Nihon Kohden ZM 940PA User Manual

TRANSMITTER

ZM-940PA

0614-009881

Model: ZM-940PA

Manual code no.: 0614-009881

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Contents

GENERAL HANDLING PRECAUTIONS.................................................................... i

WARRANTY POLICY ............................................................................................... iii

Equipment Authorization Requirement ................................................................... iii

EMC RELATED CAUTION ....................................................................................... iv

Conventions Used in this Manual and Instrument ................................................. vii

Warnings, Cautions and Notes ......................................................................... vii

Explanations of the Symbols in this Manual and Instrument ........................... viii

Introduction ....................................................................................................................1

Panel Description .......................................................................................................... 2

Front Panel ............................................................................................................... 2

Rear Panel ............................................................................................................... 3

Top Panel ................................................................................................................. 4

Bottom Panel ............................................................................................................ 4

LCD .......................................................................................................................... 6

Note on Parameter Settings .......................................................................................... 8

Important Safety Information ......................................................................................... 9

General .................................................................................................................... 9

Output Signal ........................................................................................................... 9

Preparation .................................................................................................................. 10

Installing (Replacing) Batteries ............................................................................. 10

WARNING and CAUTION for Battery Handling ............................................... 10

Battery Lifetime ................................................................................................. 10

Installing (Replacing) Batteries ........................................................................ 11

Situations Requiring Battery Replacement ..................................................... 12

Battery Condition Indication ............................................................................. 12

Turning the Transmitter On/Off ............................................................................... 13

Turning On the Power ....................................................................................... 13

Turning Off the Power ....................................................................................... 13

Check Items Before Use .................................................................................. 13

Check Items After Power On ............................................................................ 1 4

Check Items After Use ...................................................................................... 14

Changing the Transmitter Channel ............................................................................. 15

Changing Parameter Setup Settings .......................................................................... 16

Parameter Setup Setting List ................................................................................. 16

Displaying the PARAMETER SETUP Screen ....................................................... 17

Changing Settings ................................................................................................. 18

Operator's Manual ZM-940PA i

SELECTABLE INTERVALS .............................................................................. 1 8

INITIAL INTERVAL ............................................................................................ 18

INITIAL CUFF PRESS ...................................................................................... 18

NIBP MODE AFTER STAT ................................................................................ 19

START/FINISH SOUND .................................................................................... 19

OLD NIBP DATA/AFTER .................................................................................. 19

INHIBIT SpO

DURING NIBP ........................................................................... 20

2

2ND PARAMETER ........................................................................................... 20

LEADS OFF DISPLAY ...................................................................................... 21

ECG ELECTRODE ........................................................................................... 21

Changing System Setup Settings ............................................................................... 22

System Setup Setting List ...................................................................................... 22

Displaying the SYSTEM SETUP Screen ............................................................... 22

Changing Settings ................................................................................................. 23

CHANNEL/TYPE .............................................................................................. 23

PRESSURE UNIT ............................................................................................ 23

LANGUAGE ...................................................................................................... 24

BRIGHTNESS .................................................................................................. 24

SYSTEM INITIALIZE ......................................................................................... 24

Attaching NIBP Cuff, Electrodes and SpO

Probe to the Patient ................................ 25

2

Attachment Examples ............................................................................................ 25

Attaching the NIBP Cuff ......................................................................................... 26

Selecting the NIBP Cuff .................................................................................... 26

Connecting the NIBP Cuff to the Transmitter .................................................... 29

Attaching the NIBP Cuff to the Patient ............................................................. 3 1

Attaching Electrodes .............................................................................................. 35

Selecting Electrode Lead ................................................................................. 35

Connecting the Electrode Lead to the Transmitter ........................................... 36

Selecting the Electrode Position ...................................................................... 36

Attaching Electrodes to the Patient and Connecting the Electrode Leads to

Disposable Electrodes ..................................................................................... 40

Electrode Position for Respiration Monitoring ................................................. 41

Attaching the SpO

Selecting the SpO
Connecting the SpO

Probe ...................................................................................... 43

2

Probe ................................................................................ 43

2

Probe to the Transmitter ................................................ 46

2

Attaching the Probe to the Patient ................................................................... 4 6

Locking the Keys on the Transmitter ........................................................................... 48

Monitoring .................................................................................................................... 49

NIBP Monitoring ..................................................................................................... 49

Selecting the Initial Cuff Inflation Pressure ...................................................... 49

Selecting the Measurement Mode and Interval ............................................... 49

Measuring NIBP ............................................................................................... 50

ii Operator's Manual ZM-940PA

Monitoring SpO2 during NIBP Measurement ................................................... 53

ECG and Respiration Monitoring .......................................................................... 53

Electrode Detachment ..................................................................................... 55

SpO

Monitoring ..................................................................................................... 56

2

SpO

and PR Display Order ............................................................................. 57

2

Monitoring SpO

during NIBP Measurement ................................................... 57

2

Display and Message List ........................................................................................... 59

Battery Indication ................................................................................................... 59

ECG/Respiration .................................................................................................... 59

SpO

....................................................................................................................... 60

2

NIBP ....................................................................................................................... 61

Troubleshooting........................................................................................................... 62

Transmitter ............................................................................................................. 62

ECG/Respiration .................................................................................................... 63

SpO

....................................................................................................................... 63

2

NIBP ....................................................................................................................... 64

Maintenance ................................................................................................................ 66

1. External Check ............................................................................................ 66

2. Transmitter Channel..................................................................................... 66

3. LCD Display ................................................................................................. 68

4. Key Operation .............................................................................................. 69

5. NIBP Cuff for Attaching Transmitter to Patient Arm ...................................... 70

Maintenance Check Sheet .................................................................................... 7 1

Repair Parts Availability Policy.................................................................................... 72

Lifetime and Disposal .................................................................................................. 7 3

Disposing of Used Batteries .................................................................................. 73

Battery Lifetime ................................................................................................. 73

Disposal ........................................................................................................... 73

Disposing of Electrodes, SpO

Probes and NIBP Cuffs ........................................ 73

2

Cleaning, Disinfection and Sterilization ...................................................................... 74

Transmitter and Electrode Leads........................................................................... 74

Cleaning ........................................................................................................... 74

Disinfection....................................................................................................... 74

SpO

Probe ............................................................................................................ 75

2

YP-943P/944P NIBP Cuffs ..................................................................................... 75

Cleaning ........................................................................................................... 75

Disinfection....................................................................................................... 75

Specifications .............................................................................................................. 76

Measuring Parameters..................................................................................... 76

Transmitting Data ............................................................................................. 76

Displayed Data................................................................................................. 76

ECG Measurement........................................................................................... 76

Operator's Manual ZM-940PA iii

Respiration Measurement ............................................................................... 76

SpO

Measurement .......................................................................................... 76

2

NIBP Measurement .......................................................................................... 77

Pulse Rate ........................................................................................................ 77

Transmitter ........................................................................................................ 77

Power Requirements ........................................................................................ 77

Dimension and Weight..................................................................................... 77

Environment ..................................................................................................... 78

Safety Standards .............................................................................................. 78

Electromagnetic Compatibility ......................................................................... 79

Electromagnetic Emissions .............................................................................. 79

Electromagnetic Immunity ................................................................................ 80

Recommended Separation Distance between Portable and Mobile RF

Communications Equipment............................................................................ 82

System Composition for EMC Test ................................................................... 82

Standard Accessories ................................................................................................. 83

Options ........................................................................................................................ 84

Transmitter ........................................................................................................ 84

ECG/RESP ....................................................................................................... 84

NIBP ................................................................................................................. 84

SpO

................................................................................................................. 85

2

Transmission Frequencies .......................................................................................... 86

iv Operator's Manual ZM-940PA

GENERAL HANDLING PRECAUTIONS

This device is intended for use only by qualified medical personnel.
Use only Nihon Kohden approved products with this device. Use of non-approved
products or in a non-approved manner may affect the performance specifications of
the device. This includes, but is not limited to, batteries, recording paper, pens,
extension cables, electrode leads, input boxes and AC power.

Please read these precautions thoroughly before attempting to operate the instrument.

1. To safely and effectively use the instrument, its operation must be fully understood.

2. When installing or storing the instrument, take the following precautions:

(1) Avoid moisture or contact with water, extreme atmospheric pressure, excessive

humidity and temperatures, poorly ventilated areas, and dust, saline or sulphuric air.

(2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock,

even during transport.

(3) Avoid placing in an area where chemicals are stored or where there is danger of gas

leakage.

(4) The power line source to be applied to the instrument must correspond in frequency

and voltage to product specifications, and have sufficient current capacity.

(5) Choose a room where a proper grounding facility is available.

3. Before Operation

(1) Check that the instrument is in perfect operating order.
(2) Check that the instrument is grounded properly.
(3) Check that all cords are connected properly.
(4) Pay extra attention when the instrument is in combination with other instruments to

avoid misdiagnosis or other problems.
(5) All circuitry used for direct patient connection must be doubly checked.
(6) Check that battery level is acceptable and battery condition is good when using battery-

operated models.

4. During Operation

(1) Both the instrument and the patient must receive continual, careful attention.
(2) Turn power off or remove electrodes and/or transducers when necessary to assure the

patient’s safety.
(3) Avoid direct contact between the instrument housing and the patient.

5. To Shutdown After Use

(1) Turn power off with all controls returned to their original positions.
(2) Remove the cords gently; do not use force to remove them.

Operator's Manual ZM-940PA i

(3) Clean the instrument together with all accessories for their next use.

6. The instrument must receive expert, professional attention for maintenance and
repairs. When the instrument is not functioning properly, it should be clearly
marked to avoid operation while it is out of order.

7. The instrument must not be altered or modified in any way.

8. Maintenance and Inspection:

(1) The instrument and parts must undergo regular maintenance inspection at least every 6

months.

(2) If stored for extended periods without being used, make sure prior to operation that the

instrument is in perfect operating condition.

(3) Technical information such as parts list, descriptions, calibration instructions or other

information is available for qualified user technical personnel upon request from your
Nihon Kohden distributor.

9. When the instrument is used with an electrosurgical instrument, pay careful
attention to the application and/or location of electrodes and/or transducers to avoid
possible burn to the patient.

10. When the instrument is used with a defibrillator, make sure that the instrument is
protected against defibrillator discharge. If not, remove patient cables and/or
transducers from the instrument to avoid possible damage.

ii Operator's Manual ZM-940PA

WARRANTY POLICY

Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and
workmanship for one year from the date of delivery. However, consumable materials such as
recording paper, ink, stylus and battery are excluded from the warranty.

NKC or its authorized agents will repair or replace any products which prove to be defective
during the warranty period, provided these products are used as prescribed by the operating
instructions given in the operator’s and service manuals.

No other party is authorized to make any warranty or assume liability for NKC’s products.
NKC will not recognize any other warranty, either implied or in writing. In addition, service,
technical modification or any other product change performed by someone other than NKC or
its authorized agents without prior consent of NKC may be cause for voiding this warranty.

Defective products or parts must be returned to NKC or its authorized agents, along with an
explanation of the failure. Shipping costs must be pre-paid.

This warranty does not apply to products that have been modified, disassembled, reinstalled or
repaired without Nihon Kohden approval or which have been subjected to neglect or accident,
damage due to accident, fire, lightning, vandalism, water or other casualty, improper installation
or application, or on which the original identification marks have been removed.

In the USA and Canada other warranty policies may apply.

CAUTION

United States law restricts this device to sale by or on the order of a physician.

Equipment Authorization Requirement

Operation of this equipment requires the prior coordination with a frequency coordinator
designated by FCC for the Wireless Medical Telemetry Service.

Operator's Manual ZM-940PA iii

EMC RELATED CAUTION

This equipment and/or system complies with IEC 60601-2 International Standard
for electromagnetic compatibility for medical electrical equipment and/or
system. However, an electromagnetic environment that exceeds the limits or
levels stipulated in IEC 60601-1-2, can cause harmful interference to the
equipment and/or system or cause the equipment and/or system to fail to
perform its intended function or degrade its intended performance. Therefore,
during the operation of the equipment and/or system, if there is any undesired
deviation from its intended operational performance, you must avoid, identify
and resolve the adverse electromagnetic effect before continuing to use the
equipment and/or system.

The following describes some common interference sources and remedial
actions:

1.Strong electromagnetic interference from a nearby emitter source such as an

authorized radio station or cellular phone:
Install the equipment and/or system at another location. Keep the emitter
source such as cellular phone away from the equipment and/or system, or
turn off the cellular phone.

2.Radio-frequency interference from other equipment through the AC power

supply of the equipment and/or system:
Identify the cause of this interference and if possible remove this interference
source. If this is not possible, use a different power supply.

3.Effect of direct or indirect electrostatic discharge:

Make sure all users and patients in contact with the equipment and/or system
are free from direct or indirect electrostatic energy before using it. A humid
room can help lessen this problem.

4.Electromagnetic interference with any radio wave receiver such as radio or

television:
If the equipment and/or system interferes with any radio wave receiver, locate
the equipment and/or system as far as possible from the radio wave receiver.

5.Interference of lightning

When lightning occurs near the location where the equipment and/or system is
installed, it may induce an excessive voltage in the equipment and/or system.
In such a case, disconnect the AC power cord from the equipment and/or
system and operate the equipment and/or system by battery power, or use an
uninterruptible power supply.

iv Operator's Manual ZM-940PA

6.Use with other equipment
When the equipment and/or system is adjacent to or stacked with other
equipment, the equipment and/or system may affect the other equipment.
Before use, check that the equipment and/or system operates normally with
the other equipment.

7.Use of unspecified accessory, transducer and/or cable
When an unspecified accessory, transducer and/or cable is connected to this
equipment and/or system, it may cause increased electromagnetic emission
or decreased electromagnetic immunity. The specified configuration of this
equipment and/or system complies with the electromagnetic requirements
with the specified configuration. Only use this equipment and/or system with
the specified configuration.

8.Use of unspecified configuration
When the equipment and/or system is used with the unspecified system
configuration different than the configuration of EMC testing, it may cause
increased electromagnetic emission or decreased electromagnetic immunity.
Only use this equipment and/or system with the specified configuration.

9.Measurement with excessive sensitivity
The equipment and/or system is designed to measure bioelectrical signals
with a specified sensitivity. If the equipment and/or system is used with
excessive sensitivity, artifact may appear by electromagnetic interference
and this may cause mis-diagnosis. When unexpected artifact appears, inspect
the surrounding electromagnetic conditions and remove this artifact source.

If the above suggested remedial actions do not solve the problem, consult your
Nihon Kohden distributor or representative for additional suggestions.

This equipment complies with International Standard IEC 60601-1-2 (1993) which
requires CISPR11, Group 1, Class B. Class B EQUIPMENT is equipment suitable
for use in domestic establishments and in establishments directly connected to
a low voltage power supply network which supplies buildings used for domestic
purposes.

Operator's Manual ZM-940PA v

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vi Operator's Manual ZM-940PA

Conventions Used in this Manual and Instrument

Warnings, Cautions and Notes

Warnings, cautions and notes are used in this manual to alert or signal the reader to specific
information.

WARNING

A warning alerts the user to the possible injury or death associated with the use
or misuse of the instrument.

CAUTION

A caution alerts the user to possible injury or problems with the instrument
associated with its use or misuse such as instrument malfunction, instrument
failure, damage to the instrument, or damage to other property.

NOTE

A note provides specific information, in the form of recommendations,
prerequirements, alternative methods or supplemental information.

Operator's Manual ZM-940PA vii

Explanations of the Symbols in this Manual and Instrument

The following symbols found in this manual/instrument bear the respective descriptions as
given.

On Panel

Symbol Description Symbol Description

Defibrillation proof type BF
applied part

Defibrillation proof type CF
applied part

Attention, consult operator’s
manual

Direction for attaching
battery cover

Inside Battery Case

Direct current

Serial number

Year of manufacture

CSA mark

Symbol Description Symbol Description

Battery position

On LCD

Attention, consult operator’s
manual

Symbol Description Symbol Description

Full battery

Replace battery
NIBP cannot be measured

Replace battery Check electrode

viii Operator's Manual ZM-940PA

Introduction

The ZM-940PA transmitter transmits ECG, respiration, SpO2, NIBP and pulse waveform from
a patient to a Nihon Kohden monitor for continuous monitoring. The transmitter can change
channels when connected to the QI-901PK channel writer. The front LCD displays SpO
NIBP, pulse rate, pulse waveform amplitude, electrode condition mark, battery condition and
NIBP measuring mode and interval.

Read the operator’s manual for the receiving monitor together with this manual before operation.

CAUTION

• Do not use the same channel for different patients. Otherwise, two patients’
data will be lost due to mutual modulation interference, or another patient’s
data may appear on the receiving monitor screen.

• Do not use transmitters of adjacent channels in a hospital. Otherwise, radio
waves from one transmitter affect the receiver of the adjacent channel’s
transmitter and there may be interference.

• Do not use the same transmitter on more than one patient at the same time.
Do not connect different sensors on different patients to the same transmitter.

NOTE

• To prevent interference between channels, assign a channel administrator in
the hospital and only he or she should manage channel assignment.

• Use Nihon Kohden parts and accessories to assure maximum performance
from your instrument.

• For stable signal reception, it is recommended to use a diversity antenna
system on the receiving monitor. Otherwise, spike noise from transient fading
of electric field strength (for example, people moving) may interfere with the
transmitter signal and may be mistaken as an arrhythmia on the receiving
monitor.

• NIBP cannot be measured on a neonate. (ECG, respiration and SpO
monitored on a neonate.)

can be

2

%,

2

Operator's Manual ZM-940PA 1

Panel Description

Front Panel

LCD:

Displays measuring data, settings and
other information.

NIBP START/STOP key:

Starts/stops NIBP measurement in
selected mode.

NIBP INTERVAL key:

Selects NIBP measurement mode.

Refer to the WARNING below.
(This symbol is attached to the rear of the
battery case cover.)

Battery case:

Contains three 1.5 V AA batteries.

WARNING

Close the battery case cover during operation.
If the transmitter is used with the battery case cover open, the patient may get
an electrical shock when defibrillation is performed, and electrostatic discharge
by the patient may intermittently interfere with the waveform or data.

2 Operator's Manual ZM-940PA

Rear Panel

Lock plate:

Fastens the transmitter to an NIBP cuff.

Refer to the WARNING below.

WARNING

This transmitter is not waterproof. If detergent or liquid spills into the
transmitter, stop using it and contact your Nihon Kohden distributor. If a wet
transmitter is used, the patient or anyone in contact with the transmitter may
receive an electric shock or patient leakage current over the allowed amount
may flow.

Operator's Manual ZM-940PA 3

Top Panel

Refer to the WARNING on the
next page.

Refer to the WARNING on the
next page.

NIBP socket:

Connects the cuff hose.

Refer to the symbol page.

Bottom Panel

Channel number label:

Indicates the channel number of the
transmitter. Attach the channel number label
to the panel of the monitor.

Refer to the symbol
page.

ECG/impedance RESP socket:

Connects the electrode lead for
measuring ECG and/or respiration
by the impedance method.

Refer to the symbol page.

SpO

socket:

2

Connects the SpO

2

probe.

Refer to the WARNING on the next
page.

4 Operator's Manual ZM-940PA

WARNING

• Before performing defibrillation, check that the electrode leads and SpO
probe attached to the patient are properly connected to the transmitter.
Touching the metal parts of disconnected leads and probes causes serious
electrical shock or injury by discharged energy.

• When performing defibrillation, all persons must keep clear of the bed and
must not touch the patient, any equipment connected to the patient or the
metal parts of leads and probes connected to the patient. Failure to follow this
warning may result in serious electrical burn, shock or other injury.

• When performing defibrillation, discharge as far as possible from electrodes
and medicine on the chest of the patient. If there is a possibility that the
defibrillator paddle could touch electrodes and medicine, remove electrodes
and medicine from the patient. If the defibrillator contacts these materials, the
discharged energy may cause serious electrical burn on the patient.

• When using this transmitter with an ESU, the ESU return plate and the
electrodes for monitoring must be firmly attached to the patient. If the return
plate is not attached correctly, it may burn the patient’s skin where the
electrodes are attached. Refer to the instruction manual for the ESU.

2

CAUTION

Do not shake or swing the transmitter holding the leads/cables connected to the
transmitter. The transmitter may come off and injure someone or damage
surrounding instruments.

Operator's Manual ZM-940PA 5

LCD

1234

6

5

10

LOCK
KEYS

11

9

8

No. Name Description

1 NIBP SYS Displays NIBP systolic value.
2 NIBP DIA Displays NIBP diastolic value.
3 NIBP MEAN Displays NIBP mean value.

“CUFF” is displayed with the cuff inflation pressure during
measurement.

4 Check electrode mark Appears when an electrode or electrode lead becomes

detached during ECG measurement.

5 Battery replacement mark Appears when the batteries are weak. For details, refer to

the “Battery Condition Indication” section.

6 Message display area Displays messages.

When ECG is monitored with 6 electrodes and an electrode
or electrode lead is detached, “Check electrode” is indicated
as below, depending on the PARAMETER SETUP setting.
Refer to the “Changing Parameter Setup Settings” and “ECG
and Respiration Monitoring” sections.

7

LEADS OFF DISPLAY set to CHAR
ECG ELECTRODE set to AHA

LEADS OFF DISPLAY set to IMAGE

6 Operator's Manual ZM-940PA

LEADS OFF DISPLAY set to CHAR
ECG ELECTRODE set to IEC

No. Name Description

7 NIBP measurement mode Displays NIBP measurement mode. When set to auto mode,

the measurement interval is displayed.

8 NIBP interval bar graph In auto NIBP measurement, the remaining time from the last

measurement to the next measurement is displayed as a bar
graph.

9 Pulse level bar graph Displays pulse level in 7 steps.

10 %SpO

2

11 PR Displays pulse rate when NIBP or SpO

Displays SpO2 data.

the SpO

probe is attached to the patient, the real time pulse

2

rate is displayed. When the SpO

is measured. When

2

probe is not attached to the

2

patient, the pulse rate at the end of NIBP measurement is
displayed.

Operator's Manual ZM-940PA 7

Notes on Parameter Settings

When monitoring NIBP and SpO2, the following setting must be set as indicated in the table to
properly transmit the monitoring data to the receiving monitor. Otherwise, SpO
monitored properly during NIBP measurement.

Some receiving monitors require the software to be upgraded. For details, contact your Nihon
Kohden distributor.

SpO2 probe attachment site INHIBIT SpO2 DURING NIBP setting

Probe attached to the same limb as the cuff ON
Probe attached to the limb without cuff* OFF

* When the SpO2 probe is attached to the same limb as the NIBP cuff and the cuff is

inflated, the SpO

value becomes unstable and SpO2 or PR alarm may occur.

2

cannot be

2

8 Operator's Manual ZM-940PA

Important Safety Information

General

WARNING

• Never use this transmitter in the presence of any flammable anesthetic gas or
high concentration oxygen atmosphere. Failure to follow this warning may
cause explosion or fire.

• Never use this transmitter in a high-pressure oxygen medical care tank.
Failure to follow this warning may cause explosion or fire.

• Do not take this transmitter into the MRI test room. This transmitter is not
designed to be used during MRI tests.

Output Signal

WARNING

Do not use the output signal from the receiving monitor as the synchronization
signal for other equipment such as IABP, MRI, echocardiography or defibrillator
because there may be time delay between the monitor and the other equipment
caused by waveform transmission delay and spike noise may interfere on the
output signal and be mistaken as a trigger.

Operator's Manual ZM-940PA 9

Preparation

Installing (Replacing) Batteries

WARNING and CAUTION for Battery Handling

WARNING

• Do not dispose of the battery in fire because it may explode.

• Do not use a disassembled or damaged battery. The contents of the battery
are harmful and the battery may catch fire.

• If the contents of the battery contact the skin or clothes, immediately wash it
thoroughly with water.

• Never short-circuit the + and – terminals. The battery may overheat and catch
fire.

• Take care that the patient does not swallow batteries.

CAUTION

• Refer to the battery and battery charger manuals for details on handling the
batteries.

• Do not handle the batteries with wet hands.

• When the transmitter is not in use, remove batteries. When batteries are
installed, battery power is consumed even if measurement is not performed.
Especially, when NiMH batteries remain in the transmitter when the
transmitter is not in use, the battery may become unusable from
overdischarge and leak liquid which will damage the transmitter.

• The battery charger must be used outside the patient environment.

Battery Lifetime

Use three AA type alkaline dry cell batteries. NiMH rechargeable batteries can also be used.

Type Lifetime (Measuring parameters)

ECG, SpO2, NIBP ECG, SpO

2

ECG only

NiMH secondary 2 days 2 days 2.5 days
Alkaline primary 1 day 2.5 days 3 days

The above data is when new batteries are used at room temperature, NIBP is measured in auto
mode at 60 minute intervals and SpO

is measured on an index finger of a male patient with

2

weight 60 kg.
Operation time depends on the thickness of SpO

10 Operator's Manual ZM-940PA

probe attachment site.

2

NOTE

When using rechargeable NiMH batteries, shallow charging/discharging
shortens battery capacity. For details, refer to the battery operator’s manual.

Installing (Replacing) Batteries

CAUTION

Battery replacement must be performed by medical staff. When replacing
batteries of the transmitter currently used for a patient, disconnect electrode
leads from the transmitter before replacing batteries or do not touch the patient
during replacement.

If electrode leads are attached to the patient and a person replacing batteries touches the patient
during battery replacement, patient leakage current over the allowed amount may flow.

CAUTION

• Replace all batteries at the same time.

• Do not use different types of batteries together.

NOTE

Insert the batteries with the correct polarity (+ and –).

Procedure

1. Remove the battery case cover.

2. Insert three new or fully charged batteries into the
battery case observing the correct polarity.

Operator's Manual ZM-940PA 11

3. Close the cover.

NOTE

Remove the batteries before disposing of the
transmitter.

Situations Requiring Battery Replacement

Replace the batteries when any of the following occurs.

• The transmitter LCD displays the “

• The transmitter generates a constant alarm (continuous “peep” sound).

• The transmitter LCD does not display anything when the power is turned on.

• The monitor displays the battery replacement message on the screen.

Battery Condition Indication

The battery condition is indicated as follows.

Indication Condition Receiving Monitor

Fully charged battery

Batteries are low. Replace
batteries.
Batteries are low. NIBP cannot
be measured. Replace batteries.

No

indication

Dead batteries

” or “ ”mark.

Batteries are full. There is no indication on
the monitor.

Message requiring battery replacement is
displayed.

No signal can be transmitted to the monitor.
There is no indication on the monitor.

12 Operator's Manual ZM-940PA

Turning the Transmitter On/Off

Turning On the Power

Peep

Check Items Before Use

Before turning on the transmitter power, check the following to confirm that the transmitter can
be used in normal and safe condition.

When the batteries are installed correctly, the power is
turned on. A one second “peep” sounds and the startup
screen appears. (There is no “peep” sound when there is
no battery power.)

NOTE

Replace the batteries when the LCD displays
the “

Turning Off the Power

To turn off the power, remove batteries.

” or “ ”mark.

Appearance

• There are no damaged or dirty parts on the outside of the transmitter (LCD, keys, sockets,
battery case cover, battery case, lock plate, etc.).

• The transmitter is completely dry.

• The electrode lead, SpO

• There are no damaged or dirty parts on the disposable SpO

probe and NIBP cuff are not broken.

2

probe, disposable electrodes or

2

disposable NIBP cuff.

Batteries

• The battery polarity is correct.

• The battery case spring is firmly fixed and the battery is not loose.

• The battery case cover is firmly closed.

Channel Setting

• The transmitter channel corresponds to those of the receiving monitor.

• There is no transmitter in the surrounding area with the same channel.

Operator's Manual ZM-940PA 13

Check Items After Power On

After turning on the power, check the following.

Power On

• The transmitter generates about a one second “peep” sound and the startup screen appears.

• The transmitter does not generate a continuous “peep” sound.

• The transmitter does not give excessive heat.

• The transmitter LCD displays a “

” mark.

• The transmitter does not interfere with the operation of other medical instruments in use.

Basic Operation

• The “signal loss” message is not displayed on the receiving monitor when the transmitter is
inside the receiving range of the monitor.

• The battery replacement message is not displayed on the monitor.

• The keys on the transmitter function properly.

• The LCD brightness is appropriate. To adjust brightness, refer to the “Changing System
Setup Settings” section.

Check Items After Use

To use the transmitter in safe and optimum condition for next time, check the following.

Before Turning Power Off

• Temporarily changed settings are changed back to the previous settings.

• There was no malfunction on the transmitter.

Storage

• ECG electrode leads, SpO

probe and NIBP cuff are cleaned and disinfected.

2

• When the transmitter gets wet, liquid is wiped off and the transmitter is thoroughly dried.

• There are enough consumables, such as disposable electrodes.

• The transmitter power is turned off by removing batteries from the transmitter.

• Dead batteries are disposed of properly.

14 Operator's Manual ZM-940PA

Changing the Transmitter Channel

The channel of the transmitter can be changed. The optional QI-901PK Channel Writer is
required.

WARNING

The following action must be taken to properly receive the transmitter signal of
the correct patient on the receiving instrument. Otherwise, there may be signal
loss or signals may mix causing a serious accident, such as monitoring a
different patient.

• Assign a channel administrator in the hospital and only he or she should
manage channel assignment on his or her responsibility.

• The channel administrator must manage the channels in the facility so that
there is no signal interference.

• When the transmitter channel is changed, the channel administrator must
check that the channel on the receiving monitor is also changed and the signal
is properly received.

• The channel administrator must replace the channel number label on the
transmitter with the new one after changing the channel.

NOTE

The software version of the QI-901PK channel writer must be 02-01 or later to
change the channel on the ZM-940PA transmitter.

To check the transmitter channel, refer to “CHANNEL” in the “Changing System Setup
Settings” section.

Operator's Manual ZM-940PA 15

Changing Parameter Setup Settings

The initial settings on the PARAMETER SETUP screen must be changed before monitoring.
Changing these settings during monitoring interrupts monitoring.

Parameter Setup Setting List

The factory default settings are underlined.

Setting Item Description Settings

SELECTABLE
INTERVALS

INITIAL
INTERVAL

INITIAL CUFF
PRESS

NIBP MODE
AFTER STAT
START/FINISH
SOUND

OLD NIBP DATA
AFTER

INHIBIT SpO

2

DURING NIBP
2ND PARAMETER Set SpO2 and PR display order. SpO2, PR

LEADS OFF
DISPLAY

ECG ELECTRODE

Select the NIBP measurement modes for
the mode selection.

Select the initial NIBP measurement
mode at power on.

Select the NIBP cuff inflation pressure.

Select the NIBP measurement mode
after completing STAT measurement.
Turn ON or OFF the sound for NIBP
measurement start/finish.
Select whether to hide or dim the NIBP
data after measurement and how long to
wait after measurement to dim or hide it.
Turn SpO

2

monitoring on or off during

NIBP measurement.

Select the mode for displaying electrode
off. This setting is only available when
ECG is monitored with 6 electrodes.
Select the electrode lead type. This
setting is only available when CHAR is
selected for LEADS OFF DISPLAY.

STAT, 5, 10, 15, 30, 60,
120, 240
MAN., 5 min, 10 min,
15 min, 30 min, 60 min,
120 min, 240 min
120 mmHg, 150 mmHg,
180 mmHg, 210 mmHg,
240 mmHg
MAN., 5 min, 10 min,
15 min, 30 min

ON, OFF/ON, OFF

DATA: HIDE, DIM
AFTER: 5 min, 10 min,
30 min

ON, OFF

CHAR, IMAGE

IEC, AHA

16 Operator's Manual ZM-940PA

Displaying the PARAMETER SETUP Screen

1. Remove one battery.

2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.

The SETUP screen appears.

3. Press the NIBP START/STOP key to enter the PARAMETER SETUP screen.

When the cursor is moved to “EXIT” by pressing the NIBP INTERVAL key and the NIBP
START/STOP key is pressed, the startup screen appears, then the monitoring screen
appears.

4. To select or change a setting, press the NIBP START/STOP key.

To move the cursor, press the NIBP INTERVAL key.

Selects or changes setting

Moves cursor

When the cursor is moved to “RETURN” by pressing the NIBP INTERVAL key and the
NIBP START/STOP key is pressed, the SETUP screen appears.

Operator's Manual ZM-940PA 17

Changing Settings

SELECTABLE INTERVALS

During monitoring, when the NIBP INTERVAL key is pressed, the measurement mode changes
according to the modes selected in this item. MANUAL mode is already selected for the mode
selection.

1. Press the NIBP INTERVAL key to move the
cursor to the desired mode.

2. Press the NIBP START/STOP key to select or
unselect the mode. Selectable modes are: STAT,
5, 10, 15, 30, 60, 120 and 240 min.

INITIAL INTERVAL

Select the initial NIBP measurement mode at power on.

1. Press the NIBP INTERVAL key to move the
cursor to “INITIAL INTERVAL”.

2. Press the NIBP START/STOP key to select
the mode. Selectable modes are the modes
selected for “SELECTABLE INTERVALS”
and “MAN.” (MANUAL).

INITIAL CUFF PRESS

Select the NIBP cuff inflation pressure.

1. Press the NIBP INTERVAL key to move the
cursor to “INITIAL CUFF PRESS”.

2. Press the NIBP START/STOP key to select
the inflation pressure from 120, 150, 180, 210
and 240 mmHg.

18 Operator's Manual ZM-940PA

NIBP MODE AFTER STAT

Select the NIBP measurement mode after completing the STAT measurement.

1. Press the NIBP INTERVAL key to move the
cursor to “NIBP MODE AFTER STAT”.

2. Press the NIBP START/STOP key to select
the mode. The selected mode is automatically
selected for “SELECTABLE INTERVALS”
as well.

START/FINISH SOUND

Turn on or off the sound for NIBP measurement start and finish.

Start sound

End sound

1. Press the NIBP INTERVAL key to move the
cursor to “START/FINISH SOUND”.

2. Press the NIBP START/STOP key to turn ON
or OFF.

OLD NIBP DATA/AFTER

Select whether to dim or hide the NIBP data after measurement and how long to wait after NIBP
measurement to dim or hide it.

1. Press the NIBP INTERVAL key to move the
cursor to “OLD NIBP DATA/AFTER”.

2. Press the NIBP START/STOP key to select the
setting.

DATA: DIM NIBP data is dimmed after the “AFTER” interval.

HIDE NIBP data is hidden after the “AFTER” interval. “– – –” is displayed on the

screen.

AFTER: Select the interval after NIBP measurement to dim or hide.

Dimmed Hidden

Operator's Manual ZM-940PA 19

INHIBIT SpO2 DURING NIBP

Set whether or not to monitor SpO

during NIBP measurement.

2

When the SpO
OFF, the pulse may become unstable and SpO
set this setting to ON so that SpO

When the SpO

probe is attached to the same limb as the NIBP cuff and this setting is set to

2

or PR alarm may occur. It is recommended to

2

is not measured during NIBP measurement.

2

probe is attached to the other limb from the NIBP cuff, this setting can be set to

2

OFF.

NOTE

When this “INHIBIT SpO2 DURING NIBP” is set to OFF, refer to the “Monitoring
SpO

during NIBP Measurement” section.

2

1. Press the NIBP INTERVAL key to move the

ON: Stops SpO
OFF: SpO

monitoring during NIBP measurement.

2

is monitored during NIBP measurement.

2

2ND PARAMETER

Set the display order of SpO

and PR.

2

cursor to “INHIBIT SpO

2. Press the NIBP START/STOP key to select
“ON” or “OFF”.

DURING NIBP”.

2

1. Press the NIBP INTERVAL key to move the
cursor to “2ND PARAMETER”.

2. Press the NIBP START/STOP key to select
“SpO

” or “PR”.

2

When set to SpO

20 Operator's Manual ZM-940PA

2

When set to PR

LEADS OFF DISPLAY

Select the mode for displaying electrode off. This setting is only available when ECG is
monitored with 6 electrodes.

1. Press the NIBP INTERVAL key to move the
cursor to “LEADS OFF DISPLAY”.

2. Press the NIBP START/STOP key to select
“CHAR” or “IMAGE”.

When set to CHAR

When set to IMAGE

ECG ELECTRODE

Select the electrode lead type. This setting is only available when “CHAR” is selected for
LEADS OFF DISPLAY.

1. Press the NIBP INTERVAL key to move the cursor
to “ECG ELECTRODE”.

2. Press the NIBP START/STOP key to select “IEC”
or “AHA”.

AHA: RA, LA, LL, Va, Vb
IEC: R, L, F, Ca, Cb

Operator's Manual ZM-940PA 21

Changing System Setup Settings

NOTE

Changing System Setup settings must be done only by a qualified personnel.

System Setup Setting List

The factory default settings are underlined.

Setting Item Description Settings

CHANNEL Displays the transmitter channel.
PRESSURE UNIT Select the units for NIBP. mmHg, kPa
LANGUAGE Select the language for screen display. JPN, ENG
BRIGHTNESS Select the LCD brightness. 1, 2, 3, 4
SYSTEM
INITIALIZE

Displaying the SYSTEM SETUP Screen

1. Remove one battery.

2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.
The SETUP screen appears.

Initializes all settings to the factory default
settings.

3. Press the NIBP INTERVAL key to move the cursor to “SYSTEM SETUP”.

4. Press the NIBP START/STOP key to enter the
SYSTEM SETUP screen.

When the cursor is moved to “EXIT” by
pressing the NIBP INTERVAL key and the
NIBP START/STOP key is pressed, the startup
screen appears, then the monitoring screen
appears.

22 Operator's Manual ZM-940PA

5. To select or change a setting, press the NIBP START/STOP key.
To move the cursor, press the NIBP INTERVAL key.

Selects or changes setting

Moves cursor

When the cursor is moved to “RETURN” by pressing the NIBP INTERVAL key and the
NIBP START/STOP key is pressed, the SETUP screen appears.

Changing Settings

CHANNEL

The channel of this transmitter is displayed.

Channel of this transmitter

PRESSURE UNIT

Select the unit for NIBP.

1. Press the NIBP INTERVAL key to move the
cursor to “PRESSURE UNIT”.

2. Press the NIBP START/STOP key to select
“mmHg” or “kPa”.

Operator's Manual ZM-940PA 23

LANGUAGE

Select the language for screen display.

1. Press the NIBP INTERVAL key to move the
cursor to “LANGUAGE”.

2. Press the NIBP START/STOP key to select the
language.

BRIGHTNESS

Select the LCD brightness.

1. Press the NIBP INTERVAL key to move the
cursor to “BRIGHTNESS”.

2. Press the NIBP START/STOP key to select the
LCD brightness from 1 to 4.

1234

Light .............................. Dark

SYSTEM INITIALIZE

Do the following procedure to initialize the settings to the factory default settings.

1. Press the NIBP INTERVAL key to move the cursor to “SYSTEM INITIALIZE”.

2. Press the NIBP START/STOP key. The “EXECUTE” message appears.

3. Press the NIBP START/STOP key to initialize the settings to the factory default settings.

24 Operator's Manual ZM-940PA

Attaching NIBP Cuff, Electrodes and SpO2 Probe

to the Patient

The transmitter can be attached to an arm of the patient or placed on the bedside. The required
length of the electrode leads and SpO
attached to the patient.

Monitoring SpO2 during NIBP Measurement
When the SpO

probe is attached to the same limb as the NIBP cuff, the blood

2

flow decreases during NIBP measurement and pulse wave cannot be detected
and SpO

cannot be monitored properly. When “INHIBIT SpO2 DURING NIBP” on

2

the PARAMETER SETUP screen is set to ON (factory default setting), SpO
monitoring is paused during NIBP measurement to avoid SpO2 alarm
occurrence. However, when monitoring SpO
careful when reading SpO

probe cable depends on how the transmitter is to be

2

NOTE

on the same limb as NIBP, be

2

values.

2

2

When monitoring SpO

is important, attach the probe to the limb to which the

2

NIBP cuff or catheter is not attached.

Attachment Examples

When transmitter is attached on an
arm

When placing the transmitter on a bedside,
place it on a stable and flat place. If the
transmitter falls off, it may be damaged.

Operator's Manual ZM-940PA 25

When transmitter is placed on a bedside

NOTE

Attaching the NIBP Cuff

Selecting the NIBP Cuff

Select the NIBP cuff appropriate for the patient.

NOTE

NIBP cannot be measured on neonates using this transmitter.

Reusable Cuffs

When attaching the transmitter to the patient arm, a special NIBP cuff is required. An optional
YN-990P extension hose (1.5 m) is available to extend the length between the NIBP socket on
the transmitter and NIBP cuff (e.g. when not attaching the transmitter to the patient arm and
placing the transmitter on a bedside).

Reusable cuff Model Width (cm) Air hose length (cm)

For adult

Standard YP-943P 13 15

Large YP-944P 15 15

Air hose

Width

When not attaching the transmitter to the patient arm, the following cuffs can be used. To use
these cuffs, an optional YN-990P extension hose (1.5 m) is required.

Reusable cuff Model Width (cm) Air hose length (cm)

For infants YP-960T 5

For
children

For adults

26 Operator's Manual ZM-940PA

Small YP-961T 7

Standard YP-962T 10

Standard YP-963T 13

Large YP-964T 15

Width

Air hose

15

Disposable Cuffs

CAUTION

The disposable cuffs are not sterilized. If necessary, sterilize the disposable
cuffs using glutaraldehyde solution by following the instructions for the
glutaraldehyde.

When not attaching the transmitter to the patient arm, the following disposable cuffs can be used.
To use these cuffs, an optional YN-990P extension hose (1.5 m) is required.

Reusable cuff Model Width (cm) Air hose length (cm)

For infants YP-910P 6

For children YP-912P 9

For adults

Small YP-913P 12

Standard YP-914P 14

Large YP-915P 16

Width

Air hose

20

Extension Hose

CAUTION

When using an extension hose, check that the extension hose is not bent or
squeezed. Otherwise, the cuff may not inflate or deflate. If the cuff cannot
deflate, it may cause congestion on the patient at the cuff attachment site.

YN-990P extension hose, 150 cm

Operator's Manual ZM-940PA 27

Reference for selecting a cuff

The AHA (American Heart Association) recommends that the cuff width be 40% of the

circumference of the upper arm. Refer to the following graph and select the cuff which suits the

patient’s arm.

NOTE

• If a range of arm circumference appropriate for the cuff is prescribed, use a
cuff within that range.

• To obtain accurate measured values, select a wide cuff which can be attached
to the upper arm. Measuring with a very narrow cuff may result in measured
values higher than the actual values.

• The YP-943P NIBP cuff is for standard size adult. Do not use this cuff when it
does not fit the patient.

Cuff Width and Arm Circumference

Reusable Cuffs

Cuff width (cm)

15

10

Children small YP-961T

5

Infants YP-960T

Adults large YP-944P (cuff for transmitter)

YP-964T

Adults standard YP-943P (cuff for transmitter)

YP-963T

Children standard YP-962T

Disposable Cuffs

Cuff width (cm)

0

20

15

10

5

0

10 20 30

Children standard YP-912P

Infants YP-910P

10 20 30

40

Adults large YP-915P

Adults standard YP-914P

Adults small YP-913P

40

50

Arm circumference (cm)

50 60

Arm circumference (cm)

60

28 Operator's Manual ZM-940PA

Connecting the NIBP Cuff to the Transmitter

When Using YP-943P/944P NIBP Cuff

To attach the YP-943P/944P NIBP cuff to the transmitter, the lock plate is required.

YP-943P/944P NIBP cuff

Lock plate

Front cover

Belt for the strap

Lock plate pocket

Top tab

For attaching the NIBP cuff to the transmitter

Air hose

Front cover open

NOTE

Do not roll up or put weight on the cuff with the lock
plate attached to it. Otherwise, the lock plate may
break.

D ring

Belt

Bottom tab

Operator's Manual ZM-940PA 29

1. Remove the lock plate from the
transmitter.

2. Insert the lock plate into the lock plate
pocket on the NIBP cuff.

3. Attach the transmitter to the lock plate
by inserting the tabs on the lock plate
into the slots on the transmitter.

4. Cover the transmitter with the front
cover of the NIBP cuff.

5. Connect the air hose to the NIBP socket
on the transmitter. Turn the cuff
connector joint until it clicks.

2

1

30 Operator's Manual ZM-940PA

When Using YP-960T series or YP-910P series NIBP Cuff

To use these NIBP cuffs, an optional YN-990P extension hose (1.5 m) is required.

NOTE

Connect the joints properly. If there is an air leak, NIBP cannot be measured
properly.

1. Connect the NIBP cuff to the extension hose.

2. Connect the other end of the extension hose to
the NIBP socket on the transmitter. Turn the
joint clockwise until it clicks.

To disconnect the cuff from the transmitter,
turn the hose joint counterclockwise.

Attaching the NIBP Cuff to the Patient

WARNING

Be careful when measuring NIBP on a patient with known bleeding disorders or
coagulation. After NIBP measurement, there may be dot hemorrhage, or
circulatory disorder by thrombus where the cuff was attached.

CAUTION

• Do not wrap the cuff on an arm or thigh which is used for injection. NIBP
measurement on an arm or thigh which is used for injection may cause a
reflux of blood and stop injection.

• Do not wrap the cuff too tight. It may cause poor blood circulation and
congestion. If the cuff is wrapped too loosely, the NIBP value may be
increased.

• If the skin gets irritated or redness appears on the skin from the cuff, change
the attachment site or stop using the cuff.

Operator's Manual ZM-940PA 31

• NIBP and SpO2 can be measured on the same limb, but the SpO2 monitoring
may not be accurate during NIBP measurement. Be careful when reading the
SpO

values.*

2

• Do not reuse disposable cuffs.

* Monitoring SpO2 during NIBP Measurement

When the SpO
during NIBP measurement and pulse wave cannot be detected and SpO
properly. When “INHIBIT SpO
set to ON (factory default setting), SpO
avoid SpO
NIBP, be careful when reading SpO

probe is attached to the same limb as the NIBP cuff, the blood flow decreases

2

cannot be monitored

2

DURING NIBP” on the PARAMETER SETUP screen is

2

monitoring is paused during NIBP measurement to

2

alarm occurrence. However, when monitoring SpO2 on the same limb as the

2

values.

2

NOTE

• Measuring NIBP at a site other than the upper arm gives different values from
those measured at the upper arm. When making diagnosis based on the NIBP
values, measure NIBP on an upper arm.

• To accurately detect the pulsatile flow of the artery, the cuff should be
wrapped around a bare upper arm.

• Do not use an abnormal cuff. The cuff deteriorates from use and cleaning.
Before use, check the cuff and confirm that there is no flaw, crack or hole in it.
Be careful not to damage the inflation bag. If the inflation bag has a hole or a
flaw, it may burst during use. Dispose of an abnormal cuff and replace it with
a new one.

• Refer to the NIBP cuff manual for details.

Cuff Position

Place the cuffed upper arm (brachium) at the same height as

When placing the
transmitter on a bed, make
sure that the hose is not
bent.

the patient’s heart. If the cuff is not at the same level as the
heart, the weight of the blood affects the blood pressure
reading. The pressure difference per unit height is 0.7
mmHg/cm. The blood pressure reading decreases when the
arm is higher than the heart and increases when lower.

Heart

The best measuring condition is when the patient is lying on
his/her back with arms and legs relaxed. If the cuff position
cannot be on the same level as the heart, the displayed blood
pressure reading must be mathematically adjusted.

32 Operator's Manual ZM-940PA

Using the YP-943P/944P NIBP Cuff

Belt

1. Attach the NIBP cuff to the transmitter. Refer to
the “Connecting the NIBP Cuff to the
Transmitter” section.

2. Insert the end of the cuff into the belt and then
through the D ring as shown at left.

D ring

End of cuff

3. Fold back the cuff at the D ring and fasten it
using the velcro tape.

Make sure that the cuff is not attached on a joint.

NOTE

The cuff must not wrap around the elbow.

Operator's Manual ZM-940PA 33

Attaching the Strap to the Transmitter

NOTE

• Use the strap to prevent the transmitter from falling.

• Do not attach the clip to hard objects such as thick cloth or zipper. It will break
the clip.

Attach a strap provided with the transmitter to the NIBP cuff and patient clothes.

To open the clip, firmly
pull out the tab in
direction of the arrow.

To adjust the strap length,
push down the tab on the
adjuster and slide.

Belt for the strap on the NIBP cuff

1. Adjust the length of the strap.

2. Clip one end of the strap to the belt for the strap
on the NIBP cuff.

3. Clip the other end of the strap to the patient’s
clothes as shown left.

34 Operator's Manual ZM-940PA

Using the YP-960T series Reusable Cuffs or YP-910P series Disposable Cuffs

ARTERY

1. Put the cuff on the upper arm so that the

mark of “ARTERY ” aligns with the artery

of the patient.

2. Wrap the cuff so that “INDEX ” comes

within the “ RANGE ”.

RANGE

If “Index

”, change the cuff size.

” is not within the “ RANGE

Attaching Electrodes

Selecting Electrode Lead

CAUTION

Use only Nihon Kohden specified electrode leads. With electrodes and electrode
leads other than specified ones, the “CHECK ELECTRODE” message appears
and monitoring may stop.

The following electrode leads can be used on the transmitter (option).

BR-903PA,
3 electrodes,
clip type

Operator's Manual ZM-940PA 35

BR-913PA,
3 electrodes,
snap type

BR-906PA,
6 electrodes,
clip type

BR-916PA,
6 electrodes,
snap type

Connecting the Electrode Lead to the Transmitter

Connect the electrode lead to the ECG/RESP socket on the transmitter.

When the transmitter is attached on an arm

CAUTION

Hold the connector of the electrode lead when connecting/disconnecting the
electrode lead. If you disconnect the electrode lead by pulling the lead, it
damages the electrode lead.

Selecting the Electrode Position

Follow the physician’s instructions for electrode placement when available.
For ECG monitoring, electrodes are attached only on the chest to allow patient movement and
obtain continuous stable ECG. Following leads are examples. When also monitoring
respiration, refer to the “Electrode Position for Respiration Monitoring” section.

NOTE

The optimum electrode positions for ECG measurement of a patient are not
always optimum for respiration measurement of the patient. Select positions
suitable for both ECG and respiration measurements, or positions which have
priority for one measurement.

36 Operator's Manual ZM-940PA

Six Electrodes

The 6-electrode method with lead II and lead V5 is effective for monitoring myocardial ischemia.
You can improve monitoring accuracy considerably by adding lead V4 to this combination. Va
and Vb can be at any position of the standard 12 leads V1 to V6, but V4 and V5 are most
appropriate for myocardial ischemic monitoring.

RA/R

Va/Ca

RL/RF

Electrode Position

LA/L

Vb/Cb

LL/F

Symbol Lead Color

AHA IEC

AHA IEC

Left infraclavicular fossa LA L Black Yellow

Right infraclavicular fossa RA R White Red

Below lowest rib on the left anterior axillary line LL F Red Green

Right anterior axillary line at the same level as
LL/F
Fifth intercostal space on the left midclavicular
line. (V4 position of standard 12 leads)
Left anterior axillary line at the same level as Va.
(V5 position of standard 12 leads)

RL RF Green Black

Va Ca

Vb Cb

Brown-

blue

Brown-

orange

White-

brown

White-

black

Operator's Manual ZM-940PA 37

Lead Position

Standard limb leads

Lead I

Lead II Lead III

RA

LA

LL

N (RL)

RA

LL

N (RL)

Monopolar limb leads

aV

R

lead aVL lead aVF lead

RA

LA

RA

LL

N (RL)

Monopolar chest leads

V1 to V6 leads

LA

RA

LL

N (RL)

N (RL)

to

LA

LL

N (RL)

N (RL)

RA

RA

LALA

LL

LA

LL

38 Operator's Manual ZM-940PA

Three Electrodes

• Lead MII, which is similar to standard lead II, used when ECG measurement has priority

Electrode Position

Symbol Lead Color

AHA IEC AHA IEC

Left infraclavicular fossa LA L Black Yellow
Right infraclavicular fossa RA R White Red
Below lowest rib on the left
anterior axillary line

• Lead MI, which is similar to standard
lead I
Change F/LL and L/LA of the lead

LL F Red Green

• Lead MIII, which is similar to standard lead
III.
Change R/RA and L/LA of the lead MII.

MII.

If the electrode position shown above is not available due to chest surgery, attach the electrodes
to the root of the limbs or below the clavicles for stable ECG monitoring.

Operator's Manual ZM-940PA 39

Attaching Electrodes to the Patient and Connecting the Electrode Leads to
Disposable Electrodes

Prepare the Patient Skin

Shave off excessive body hair.
To reduce skin impedance, clean the electrode site with cream or with a cotton pad moistened
with alcohol. Thoroughly dry the skin with a clean cotton pad.

NOTE

• For a patient with frequent body movement, rub the sites with Skinpure skin
preparation gel. However, do not use Skinpure skin preparation gel on
sensitive skin.

• Do not place electrodes on a wound or on an inflamed, wrinkled or uneven skin
surface.

Attaching Electrodes to the Patient

CAUTION

Do not reuse disposable products.

NOTE

• To maintain good contact between the electrode and skin, check that the paste
of the disposable electrode is not dry.

• When contact between the disposable electrode and skin becomes poor,
replace electrodes with new ones immediately. Otherwise, contact impedance
between the skin and the electrode increases and the correct ECG cannot be
obtained.

Refer to the electrode operator’s manual for details.

1. Carefully remove the backing paper from the electrode.
Avoid touching the adhesive surface.

2. Place the electrode on the previously cleaned skin.
Pay attention to the electrode lead color and symbol.

3. Clip the electrode lead to the electrode.

4. Fasten the electrode lead wire with surgical tape with
an extra length of wire between the tape and the
electrode. This lessens the movement of electrode
leads by body movement and helps stable monitoring.

40 Operator's Manual ZM-940PA

Electrode Position for Respiration Monitoring

Place the R/RA and F/LL electrodes so that the lungs are between the electrodes.

NOTE

The optimum electrode positions for ECG measurement of a patient are not
always optimum for respiration measurement of the patient. Select positions
suitable for both ECG and respiration measurements, or positions which have
priority for one measurement.

Electrode Position Examples

NOTE

The following examples are when monitoring with 3 electrodes. ECG cannot be
monitored correctly when electrodes are attached as the following examples
when monitoring with 6 electrodes.

Position 1
In this position, respiration measurement is available; however, there is a difference in amplitude
between different patients.

R or RA F or LL

Right infraclavicular
fossa

Fifth intercostal space on the
left midclavicular line, V4

Position 2
In this position, the waveform amplitude is usually large and the ECG lead is similar to Lead
MII. This position can be generally recommended.

R or RA F or LL

Right infraclavicular
fossa

Operator's Manual ZM-940PA 41

Fifth intercostal space on the
left midaxillary line, V6

Position 3
In this position, the respiration waveform is optimum, but the ECG lead is unusual.

R or RA F or LL

Right midaxillary at the
horizontal level of V4

Fifth intercostal space on the
left midaxillary line, V6

Position 4
In this position, the respiration measurement is influenced by the impedance variation of the
abdomen, so the cardiac pulse wave included in the respiration wave is reduced. Note that the
waveform is inverted in phase compared with the chest movement (the waveform goes down
during inspiration). It is difficult to measure the ECG at the same time.

R or RA F or LL

Lowest rib on the right
anterior axillary line

Lowest rib on the left
anterior axillary line

42 Operator's Manual ZM-940PA

Attaching the SpO2 Probe

Selecting the SpO2 Probe

Select an appropriate probe for the patient.

CAUTION

• Use Nihon Kohden specified SpO2 probe to assure maximum performance
from your instrument.

• Do not use damaged or disassembled probe. It causes incorrect
measurement and may hurt the patient.

Reusable Probes

When using a TL-201T finger probe, choose the appropriate cable length for attachment.

Probe Cable Length Patient Attachment site

Finger probe TL-201T

0.6 m

1.6 m

Adult or children
20 kg or more

Finger

Attachment tape

Adult or Infant

Finger or toeMulti-site probe TL-220T

3 kg or more

Neonate

Instep and sole

3 kg or less

Operator's Manual ZM-940PA 43

Disposable Probes

CAUTION

• Use the disposable probe only for one patient. Never reuse the disposable
probe for another patient because it causes cross infection.

• Disposable probes are not sterilized.

Probe Patient Attachment site

TL-251T Adult

30 kg or more

Finger or toe

TL-252T Child

3 to 40 kg

TL-253T Neonate

3 kg or less

Multi-site Y probe TL-260T

Attachment tape

Low birth weight infant
1 kg or less
Neonate or Child
3 kg or more
Neonate
3 kg or less
Adult
50 kg or more

40 mm

Neonate
3 kg or less

Cable length TL-051S: 80 cm

TL-052S: 160 cm

Child or Adult
15 to 50 kg

Finger or toe

Instep and sole

Instep and
sole

Attachment
tape S

Finger or toe Attachment

tape S
Instep and
sole

Attachment

tape L
FingerTL-051S/052S

Instep and sole

FingerTL-061S/062S

35 mm

Infant

Toe

3 to 15 kg

Cable length TL-061S: 80 cm

TL-062S: 160 cm

44 Operator's Manual ZM-940PA

Model Patient Attachment site

TL-271T Adult

30 kg or more

TL-272T Child

10 to 50 kg

TL-273T

Neonate
3 kg or less

Adult
40 kg or more

TL-274T Infant

3 to 20 kg

Finger or toe

Instep

Finger or toe

Operator's Manual ZM-940PA 45

Connecting the SpO

Connect the probe to the SpO

Probe to the Transmitter

2

socket on the transmitter.

2

When the transmitter is attached on an arm

CAUTION

Hold the connector when connecting/disconnecting the probe. If you disconnect
the SpO

probe by pulling the cable, it damages the cable.

2

Attaching the Probe to the Patient

Attach the probe to the patient by referring to the probe’s manual. Make sure that the light
emitter and photo detector of the probe face each other at the attachment site.

WARNING

• When using a TL-201T finger probe, do not fasten it to a finger by wrapping the
probe to the site with some tape. It may cause poor blood circulation,
congestion, pressure necrosis or burn.

• When using probes other than a TL-201T finger probe, do not wrap the tape too
tight. Check the blood circulation condition by observing the skin color and
congestion at the skin peripheral to the probe attachment site. Even for short­term monitoring, there may be burn or pressure necrosis from poor blood
circulation, especially on neonates or low birth weight infants whose skin is
delicate. Accurate measurement cannot be performed on a site with poor
peripheral circulation.

46 Operator's Manual ZM-940PA

• Check the circulation condition by observing the skin color of the measuring
site and the pulse waveform. Change the measuring site every 8 hours for
disposable probes and every 4 hours for reusable probes. The skin
temperature may increase at the attached site by 2 or 3°C (4 or 5°F) and
cause a burn or pressure necrosis. When using the probe on the following
patients, take extreme care and change the measurement site more
frequently according to symptoms and degree.

• A patient with a fever

• A patient with a peripheral circulation insufficiency

• Neonate or low birth weight infant with delicate skin

CAUTION

• If the attachment site is dirty with blood, clean the attachment site before
attaching the probe. If there is nail polish on the attachment site, remove the
polish. Otherwise, the amount of transmitted light decreases and the
measured data may be incorrect or measurement cannot be performed.

• If the skin gets irritated or redness appears on the skin from the probe,
change the attachment site or stop using the probe.

• When the probe is attached on an appropriate site with sufficient circulation,
but the error message confirming the probe attachment repeatedly appears,
the probe may be deteriorated. Replace it with a new one.

• Do not use a probe that is deteriorated by aging. Accurate measurement
cannot be performed.

• When using probes other than a TL-201T finger probe on a neonate, be careful
when removing the adhesive tape from neonatal skin.

• When removing a probe taped to the skin, do not pull the cable. Otherwise the
cable may break.

• When removing the probe from the attachment tape, do not pull the sensor
cable. Otherwise the cable may get damaged.

• Before using the TL-260T multi-site Y probe, be sure to attach the probe to the
sponge attachment tape S or L. Do not use the probe without the sponge
attachment tape attached. It causes incorrect measurement and may damage
the attachment site on the skin.

• When fixing the TL-260T multi-site Y probe with the sponge attachment tape,
confirm that the adhesive part of the tape is not on the skin. The adhesive may
cause oversensitive symptoms on the skin such as redness or itch. If the
adhesive touches the skin, remove it carefully and slowly because neonatal
skin is very delicate.

• Do not use a dirty sponge attachment tape. The measurement value may be
incorrect.

• Refer to the probe instruction manual for details.

Operator's Manual ZM-940PA 47

Locking the Keys on the Transmitter

To prevent the patient from pressing the keys on the transmitter during monitoring, you can lock
the NIBP START/STOP and NIBP INTERVAL keys.

1. Press the NIBP INTERVAL key for about 3 seconds.

2. A “pip, pip” sounds and the “LOCK KEYS” message is displayed on the LCD.

Pip, pip

LOCK
KEYS

When the NIBP START/STOP key or NIBP INTERVAL key is pressed while the keys are
locked, the “PRESS INT. KEY 3S TO UNLOCK” message appears.

To unlock the keys:

1. Press the NIBP INTERVAL key for about 3 seconds.

2. A “pip, pip” sounds and the keys are unlocked. The “UNLOCK KEYS” message appears
and the keys are unlocked.

48 Operator's Manual ZM-940PA

Monitoring

When preparation is done, monitoring starts.

NIBP Oscillometric Method

NIBP is measured from the change in amplitude pattern of pulsatile oscillation in cuff pressure
as the cuff pressure is reduced from above systolic to below diastolic pressure. The occlusive­oscillometry method uses this to determine the systolic, diastolic and mean arterial pressure.

NIBP Monitoring

Selecting the Initial Cuff Inflation Pressure

The initial cuff inflation pressure can be changed on the PARAMETER SETUP screen. The
default setting is 180 mmHg. To change the setting, refer to the “Changing Parameter Setup
Settings” section.

Selecting the Measurement Mode and Interval

Measurement Modes

There are three measurement modes: manual, auto and STAT. The selected mode or interval is
displayed at the lower right of the screen.

The measurement mode and interval can be changed by pressing the NIBP INTERVAL key.
When the key is pressed, the measurement mode changes according to the modes selected at
“SELECTABLE INTERVALS” on the PARAMETER SETUP screen. MANUAL mode is
already selected for the mode selection.

To select the modes for the mode selection, refer to the “Changing Parameter Setup Settings”
section.

Manual Measurement

In Manual mode, a single NIBP measurement is performed when the NIBP START/STOP key
is pressed.

STAT (Continuous) Measurement

In STAT mode, measurement is continuously repeated for 15 minutes after the NIBP START/
STOP key is pressed.

When the STAT measurement for 15 minutes is completed, the measurement mode automatically
changes to the Manual mode or Auto mode of selected interval depending on the “NIBP MODE

Operator's Manual ZM-940PA 49

AFTER STAT” setting on the PARAMETER SETUP screen. The default setting is Manual
mode. Refer to the “Changing Parameter Setup Settings” section.

The STAT measurement completes within 15 minutes. When more than 12 minutes elapse from
the start of measurement, there will be no more measurement performed and the measurement
mode changes to the mode selected for “NIBP MODE AFTER STAT” on the PARAMETER
SETUP screen.

Auto Measurement

In Auto mode, measurement is performed automatically at the preset time intervals.

In Auto mode, a single measurement can be performed by pressing the NIBP START/STOP key
between auto measurements.

Measuring NIBP

WARNING

• Be careful when measuring NIBP on a patient with known bleeding disorders

or coagulation. After NIBP measurement, there may be dot hemorrhage, or
circulatory disorder by thrombus where cuff is attached.

• NIBP measurement may be incorrect in the following cases.

• When using an electrical surgery unit.

• When there is body movement.

• When the pulse wave is small (insufficient peripheral circulation).

• Too many arrhythmia.

• When there is vibration.

• When there is a rapid blood pressure change.

• During CPR.

• When performing NIBP measurements in STAT mode or 5 minute intervals,

periodically remove the cuff from the patient for ventilation. Otherwise, the
skin temperature may increase at the cuff attachment site by 2 or 3°C (4 or
5°F). When measuring a patient with a fever or peripheral circulation
insufficiency, it may cause a burn.

CAUTION

When performing NIBP measurement repeatedly, have a rest between
measurements to recover adequate circulation.

50 Operator's Manual ZM-940PA

NOTE

• When measuring patients who are conscious, help the patient to relax.
Measurement may not be accurate if the patient’s arm is tense or if the patient
talks.

• The data for measurement on a leg tends to be higher than measurement on
the arm. When making diagnosis based on the NIBP values, measure NIBP on
an upper arm.

• Do not apply pressure to the cuff or air hose. NIBP may not be measured
correctly because of noise or NIBP measurement may stop due to the NIBP
safety circuit.

• When the transmitter is attached to the patient arm and the NIBP
measurement is performed when moving, tell the patient to relax and keep
quiet. Otherwise, measurement may be stopped or remeasurement is
repeated due to body movement.

• If there is an abnormal noise generated during measurement, stop using the
transmitter and contact your Nihon Kohden distributor.

• Do not measure NIBP of a patient on whom an IABP is being used.
Measurement may be incorrect due to the mixing of the patient’s own pulse
and IABP pulse.

• NIBP cannot be measured on a neonate using this transmitter.

1. Select the measurement mode by pressing the NIBP INTERVAL key.

2. Press the NIBP START/STOP key to perform measurement.

Operator's Manual ZM-940PA 51

The cuff is inflated and the inflation pressure is displayed on the screen.

Inflation pressure

In manual mode: Measurement is performed once.
In STAT mode: Measurement is performed repeatedly for 15 minutes.
In auto mode: The first measurement is performed when the NIBP START/STOP key

is pressed. The second measurement is performed when the current time
in the transmitter reaches the selected time interval.

To stop measurement during measurement, press the NIBP START/STOP key again.

In STAT mode, after completing the STAT measurement, the measurement mode changes to
the mode set for “NIBP MODE AFTER STAT” on the PARAMETER SETUP screen.

In auto mode, to stop measurement in auto mode, change the mode to manual. To cancel
one measurement, press the NIBP START/STOP key during measurement.

After the measurement is complete, the measured data is displayed on the screen and is
transmitted to the monitor.

When SpO2 is not monitored, the pulse rate at the end of NIBP measurement is displayed.

During auto mode measurement, the measurement mode can be changed. During the interval,
press the NIBP INTERVAL key to change the mode. When “MANUAL” is displayed for more
than one second, the measurement in auto mode is stopped.

A buzzer can be set to sound at the start and end of NIBP measurement. Refer to the “Changing
Parameter Setup Settings” section.

52 Operator's Manual ZM-940PA

Data Display After NIBP Measurement

When the time set at “OLD NIBP DATA” on the PARAMETER SETUP screen elapses after
the last measurement, the NIBP data is dimmed or hidden. Whether to dim or hide the old data
can also be selected at “OLD NIBP DATA”. Refer to the “Changing Parameter Setup Settings”
section.

Monitoring SpO

When the SpO
during NIBP measurement and pulse wave cannot be detected and SpO
properly. When “INHIBIT SpO
to ON (factory default setting), SpO
SpO

alarm occurrence. However, when monitoring SpO2 on the same limb as the NIBP, be

2

careful when reading SpO

during NIBP Measurement

2

probe is attached to the same limb as the NIBP cuff, the blood flow decreases

2

cannot be monitored

2

DURING NIBP” on the PARAMETER SETUP screen is set

2

monitoring is paused during NIBP measurement to avoid

2

values.

2

ECG and Respiration Monitoring

When the electrodes are attached and the ECG leads are connected to the electrodes, heart rate,
ECG, respiration rate and respiration waveform appear on the monitor.

When 6 leads are used on this transmitter, up to 8 lead (I, II, III, aVR, aVL, aVF, Va and Vb) of
ECG waveforms can be displayed on the receiving monitor. The heart rate is also measured.
When 3 leads are used, one channel ECG waveform of lead II can be displayed on the receiving
monitor. Refer to the operator’s manual of the monitor for details.

Respiration is monitored by measuring changes in impedance between the RA and LL ECG
electrodes. This transmitter sends the changes in impedance to the monitor as a respiration
waveform. The monitor displays the respiration waveform and calculates respiration rate. Refer
to the operator’s manual of the monitor for details.

WARNING

Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac
monitoring and Diagnostic Equipment*
The bioelectric impedance measurement sensor of a minute ventilation rate­adaptive implantable pacemaker may be affected by the transmitter which is
connected to the same patient. If this occurs, the pacemaker may pace at its
maximum rate and the transmitter may give incorrect data to the monitor. If this
occurs, disconnect the electrode leads from the patient or change the setting on

Operator's Manual ZM-940PA 53

the pacemaker by referring to the pacemaker’s manual. For more details,
contact your pacemaker distributor or Nihon Kohden distributor.

* Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectric

impedance measurement (BIM). Many medical devices in addition to pacemakers use this
technology. When one of these devices is used on a patient with an active, minute ventilation
rate-adaptive pacemaker, the pacemaker may erroneously interpret the mixture of BIM signals
created in the patient, resulting in an elevated pacing rate.

For more information, see the FDA web site.
http://www.fda.gov/cdrh/safety.html

WARNING

When using this transmitter with an ESU, the ESU return plate and the
electrodes for monitoring must be firmly attached to the patient. If the return
plate is not attached correctly, it may burn the patient’s skin where the
electrodes are attached. Refer to the instruction manual for the ESU.

CAUTION

Turn off the power of cell telephones, small wireless devices and other devices
which produce strong electromagnetic interference. Otherwise, the waveforms
and measurements are affected by such interference and the displayed data
may be incorrect.

NOTE

• Noise generated from an electrosurgery unit may interfere on an ECG
waveform, but will not damage it.

• If an electric blanket is used and incorrect heart rate is displayed on the
monitor, turn off the pacing spike detection on the monitor.

• Turn the pacing spike detection to ON on the monitor when monitoring a
pacemaker patient. Pacing pulse is detected by the transmitter and
transmitted to the monitor. If the pacing spike detection is turned OFF, QRS
and pacemaker spike may not be distinguished and pacemaker failure may
not be recognized.

54 Operator's Manual ZM-940PA

Electrode Detachment

In the following conditions, the check electrode indication is displayed on the LCD of the
transmitter and the “CHECK ELECTRODE” message is displayed on the monitor.

• Electrode is detached from skin.

• Electrode lead is disconnected from the electrode.

• Polarization voltage between the electrode and skin is excessively high.

In these cases, check the cause and if necessary, replace electrodes with new ones.

CAUTION

When the “ELECTRODE OFF” or “CHECK ELECTRODE” message is displayed
on the receiving monitor, check electrodes and electrode leads and remove the
cause. While the “ELECTRODE OFF” or “CHECK ELECTRODE” message is
being displayed, there is no ECG monitoring and no alarms.

Check Electrode Indication on the Transmitter when Monitoring with 3 Electrodes

The “

” mark is displayed.

Check electrode symbol

Check Electrode Indication on the Transmitter when Monitoring with 6 Electrodes

The “

” mark and either the detached lead or detached electrode position is indicated,

depending on the LEADS OFF DISPLAY setting on the PARAMETER SETUP screen.

Check electrode symbol

Check electrode indication

When LEADS OFF
DISPLAY is set to CHAR, the
detached lead is indicated

Operator's Manual ZM-940PA 55

When LEADS OFF
DISPLAY is set to IMAGE,
the detached electrode
position is indicated with X

SpO2 Monitoring

When monitoring starts, SpO2 and pulse waveform are sent to the monitor and SpO2, pulse rate
and pulse level bar graph are displayed on the transmitter LCD.

WARNING

• Measurement may be incorrect in the following cases.

• When the patient’s carboxyhemoglobin or methemoglobin increases

abnormally.

• When dye is injected in the blood.

• When using an electrical surgery unit.

• During CPR.

• When there is body movement.

• When there is vibration.

• When measuring at a site where there are venous pulses.

• When the pulse wave is small (insufficient peripheral circulation).

• When using an IABP (intra-aortic balloon pump).

• Check the circulation condition by observing the skin color of the measuring
site and pulse waveform. Change the measuring site every 8 hours for
disposable probes and every 4 hours for reusable probes. The skin
temperature may increase at the attached site by 2 or 3°C (4 or 5°F) and
cause a burn or pressure necrosis. When using the probe on the following
patients, take extreme care and change the measurement site more
frequently according to symptoms and degree.

• A patient with a fever

• A patient with peripheral circulation insufficiency

• Neonate or low birth weight infant with delicate skin

• When not monitoring SpO
Otherwise, noise may interfere from the probe sensor and incorrect data is
displayed on the screen.

, disconnect the SpO2 cable from the transmitter.

2

CAUTION

• Turn off the power of cell telephones, small wireless devices and other devices
which produce strong electromagnetic interference. Otherwise, the
waveforms and measurements are affected by such interference and the
displayed data may be incorrect.

• Normally external light does not affect monitoring, however, strong light such
as an operating lamp or sunlight may affect monitoring. If affected, cover the
measuring site with a blanket.

56 Operator's Manual ZM-940PA

• Do not pull or bend the probe cable, and do not run over the probe cable with
caster feet. Do not immerse the probe cable in detergents or water. Failure to
follow these cautions may cause cable discontinuity, short circuit, skin burn
on the patient and incorrect measurement data. Replace any broken probe
with a new one.

• When the probe is attached on an appropriate site with sufficient circulation
and the error message confirming the probe attachment repeatedly appears,
the probe may be deteriorated. Replace it with a new one.

• When the probe failure message appears on the screen, replace it with a new
one. Otherwise SpO

data may not be accurate.

2

• While a patient is on medication which causes vasodilation, the pulse
waveform may change and in rare cases the SpO

value may not be displayed.

2

NOTE

In order to maintain sufficient blood circulation, keep the measurement site
warm by covering it with a blanket or something similar. Warming the site is
effective, especially for a patient with a small pulse amplitude.

SpO

and PR Display Order

2

You can select the display order for SpO
“Changing Parameter Setup Settings” section.

and PR (pulse rate) on the LCD. Refer to the

2

Monitoring SpO

When the SpO
during NIBP measurement and pulse wave cannot be detected and SpO
properly. When “INHIBIT SpO
to ON (factory default setting), SpO
SpO

alarm occurrence. However, when monitoring SpO2 on the same limb as NIBP, be careful

2

when reading SpO

When monitoring SpO

during NIBP Measurement

2

probe is attached to the same limb as the NIBP cuff, the blood flow decreases

2

cannot be monitored

2

DURING NIBP” on the PARAMETER SETUP screen is set

2

monitoring is paused during NIBP measurement to avoid

2

values.

2

is important, attach the probe to the limb to which the NIBP cuff or

2

catheter is not attached.

When SpO2 monitoring is paused during NIBP measurement, the SpO2 value just before the
start of NIBP measurement and an
When NIBP measurement is not completed after 30 seconds, “– – –” is displayed for the SpO

mark are displayed on the transmitter for 30 seconds.

2

value. The same data also appears on the monitor screen.

Operator's Manual ZM-940PA 57

NOTE

• When continuous SpO2 monitoring is necessary, attach the probe to the limb to
which the NIBP cuff is not attached and set “INHIBIT SpO
the PARAMETER SETUP screen to OFF.

• When the probe is attached to the same limb as the NIBP cuff, set the sync
source to a parameter other than SpO

• When monitoring SpO

during STAT NIBP measurement, attach the probe to the

2

on the receiving monitor.

2

limb to which the NIBP cuff is not attached.

DURING NIBP” on

2

58 Operator's Manual ZM-940PA

Display and Message List

Battery Indication

Indication Cause Countermeasure

Fully charged battery

Batteries are low.

No

indication

Batteries are low. NIBP cannot be measured.

Dead batteries

Replace batteries.

ECG/Respiration

Indication Cause Countermeasure

Electrode lead is disconnected from the
electrode.
Electrode lead is disconnected from the
transmitter.

Electrode lead discontinuity.

Electrode is not firmly attached to the skin.

Polarization voltage is abnormally high.

When monitoring ECG with 6 electrodes, the electrode or lead detached position is indicated by
either lead or electrode position. This is set at LEADS OFF DISPLAY on the PARAMETER
SETUP screen. Refer to the “Changing Parameter Setup Settings” section.

LEADS OFF DISPLAY set to CHAR
ECG ELECTRODE set to AHA

LEADS OFF DISPLAY set to CHAR
ECG ELECTRODE set to IEC

Firmly connect the electrode
lead to the electrode.
Firmly connect the electrode
lead to the transmitter.
Replace the electrode lead
with a new one.

Replace the electrode with a
new one.

LEADS OFF DISPLAY set to IMAGE

Operator's Manual ZM-940PA 59

SpO

2

Message Cause Countermeasure

During NIBP
measurement

Detecting
body
movement

SpO2 CHECK
PROBE

SpO2 CHECK
PROBE SITE

SpO2 DETECTING
PULSE

SpO2 monitoring is paused for
NIBP measurement.

Considerable body movement.

The probe is not attached to
the patient properly.

The probe is not attached to
the patient properly.
The probe is not attached at
the appropriate site.

Wait for NIBP measurement to
finish.
When the message is displayed
frequently, check the patient
condition and, if necessary, change
the attachment site.
Attach the probe to the patient
properly.
Attach the probe to a site 6 to 14
mm thick.

Probe is expired. Replace the probe with a new one.

Searching for the correct pulse
wave.

Wait until the pulse wave is

detected.
The SpO2 value cannot be
obtained because the
waveform is unstable.
The probe is not attached to

Attach the probe to the patient

properly.

the patient properly.
SpO

measurement site is

SpO2 LIGHT
INTERFERENCE

SpO2 PROBE
FAI LU RE

SpO2 WEAK PULSE

2

under fluorescent light,
surgical light, sunlight, etc.

Probe is expired. Replace the probe with a new one.

Probe is damaged or short­circuited.

Poor peripheral circulation.

The probe is attached too
tightly and is obstructing the
blood circulation.

Cover the measurement site with a

blanket or cloth.

Replace the probe with a new one.

Check the patient condition and

change the attachment site.

Check the probe attachment

condition and if necessary,

reattach the probe.

60 Operator's Manual ZM-940PA

NIBP

Message Cause Countermeasure

The cuff and extension hose are not

NIBP AIR LEAK

NIBP CANNOT
DETECT PULSE

NIBP CUFF
OCCLUSION

NIBP HIGH CUFF
PRESS

NIBP INFLATION
PRESS LOW

NIBP MEAS TIME­OUT

NIBP MODULE
FAI LU RE

NIBP REMEASURING

NIBP SAFETY
CIRCUIT RUNNING
(When this message is
displayed, measurement
cannot be performed for
40 seconds.)

NIBP SYS OUT OF
RANGE

NIBP WEAK PULSE

NIBP ZEROING

properly connected.
The cuff hose (or extension hose) is
not properly connected to the NIBP
socket.
The cuff or extension hose is
damaged.

The patient’s pulse wave is small. Measure by palpation or auscultation.

The cuff is not wrapped on the
patient properly.

Transmitter malfunction.

Enormous pressure was applied by
the pressure of the cuff.

Insufficient cuff inflation pressure.

The measuring time exceeded the
specified time due to arrhythmia,
body movement, vibration or, cuff
or air hose being squeezed.

Module malfunction.

NIBP is being remeasured due to
arrhythmia, body movement,
vibration or, cuff or air hose being
squeezed.

Measurement stopped by the safety
circuit.

The maximum blood pressure
cannot be measured even when the
cuff inflation pressure exceeded 280
mmHg when using adult cuff.
The patient’s pulse wave is too
small.

The cuff is wrapped too loosely. Wrap the cuff properly.

The cuff size is not appropriate. Use the appropriate cuff.

NIBP zero balance is being
adjusted.

Connect them properly.

Replace with a new one.

Wrap the cuff on the patient properly.

Immediately remove the cuff from the
patient and contact your Nihon Kohden
distributor.

Remove the cause.

Wait for the remeasurement to be
performed with increased cuff inflation
pressure.

Remove the cause if the cause is body
movement, vibration or squeezing of
cuff or hose.

Contact your Nihon Kohden
distributor.
If the message still appears after
remeasurement, remove the cause if
the cause is body movement, vibration
or squeezing of cuff or hose.
Check that the hose is not bent or
squeezed.
Wait 40 seconds, then perform
remeasurement. If the message still
appears, contact your Nihon Kohden
distributor.

Measure by palpation or auscultation.

Measure by palpation or auscultation.

Do not touch the cuff during zeroing.
Wait for the message to disappear.

Operator's Manual ZM-940PA 61

p

Troubleshooting

If the problem still remains after checking the following, contact your Nihon Kohden distributor.

Transmitter

Problem Cause Countermeasure

displayed on the
LCD after
turning the
power on.
LCD is difficult
to see (too dark
or too light).

Nothing is
displayed on the
monitor after
turning the
transmitter
power on.

Signal receiving
condition is

oor.

Batteries are not installed
correctly. The battery
polarity is wrong.
Batteries are completely
discharged.
LCD brightness is not
appropriate.

The channel of the
transmitter and monitor
does not match.
The software version of
the multiple patient
receiver is old.

Another transmitter of the
same channel is used
nearby.

Signals are mixing. Follow the instructions of your channel

The transmitter is
damaged.

Install the batteries correctly.Nothing is

Replace the batteries with new ones.

Change the LCD brightness on the
SYSTEM SETUP screen. Refer to the
“Changing System Setup Settings”
section.
Set the correct channel on the monitor.

Upgrade the multiple patient receiver
software to receive signal from the
transmitter. The software version must be
01-09 or later.
Turn the transmitter power off. If the
monitor still receives a signal, there is a
high probability that another transmitter
of the same channel is used nearby.
Follow the instruction of your channel
administrator and use another transmitter
of a different channel.

administrator and use another transmitter
of a different channel.
Contact your Nihon Kohden distributor.

62 Operator's Manual ZM-940PA

ECG/Respiration

Problem Cause Countermeasure

The heart rate is
unstable.

The “CHECK
ELECTRODE”
message appears
on the receiving
monitor.

ECG baseline is
thick.
(Hum is
overlapping)

Respiration
waveform
measurement is
unstable.

Pacing detection setting on the
monitor is not correct.

Turn off the pacing detection setting
on the monitor.
When monitoring a pacemaker

patient, turn on pacing detection.
Electrode lead is disconnected
from the electrode.

Firmly connect the electrode lead to

the electrode.
Electrode lead discontinuity Replace the electrode lead with a new

one.
Electrode is not firmly

Replace the electrode with a new one.
attached to the skin.
Polarization voltage is
abnormally high.
The gel on the electrode is

Use Nihon Kohden specified

electrodes.

Replace the electrode with a new one.
dried out.
The gel on the electrode is
coming off.
Electric blanket is used. Cover the blanket with a shield cover.
Hum filter is set to OFF on the

Set the filter to ON.
monitor
The gel on the electrode is

Replace the electrode with a new one.
dried out.
The gel on the electrode is
coming off.

SpO

2

Problem Cause Countermeasure

SpO2 data is
unstable and
not reliable.

The probe size is not
appropriate for the patient.
Probe attachment condition
is poor. Probe is partly

Use the appropriate probe for the patient.

Firmly attach the probe according to the

procedure in the probe operator’s manual.
detached from the skin.
External light gets in.
Measurement site is dirty.

Remove dirt and nail polish.
Patient is wearing nail
polish.
Probe is attached to the
same limb that is used for
NIBP measurement.

When the probe and cuff are attached to

the same limb, set “INHIBIT SpO

2

DURING NIBP” setting on the

PARAMETER SETUP screen to ON.

Attach the probe to the opposite limb.

Avoid a site where blood circulation

condition changes greatly.

Operator's Manual ZM-940PA 63

NIBP

Problem Cause Countermeasure

Cuff inflation
pressure is less than
10 mmHg.

The cuff does not
inflate when the
NIBP START/STOP
key is pressed.

Abnormal
measurement results
are displayed.

The cuff is suddenly
deflated during
inflation.

Auto mode
measurement does
not start even when
the time interval has
passed.
The cuff suddenly
inflates.

Cannot connect cuff
to the air hose.

The cuff hose is not connected
to the NIBP socket properly.
The cuff is not wrapped
around the arm or is wrapped
too loosely.
The cuff hose is not connected
to the NIBP socket.
The cuff hose or extension
hose may be folded or
squeezed when the cuff
pressure display on the screen
increases quickly but the
actual cuff does not inflate.

The cuff size is not correct. Select the cuff which fits the

The cuff is not wrapped
around the arm correctly.

NIBP data is not correct
because of body movement.

Vibration on the cuff.

The NIBP START/STOP key
is pressed during inflation.

The NIBP INTERVAL key is
pressed and the measurement
mode is changed.

The measurement mode is set
to auto mode.

Unspecified cuff is used. Use a cuff specified by Nihon

Connect the cuff hose to the socket
properly.
Wrap the cuff around the upper
arm.

Connect the cuff hose to the socket
firmly.
Check the cuff hose and air hose.

patient’s limb circumference.
Wrap the cuff around the upper
arm, not too tightly or too loosely.

Prevent the patient from moving
during measurement.
Check that nothing is touching the
cuff during measurement.
Change the measuring site.

Check the measurement mode and
interval.

Check the time interval. If
necessary, stop measurement.

Kohden.

64 Operator's Manual ZM-940PA

Problem Cause Countermeasure

Cannot measure
NIBP.

Vibration on the cuff.

The cuff hose or extension

Check that nothing is touching the
cuff during measurement.

Remove the cause.
hose is bent or squeezed.
The cuff has worn out. Use a new cuff.

Measuring over a long

occurs.

period of time at short
intervals.

Thrombus occurs. Measuring on a patient

with known bleeding

Increase the measuring interval.Blood congestion

Do not measure NIBP over a long

time.

Do not perform NIBP measurement

on such a patient.
disorders or coagulation.

NIBP data on the
screen is --- or dark.

The time set for “OLD
NIBP DATA” on the
PARAMETER SETUP

When NIBP is measured again, the

data is displayed in normal

brightness.
screen elapsed from the last
measurement.

Three loud pip
sounds indicting
NIBP measurement

The cuff is not deflated
enough to start another
measurement.

Wait 30 seconds and measure again.

cannot be started.

Operator's Manual ZM-940PA 65

Maintenance

To use the instrument in safe and optimum condition, perform maintenance check once every six
months.

CAUTION

Do not disassemble the transmitter when performing maintenance and
inspection. Do not repair the transmitter. When there is any problem with the
transmitter after maintenance and inspection, contact your Nihon Kohden
distributor.

A maintenance check sheet is provided at the end of this section. Make a copy of this check
sheet before performing maintenance check.

1. External Check

• There are no damaged or dirty parts on the outside of the transmitter.

• The battery case cover is not damaged, the spring is firmly fixed and the battery case cover
can be closed firmly.

• NIBP socket is not damaged.

• Keys are not damaged.

• Electrode leads are not damaged.

• There is no blood or chemicals on the transmitter.

2. Transmitter Channel

Check that the channel of the transmitter and the label match.

1. Check that the channel number label attached to the transmitter is not torn or removed.

Channel label

66 Operator's Manual ZM-940PA

2. Remove one battery.

3. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.
The SETUP screen appears.

4. Press the NIBP INTERVAL key to move the cursor to “SYSTEM SETUP”.

5. Press the NIBP START/STOP key to enter
the SYSTEM SETUP screen. The channel of
this transmitter is displayed.

Channel

6. Check that the channel displayed on the LCD

matches the label on the transmitter.

Operator's Manual ZM-940PA 67

3. LCD Display

Check that there are no dots missing on the LCD.

1. Remove one battery.

2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.
The SETUP screen appears.

3. Press the NIBP INTERVAL key twice to move the cursor to “MANUAL CHECK”.

4. Press the NIBP START/STOP key to
enter the MANUAL CHECK screen.

5. Check that the cursor is on “LCD
TEST” and press the NIBP START/
STOP key.

68 Operator's Manual ZM-940PA

6. Every time the NIBP INTERVAL key is pressed, the screen changes as below. Check that
there are no dots missing.

When the NIBP START/STOP key is pressed, the screen returns to the MANUAL
CHECK screen.

4. Key Operation

NIBP START/STOP Key

1. Attach the NIBP cuff to your upper arm.

2. Press the NIBP START/STOP key. Check that the cuff inflates and deflates properly.

3. Press the NIBP START/STOP key again. During inflation, press the NIBP START/STOP
key to check that the cuff deflates properly.

NIBP INTERVAL Key

1. Press the NIBP INTERVAL key and check that the NIBP measuring mode can be changed.

2. Select any interval and press the NIBP START/STOP key to perform auto measurement.
Check that the NIBP is measured at the selected interval.

Operator's Manual ZM-940PA 69

5. NIBP Cuff for Attaching Transmitter to Patient Arm

The NIBP cuff is a consumable. Check the following and when necessary, replace it with a new
one.

Appearance

• There are no dirty parts.

• There are no broken stitches on the cuff.

• The label on the cuff is readable.

• The velcro tape on the cuff is not removed and there are no broken stitches.

• The lock plate is not damaged and functions properly.

Inflation bag

• The inflation bag is not torn or damaged.

• There is no water inside the inflation bag.

• The connector on the inflation bag is not damaged.

70 Operator's Manual ZM-940PA

Hospital/Organization:

Service Personnel:

Maintenance Check Sheet

Instrument Name:

Instrument Model:

Instrument Serial Number:

Hardware Revision Number:

Software Revision Number:

1. External Check OK No

2. Transmitter Channel OK No

3. LCD Display OK No

4. Key Operation OK No

5. NIBP Cuff for Attaching Transmitter to Patient Arm OK No

Overall Judgement

OK

Transmitter

ZM-940PA

Can be used but needs maintenance

Maintenance required. Cannot be used.

Operator's Manual ZM-940PA 71

Repair Parts Availability Policy

Nihon Kohden Corporation (NKC) shall stock repair parts (parts necessary to maintain the
performance of the instrument) for a period of 8 years from the date of delivery. In that period
NKC or its authorized agents will repair the instrument. This period may be shorter than 8 years
if the board or part necessary for the faulty section is not available.

72 Operator's Manual ZM-940PA

Lifetime and Disposal

Disposing of Used Batteries

Battery Lifetime

Replace the batteries when the battery replacement indication appears on the transmitter. When
using rechargeable batteries, recharge them.

Type Lifetime (Measuring parameters)

ECG, SpO2, NIBP ECG, SpO

NiMH secondary 2 days 2 days 2.5 days
Alkaline primary 1 day 2.5 days 3 days

The above data is when new batteries are used at room temperature, NIBP is measured in auto
mode at 60 minute intervals and SpO
weight 60 kg.

Operation time depends on the thickness of SpO2 probe attachment site.

Disposal

is measured on an index finger of a male patient with

2

NOTE

Remove the batteries before disposing of the transmitter.

Before disposing of the batteries, check with your local solid waste officials for details in your
area for proper disposal. It may be illegal to dispose of these batteries in the municipal waste
stream.

2

ECG only

Disposing of Electrodes, SpO2 Probes and NIBP Cuffs

Refer to the manual of each item.

Operator's Manual ZM-940PA 73

Cleaning, Disinfection and Sterilization

Transmitter and Electrode Leads

CAUTION

• This transmitter is not waterproof. If detergent or liquid spills into the
transmitter, stop cleaning/disinfecting/sterilizing it and contact your Nihon
Kohden distributor. The transmitter needs to be checked for safety and
function before use.

• Before cleaning or disinfecting the transmitter, remove the batteries from the
transmitter.

• The transmitter cannot be sterilized.

Cleaning

Wipe the transmitter and electrode leads with a soft cloth moistened with disinfecting alcohol or
neutral detergent diluted with water. After cleaning, dry them completely.

Disinfection

CAUTION

• Do not immerse the electrode lead connector in liquid.

• Do not disinfect with hypochlorous acid.

• Use the recommended concentration.

Wipe the outside surface of the transmitter and electrode lead with a non-abrasive cloth
moistened with any of the disinfectants listed below. Use the recommended concentration.

Disinfectant Concentration (%)
Glutaraldehyde solution 2.0
Hydrochloric alkyl diaminoethylglycine 0.5
Benzalkonium chloride 0.2
Benzethonium chloride solution 0.2
Chlorohexidine gluconate solution 0.5

74 Operator's Manual ZM-940PA

SpO2 Probe

Refer to the probe manual.

YP-943P/944P NIBP Cuffs

CAUTION

• Do not autoclave.

• Use only glutaraldehyde solution.

• Never allow liquid to get inside the rubber cuff.

• Do not sterilize or disinfect the cuff with ultraviolet light or ozone.

Cleaning

To clean the cuff, remove the lock plate and carefully pull out the inflation bag from the cloth
cover.
Cloth cover: Wash with neutral detergent and water. Thoroughly dry it. When washing in a

washing machine, put it in a net.

Inflation bag: Wipe with a soft cloth or cotton moistened with disinfecting alcohol.

Thoroughly dry it.

Disinfection

To disinfect the cuff, use glutaraldehyde solution. Use the recommended concentration of the
disinfectant. Refer to the disinfectant manual for details. After disinfection, clean the cuff as
described above.

Operator's Manual ZM-940PA 75

Specifications

Measuring Parameters

Measuring waveforms: ECG, Respiration in impedance method, pulse
Measuring numeric data: SpO

Transmitting Data

Waveform data: ECG, respiration, pulse wave
Numeric data: SpO
Status information: Battery replacement, channel ID, type of transmitter, check

Displayed Data

SpO2, NIBP, pulse rate, pulse wave bar graph, check electrode, battery replacement, NIBP
measurement mode and status information

ECG Measurement

Channels: 4
Input range: ±5 mV or more
DC offset: ±500 mV or more
Input impedance: 5 MΩ or more (5 Hz)
Pacing pulse detection: ANSI/AAMI EC13

, NIBP, pulse rate

2

and NIBP

2

electrodes, abnormal polarization voltage, pacing data, SpO
status

Based upon Pacemaker pulse rejection Capability

2

Respiration Measurement

Measuring method: Impedance method
Impedance range: 0 to 2 kΩ or less

SpO

Measurement

2

Display range: Depends on the receiving monitor
Measuring range: 0 to 100%, in 1% steps
Minimum display range: 1%

Measuring accuracy (When the measuring accuracy of the SpO

±1 (80% ≤ SpO

±2 (50% ≤ SpO

≤ 100%)

2

< 80%)

2

probe is not considered):

2

Less than 50% is not specified.

(When considering the measuring accuracy of the SpO

±2 (80% ≤ SpO

±3 (70% ≤ SpO

probe):

2

≤ 100%)

2

< 80%)

2

Less than 70% is not specified.

76 Operator's Manual ZM-940PA

NIBP Measurement

Displayed items: Systolic, diastolic, mean
Cuff pressure display range: 0 to 300 mmHg
Measurement modes: Manual, STAT, auto at 5, 10, 15, 30, 60, 120 or 240 minute

interval

Pulse Rate

Measuring range: 30 to 200 beats/minute ±8 beats/min (NIBP)

30 to 250 beats/min ±3% ±1 beat/min (SpO

)

2

Transmitter

FCC regulation: FCC part 95 Subpart H

Wireless Medical Telemetry Service (WMTS)
Field strength limits: <200 mV/m (at 3 m)
Undesired emission: below 960 MHz: 200 µV/m (at 3 m)

above 960 MHz: 500 µV/m (at 3 m)
Antenna: Internal
Transmission channel: indicated on the transmitter
Transmission frequency range: 608.0250 to 613.9750 MHz
Channel spacing: 50 kHz (25 kHz when interleave)
Type of emission: F1D
Occupied bandwidth: <20 kHz
Effective radiated power: 1.0 mW (conducted)

Power Requirements

Operating voltage: 3.2 to 4.8 V
Battery type: Three AA type NiMH secondary batteries

Three AA type alkaline dry cell primary batteries
Battery lifetime:

Type Lifetime (Measuring parameters)

ECG, SpO2, NIBP ECG, SpO

2

ECG only

NiMH secondary 2 days 2 days 2.5 days
Alkaline primary 1 day 2.5 days 3 days

The above data is when new batteries are used at room temperature, NIBP is
measured in auto mode at 60 minute intervals and SpO

is measured on an index

2

finger of a male patient with weight 60 kg.
Operation time depends on the thickness of SpO

probe attachment site.

2

Dimension and Weight

Dimension: 114 W × 103 H × 58 D (mm)
Weight: 280 g ±30 g (excluding batteries, NIBP cuff and other

accessories)

Operator's Manual ZM-940PA 77

Environment

Operating environment

Operating temperature: 5 to 40°C, 41 to 104°F

When using NIBP cuff, 10 to 40°C, 50 to 104°F
Operating humidity: 30 to 85% (non-condensing)
Operating atmospheric pressure: 70 to 106 kPa

Storage environment

Storage temperature: −20 to 65°C, −4 to 149°F
Storage humidity: 10 to 95%
Storage atmospheric pressure: 70 to 106 kPa

Safety Standards

Safety standard: CAN/CSA-C22.2 No. 601-1 M90:1990

CAN/CSA-C22.2 No. 601-1. 1S1-94:1994
CAN/CSA-C22.2 No. 601-1. 1B-90:R2002
CAN/CSA-C22.2 No. 60601-2-49-04:2004
IEC 60601-1:1988
IEC 60601-1 Amendment1:1991
IEC 60601-1 Amendment2:1995
IEC 60601-1-2:2001
IEC 60601-2-27:1994
IEC 60601-2-30:1999

IEC 60601-2-49:2001
According to the type of protection
against electrical shock: INTERNALLY POWERED EQUIPMENT
According to the degree of protection
against electrical shock:

ECG and impedance method respiration: DEFIBRILLATION-PROOF TYPE CF APPLIED

PA RT

SpO

and NIBP: DEFIBRILLATION-PROOF TYPE BF APPLIED

2

PA RT
According to the degree of protection
against harmful ingress of water: IPX0 (Ordinary equipment)
According to the degree of safety of
application in the presence of a
FLAMMABLE ANAESTHETIC
MIXTURE WITH AIR, OR WITH
OXYGEN OR NITROUS OXIDE: Equipment not suitable for use in the presence of

FLAMMABLE ANAESTHETIC MIXTURE WITH
AIR, OR WITH OXYGEN OR NITROUS OXIDE

According to the mode of operation: CONTINUOUS OPERATION

78 Operator's Manual ZM-940PA

Electromagnetic Compatibility

IEC 60601-1-2 (2001)
Emissions: CISPR11 Group1,Class B

Electromagnetic Emissions

This Model ZM-940PA is intended for use in the electromagnetic environment specified below.
The customer or the user of the ZM-940PA should assure that it is used in such an environment.

Emissions test Compliance Electromagnetic environment guidance

RF emissions
CISPR 11

Group 1 The ZM-940PA uses RF energy only for its

internal function. Therefore, its RF emissions are
very low and are not likely to cause any

interference in nearby electronic equipment.
RF emissions
CISPR 11
Harmonic emissions

Class B

Not applicable

The ZM-940PA is suitable for use in all

establishments, including domestic establishments.

IEC 61000-3-2
Voltage fluctuations/

Not applicable
flicker emissions
IEC 61000-3-3

Operator's Manual ZM-940PA 79

Electromagnetic Immunity

This Model ZM-940PA is intended for use in the electromagnetic environment specified below.
The customer or the user of the ZM-940PA should assure that it is used in such an environment.

Immunity test

Electrostatic
discharge
(ESD)
IEC 61000-4-2

IEC 60601 test

level

6 kV contact

±

8 kV air

±

Compliance

level

6 kV contact

±

8 kV air

±

Electromagnetic

environment -Guidance

Floors should be wood,
concrete or ceramic tile. If
floors are covered with
synthetic material, the relative
humidity should be at least

30%.
Electrical fast
transient/ burst
IEC 61000-4-4

2 kV for power

±

supply lines

1 kV for

±

Not applicable

input/output lines
Surge
IEC 61000-4-5

Voltage dips,
short

1 kV differential

±

mode

2 kV common mode

±

T

<5% U

(>95% dip in

U

T) for 0.5 cycle

Not applicable

Not applicable

interruptions
and voltage
variations on

T

40% U

(60% dip in

T

U

) for 5 cycles
power supply
input lines
IEC 61000-4-11

Power
frequency
(50/60 Hz)
magnetic field
IEC 61000-4-8

T

(30% dip in

70% U

T

U

) for 25 cycles

T

(>95% dip in

<5% U

T

U

) for 5 s

3 A/m 3 A/m Power frequency magnetic fields

should be at levels characteristic
of a typical location in a typical
commercial or hospital
environment.

NOTE UT is the AC mains voltage prior to application of the test level







80 Operator's Manual ZM-940PA

Immunity test

IEC 60601

test level

Compliance

level

Electromagnetic environment -

guidance

Portable and mobile RF communications
equipment should be used no closer to any
part of the ZM-940PA, including cables,
than the recommended separation distance
calculated from the equation applicable to
the frequency of the transmitter.

Recommended separation distance

Conducted RF

3 Vrms

3 Vrms

d = 1.2√P

IEC 61000-4-6

Radiated RF
IEC 61000-4-3

3 V/m 80 MHz
to 2.5 GHz

3 V/m 80 MHz
to 2.5 GHz

d = 1.2√P 80 MHz to 800 MHz

d = 2.3√P 800 MHz to 2.5 GHz

where P is the maximum output power
rating of the transmitter in watts (W)
according to the transmitter manufacturer
and d is the recommended separation
distance in meters (m).

Field strengths from fixed RF transmitters,
as deter mined by an electromagnetic site

1

, should be less than the compliance

survey*
level in each frequency range*

2

.

Interference may occur in the vicinity of
equipment marked with the following
symbol:

NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by

*1Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and

2

*

absorption and reflection from structures, objects and people.

land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted
theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an
electromagnetic site survey should be considered. If the measured field strength in the location in which
the ZM-940PA is used exceeds the applicable RF compliance level above, the ZM-940PA should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be
necessary, such as re-orienting or relocating the ZM-940PA.
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.

Operator's Manual ZM-940PA 81

Recommended Separation Distances between Portable and Mobile RF
Communications Equipment

The ZM-940PA is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the ZM-940PA can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile
RF communications equipment (transmitters) and the ZM-940PA as recommended below,
according to the maximum output power of the communications.

Rated maximum output
power of transmitter
(W)

0.01 0.12 0.12 0.23

0.1 0.38 0.38 0.73
1 1.2 1.2 2.3

10 3.8 3.8 7.3

100 12 12 23
For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in meters (m) can be estimated using the equation applicable to the frequency of the
transmitter, where P is the maximum output power rating of the transmitter in watts (W) according
to the transmitter manufacturer.
NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range

applies.

NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is

affected by absorption and reflection from structures, objects and people.

Separation distance according to frequency of transmitter (m)

150 kHz to 80 MHz

d = 1.2√P

80 MHz to 800 MHz

d = 1.2√P

800 MHz to 2.5 GHz

d = 2.3√P

System Composition for EMC Test

The ZM-940PA bedside monitor is tested to comply with IEC 60601-1-2 (2001) with the
following composition. If any part which is not specified by Nihon Kohden is used, the EMC
specifications may not comply.

Units Cable length

ZM-940PA transmitter --­YP-943P NIBP cuff 0.15 m

BR-906P ECG electrode lead 0.8 m
TL-201T finger probe 1.6 m

82 Operator's Manual ZM-940PA

Standard Accessories

1

2

No. Name Model Q’ty Supply Code No.

1 NIBP cuff for adult, standard YP-943P 1 S938B
2 Strap --- 1 Y236

The following parts are available for replacement.

34

Lock plate is a
standard accessory of
the YP-943P/944P
NIBP cuff.

No. Name Model Q’ty Supply Code No.

3 Battery case cover 1 6144-012004
4 Lock plate 1 6113-049585

Operator's Manual ZM-940PA 83

Options

CAUTION

Use only Nihon Kohden electrodes, electrode leads, SpO2 probes and NIBP cuffs
to assure maximum performance from your instrument.

Transmitter

Channel writer, QI-901PK

ECG/RESP

Name Application Model Q’ty Supply Code No.

Electrode
lead

3 electrodes,clip type,
lead length 80 cm
3 electrodes, snap type,
lead length 80 cm
6 electrodes,clip type,
lead length 80 cm
6 electrodes,snap type,
lead length 80 cm

BR-903PA 1 K911A

BR-913PA 1 K910B

BR-906PA 1 K912A

BR-916PA 1 K915A

NIBP

(cm)

Air Hose

Length

(cm)

15

15

20

Model Q’ty

YP-944P*

YP-964T

YP-915P

Name

Cuff for adult, for
attaching transmitter to
patient arm
Cuff for infants 5 YP-960T S943A

Cuff for children

Cuff for adult

Disposable cuff for infants 6 YP-910P --­Disposable cuff for children 9 YP-912P ---

Disposable cuff for adults

Extension hose 150 YN-990P 1 S903

* The lock plate is provided with these NIBP cuffs.

84 Operator's Manual ZM-940PA

Standard 13 YP-943P* S938B

Large 15

Small 7 YP-961T S943B
Standard 10 YP-962T S943C
Standard 13 YP-963T S944B
Large 15

Small 12 YP-913P --­Standard 14 YP-914P --­Large 16

Width

20

Supply

Code

No.

1

S938C

1

S944C

---

SpO

2

Name

Finger probe (reusable)

Cable
length

0.6 m P225H

1.6 m

Multi-site probe (reusable) TL-220T

Model/

Code No.

TL-201T

Q’ty

1

Supply

Code No.

P225F

P225G
SpO2 probe (for adult, disposable) TL-251T P201A
SpO2 probe (for child, disposable) TL-252T P201B
SpO2 probe (for neonate,
disposable)

TL-253T P201C

5
Multi-site Y probe
(for low birth weight infant/child/
neonate, disposable)

1.6 m

TL-260T

P205A

SpO2 probe (for adult, disposable) TL-271T P203A
SpO2 probe (for child, disposable) TL-272T P203B
SpO2 probe (for neonate/adult,
disposable)
SpO2 probe (for child/infant,
disposable)
SpO2 probe(for adult/neonate,
disposable)
SpO2 probe (for child/infant,
disposable)

TL-273T P203C

TL-274T

0.8 m TL-051S P228A

1.6 m TL-052S P228B

0.8 m TL-061S P229A

1.6 m TL-062S

24

P203D

5

P229B
COTTONY tape 340703 20 P259
Foam tape for TL-051S/052S/
061S/062S
Attachment tape for TL-220T/
251T/252T/253T

---

---

Attachment tape S for TL-260T P260A
Attachment tape L for TL-260T

4 × 25 package

3 × 30 package

24

P260

P263

P260B

Operator's Manual ZM-940PA 85

Transmission Frequencies

USA

BAND

Transmission

frequency

(MHz)

608.0250 9002 608.7750 9062 609.5250 9122

608.0500 9004 608.8000 9064 609.5500 9124

608.0750 9006 608.8250 9066 609.5750 9126

608.1000 9008 608.8500 9068 609.6000 9128

608.1250 9010 608.8750 9070 609.6250 9130

608.1500 9012 608.9000 9072 609.6500 9132

608.1750 9014 608.9250 9074 609.6750 9134

608.2000 9016 608.9500 9076 609.7000 9136

608.2250 9018 608.9750 9078 609.7250 9138

608.2500 9020 609.0000 9080 609.7500 9140

608.2750 9022 609.0250 9082 609.7750 9142

608.3000 9024 609.0500 9084 609.8000 9144

608.3250 9026 609.0750 9086 609.8250 9146

608.3500 9028 609.1000 9088 609.8500 9148

608.3750 9030 609.1250 9090 609.8750 9150

608.4000 9032 609.1500 9092 609.9000 9152

608.4250 9034 609.1750 9094 609.9250 9154

608.4500 9036 609.2000 9096 609.9500 9156

608.4750 9038 609.2250 9098 609.9750 9158

608.5000 9040 609.2500 9100 610.0000 9160

608.5250 9042 609.2750 9102 610.0250 9162

608.5500 9044 609.3000 9104 610.0500 9164

608.5750 9046 609.3250 9106 610.0750 9166

608.6000 9048 609.3500 9108 610.1000 9168

608.6250 9050 609.3750 9110 610.1250 9170

608.6500 9052 609.4000 9112 610.1500 9172

608.6750 9054 609.4250 9114 610.1750 9174

608.7000 9056 609.4500 9116 610.2000 9176

608.7250 9058 609.4750 9118 610.2250 9178

608.7500 9060 609.5000 9120 610.2500 9180

CHANNEL

SPACING

C

25 kHz step

Channel No.

USA

BAND

Transmission

frequency

(MHz)

CHANNEL

SPACING

C

25 kHz step

Channel No.

USA

BAND

Transmission

frequency

(MHz)

CHANNEL

SPACING

25 kHz step

Channel No.

C

86 Operator's Manual ZM-940PA