then once every 10 minutes.

3.4.3 Effects of Changing the Room Number and/or Bed Letter on the Interval Setting

When the Room Number and/or Bed Letter is changed, the interval setting will remain the same.

NOTE: The interval setting can be changed if required. Also, if an

NIBP measurement is in progress, the measurement will stop and the cuff will deflate. The timed interval measurements will not activate again (interval indicator flashes) until the START NIBP key (38) is pressed.

3.4.4 START and DEFLATE Functions

The START NIBP and DEFLATE functions have the following effects on the timed measurement sequence.

INTERVAL mode is active and the START NIBP key (38) is pressed causing an unscheduled measurement to be taken. Taking this unscheduled measurement does not affect the timing of the interval cycle, therefore, the scheduled measurements will still be taken as if there were no interruptions. Only one measurement is taken for each measurement cycle - even if the unscheduled measurement coincides with the scheduled measurement.

INTERVAL mode is active and the DEFLATE key (36) is pressed. The INTERVAL INDICATOR (35) flashes. No additional measurements will be taken until the START NIBP key (38) is pressed. If a timed measurement is in progress, the measurement is suspended and the cuff deflates.

INTERVAL mode is active and the interval time is changed. The measurement cycle is reset with the new interval. A measurement will be taken after the new interval time has elapsed.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 9

Alarms Operation

_ _

_ _ _

_ _

3.5 Alarms

The Accutorr Plus provides “HI” and “LO” alarm limit settings for systolic, diastolic, MAP, pulse rate and SpO or falls outside the limits that have been specified.

WARNING: Removing the battery from the Accutorr Plus while the AC

3.5.1 Setting Alarm Limits

The Factory Default for all parameter alarms, except Low SpO2, is OFF. The Low SpO2 factory default is 86. The User Configuration mode can be used to set custom defaults. See section 3.15, User Configuration for details. The factory and custom defaults for alarms can be changed as required to accommodate the needs of individual patients. The SET ALARMS key (29) and the Patient Info. Up and Down Arrow keys (27 & 28) are used to set alarm values.

1. Press the SET ALARMS key (29) (1 beep) to enter into the alarm set mode.

. An alarm violation occurs when one or more patient parameters equals

line cord is disconnected may cause the alarm settings to be reset to their defaults.

The first time this key is pressed, all NIBP displays blank except for the systolic display which shows the current high systolic alarm value. The word HI is displayed in the Interval/Elap. Time/Temp display (33).

The second time the SET ALARMS key (29) is pressed the Systolic LO parameter is selected. The word LO is displayed in the Interval/Elap. Time/Temp display (33). When the unit has been configured to display graphics, the symbol is displayed.

_ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _

_ _ _ _

_ _ _

_ _ _ _

When the graphic is displayed, the bottom lines blink. This indicates the low alarm is selected.

Each time the SET ALARMS key (29) is pressed a new parameter is selected for alarm setting (all other displays blank). The order they are available is: Systolic HI, Systolic LO, Diastolic HI, Diastolic LO, MAP HI, MAP LO, Pulse Rate HI, and Pulse Rate LO, SpO

and SpO2 LO. When all of the available parameters have been selected, the next press of the ALARM SELECT key returns the Accutorr Plus to normal operation.

2. To change an alarm limit setting, use the Patient Info. Up & Down Arrow keys (27 & 28).

The Up arrow increments the alarm limit setting. The Down arrow decrements the alarm limit setting.

To cancel all of the changed alarm values while still in progress of changing, press the DEFAULTS key (14) (1 beep tone).

If the SET ALARMS or Arrow keys have not been pressed for 15 seconds, the Accutorr Plus returns to normal operation and saves any alarm limit changes.

NOTE: If the patient size is changed, the alarm settings will change

to the default settings for the new patient size.

3 - 10 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation Alarms

Alarm Limit Table

PAR AMETE R RANGE UNITS

Systolic High Adult Pediatric Neonate

Off, 60-260 Off, 60-160 Off, 50-125

mmHg Off 5

Systolic Low Adult Pediatric Neonate

Off, 55-150 Off, 55-130 Off, 45-115

mmHg Off 5

Diastolic High Adult Pediatric Neonate

Off, 40-200 Off, 40-150 Off, 35-100

mmHg Off 5

Diastolic Low Adult Pediatric Neonate

Off, 30-120 Off, 30-50 Off, 25-50

mmHg Off 5

MAP High Adult Pediatric Neonate

Off, 90-200 Off, 90-150 Off, 60-110

mmHg Off 5

MAP Low Adult Pediatric Neonate

Off, 40-100 Off, 40-70 Off, 30-70

mmHg Off 5

Pulse Rate High Adult Pediatric Neonate

Off, 100-245 Off, 100-245 Off, 100-245

bpm Off 5

Pulse Rate Low Adult Pediatric Neonate

High

SpO

Adult Pediatric Neonate

SpO

Low

Adult Pediatric Neonate

Off, 35-120 Off, 35-150 Off, 75-200

Off, 61-99 Off, 61-99 Off, 61-99

60-95 60-95 60-95

bpm Off 5

%SpO

FACTORY DEFAULT

Off 1

86 1

UNITS OF INCREMENT

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 11

Alarms Operation

3.5.2 Alarm Violations

An alarm condition exists if the physiological parameter is equal to or is outside the high/low limit range that has been set. When an alarm limit is violated, the following actions occur:

• The LEDs for the parameter in an alarm condition flashes.

• The parameter in an alarm condition is in reverse video on the LCD (Accutorr Plus

advanced models).

• The alarm tone is sounded (unless muted with the MUTE key (30)).

• The parameter(s) that was in an alarm condition will be in brackets [ ] when printed on

the recorder.

3.5.3 How to Mute Alarms

When an NIBP alarm exists, press the MUTE key (30) (1 beep tone) to silence the alarm tone for 2 minutes. The alarm tone will return after the next measurement value that violates the selected limits.

When an SpO tone for two minutes. The alarm tone will return after two minutes, unless the SpO2 value changes and is within the alarm limits. If during that two minutes the measured SpO changes to a value that is within the acceptable range, and then returns to a value that is outside the set alarm limit, the alarm tone will return before the two minutes elapse. Example (within 2 minutes): • SpO the alarm tone sounds and the SpO measured at 88; there is no alarm tone, but the SpO2 display flashes. • SpO2 is measured at 91; no alarm tone sounds and the display stops flashing. • SpO alarm tone sounds and the SpO

Press and hold the MUTE key (30) (2 beep tones, approx. 3 seconds) to permanently silence the alarm tone. The MUTE LED (31) illuminated. The LEDs for the alarming parameter will continue to flash. To reactivate the alarm tone function, press the MUTE key (30) again.

alarm exists, press the MUTE key (30) (1 beep tone) to silence the alarm

low alarm limit has been set to 90. • SpO2 is measured at 89;

display flashes. • The MUTE key is pressed. • SpO2 is

is measured at 89; the

display flashes.

3.5.4 Alarms and Changing the Room Number and/or Bed Letter

When changing the rooms and beds, the alarm settings will change if the final room/bed displayed is a different patient size than the original room/bed. When a new patient size is detected, the alarm settings change to the defaults for the different patient size. See section

3.15 for information on custom defaults.

The table below describes 6 measurements in different rooms/beds and different patient sizes, and the effect on the alarm settings.

value

3 - 12 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation Alarms

MEASUREMENT ORDER

1 1/a Adult Have been manually set.

2 1/b Adult Remain the same.

3 2/a Pediatric Changed to defaults for a pediatric size

4 3/a Adult Changed to defaults for an adult size patient.

5 4/a Adult Remain the same.

6 1/a Adult Remain the same. If the alarm settings that

NOTE: The alarm settings can be changed, if necessary, when

changing the room/bed and the patient size is the same.

CAUTION: It is the user’s responsibility, when changing the room/bed,

to assure the patient size and alarm settings are set as required.

ROOM/ BED

PATIENT SIZE ALARM SETTINGS

patient.

were set from the 1st measurement are required, they need to be set again manually.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 13

To View and Delete Stored Data (Trend Mode) Operation

3.6 To View and Delete Stored Data (Trend Mode)

The Accutorr Plus is capable of storing up to 100 entries of measurement data. Each time a successful NIBP measurement is made, the data is automatically stored in memory. When a temperature measurement is made between two minutes before and two minutes after an NIBP measurement, it is stored as the same entry with the NIBP measurement. If a temperature measurement is made outside this time, it is stored as a separate entry. When either NIBP or temperature measurements are stored and SpO the SpO

When 80 to 99 entries are stored into trend memory, the MEMORY FULL Indicator (20) will flash. When 100 entries are stored into trend memory, the MEMORY FULL Indicator (20) will illuminate continuously. Once 100 entries are stored, old data can be deleted manually for any patient; or when new data is available, the Accutorr Plus will automatically delete the oldest data for the currently displayed patient.

data is also stored.

information is available, then

NOTE: The unit will also automatically delete data that is 24 hours

The Accutorr Plus basic model uses the Systolic, Diastolic, MAP, and Temp displays to view stored data. The Accutorr Plus advanced models display up to 5 measurements at a time. The stored data that is viewed is for the currently selected patient (indicated by the room number/ bed letter).

old.

3.6.1 To View the Stored Measurements on the Accutorr Plus, basic model

1. Press the DATA SCAN key (22) (1 beep tone). The DATA SCAN Indicator (23)

illuminates.

2. Press the PATIENT INFO. Up and Down Arrow keys (27 & 28) to view stored data

for the current patient. The stored data is displayed in the Systolic, Diastolic, MAP, Pulse Rate and Temp displays.

Consecutive presses or pressing and holding the UP or DOWN arrow will allow the stored measurements to continuously wrap around. When the measurements wrap, a double beep tone will sound. If a temperature measurement is not available for the NIBP measurement that is displayed, then - - - - is shown in the Interval/Elap. Time/Temp display (33). To view the time of measurements, press the TIME/TEMP key (32).

3. To exit the view stored data mode, press the DATA SCAN key (22) (1 beep).

3.6.2 To View the Stored Measurements on the Accutorr Plus, advanced models

The stored measurements on the Accutorr Plus advanced models are displayed in the LCD. Up to 5 stored measurements are displayed at one time. Measurements are displayed in time order, with the newest measurement at the top. A scroll bar with one or both arrows will display on the right side of the LCD when more measurements are available to view. When only one arrow displays, more measurements are only available in the direction of the arrow.

3 - 14 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation To View and Delete Stored Data (Trend Mode)

1. To view more measurements press the LCD Up or Down Arrow key (9 & 10).

TimeDate

F/C

S / D / M

20/05

20/05 20/05 20/05 20/05

FIGURE 3-3 LCD Trend List Display

03:00 02:58

02:35 02:33

02:30

114/64

123/61 127/62

185/105

129/62

Alarm Violated Measurement

83 84 83

135

61 60

58 56 59

98.7

98.5

97.6

----

98.2

%SPO2

96 97

96 96 97

3.6.3 To Delete the Stored Measurements on the Accutorr Plus

While viewing stored data, you can delete the most recent measurement or all of the stored measurements for the currently displayed patient.

1. Select a room/bed where stored information can be deleted. (See section 3.2.3 for

details on selecting a room/bed.) If it is the currently displayed room/bed, go to step 2. When you are uncertain what rooms/beds have stored data, press and hold the DATA SCAN key (22) (2 beep tones, more than 3 seconds). The Accutorr Plus will scan through all of the rooms/beds that have data stored. To stop on a Room/ Bed as the Accutorr Plus is scanning, press the DATA SCAN key (22).

NOTE: The Accutorr Plus will scan through the rooms/bed with

stored data only once.

Scroll Bar

2. On the Accutorr Plus NIBP only, when the desired room/bed is displayed, press the DATA SCAN key (22) (1 beep tone). The DATA SCAN Indicator (23) illuminates.

3. When the most recent stored data is displayed, press and hold the DELETE INFO. key

(21) (1 beep tone, approx. 3 seconds) to delete this measurement.

4. When viewing any of the stored measurements, press and hold the DELETE INFO. key (21) (2 beep tones, approx. 6 seconds) to delete all stored measurements for the current patient. When all data is cleared the patient size will be the default selection.

5. On the Accutorr Plus NIBP only, press the DATA SCAN key (22) (1 beep tone) to exit the delete data mode.

NOTE: The unit will also automatically delete data that is 24 hours

old.

NOTE: To delete all information for all patients, press and hold the

DELETE INFO. key (21) while powering on the unit.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 15

Setting the Alarm Volume and Beep Volume Operation

3.7 Setting the Alarm Volume and Beep Volume

The LCD on the Accutorr Plus advanced models is used to display the Trend List as described in section 3.6. It is also used to display a menu which is used to set the alarm volume and the SpO

beep volume. The MENU key (8), the LCD Up and Down Arrow keys (9 & 10), and the

SELECT key (11) are used to set these volumes. The User Configuration mode can be used to set custom defaults for the alarm volume and beep volume. See section 3.15, User Configuration for details.

1. Press the MENU key (8) to display the menu. The menu is shown in figure 3-4. The alarm volume is initially highlighted when the menu is displayed. The highlighting indicates this item can be changed.

2. Press the LCD Up and Down Arrow keys (9 & 10) to change the current selection for the alarm volume. The selections are: OFF, 1, 2, 3, 4, and 5 with 5 being the loudest.

3. Press the SELECT key (11) to move the highlighting to SpO2 beep volume.

4. Press the LCD Up and Down Arrow keys (9 & 10) to change the current selection for

the SpO2 volume. The selections are: OFF, 1, 2, 3, 4, and 5 with 5 being the loudest.

5. Press the MENU key (8) again to exit the menu and return to the Trend screen.

NOTE: Any changes made to the alarm volume or the SpO2

volume will be erased when the unit is turned off and then back on again. Also, any changes made (except off) will restore and enable the alarm tone, regardless of prior mute condition.

Alarm Vol um e

SpO2 Beep Vol um e

3 3

FIGURE 3-4 Menu

3 - 16 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation Setting the LCD Contrast (View Angle Adjustment)

3.8 Setting the LCD Contrast (View Angle Adjustment)

The LCD on the Accutorr Plus advanced models can be adjusted for optimum viewing. The MENU key (8) and the LCD Up and Down Arrow keys (9 & 10) are used to adjust the contrast.

1. Press and hold the MENU key (8) (2 beep tones, approx. 3 seconds). A beep tone is generated when the key is first pressed and the display changes to the menu. When a second beep tone is generated, release the key.

2. To quickly adjust the contrast, press and hold either the LCD Up or Down Arrow key (9 or 10). For fine adjustment, momentarily press either the LCD Up or Down Arrow key.

3. The LCD contrast adjustment is saved by either pressing the MENU key (8) again or not pressing either the LCD Up or Down Arrow keys (9 & 10) for 15 seconds.

NOTE: The contrast setting will be the same each time the unit is

turned on, unless readjusted by the user.

3.9 Display Time Out Mode

To conserve power, most displays will blank at user selected times. The LCD illumination time out can be set between 3 and 15 minutes. The LED display time out can be set between 5 and 60 minutes. Since the Accutorr Plus can be powered from either an AC or DC source, the user configuration allows the setting of separate times for each type of power source. See User Configuration, section 3.15 for more information on setting the time out minutes.

To turn on the LCD light, press the MENU key (8). To turn on the LED displays, press any key.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 17

SpO2 Measurements (Accutorr Plus advanced models) Operation

3.10 SpO2 Measurements (Accutorr Plus advanced models)

To obtain SpO2 measurements and SpO2 Heart Rate from the Accutorr Plus advanced models, see section 3.10.2 for units with Nellcor SpO2, and section 3.10.3 for units with Masimo SpO

CAUTION: Do not place the sensor on an extremity with an invasive

CAUTION: A pulse oximeter should not be used as an apnea monitor.

CAUTION: A pulse oximeter should be considered an early warning

CAUTION: Ensure proper routing of the patient cable to avoid

catheter or blood pressure cuff in place.

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.

entanglement and/or strangulation.

NOTE: In the event you are unable to obtain a reading, or the

reading is inaccurate, check the patients vital signs by alternate means and consider the following:

• If your patient is poorly perfused, try applying the sensor to another site (i.e. a different finger or toe).

• Check that the sensor is properly aligned.

• In electrosurgery, make sure the sensor is not too close to ESU devices or cables.

• Check to make sure the site area is clean / non-greasy. Clean the site and sensor if needed. Nail polish and fungus should be removed.

3.10.1 Pulse Oximetry Sensors

A. Sensor Selection and Application

Selection of a specific sensor is based on the patient’s size, physical condition, and expected monitoring duration. Instructions for the application of a sensor to a patient are provided in each sensor package. For optimal placement, ensure that cable side is placed in the correct position see FIGURE 3-5 and FIGURE 3-6).

Cable on Top

Cable on Bottom

FIGURE 3-5 Typical reusable sensor

placement

FIGURE 3-6 Typical flexible sensor

placement

B. Sensor Connection to the Accutorr Plus advanced model:

3 - 18 0070-10-0692-02 Accutorr Plus™ Operating Instructions

Operation SpO2 Measurements (Accutorr Plus advanced models)

1. Align the cable connector on the sensor assembly with the SpO2 Connector (15) on the

Accutorr Plus advanced model.

2. Push the cable connector into the SpO2 Connector (15). Confirm that the cable

connector is securely in place.

3. The digital SpO

values and SpO2 pulse rate will be displayed in the SpO2 and pulse

Rate LED windows.

4. If desired, adjust the beep volume. See section 3.7, Setting the Alarm Volume and Beep

Volume, for details on adjusting the beep volume.

C. Sensor Inspection

Before use, always inspect sensors, cables, and connectors for damage, i.e., cuts and abrasions. Do not use the sensor, cable or connector if damaged. Replace with a good working sensor.

For long sensor life:

• Do not drop on the floor, or give other sharp shocks to the sensor(s). Between use, store the sensors in the accessory pouch, or coil the sensor cable and store on the side of the Accutorr Plus rolling stand using the optional cable retainer. For accessory part number information see section 5.0, “Accutorr Plus Versions and Accessories”.

• Avoid running any cart, bed, or any piece of equipment over the sensor cable.

• Avoid strong pulls on the sensor cable (10 lbs/4kg).

• Watch for cracks in the housing.

• Watch for cracks, cuts, rips, fogging, or signs of moisture accumulation.

D. Sensor Performance

For the BEST performance:

• DO NOT PLACE any sensor on an extremity with an arterial catheter or blood pressure cuff in place. Placement of an arterial catheter or blood pressure cuff on an extremity may obstruct normal blood flow. False pulse rate information may result if the sensor is placed on that same extremity. Place the sensor on the limb opposite the site of the arterial catheter or blood pressure cuff.

• Encourage the patient to remain still. Patient motion may affect the sensor’s performance. If it is not possible for the patient to remain still, replace the sensor bandage on the sensor to assure good adhesion, or change the site of the sensor.

• Check the reusable sensor site every 2 hours and check the disposable sensor site every 8 hours for indications of skin abrasions, sensor displacement, sensor damage, or circulation impairment. Check the sensor site every 4 hours if the ear clip is used. If necessary, remove and reapply the sensor. If any of the above mentioned indications occur, immediately remove the sensor and find an alternate site. NOTE: Check the sensor site more frequently on infant and active patients.

• Incorrect placement can also reduce the acquired sensor signal, and therefore compromise performance. Select an alternate site (toe) if the sensor can not be placed on the patient’s finger correctly or if the fingernails interfere with the acquisition of a reliable signal.

• Use of the reusable sensor is not recommended for long-term monitoring (4-6 hours). For monitoring situations exceeding 4-6 hours, either reposition the reusable sensor every 2-4 hours to a different site (finger/toe) or use a disposable sensor with its appropriate bandage.

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 19

SpO2 Measurements (Accutorr Plus advanced models) Operation

• Do not over-tighten the sensor bandages. Excessive pressure on the monitoring site can affect SpO2 readings and may reduce readings below true SpO2. Excessive pressure can also result in pressure necrosis and other skin damage.

3.10.2 Sequence for establishing SpO2 with Nellcor® Pulse Oximetry

*This feature applicable only if available or installed on your unit.

1. Plug the sensor directly into the SpO

DOC-10 extension cable.

2. See package insert(s) for use and care instructions. Additional information is available

from Nellcor Puritan Bennett Inc. at WWW.NELLCOR.COM.

NOTE: Do not place the sensor on an extremity with an invasive

catheter or blood pressure cuff in place.

CAUTION: When equipped with Nellcor® SpO2, use only Nellcor®

oxygen transducers including Nellcor® Oxisensor® patient dedicated adhesive sensors. Use of other oxygen transducers may cause improper oximeter performance.

CAUTION: Tissue damage or inaccurate measurements may be caused

CAUTION: Excessive ambient light may cause inaccurate

measurements. Cover the sensor with opaque materials.

CAUTION: Inaccurate reading may be caused by incorrect sensor

connector (15) or if necessary, use a Nellcor®

CAUTION: In certain situations in which perfusion and signal strength

are low, such as in patients with thick or pigmented skin, inaccurately low SpO2 readings will result. Verification of 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,

3 - 20 0070-10-0692-02 Accutorr Plus™ Operating Instructions

discontinue use immediately. To prevent damage do not soak or immerse the sensor in any liquid solution. DO NOT ATTEMPT TO STERILIZE.

Operation SpO2 Measurements (Accutorr Plus advanced models)

3. The digital SpO2 value and SpO2 Pulse Rate will be displayed on the SpO2 and Pulse

Rate LED’s.

4. If desired, adjust the beep volume. See section 3.7, “Setting the Alarm Volume and Beep

Volume”, for details on adjusting the beep volume.

3.10.2.1 NELLCOR® Sensors

NELLCOR® provides a family of sensors suitable for a wide variety of clinical settings and patients. See package insert(s) for use and care instructions. Additional information is available from Nellcor Puritan Bennett Inc. at WWW.NELLCOR.COM.

3.10.3 Sequence for Establishing SpO2 with Masimo® Pulse Oximetry

*This feature applicable only if available or installed on your unit.

1. Select the appropriate sensor for the patient from the tables below. All sensors below are

non-sterile and can be used during patient movement.

MASIMO

SELECTION PART NUMBER PATIENT SIZE

LNOP Sensor

LNOP Disposable Sensor

LNOP adhesive sensor

LNOP Sensor

LNOP Disposable Sensor

LNOP Finger Sensor

LNOP Sensor

LNOP Check Sensor

LNOP

PC Series Patient Cable Extension 0012-00-1099-02 All Re-usable

LNOP® Sensor Family

DISPOSABLE /REUSABLE

•Adt Adult Disposable Finger

•ADT Pediatric/Slender Digit

•II Inf-L-Infant L single patient

•Neo Neonatal Disposable

•NeoPt Neonatal Pre-term

•DC-12 Adult Reusable

•DCI Adult Reusable Finger

•DCSC Adult Reusable Spot

•YI Multisite Reusable Sensor 0600-00-0078 > 1 kg. Re-usable

•EAR Reusable Ear Sensor 0600-00-0110 > 30 kg. Re-usable

0600-00-0043-01 > 30 kg. Disposable

0600-00-0044-01 10 to 50 kg. Disposable

0600-00-0100 3 to 20 kg. Disposable

0600-00-0045-01 < 10 kg. Disposable

0600-00-0046-01 < 1 kg. Disposable

0600-00-0120 > 30 kg. Re-usable

0600-00-0047 > 30 kg. Re-usable

0600-00-0077 > 30 kg. Re-usable

MASIMO® LNCS® Sensor Family

SELECTION PART NUMBER PATIENT SIZE

•DC-I Adult finger reusable

LNCS sensor

•DC-IP Pediatric finger

LNCS reusable sensor

•TC-1 Reusable Adult Ear

LNCS Sensor

Accutorr Plus™ Operating Instructions 0070-10-0692-02 3 - 21

0600-00-0126 > 30 kg. Re-usable

0600-00-0127 10 to 50 kg. Re-usable

0600-00-0128 > 30 kg. Re-usable

DISPOSABLE /REUSABLE

SpO2 Measurements (Accutorr Plus advanced models) Operation

MASIMO® LNCS® Sensor Family

SELECTION PART NUMBER PATIENT SIZE

•ADTX Adult single patient

LNCS

0600-00-0121 > 30 kg. Disposable

DISPOSABLE /REUSABLE

adhesive sensor

•PDTX Pediatric single patient

LNCS

0600-00-0122 10 to 50 kg. Disposable

adhesive sensor

•INF-L Infant single patient

LNCS

0600-00-0123 3 to 20 kg. Disposable

adhesive sensor

•NEO-L Neonatal single

LNCS patient adhesive sensor

•NEO PT-L Neonatal preterm

LNCS

0600-00-0124 < 3 kg. or

Disposable

> 40 kg.

0600-00-0125 > 1 kg. Disposable

single patient adhesive sensor

LNC-4 SpO2 Patient cable, 4' 0012-00-1652 All Re-usable

LNC-10 SpO2 Patient cable, 10' 0012-00-1599 All Re-usable

LNC-14 SpO2 Patient cable, 14' 0012-00-1653 All Re-usable

2. Attach the appropriate corresponding Patient Cable (P/N 0012-00-1099-02, 0012-00-

1652, 0012-00-1599, or 0012-00-1653 from table above) to the sensor and plug the other end of the patient cable into the SpO

NOTE: The PC Series Patient Cable is not used with the

NOTE: Do not place the sensor on an extremity with an invasive

•DCSC Sensors.

LNOP

catheter or blood pressure cuff in place.

connector (15).

NOTE: Ensure proper routing of patient cable to avoid

entanglement and/or strangulation.

CAUTION: When equipped with MASIMO® SpO2, use only MASIMO®

oxygen transducers including MASIMO LNOP® patient dedicated adhesive sensors and MASIMO PC Series Patient Cable. Use of other oxygen transducers may cause improper Oximetry performance.

CAUTION: Tissue damage or inaccurate measurements may be caused

CAUTION: Excessive ambient light may cause inaccurate

measurements. Cover the sensor with opaque materials.

3 - 22 0070-10-0692-02 Accutorr Plus™ Operating Instructions