Ohmeda BiliBlanket Plus User manual

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АСТИ

BiliBlanket® Plus

Phototherapy System

Operation, Maintenance and Service Manual

—

\ W

=

General Precautions

IMPORTANT CLINICAL INFORMATION

PLEASE READ CAREFULLY BEFORE USING THIS DEVICE

ο

Care of the Skin

The skin serves as a protective barrier against chemical, mechanical, and biological

insults.

The skin

is also important in

the

regulation

of body

temperature and

serves as

a route of water excretion,

especially

in

premature infants.

The

introduction

of new

intensive-care

techniques

has

been

associated

with

the

increased

survival

of

very

small, premature

infants.

The

immaturity

of the

skin

of

the

very

low

weight

infants,

coupled

with

excessive instrumentation and handling, poses previously unrecognized

problems

for

the

nursing

care

of these

infants’.

Please read, evaluate and implement the following recommendations as appropriate:

1.Please refer to the following standard of skin care recommendations as given in the

literature?			when utilizing		this device with all infants.		Special attention should be
given to		sanitation and			skin integrity.
*	Observe		color,	rashes,	excoriation
+	Clean	skin with		warm	water
*	Clean	perineal		area after		stooling
e	Change		infant's	position		every 2 hours	©

This device is intended only for the treatment of existing hyperbilirubinemia. Use of

this device for prophylactic treatment, particularly of premature infants, is not recommended. These infants have extremely fragile skin? and various clinical studies have produced inconsistent conclusions concerning the effectiveness of

prophylactic phototherapy treatment 45.

NAACOG(1992), OGN Nursing Practice Resource, Neonatal Skin Care, NAACOG.

ibid

Rutter, N., The immature skin, British Medical Bulletin, Vol. 44, No. 4, 1988

Curtis-Cohen, M., et al, Randomized trial of prophylactic phototherapy in the infant with very low birth weight, TheJoumal of Pediatrics, July, 1985

Brown, A., et al, Efficacy of Phototherapy in Prevention and Management of Neonatal Hyberbilirubinemia, Pediatrics,

February , 1988

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Table

of Contents

1/General

Information ......

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|

Description

nen non non coran ananana nora nc cn cana cnnacnn non

1

©

Light source controls, indicators and

connectors

…...........................ss

4

Accessories and replacement parts ii

6

2/Operation .........................

ee

ee

1

Checkout

procedure before Operation .............

ocomooononnonoconncccnnnnannaconnonancnnananonanonocananancas

2

Checkout

procedure

n

2

UsingtheBiliBlanketPiusPhototherapySystem......................................................

3

Using the transilluminator ii

6

3/Maintenance..............

ee ee

ee

1

Maintenance

schedule

.................................................

nen renee

1

Operator

Maintenance

ee

нии

линнеяжннния

1

Service

maintenance

ини

имении нити

и ити

тотнннииа

1

Cleaning

and

disinfecting

i

1

Bulb replacement

.............

iii

2

Cleaning

the

fan

fe

renge

4

Attaching the dovetail rail mounting

bracket

accessory

… …

4

4/Service .ee

ee PA

1

Repair policy and procedure rie

1

©

Troubleshooting

…

AREA

REP KAP KOP

a Ke tn Ranné

2

Functional description pe

3

Repair DrocedureS

es

4

Replacing a fuSe .es

5

Replacing the light source cover

... sise

6

ReplacingthePCboard...........................................

een een ena

AR

6

Replacingthecoolingfan...........................................

6

Replacing

the brightness

CONtrol..............

sis

nen gene

7

Replacing the power SUpply iii

7

Replacingthethermalcutout switch...

8

Replacing the optical filter assembly...

enes 8

Replacing the bulb holder eee

9

Replacing the power inlet module ..................

ii

9

Replacing

a

bezel/hour

Meter

ss

nen n nn

10

Replacing

a

front

bezel

label

i

10

Electrical

зау

ргоседигез ...........

тиииляшинини ининин нелли ли ниниининни

11

Ground

continuity

nerne nen e nn rese kranse krans

11

Leakagecurrent..........................................

ини

нана

11

Light Output

Measurement

ини ини

11

lllustrated

service

DaS

oo...

iii

13

ο

Schematics .es

17

Appendix .es

ee

ee 1

Specifications

...............

ii

1

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i

General Precautions

Definitions

What the attention

Next

to

each

warning

or caution,

we

have

placed

an

“attention,

read

symbo! means

accompanying

documents”

symbol

to

alert

you

to

the

presence

of these

important

statements. This

is

the

attention

symbol:

A

When

the

attention

symbol

appears

in

front

of

text

that is printed

on the

system

itself,

it means

that

the text

is

elaborated

upon in the operation manual.

WARNING:

A

Warning

statement

is

used

when

the

possibility

of

injury to the patient or

the operator

exists.

CAUTION:

A

Caution

statement

is

used

when

the

possibility

of

damage

to the

equip-

ment

exists.

Indicates

alternating

current.

Indicates

IEC

Type

B

equipment.

This letter appearing before a fuselink value indicates a time delay fuselink.

Important: An Important statement is similar to a note but is used for greater empha- sis.

Note: A Note provided additional information to clarify a point in the text.

The following are general Warnings and Cautions. Precautions specific to certain procedures are found in the text of the manual.

WARNINGS A

Do not use the BiliBlanket Plus Phototherapy System in the presence of flammable anesthetics; a possible explosion hazard exists under these conditions.

	Service described		in this	manual must	be performed by a technically competent
	individual	as described in		this manual.	Detailed drawings and procedures for more
	extensive repairs are included in this				manual	solely	for the convenience of qualified
	personnel	having	proper	knowledge,	tools and	test	equipment, or for Ohmeda service
	representatives.
CAUTIONS	A

Servicing of this product in accordance with this service manual should never be

undertaken without the proper tools, test equipment and the most recent revision of this service manual which is clearly and thoroughly understood.

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1/General Information
In this Section
Description	ii sssssissicersssneeeeneennenneessecesesssesseneessenneenee	1-1
Light source controls, indicatorsandconnectors ...................................		1-4
Light source and pad eserinin		1-4
Light source back panel	.................. iii	1-5
Accessoriesandreplacementparts...............................................	eee	1-5

WARNING	ZX Do	not	turn	on	or	operate the BiliBlanket Plus Phototherapy System in
	the	presence		of	a	flammable anesthetics; a possible explosion hazard
	exists		under	these		conditions.

General Information

This

manual

describes

how

to

checkout,

operate

and

maintain

the

Ohmeda

BiliBlanket

Plus

Phototherapy System.

It

also

describes

for

the

technically

competent person how

to service the BiliBlanket Plus.

Before

using

the

BiliBlanket

Plus

Phototherapy

System

*

Read

through

sections

one

through three of this manual.

*

Pay

special

attention

to

the

Warnings

and

Cautions

which

appear

in

the

manual.

+

Read

the

User

Responsibility statement

located

on

the

inside front

cover;

it de-

scribes what

is

expected

of

the user

to

maintain

a safe

and

accurate

product.

+

Read

the

Warranty;

it

describes

Ohmeda's

responsibility

in

case

of

a

functional

defect.

Keep this manual available for answering guestions which may arise.

Description

The Ohmeda BiliBlanket Plus Phototherapy System uses a fiber optic cable to deliver light from a high intensity lamp to a woven fiber optic pad. The pad is placed in a disposable cover that is in contact with the patient. The patient is exposed to light in the ideal 400 to 550 nanometer range for phototherapy treatment.

On units	with the	transilluminator option,	unfiltered	light in the visible	spectrum travels
through	a flexible	light pipe to appear at	the tip of	the transilluminator	cable. The light

from the cable is used to facilitate vascular sticks or injections. It is also used to find pneumothoraces.

The

BiliBlanket

Plus

Phototherapy system

consists of a light

source unit

and

a

light pad

with

a four foot long

fiber

optic

cable.

The

light

source

unit contains

a lamp,

light filters,

a variable

power

supply

for

the

light source, a

cooling

system

and

overheating

protec-

tion

near

the

lamp.

The

light

source

lamp

is

a

high

intensity,

tungsten halogen bulb with a built-in reflector.

The

reflector

is

coated

with

a dichroic

surface

which

reduces

the infrared

energy

transmitted. This bulb is specifically manufactured for use with the BiliBlanket Plus.

Although there will be a slight degradation over time, the bulb will maintain approxi- mately the same light intensity throughout its life.

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1-1

1/General Information

A light filter, positioned in front of the lamp, rejects light outside the 400 to 550 nanom-

eter range. This filter blocks nearly all ultra-violet and infrared light; only the blue light is allowed to pass. This filtered light is focused on the inlet of the fiber optic cable.

Any	light	intensity	may be	selected	by the front panel brightness rotary control. Table
1-1	shows	the light	output	values at	the low, center and high positions.

	Brightness			Output
	Rotary	Control		(pW/cm?/nm)
Low	EN		Full Counter	15+3.75 *
			Clockwise	*
			Center	*
Medium	©		Detent	2046.25
.			Full
High	se	== |	Clockwise	35 + 8.75"

* For more precise control of light output, use the Ohmeda BiliBlanket® Meter and follow Light Output Measurement Procedures in Section 4.

Table 1-1

BiliBlanket Plus phototherapy light output values

Mode select

Selects the operating mode ; phototherapy or transillumination. Using the Ohmeda transilluminator light pipe, the BiliBlanket Plus System can be used as a transilluminator.

Supply

power

Power

for the

light

source unit

can be

supplied by

any

standard

AC mains

power

source

at either 50 or 60 Hz that have

voltages in

the

range:

90

- 132

or

180

- 264.

Power

enters

the

light source

through

a receptacle that has

an

integral

power

switch.

Cooling

A fan cools the light source unit. A thermal cutout switch located next to the light-filter protects the light source unit and fiber optic cable or transilluminator from overheating.

Fiber optic cable

The

fiber

optic cable

contains

2400

individual

plastic

fibers

which

transmit

the

light

from

the

light

source

to the

light

pad.

The

light

pad

is

constructed

by

weaving

these

fibers

into a mat. This patented process produces a

pad with light over the entire surface.

These

fibers

are

randomized

in

the

cable

to

eliminate any

local

intensity

gradients

due

to bulb hot spots, dust on the

filter,

dust

on

the cable

end,

etc.

This allows

the

nearly

uniform, continuous blanket of light. A disposable protective pad

cover

is

provided

to

reduce the risk of cross-contamination and make the patient more comfortable.

Disposable

cover

The disposable cover is designed

for

use

with

both

premature

and full-term infants.

The

infant lies directly on the disposable-covered

pad

without

any

method

of

attachment

between

the

pad

and

the

infant.

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1/General Information

Disposable vest

A disposable vest is designed to secure the fiber optic pad to the infant. With the disposable vest, it is possible to hold and nurse the infant while continuing

phototherapy treatment. The disposable cover should be used for premature infants and full-term infants who can’t tolerate having the vest secured around the midsection.

Transilluminator

The transilluminator light pipe contains plastic fibers which transmit light from the light source to the tip.

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1-3

1/General Information

Light source controls, indicators and connectors

Phototherapy Syste:

			4. Wernlag: intense Light
			ConnectPadPrior to Operation
			Nontransilluminator Unit
	Figure	1-1
	Light source,		pad and transilluminator cable
1-4	6600 0228	000	04/22/96

019,020,016.

C1 17.

1/General Information

Refer to Figure 1-1.

Power indicator

1. The green light-emitting diode (LED) tights when the light source unit power is on.

Air flow failure indicator

2. The red light-emitting diode (LED) lights when there is an air flow failure.

Timer

3.Nonresettable timer runs whenever the bulb is turned on.

Brightness	selector
4. The rotary control		selects the	light intensity, and has a center detent at the medium
intensity	position.	(see Table	1-1 for light intensity values).

Mode select

5. The mode select slide selects the operating mode: phototherapy or transilluminator.

Light source port

6.The light source port is for attaching the fiber optic cable connector or transilluminator.

Pad assembly

7.	The	pad assembly	attaches to	the light source port. Light		is	fed	through the optical
	fiber cable to the optical fiber			woven	pad.
Transilluminator cable
8.	The	cable attaches	to the light	source	port. Light appears	at	the	tip.

AED

BiliBlanket Plus

Phototherapy System

010 . 17 . C1

Figure 1-2

Light source back

Refer to Figure 1-2.

Power cord receptacle

1. The power cord plugs into the power cord receptacle.

Power switch

2. The power switch switches the light source unit on.

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1-5

1/General

Information

Accessories

and

replacement

parts

Table

1-2

Stock

number

Item

6600-0213-800

Carrying

case

6600-0270-200

Disposable

covers

(50)

6600-0461-200

Disposable

vest (50)

6700-0025-800

Mobile

stand,

less accessories

6700-0014-800

Mobile stand slide bracket assembly, female

6600-1974-100

User

card

6600-0521-800

New

pad

assembly

6600-0730-224

Phototherapy

cable

repair

tape

6600-0730-207

Power Cord, North America (120V)

6050-0002-259

Power

Cord,

United

Kingdom

6030-0000-006

Power

Cord,

Continental

Europe

6600-0522-800

Transilluminator

6600-0031-900

Dovetail

rail

mount slide bracket kit, female (See A, Figure 1-3)

6600-0198-800

Dovetail rail mount slide bracket accessory, male* (See B, Figure 1-3)

6600-0680-200

Replacement

lamps

(6)

6600-0531

-800

Transilluminator or

accessories

pouch

9

*

Allows

the

BiliBlanket

Plus to be attached to

the dovetail rail mount slide

bracket by using two of the mounting screws

on

the left

side

of the light

source unit.

B 6600-0198-800

A 6600-0031-900

032,033.

C1 01.

Figure	1-3
Slide mounting bracket accessory slides		into a dovetail	mount	slide	bracket	0
Dovetail	rail systems are used to mount	accessories on	Ohio“	Care	Plus®	incubators
and Infant Warmer Systems.

1-6

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In this

section

Checkout

procedure

before

operation i

σος 2-2

Using the BiliBlanket Plus Phototherapy System ss.

2-3

Using the Transilluminator eee

2-6

WARNING

A

Do

not

use

the

BiliBlanket

Plus

Phototherapy

System

in

the

presence

of

flammable anesthetics; a possible explosion hazard exists under these

conditions.

Factors

which

affect

light

output

and

life

Lamp

light

output and

life are affected

by

various

factors

among

which

are:

*

Lamp

variations

e

Brightness

selector

setting

e

Vibration

and

mechanical

shock

* Non-recommended lamp

Bulb

variations

The light output from bulb to

bulb

may

vary by as

much

as

10%.

Intensity

setting

The

bulb

life

will

vary

greatly

with the intensity at which

the

light

source

is

operated.

Table

2-1

provides an example.

Brightness

knob

setting

Nominal bulb life

hours:

Low

10,000

Medium

1,500

High

800

Table

2-1

Brightness knob setting effect on bulb life

Vibration

and

mechanical

shock

Vibration and mechanical shock will significantly

reduce

the

bulb

life. Care

should

be

taken

when

moving

the light

source. To maximize the bulb life, the light source should

be

mounted

or

placed

on a

surface which

is stable and

not

exposed

to

vibration.

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2-1

2/Operation

CAUTIONS

À

Allow

the

light

source

to cool for a minimum

of

ten

minutes

before

moving

the

light

source

or

changing

the bulb.

-

ZX

To ensure

the

proper

operation

and light

intensity,

replace

the

lamp only

with

the proper lamp as listed in the Appendix.

Use

of

other lamps

will

affect the

performance

of

and

may

result

in damage

to

the BiliBlanket

Plus

Phototherapy

System.

ÀUse only Ohmeda light pad assemblies or transilluminator cables. Light pads or transilluminators from other manufacturers can affect performance and may damage the unit.

Non-recommended lamps

Using any lamp other than that recommended and distributed by Ohmeda for the BiliBlanket Plus system will affect the performance of and may result in damage to the

light source or the fiber optic pad or transilluminator.

Checkout procedure before operation

Before operating the Ohmeda BiliBlanket Plus Phototherapy System, the following steps should be taken to ensure that the BiliBlanket Plus will provide effective

phototherapy treatment or the transilluminator delivers the proper

light.

This

checkout

procedure assumes that you are

familiar

with

the

unit’s

controls.

CAUTIONS

A\

Lamp

life

is

greatly

reduced

if

the

lamp

or

the

light source

is subjected

to

shock

or

bumping,

or

if

the

unit is

moved

while the

bulb

is

hot.

Allow

the

bulb

to

cool

for

at

least ten

minutes

before

moving

the

unit.

A

Do

not

allow

the

fiber

optic

cable, pad or transilluminator to rub on sharp or

abrasive

surfaces. The

protective

coverings

may

be

damaged.

ZA

Observe

the

following

fiber

optic

cable

and

pad

assembly

and transilluminator

guidelines:

e

İf you

hang

the

fiber

optic

cable and pad or transilluminator

assembly

for tempo-

rary

storage

on

an

IV pole, door,

wall

hook

or

similar

item,

do not pull the cable

when

removing

it

for

use.

Carefully lift

the

cable

free

of

obstructions

when

ready

to use

it.

+

Do

not

lay

the

fiber optic

cable

or

transilluminator where

it

could

be

crushed.

+ Do not place anything on the fiber optic cable or transilluminator. Not observing the guidelines may cause excessive stress and may: ¢ damage the cable’s outer protective conduit,

* damage the cable’s optical fibers,

+decrease light intensity at the light pad or transilluminator.

Checkout procedure

1. Place the light source on a flat, level surface (or use the mounting slide bracket) to locate the light source within a few feet of the treatment location.

2. Verify that the air circulation	vents on the sides of the	light source are unobstructed.
The air filter should be free	from excessive amounts	of lint.

2-2

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2/Operation

CAUTION

ZX Do not block the air intake or outlet.

3. Examine the power cord, fiber optic cable and transilluminator cable for obvious signs of damage. Replace them if they are damaged.

4. Connect the power cord to the light source first and then to the line power supply.

5.

Fully

engage

the

fiber

optic cable

connector

or transilluminator

into the

light

source

port.

CAUTION

A

Do

not

scratch

or soil the light-input end of the connector cable.

Do

not

put

sharp

or heavy

objects on

the

fiber

optic

pad,

vest or

connecting

cable.

6.

Select

“|”

on

the

power

switch

to

turn

the power

on. The

green

power

indicator light

will light.

7. Using the brightness selector switch on the front panel, select any light intensity and ensure that light is being emitted from the pad.

8. Select “O” on the power switch to turn the power off.

WARNING	A A hot surface		is	exposed	when	the	fiber	optic		cable	is disconnected from
	the	light source		port. Do	not insert		fingers		or	foreign	objects into the
	light	source	port	whether	the	lamp	is on	or	off.

Using the BiliBlanket Plus Phototherapy System

The disposable cover is designed for use with both premature and full-term infants. The

infant lies

directly on the

covered

pad

without

any

method of

attachment

between the

pad

and

the

infant.

WARNING

А

If there

is a concern about

exposure

to direct

light

from the

light pad,

cover the patient’s eyes when

using

the

BiliBlanket

Plus Phototherapy

System

to shield

them or

when

the BiliBlanket

Plus

is

used

in conjunction

with conventional phototherapy lights. Eye patch use with the BiliBlanket Plus may not be necessary under these conditions:

1.	When	using the		vest.
2.	When	the	pad is	kept against the	patient’s	back.
3.	When	the	patient	is clothed after	applying	the pad to the patient’s chest

or abdomen.

The disposable vest secures the fiber-optic pad to the infant. For premature and fullterm infants who cannot tolerate having the vest secured around the midsection, the

disposable

cover

should

be used.

The

infant,

along

with

the

light

pad,

may

be covered

or wrapped

in a

blanket.

The

infant

will continue to receive effective phototherapy treatment as long

as

the disposable-

covered,

light-emitting

section

of

the

pad

remains in

contact

with

the

skin.

The

disposable cover

should

be

the

only

material between the light-emitting

side

of the

pad

and

the

infant's skin. If the disposable cover becomes

soiled,

it

should

be replaced

with

a

new

cover. The disposable cover should also be replaced

between

patients.

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